Many couples are choosing to marry in their 30s due to career and financial considerations. However, a late marriage doesn’t necessarily mean delayed pregnancy and careful planning is crucial to ensure healthy conception and pregnancy. Understanding how age, lifestyle and fertility impact pregnancy can help couples make informed decisions about when to start a family.
Start early
Kriti (31) has polycystic ovarian disease (PCOD). Aware of the potential fertility issues linked with PCOD, she decided to opt for an early pregnancy after her marriage. But Kriti experienced an ectopic pregnancy (when a fertilised egg grows outside the uterus, mostly in a fallopian tube). However, with lifestyle changes, ovulation therapy and patience, she was finally able to conceive naturally at 35 and gave birth to a healthy baby boy. Her journey highlights the importance of understanding reproductive health and seeking medical support when necessary.
Age is a significant factor in fertility, particularly for women. Biologically, women are most fertile in their early to mid-20s, with fertility gradually declining after 30 and a sharp decrease after 35. By age 40, chances of natural conception drop significantly due to reduced egg quantity and quality. Similarly, men also experience a decline in sperm quality as they age, impacting the chances of successful conception.
While there is no universal ‘right’ age for pregnancy, doctors often recommend that conception before the mid-30s can minimise complications. However, this doesn’t mean women in their late 30s or early 40s cannot conceive; it simply necessitates proactive planning and medical guidance.
Marrying late should not mean delayed pregnancy. Some such couples immediately plan a child after marriage, while others take time to settle into their careers or relationships before planning a family. Each choice comes with its own unique concerns.
Sometimes, either due to under-awareness or over-awareness, some couples assume they can delay conception and can opt to have a child as and when they want with the help of reproductive technology. Avantika (29) consulted me after four years of marriage, and sought immediate IVF treatment due to her pilot husband’s irregular availability. She believed IVF was the quickest solution. However, after counselling on natural conception and fertility tracking, as well as lifestyle adjustments and ovulation monitoring, she has opted for natural pregnancy. Her case underscores the importance of planning a pregnancy and not rushing into assisted reproductive treatments (ART) prematurely. However, late pregnancy has its own challenges.
Declining fertility: A woman’s ovarian reserves start diminishing in her 30s, reducing chances of conception. Additionally, older/mature eggs have a higher risk of chromosomal abnormalities, raising the risk of miscarriage or genetic disorders such as Down Syndrome.
Increased health risks: Pregnancies after 35 are considered high-risk due to higher chances of gestational diabetes, high blood pressure, and preterm birth. Mature maternal age is also linked to a higher risk of Caesarean delivery.
Stress and career pressure: Many working couples lead stressful lives and delay pregnancy due to various personal or professional reasons. Prolonged stress can negatively impact fertility, leading to irregular ovulation and hormonal imbalance.
Lack of awareness: Couples often overlook natural fertility-enhancing methods and assume ART is the only option for late pregnancy. While IVF and egg freezing are advancements in reproductive medicine, these should not be substitutes for timely family planning.
Solutions for enhancing fertility
To improve the chances of natural conception, couples can take several proactive steps:
Preconception health check-ups: Consulting a gynaecologist for ovarian reserve tests, sperm analysis and overall reproductive health assessments can provide clarity on a couple’s fertility status.
healthy lifestyle: Maintaining optimal weight, regular exercise, and a balanced diet rich in antioxidants, protein, and omega-3 fatty acids can enhance fertility.
Stress management: Practising yoga, meditation, and mindfulness techniques can regulate hormones and improve reproductive health.
Tracking ovulation: Understanding ovulation cycles using fertility tracking apps or ovulation kits can help identify peak fertility days for conception.
Avoid harmful substances: Limit caffeine intake, quit smoking and reduce alcohol consumption.
Spacing between pregnancies
After the first childbirth, the World Health Organisation (WHO) recommends 18-24 months’ gap in the next pregnancy to allow the mother’s body adequate recovery time. Proper spacing reduces the risks of preterm birth, low birth weight, and maternal complications.
Couples who marry later may feel pressured to plan pregnancies in quick succession. However, closely spaced pregnancies can increase the risk of uterine rupture, nutritional deficiencies and exhaustion.
Make Tech a backup plan, not a primary choice
With advancements in reproductive medicine, ART options like IVF, intrauterine insemination (IUI) and egg freezing provide alternatives for couples struggling with infertility. However, technology should not replace natural methods unless it is a medical necessity. Nothing can replace the benefits of early planning and a holistic approach to reproductive health.
Late marriage does not necessarily mean late pregnancy, but proactive planning is essential. Understanding fertility decline, adopting a healthy lifestyle, and seeking timely medical guidance can significantly improve the chances of natural conception. Couples should be aware of biological limitations while balancing career and family goals to ensure a smooth and healthy pregnancy journey.
— The writer is Associate Director, Obstetrics and Gynaecology, Cloudnine Group of Hospitals, Chandigarh
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