In the apparent age of wokeness, womn the world over are now reclaiming agency over their lives, bodies, careers and choices, so much so that some statistics show that more women are deciding to marry and start their families later than past generations. In Nigeria, traditionalism and religion are still held in incredibly high esteem, and a woman’s worth is so intrinsically tied to her fertility. Fear-mongering and misinformation are widespread as a tool to convince women that time is of the essence when it comes to their biological clocks. While the intention is routed in some truth, what are the real facts? Are all women under threat of infertility once they approach the age of 35? Are the complexities so black and white and similar for all women? We spoke to two fertility specialists at The Bridge Fertility Clinic in an attempt to gain clarity, truth and to debunk widely (but perhaps wholly inaccurate) beliefs surrounding female reproductivity.

– RACHEAL ABIRIBA

Women are delivering healthy babies throughout their 30s and beyond. The age of 35 is simply an age that certain risks become more worthy of discussion. The biggest drawback of having a child in your late 40s is [that] it’s harder to get pregnant. Egg-supply decreases significantly with age, and older eggs are more likely to have chromosomal problems, raising the risk of miscarriage and birth defects. 40-year-old women treated for infertility had a 25 percent chance of getting pregnant using their own eggs.” said Dr. Bamidele Babatunde, Fertility Specialist at The Bridge Fertility Clinic, Lagos.

Yes. Biological clocks exist, but they do depend on the time when puberty began for each woman. So it’s important to note that there’s no umbrella time for every woman. For example, a woman who hits puberty at the age of 10, will find that her biological clock is ticking (so to speak) at a different rate than a woman who began her cycle at the age of 13. Medically though, there’s an average age which is generally recognised as the time when a woman’s biological fertility peaks (early to mid-20s) after which it begins to decline at about 35, the average age at which fertility begins to reduce. This biological clock is different from menopause, which also occurs at different times for different women, generally in their 40s, 50s, and 60s, and which marks the cessation of fertility (although age-related infertility can occur before then).

So now that we have acknowledged this fact, what does it mean for women who are now deciding to have children later in life (post-28)?

In recent times, there has been increased awareness of this situation and women are now opting for fertility treatments as chances for natural conception also decrease dramatically with age.
Proper counseling is an important part of dealing with fertility/infertility. It is important to let women know that after the eggs have been collected and frozen, all the eggs might not survive the process of thawing and the likelihood of matured eggs surviving this thawing process is also not high. They need to be sensitised to the various other options available to them such as using donor eggs and surrogate mothers. Education about the options for fertility and acceptance of these options by religious groups and more traditionalist societies could help reduce the cases of infertility.

Although the onus of having a child does not depend solely on women, the Nigerian society expects women to want to have children. With a booming population and a serious hike in expenses in the coming decades, it has become challenging to provide for a child, let alone multiple children. Considering this, getting pregnant at an older age (mid-30’s) may be a tedious task, but also carrying the pregnancy so that a healthy baby is delivered might also present a challenge. Thus, couples resort to fertility treatments meant for both men and women. This initiative has proven to be fruitful and given hopes to millions of childless couples. But this process is more cumbersome and complicated than the more conventional way of reproduction, with possibilities of unsatisfactory outcomes.

One of the most sought-after treatments in recent times has been the egg-freezing option. These eggs are frozen at a young age to pause their natural ageing process, the eggs can be thawed (essentially, defrosted) at a later date when the woman is ready to get pregnant, so that the effects of aging do not come into play.

“But the flipside is that the treatment is not so affordable for the average Nigerian, and like every medical procedure, there are complications such as punctures of the blood vessels during the process of collecting the eggs, infections (if the procedure is not well done), and Ovarian Hyperstimulation Syndrome, which happens when there are too many fluids and eggs as a result of the Hormone Stimulating treatments, which have been administered to the woman to stimulate the release of the eggs. In the case of Ovarian Hyperstimulation Syndrome, the fluids will first be drained before the eggs will be collected.” added Dr. Joseph Olayinka Uwa, Embryologist at The Bridge Fertility Clinic, Lagos.

Medical conditions such as fibroids complicate the process of egg collection, especially if it is larger in size and in a position where it will interfere with the collection process. Huge fibroids can make reaching the ovaries very difficult during egg collection; such clients will be advised to have the fibroid removed when visualised during egg collection.

It is advised that women come in early for testing and egg collection because the best quality eggs can be collected from the age of commencement of puberty to 35.

At the end of the day, the right to give birth or postpone a pregnancy is entirely an individual’s choice. Therefore, it is advisable that a lady in her late 20s at least begins thinking about her reproductive goals and seeks advice from medical professionals once she has reached a decision. Your biological clock is ticking, yes, but you still have control over just how fast that clock ticks.

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