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Anita Gour |
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Now or never |
We are living in times of plenty and we are trying to gain control of everything. Nature is kind but firm with its rules. Ageing, disease and death are noble truths. Women can conceive during a certain age. It's difficult for women to balance career and child bearing. The world is hostile and competitive; it will never allow a woman to compete with a man until she gives up her natural desire to mother a child. Ironically the women who work due to economic hardship, do not face much of a problem in postponing child-bearing. This is the fire of corporate. Either you progress or you will perish. Focus, work hard and don't get emotional from family pressures, if you are pregnant, you are finished.
Now the big question is how to finish this child-bearing in haste. As a result of this delaying, millions of women throughout the world are deprived of natural motherhood. Once you cross your 30s your chances of getting pregnant decline every year.
Fertility experts always advise a woman to conceive at an appropriate age. If she fails to conceive after one year of unprotected sex, the experts advise fertility investigations of both partners. The reproductive potential is at its peak in her 20s and declines drastically after 35 years. Fertility declines gradually in a woman as she approaches a specific milestone, menopause. At that time, she abruptly ceases to produce eggs.
The egg quality declines due to a decrease in energy supplied by the mitochondria. This means that eggs, which were healthy at a younger age, cannot support fertilization and growth once they grow older. Unfortunately, even with advancement in IVF (in vitro fertilization) techniques, we cannot reverse this process. Hormone injections (given during IVF treatment) do not work very well in older women, as their ovaries become less responsive, which in turn escalates the cost of drug treatment.
Age is not the only factor that affects fertility. There are other medical conditions, such as uterine fibroids and endometriosis that may progress with age and affect fertility. Even regular smoking and alcohol can affect fertility. Pregnancy after 35 years of age significantly increases the risk of genetic foetal abnormalities, Down's syndrome and miscarriage rate. All these risks should be borne in mind before considering delaying pregnancy.
As age advances, the ovaries start getting tired and a particular hormone FSH starts rising which strongly indicates poor ovarian reserve. A career woman with delayed child-bearing age has a big menu of choices like test tube baby, egg donation and surrogacy; but these options are not free from physical and psychological trauma besides being difficult to arrange and expensive.
It is interesting to know that about 50 or 60 years ago, parents were keen to get their children settled in marriage so that the life cycle of the next generation was not jeopardized. In spite of their lack of knowledge about the biological clock and ovarian reserve, they were wise enough to foresee and advise their children to marry early.
Fertility is nowhere in the public health agenda. There are no educational campaigns from government or non governmental organizations promoting child-bearing at the right age. It should also be the duty of corporate organizations to look after the family planning needs of female employees.
The department of health has done very little to help childless couples receive fertility treatment, which is very expensive in private clinics. For this reason, it is more important to prevent infertility by more awareness and empathy. Needless to say, it is important to clarify the delusion created by media reports of 40-some women conceiving and delivering with the help of advanced technology. It is essential to empower women by giving them facts and dissolving myths, so that they can reach an informed decision about when to conceive, whether 'later' could become never and 'now' is the right choice.
gouranita@gmail.com
(Dr. Anita Gour is a Fertility Specialist in India)
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