Becoming a mom at 35+ is sometimes not so easy anymore. Darja Wagner is a cell biologist and fertility consultant. Here, in an interview, she tells us what women need to know beyond the "magic" age can do to improve the quality of their oocytes.
Dear Darja, how did you decide to become a fertility consultant??
As a cell biologist, I have spent years studying hormones, vitamins and human cells. In my last years at FU, my students and I experimented with adult stem cells, they fascinated me so much. And the eggs are the ultimate stem cells from which all organs and the human being itself are created.
When I was 35 and finally ready to start my own family, it soon became clear that the path to this goal is not necessarily a straight one. Fortunately, my own wish to have a child was fulfilled at some point. But during this time I became aware of how many women – and especially how many academics – have children very late in life. And how often they are at a loss when they have done and planned everything correctly, but their wish for a child remains unfulfilled.
I have also been struck by how little women know about their bodies. How fast their own biological clock is ticking? How many eggs do you have left? When does ovulation take place?
I think our society does nothing to prepare women for their role as mothers. From an early age, we women are made to understand that education, work, and even careers will play an important role in our lives. So we first spend 20 years and more to meet all expectations. And then many women in their mid-30s and early 40s are surprised that they no longer have any eggs.
I felt anger during this time and also a kind of responsibility to make my cell biological knowledge available to others. So I started Paleo Mama Blog, with the desire to make the biology behind wanting children universally understood.
Why do the chances of pregnancy worsen with age??
A woman’s age is by far the most important factor in why fertility declines after a certain point, and with it the likelihood of becoming pregnant. With increasing age, the quantity as well as the quality of the available eggs decreases exponentially. But two people are involved in the creation of a child – and equally so. It happens that sperm cells do not manage to swim up to the egg and unite with it. At least forty percent of the causes of infertility are due to the man and about twenty are due to both partners.
Women are born with all their eggs already – there is nothing they can do to improve their chances of a successful pregnancy?
Until a few years ago, the dogma held that a woman could not influence her eggs at all. Despite scientific advances, there are still people and even doctors who believe eggs work like little kitchen clocks – wound to 40 years and with a clearly defined expiration date. And none of what a woman does with her body can affect it.
But that doesn’t make sense: the same therapists who understand well that everyone can help their heart, liver, brain and almost every other organ by adjusting their lifestyle, diet, vitamins and exercise, did not want to accept for a long time that ovaries can also be supported. Especially for those late mothers whose biological clocks are beating the last minutes, these adjustments can be crucial. It is often possible to turn back the biological clock by a few minutes with small changes in lifestyle. Sometimes even more, but this is really very individual.
What can women over 35 specifically do to promote a desired pregnancy??
It is first important to know that it is (almost) always possible to support the ovaries to stay fitter and create good ovulations at a later age. The diet should be based on the Mediterranean diet. And it should be remembered that "Mediterranean" does not mean pizza and pasta, but above all a lot of fresh vegetables and fruits, often fish, carbohydrates such as bulgur, quinoa and wild rice, and a lot of olive oil. Several studies have clearly shown that couples who followed a Mediterranean diet for just six months were more likely to get pregnant, whether naturally or through artificial insemination. Alcohol is best avoided, except for a little red wine.
A few more measures are generally beneficial: extra omega-3 and an adequate supply of vitamin D. There are other ways to support the eggs as well as the uterus of the older mothers; however, these must be adapted to the individual hormone picture. We should also not forget factors that we have known for a long time and that favor a successful pregnancy. Z.B. a good BMI (body mass index). Women whose weight is as close as possible to their ideal weight and who eat a healthy diet low in fat and sugar have the best chances of getting pregnant and staying pregnant. In addition, there are a few vitamin supplements, the most important of which would be folic acid.
Why folic acid is important for women before pregnancy?
If a woman can remember only one vitamin associated with childbearing, it should be folic acid. Sufficient supply of folic acid in the first weeks of pregnancy helps to almost completely prevent some of the serious neurological diseases in babies. In this case, their genetic predisposition plays little role. So it’s their decision alone to take the folic acid in time, which will make a huge difference in the future and health of their child. It is very interesting how many women think about folic acid during the first pregnancy, but not anymore with the later children.
When the desire to have children remains unfulfilled for a longer period of time, many couples become nervous.
Especially for late mothers, impatience is high. Their life plans are already set, plus they are aware of the risks of late pregnancy. Or they absolutely want it to work out with a sibling yet. That is why their nervousness is very easy to understand. If the pregnancy does not work out as expected, the next stress factor is added: a psychological strain consisting of a mixture of uncertainty and loss of control. And from silence, because of unfulfilled desire to have children do not speak.
When should a couple with an unfulfilled desire to have children see a doctor? And which doctor?
If, after about a year of regular "practice", getting pregnant still doesn’t work out, see a doctor. But this does not apply to women over 35. For many in this group, the chance of getting pregnant decreases from month to month, and there is really no reason to hesitate too long before reporting to a fertility clinic.
First of all, a whole series of tests is carried out there; this is called cycle monitoring. Does ovulation take place regularly? What about hormones? If the fallopian tubes are permeable, the uterus is fit? Semen quality is also tested – this all takes time and takes another few months for all the information to come together.
That’s why it’s best for women over 35 not to wait too long to make the leap from gynecologist to fertility clinic. This way they keep as many options open as possible. You should also adjust your lifestyle so that it supports your femininity and fertility and does not work against it.
Why should I have the quality and quantity of my eggs determined at all??
Because the individual differences between women are big. While most people can have children at 25 and 30 without any problems, at 35-40 it is already very individual. That’s why every woman should have her egg reserve checked at the latest at the age of 30, in order to have her life under better control and to keep as many options open for herself as possible.
We women are born with about 300.000 to 400.000 eggs are born and, once we reach puberty, about 1000 eggs are lost every month. Whether we want to have a child or not, use contraception or not, have a relationship or not, want to study and make a career or not .. does not matter at all for the oocytes.
But our biological clocks do not all tick at the same speed. That’s why some women can still have children in their 40s without any problems; but some others can’t. Therefore, it is important to have this information in time to better plan your relationships and career.
And what if I was told I only had three little rushes left?
Haha… Such a result would not be possible at all, because tests are not sensitive enough for that… Also, the reserve is not counted, but predicted – also something that today’s girls should be taught in biology classes.
And is it true that the determination of egg quality is covered by health insurance??
It is only the quantity and not the quality of the eggs that can be determined. Besides, the tests do not provide numbers. This is also an outdated idea – that eggs tick like little kitchen clocks until they eventually expire and there are none left.
What is measured are two simple hormone values, which, combined with a simple ultrasound examination, give a precise statement about the fertility of the woman. The best way to get this examination is to see a fertility doctor. Depending on the life constellation, this test can be a health insurance benefit, but even if you pay for it out of your own pocket, the valuable information still costs less than a single trip to H&M.
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Darja Wagner is a cell biologist, fertility counselor and author of "Getting pregnant after 35+".