In the female, predisposing factors
include having low egg reserve, premature ovarian failure or menopause,
menstrual irregularities, polycystic ovarian syndrome, blockage of the
fallopian tubes, uterine fibroids, endometriosis and complications from sexual infections.
Female fertility declines with age and
has been proved by epidemiologic and scientific research. The decline
becomes more pronounced and accelerated in females especially in their
late 30s and early 40s. Not surprisingly, this is the time most women
decide to settle down after satisfying their career ambitions.
There is nothing wrong with being
career-minded but the fact is that from the late 30s, there has been a
decline in the female egg reserves. From research findings, the ovary
contains a finite/fixed number of eggs, which decrease exponentially
with age. It is estimated that at birth the ovary contains about two
million eggs, which decline to about 200-400 thousand at menarche (10-13
years of age), and decline to about a thousand at age 50-51 years of
age when menopause likely sets in. There is a strong correlation between
the age of a woman and the quantity/quality of her eggs.
Therefore, the older a woman becomes the
lesser the number of eggs she has in reserve and the higher the number
of poor quality eggs she possesses in her ovary. The best time for
child-bearing in a woman is around 20 to 30 years of age.
There is an exponential decline in
female egg quantity and quality with increased age-related complications
of pregnancy and childbirth, including miscarriages often due to
genetic abnormalities, need for operative vaginal birth and caesarean
delivery, ante-partum/post-partum bleeding, raised blood pressure and
gestational diabetes mellitus.
For example, the pregnancy miscarriage
rate, the risk of having a chromosomal or genetically abnormal child
(like a Downs-Syndrome baby) and medical diseases like diabetes,
fibroids, fallopian tubal blockages, pelvic adhesions and consequences
of endometriosis all increase with age.
Mrs. RO is the 42-year old financial
director of an institution who got married a year ago to Mr. PO, a
43-year-old company executive. Neither of them has children. Mrs. RO, in
her early teens, had vowed to complete her ACCA in accountancy, then
get a job, before considering marriage and raising a family. She got all
this accomplished, but it took some time. Now 42 years old, she thought
it was time to raise a family but examination revealed poor ovarian
reserve.
Luckily, with some days of regeneration
with Mayr therapy, she succeeded in getting two follicles at Oocyte
retrieval and was transferred and she ended up with a baby girl. This is
not always the story in all cases. Many will end up using donor eggs,
and in some cases may end up with adoption after several failed IVF
attempts.
Artificial Reproductive Techniques like
IVF, egg and/or embryo freezing during late teens or early 20s for use
in older age, receiving donor eggs to achieve pregnancies are not the
answers, guarantees or panacea, and cannot compensate for the
age-related decline in egg reserve, quality and fertility. Besides,
infertility treatment across the world is very expensive, and largely
unaffordable by many patients, especially in low-resourced areas of the
world that include Nigeria.
In the United States of America, young
women now go to fertility clinics to freeze their eggs in the event of
career pursuit, waiting for the right partner or awaiting to do IVF
after cancer treatment or other terminal illness, in which case they can
even use surrogates, using their own eggs and their partners, sperm or
even donor sperm in the event Mr. Right never shows up.
Africans, especially Nigerian women, may
also take to this route. The technique of Oocyte – freezing – has now
been perfected to an advanced stage. Luckily we have been able to
establish pregnancy from frozen Oocytes.
Lastly it is pertinent to remind the
upwardly mobile, career-oriented ladies waiting for Mr. Right, that the
optimal reproductive age is between 19 and 25 years and, in some cases,
30. So, it must be stressed that the freezing of eggs is a recommended
medical option.
So, please, as much as possible, make haste while the ‘fertility sun’ shines.
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