Social changes in recent decades have facilitated women's access to the world of work. This incorporation at work has created a dilemma for many women in terms of reconciling a professional career with the desire to be mothers and start a family. Thus, women have slowly postponed their motherhood for the sake of greater professional stability. Nowadays, the average age in Spain for the first child is 31 years --one of the highest in Europe-- while in 1980 the average for first-time mothers was 25 years of age.
Assisted Reproduction Techniques
The adverse effects of maternal age on fertility are well known. The most fertile age according to professionals is between 20 and 30 years, with 35 years being when fertility begins to decline. From the age of 40, the chances of conceiving naturally are extremely low. Assisted reproduction techniques offer women with difficulties conceiving different treatments that adapt to their age and unique problems.
Legal Age Limit
In Spain, there is no legal limit to access assisted reproduction treatments; thus, it is possible to find differences between the public and private health systems in terms of a maximum age. Spanish Social Security establishes a limit of 40 years, above which it does not offer assisted reproduction treatments. Likewise, a maximum of three cycles has also been set: both for in vitro fertilization and for artificial insemination .
The Spanish Fertility Society strongly recommends a limit of 50 years for accessing assisted reproduction treatments. This is the limit to which most Spanish clinics adhere as, although the law does not establish a maximum age, it mentions the reasonable chances of getting pregnant and avoiding risks for both mothers and babies.
Risks of a Pregnancy in Older Women
A pregnancy from the age of 40 carries an increased risk of preeclampsia, gestational diabetes, spontaneous abortion, preterm labor, and complications during delivery. Beyond the difficulties during pregnancy, we must also consider the future welfare of the newborn. The mother must have the proper physical condition and the necessary vitality to care for the growing child.
Recommended Age Limit by Treatment
Although the age limit is 50 years, there are also other recommended maximums depending on the treatment. Generally, artificial insemination treatments are not proposed for patients over 38 years of age. In the case of an in vitro fertilization cycle with the mother's own egg, the limit from which the probability of success decreases enormously is 43 years. From that age on, professionals recommend leaning towards egg donation.