Women deferring pregnancy risk fertility problems

Women who put off getting pregnant till past their mid-thirties are defying nature and risk the heartbreak of infertility, Miscarriage or other complications, doctors warned on Friday.

"Women want to 'have it all', but biology is unchanged," they said in an editorial in the British Medical Journal.

An increasing number of women in Western countries are delaying having a baby till later, many for career reasons.

But women over 35 face a greater chance of suffering age-related fertility problems including Miscarriages, Ectopic pregnancies, twin births, bleeding and high blood pressure.

Once women pass 40 these risks increase dramatically, said consultant obstetrician Susan Bewley, one of the editorial's authors.

"We are seeing the disease burden of this social trend going up," she said.

Ectopic pregnancy occurs when a fertilized egg implants in tissue outside of the uterus, and the placenta and fetus begin to develop there. The most common site is within a fallopian tube. However, ectopic pregnancies can rarely occur in the ovary, the abdomen, and in the lower portion of the uterus (the cervix).
"As the number of older mothers is going up, most are fine, but in our gynaecological and obstetric clinics we are seeing a lot of casualties of this trend," she told BBC radio.

Bewley and her colleagues warned in their editorial public health authorities were ignoring an "epidemic of pregnancy in middle age."

On occasion, a woman will become pregnant after elective tubal sterilization. The risk of an ectopic pregnancy occurring in this situation may reach 60%. Women who have had surgery to reverse previous tubal sterilization in order to become pregnant also have an increased risk of ectopic pregnancy when reversal is successful.
"Doctors and healthcare planners need to grasp this threat to public health and support women to achieve biologically optimal childbearing," they wrote.

"No serious research is being undertaken into the additional costs to the National Health Service, the increased load on maternity services and neonatal units, the extra costs to employers of later maternity leave, or consideration of means that enable women to have children earlier."