A recent review paper emphasises the need for improved provision of fertility information, especially regarding age-associated risks, as the trend for women having children later in life continues.
Dr David Utting, Specialty Registrar in Obstetrics and Gynaecology at Kingston Hospital NHS Trust who co-authored the review, said: 'Clear facts on fertility be made available to women of all ages to remind them that the most secure age for childbearing remains 20 to 35. However women and doctors should remain vigilant to prevent unplanned and unwanted pregnancies'.
The review says basic information about pregnancy including contraception, normal cycles, the dangers of sexually transmitted diseases and age-related risks should be reinforced through schools, family planning and sexual health clinics and the media, so the general public can be better informed.
The age of first-time mothers has risen from 23 in 1968 to 29.3 in 2008 and women aged 30 to 34 are more likely to enter into motherhood than any other age group, based on data from the Office for National Statistics. The authors propose a wider choice of reliable contraception as a possible reason and refer to the results of a 2006 survey in which most women described career and money, with a number also highlighting the need to find a suitable partner, as delaying motherhood.
According to the review, 'at the age of 25 just five percent of women take longer than a year to conceive with regular intercourse, rising to 30 percent in those aged 35'. An increased risk with age of miscarriage and other pregnancy related complications including premature births and stillbirths was also identified.
Interestingly the authors discuss the male 'biological clock' and said a man's fertility similarly declines with age. They estimate that the average 40-year-old male takes two years to get his partner pregnant, even if she is in her twenties.
Together with Dr Susan Bewley, a consultant obstetrician at Guy's & St Thomas', London, Dr Utting did not present any new findings but reviewed previous studies on fertility. They recommend efforts be focused on preventing infertility and that IVF is not relied upon to make up for the delay and physiological decline in motherhood.
'This review highlights the problems associated with later maternal age. Women should be given more information on the unpredictability of pregnancy and the problems that can occur in older mothers' said Jason Waugh the Editor-in-Chief of The Obstetrician and Gynaecologist in which the review was published.
Article: 31st January 2011 BioNews 593
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