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Sunday, September 18, 2005

Pregnancy at 46

Dear Dr. Amy,

I am very interested in becoming pregnant again. I would appreciate it if you could provide me with statistical information regarding birth defects? Currently I am 46 years old. I have a beautiful 6year old boy and would like very much to have another child. I should add that twins do run in the family for second pregnancies. My previous pregnancy was a "C section" since the baby was in breech position. I have had my appendix removed as well so there is scar tissue.
I understand that a woman is more likely to have a miscarriage at my age. What are your suggestions to ensure the best possible pregnancy?


Dear Carol,

The first thing to keep in mind is that it may be difficult or impossible to become pregnant. Fertility drops dramatically at age 40, and very few women who are 46 can become pregnant without fertility treatment, or even with fertility treatment.

The miscarriage rate rises dramatically also, as well as the risk of chromosomal problems such as Down's syndrome. For example, the risk of Down's syndrome rises from 1 in 200 at age 35 to 1 in 20 at age 45.

Many women have developed medical issues by age 46, such as high blood pressure, and these can affect the pregnancy. In addition, there is a much higher risk of developing pre-eclampsia.

Most of these problems are factors beyond your control. There is nothing that you can do specifically to counteract these issues. That doesn't mean that you can't have a healthy baby at age 46, but the chances are much lower than at age 35 or age 40.



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