Nahim Qasim, BBC News Arabic
My aunt gave birth at 45, my friend gave birth at 47, my neighbor at 43, these phrases spread among women in the Arab region.
Nevertheless, these statements are inseparable from warnings to women to postpone pregnancy “because they will not be able to bear children after a certain age, but men can have children at any age.”
What is the scientific accuracy of this warning?
Dr. Hind Abdel Salam told the BBC that many women expect that if they reach this age, they will not be able to have children, and sometimes people around them scare them that there is no chance of getting pregnant anymore, and this is not the case. Generally true, because the case is different for women and there are women who can get pregnant at forty-eight and later.
Doctors say women trying to have children after 35 need special medical care because they face different risks than women who are pregnant under 35.
The problem at this age is that if there is a genetic factor, such as consanguinity, or if there is a genetic problem, the chances of a miscarriage will be greater.
There are differences in the reproductive capacity of men and women, the most important of which is related to fertile age.
For a woman, the progressive deterioration of fertility occurs from the age of 35. The reason for this is that a woman is born with all the eggs she can produce in her lifetime, and this number decreases with age.
A woman is born with about two million eggs and this number drops to 400,000 at puberty and then to 25,000 by the time she reaches the age of 37, as most women lose 90% of their eggs by this age, before a woman has an egg. It only reaches 1000 when he turns 51.
Thus, the chances of conceiving gradually decrease every month and reach only 5% in women over 40, which means that the chances of conceiving are still there, but at a lower rate. It also varies from woman to woman.
On the other hand, men’s fertility rates decline like women’s, contrary to normal, but they decline later and more slowly than women’s. Male fertility begins to decline between the ages of 40 and 45.
Unlike eggs in women, men produce sperm throughout their lives, but the quality of this sperm declines with age, and fertility is linked to the quality of eggs and sperm, not just the ability to produce sperm.
The older a man is, the greater the chance of mutations in the genetic material of these spermatozoa and, therefore, the greater the likelihood of premature birth and low birth weight.
According to scientific studies, the birth rate of children with autism and attention deficit hyperactivity disorder, as well as the risk of miscarriage, is higher in children whose parents are over forty years old.
However, doctors often focus only on a woman’s age to determine whether a healthy baby will be born.
Pregnancy over 40 years
Dohaou Al-Safty confides to the BBC: “After about 6 months of quarantine, I found out I was pregnant and it was an absolutely unexpected surprise.”
Dohau hid her pregnancy from everyone because she was afraid of comments that could be “sometimes offensive, like someone wondering if you still have the energy to have children, or that you should think about marrying off your children instead of thinking about having them.” children.”
For this reason, Dohau wore baggy clothes throughout her pregnancy and avoided talking about her pregnancy.
The problem, Dohau said, was not a family one. Her family supported her, gave her advice and told her about other women who have given birth over 40 and who are healthy and their children are also healthy, but some friends and doctors helped to “intimidate” Dohau.
Dohau told me about the long and stressful journey to find a supportive doctor, saying: “The first doctor I saw told me that I was old and that I should give birth before the ninth month, fearing complications. The second one prescribed me many drugs. To stabilize the pregnancy, I say that I am prone to miscarriage, Because I’m old and blood thinners because I’m old.”
“I was very afraid. I knew that after forty years, the quality of eggs decreases significantly, which can affect the fetus, for example, birth with Down syndrome, deformity or congenital problems,” she adds.
Fear of the fetus wasn’t the only thing controlling Dohau’s pregnancy experience, but so was her own, especially in light of her doctors’ insistence on “scaring her past 40 years of experience with hypertension and diabetes.”
Dohau gave birth to her fifth child, Amar, earlier this year and is healthy. Doha is in good health.
“There is no specific age for having children, but it is a good preparation for having a child. I have given birth four times before, but this time is completely different. I feel that I am more mature and experienced than before this time. Despite all the fears, I really enjoyed the experience,” he says.
Dohau sometimes feels that Amar has been lucky with her and her previous experiences, but sometimes she feels sorry for him: “When I go to get my scheduled vaccinations, I realize that I am older than all the mothers around me. I left him early, but at the same time I feel that I am better with him than with others.”
We asked men and women from several Arab countries about the optimal age to reproduce, and they all focused on the woman’s age without mentioning the man’s age. Most of them assumed that she was thirty years old, and all agreed that women cannot bear children after thirty-five, which is not the case in practice.
Dr. Hind Abdel Salam says that there is nothing to fear at this age, it is about the need for quality medical services: “If there are habits such as smoking or drinking alcoholic beverages, the mother should also stop them.”
Dr. Hynd recommends that pregnant women over 40 continue to exercise, eat a healthy diet and get the vitamins they need during pregnancy, and continue to take folic acid to prevent health problems, fetal health or deformities.
Doctors note that women over 40 have a greater risk of miscarriage after IVF than their peers in their 30s or late 20s. But this warning does not mean that they cannot have a child, either through artificial insemination or naturally.
The same goes for the ability to breastfeed, which women continue to enjoy even after menopause. Just as the fertile period varies from woman to woman, the ability to conceive varies from woman to woman and no one can predict.