Biological clock…..two words which have far-reaching, almost scary implications for women struggling with infertility issues! Scientifically speaking, the fertility of a woman ebbs with her age, which is the reason it is said that her biological clock is ticking as the chances of her getting pregnant decline as she grows older. Though the period between the twenties to early thirties is regarded as the “window of opportunity” for pregnancy, it is subjective and varies from woman to woman. Also, this is the time when a woman is least likely to come across pregnancy related complications.
As a result, it is imperative for a woman to be worried about her biological clock ticking as she steps on the wrong side of her mid-thirties. Therefore, medical science and research have been focused on devising ways for countering the issue of biological clock to help the women who want to postpone motherhood to a later age because of career commitments or otherwise.
Diminishing Female Fertility: The Role of Ovarian Reserve
Besides the age, the reproductive health of a woman is influenced to a considerable extent, by her ovarian reserve. In simple terms, the ovarian reserve refers to the number and quality of eggs in the ovaries of a woman. The most amazing thing is that every female is born with an ovarian reserve, with even a female fetus having millions of eggs. The number, however, comes down with her birth and goes on declining as the she grows older.
The more the number of eggs in a woman’s ovaries (the larger the ovarian reserve) and the better the quality of eggs, the greater are her chances of conceiving. As the woman grows older, the number of eggs in the reserve keeps coming down, causing decrease in ovarian reserve, and thus having her biological clock go on ticking.
A healthy woman ovulate these eggs during her reproductive years and they gradually die as she reaches her menopause in her late forties. The number of eggs goes down with the years, which is the reason why a 30 year old has 20% chances of conceiving in a month, while this falls to only 5% in a 40 year old. Therefore, it would be a wise decision to draw a plan of action for young women who want to get pregnant after their mid-thirties, as an insurance against the failure of egg reserve.
What are the options to counter the impact of biological clock on female fertility?
Consider a young woman in her twenties, who is focused on achieving her career goals and for this reason she does not want to have children for, say another 10 years. At present, she might shrug off the idea of motherhood, but some years down the line, she might realize that she is in a fix. So it would be a good idea to be aware about the concept of biological clock well in time, rather than wait for the issues to surface at a later age.
Medically, there are two options for women who want to have children at a later age, and they can choose amongst these depending upon their individual circumstances.
Egg Freezing or Cyropreservation
A ground breaking technique, egg freezing or cryopreservation enables a woman to preserve her reproductive potential and conquer her so-called biological clock by having her oocytes frozen for use a few years later. While many women would be opting for egg freezing for career reasons, others could do the same because of health complications. These could be the women with family history of ovarian failure at a young age, or those who have to undergo cancer treatments like surgical removal of ovaries, radiation and chemotherapy of the pelvic region. Yet others could want to delay motherhood for the simple reason that they want to wait till they find the right partner.
When a woman has had her eggs cyropreserved, she can have them thawed at a later age, when she is ready to have a baby. The egg can then be fertilized in the lab and she can get pregnant successfully with the help of IVF technique.
The second option is that of donor eggs, in which the woman has to use eggs of another woman for IVF because she is not producing eggs at all or her eggs are not viable enough to grow into a healthy pregnancy. Although a woman would definitely want to be pregnant with her own eggs, this option has to be used when her biological clock has failed or is on the verge of failure.
The positive aspect of using donor eggs is that the success rate of IVF ( In vitro fertilisation) is equivalent to that of the donor rather than the recipient, which means that a 40 year old woman would have as good a chance of conceiving as that of a 25 year old, if the latter is donating her eggs for the procedure.
While many older women would assume that the ticking of biological clock deprives their uterus of its ability to safely harbor the pregnancy, the real reason could be the eggs running out. So they need to be aware that cryopreservation or egg donation would be better options for them as compared to surrogacy, which might be considered for specific cases. Other factors such as the medical condition of male partner and presence of infertility related complications and/or sexually transmitted diseases in either or both the partners also need to be taken into account for deciding the best alternative for the woman looking to counter the complications related to the ticking of her biological clock.