Pregnancy after 40 years old - is a realized reality?

Introduction: An increase in a woman's age at her frst birth has occurred across all age groups but has been most pronounced in relatively older women, such that one out of every fve women in the world has her frst child after the age of 35, an 8-fold increase over the previous generation. Objective: What do infertile women in Каzakhstan over the age 40 understand of the relationship between age and fertility?
Methods: 82 medical card women over the 40 years old, who had consultation in IVF department of National research Center of Maternity & Child Care, were retrospectively analyzed. The data include responses to the interview questions ‘What information did you have about fertility and age before you started trying to get pregnant?’ and ‘What did you learn once you proceeded with fertility treatment?’, as well as any discussion of these topics.
Results: 31.7% of women in our cohort frst attempted conception at an average age more than 35 and 61% stated that they had some awareness that fertility declined after age 40. Yet 90.2% of women expected their fertility to decline gradually until menopause at around 50 years and 30.5% reported that they expected to get pregnant without difculty at age 40. When entering into the medical realm, very few participants had considered the possibility that they would need IVF and 53.7% reported being ‘shocked’ and ‘alarmed’ to discover that their understandings of the rapidity of age-related reproductive decline were inaccurate. There were 97.6% of women who advocated better fertility education earlier in life so that men and women could make more informed childbearing decisions and 80.5% who indicated that with more information about declining fertility they might have attempted conception at an earlier age.
Conclusion: We found that women in our country did not have a clear understanding of the age at which fertility begins to decline. Over half of participants were ‘shocked’ to discover that the chances of conception at their ages were much lower than they had anticipated. As a result, we conclude that while the failure to appreciate the true biological relationship between aging and fertility may reflect inaccessibility or misinterpretation of information, it is not suffcient to explain the decades-long socio-demographic phenomenon of delayed childbearing.