Fertility decreases as biological clock ticks faster

My husband and I celebrated our fifth wedding anniversary recently. It was during the celebrations that a friend asked when we were planning to start a family. I brushed off the question by smiling politely, saying, "We're still too young to get into that!"

But when I visited my gynaecologist a few days later, she sounded a note of caution: once you reach 35, your body enters a fertility risk zone.

Is there really a biological clock that is ticking? As women enter their 30s, they experience a decline in fertility. "A women's fertility rate is best between the ages of 18 to 25,'' says Dr Urmil Verma, senior consultant obstetrician and gynaecologist at Al Zahra Hospital in Dubai. "It's more or less the same until the age of 30, after which time it starts declining. Fortunately, this decline is not significant until the age of 35 and it is more marked above the age of 40. Some studies have shown the fertility rate is 42 per cent lower between the ages of 35 to 39 as compared to ages 20 to 24."

Do men's biological clocks start ticking too, once they hit their thirties? Apparently not. "Women over 40 are considered to be at an advanced maternal age. Men are not considered to be at an advanced paternal age until they're in their 50s. Of course, as they get older the risk increases that there may be genetic problems in the child," she says.

Susan Newman, a social psychologist and author of several parenting books, explains: "In the 1950s, the expectations of women were for them to marry and have two children. Expectations are very different now that women have career ambitions and are more independent. Many are not ready to compromise on anything that may slow their professional progression. By the time they have earned a degree, worked for a few years and got married, they are most likely to be in their mid-30s."

Vanessa Lee is a 24-year-old professional from New York. "Having a baby changes one's life completely. I love kids and would like to have one or two in the future, but at the moment I am very focused on my career and where I will be in the next five years professionally. I don't plan on being a stay-at-home mom. I would like to have my first baby sometime in my 30s," she says.

Jolly Patel is a chartered accountant who got married at 22. She then finished her masters, took up a job and, eight years later, is expecting her first baby at the age of 30.

When asked why she waited so long, she responds: "For the most part, both partners are working and want to travel the world before they start a family.

"I got married when I was young. I felt like a child then, so how couldI bring one into this world? My husband and I were sure about one thing from day one: we would only have a baby once we were settled with each other. And we are very happy with our decision today. I feel content now taking on this lifetime responsibility as I have achieved everything I set out to. I'm now ready for the next challenge."

Can waiting for the right time go against your biological clock?"

Pregnancy is not in anyone's control. You can have all the medical statistics lined up declaring you 100 per cent fertile, but they could prove to be inconclusive when it comes to conceiving; fertility is largely unexplained," says Dr Verma.

"If you get pregnant later in life, there is a greater chance of a complicated pregnancy and the risk of the child having Down's syndrome, which is 1 in 400 in patients aged 35 and above, is higher. It is 1 in 100 among those women who conceive after the age of 40. Fortunately, there are antenatal screening tests which can predetermine the risks, but an older woman will still have to seek medical help very early in her pregnancy."

That is not to say that complications are linked exclusively to age. Meera Rajwani, a 30-year old entrepreneur in Dubai, faced problems when she decided to have a baby three years into her marriage. At nine weeks, she had a miscarriage. Her second pregnancy also ended in a miscarriage. Her doctor advised that it was stress that was leading to the complications and assured her that she was perfectly capable of having a baby. Her doctor told her to relax and to not focus her energy solely on starting a family.

It worked. Today Rajwani is a mother of a two-year-old girl. "Doctors advise that couples should start trying to have a baby within two years of marriage," she says. "Having children is not a stress factor at this point. However, as the childless years roll by, stress enters the relationship as pressure to conceive intensifies.

"Stress is a major hindrance in conceiving and plays an underestimated role in delayingor jeopardising the chances of having a child.''

Is motherhood impossible after 35?

Thanks to medical developments, genetic tests during pregnancy can to some extent predetermine dangers.

"Being older doesn't mean that you are bound to have problems in conceiving or that you will necessarily have complicated pregnancies or difficult deliveries; a lot depends on your lifestyle and general health. Factors such as high blood pressure, diabetes, thyroid problems and so on, all influence how your pregnancy will go," Dr Verma says.

Supporting this view is Catherine Cram, a maternal fitness expert based in Atlanta in the US.

"Every woman is different. It all depends on her and her partner's fertility. I advise women in their 30s that if they want to have a baby, they should start trying as soon as they're ready, because it may take longer than they think."

Is it true that the sooner you become a mother, the quicker your recovery?"

This is a myth," says Dr Verma. "A pregnant 42-year-old who exercises regularly and eats correctly throughout her pregnancy will recover sooner compared to a pregnant patient who is 22, is overweight and who has never exercised. It all depends on the patient's health, motivation, support and attitude."

Cram advises women to think long and hard before they decide to have a baby. "It's a huge responsibility. I think that women should think about whether they really want to be a mother. I do think that some women are coerced into it by societal and family pressures or feel it is something of a womanly obligation," she says.

Cram says that a significant percentage of women in her classes are in their late 30s and early 40s. "I believe that many women are better prepared to be a mother later in life. They are more mature; they know their bodies, they are often fitter and healthier during their pregnancy than young women.

"Responsibility increases with age. They have also gone through their career phase and have felt that they have done the things they wanted to and are now ready to focus on motherhood."

Acknowledging the fear factor

Sometimes women are scared to embrace this new responsibility no matter what their age. There is often the fear that they will be out of their depth and will not know what to do, says Newman. She recommends parenting classes for women who are pregnant to combat this fear. "Let's face it: it's an awesome responsibility. Parenting is not easy and you should not delude yourself into thinking that it is. Talk to a therapist and new parents. If you have a relative who has a baby, offer to babysit for a weekend and see how you feel. There will also be cases where partners would be ready at different times. Starting a family is a step where you need to have a mutual agreement. After all, it's a commitment to last a lifetime," she says.

No matter what you decide, there is no way you can ignore your biological clock. You can get back to your career one day and hire a personal trainer to get you back in shape, but you cannot turn back the clock.