Am I too old to try for my second baby at 46?
QI AM a 46-year-old mother of a one-year-old child. I had hormonal problems for years, so was thrilled to conceive naturally and easily. Now I can’t shake off the longing for another child. Am I too old? I fear the chances of conceiving naturally are small and worry about complications if I did become pregnant. I’m also worried about what others would say. A YOU’RE not too old, but you need to be realistic about the chances and aware of the facts. In the past two decades the conception rate for women in their 40s has more than doubled, with about 29,000 a year conceiving now.
As for worrying about what others might say – I wouldn’t. Many women now leave motherhood until later for medical or career reasons. But fertility falls dramatically in your 40s, making getting pregnant much less likely. The ovaries’ capacity to provide eggs is at its maximum at birth – 100 per cent. By the 30s, it is down to only 12 per cent, and by your 40s it is three per cent.
This significantly cuts your chances of success – we know that for every 100 women trying to get pregnant naturally at 40, only five per cent will.
To manage your own expectations, I would start with some hormone tests at the GP for oestrogen and follicle stimulating hormone (FSH) – to see if your ovaries are still functioning well.
If tests show you are entering peri-menopause, you will save the heartache of trying naturally. Perhaps you would consider surrogacy or adoption. You would not be considered for IVF at your age on the NHS.
Of course, there is a chance of getting pregnant – which is why we don’t advise a woman to stop using contraception until she has actually reached menopause. Conceiving at 46 is high-risk for the baby and you – so is especially to be avoided in unplanned circumstances. If you get pregnant, you will have to be carefully monitored and screened for genetic problems in the baby as well as risks to you such as pre-eclampsia. At your age, your chances of having a child with Down’s syndrome would be one in 30 compared to one in 1,250 at age 25.
Q SEVEN years ago I was diagnosed by my GP with the skin condition granuloma annulara. Since then, I’ve been given little or no advice – other doctors at my surgery haven’t even heard of it.
It’s dreadfully unsightly, with huge ugly rings of raised, red spots on my arms and legs that mean I stay covered up all summer. I recently fractured my wrist and it got much worse. Is there anything I can do to rid myself of this horrible disease? A THE problem with many skin conditions is that they don’t kill or do any physical harm, but they often don’t get much better. Causes are only hazily understood, so treatment is a lengthy process of trial and error.
Patients are often left to amble along with something unsightly. Granuloma annulara is benign, but if it’s distressing you, ask for a referral to a dermatologist. You have options: steroid creams, ointments, or injections may clear up the rash. Severe cases can be treated with ultraviolet light therapy or medicines to suppress the immune system. Try to manage stress.