Since the full liberalization of the two-child policy, our fertility center has responded to patients’ voices and launched the “Second-Child Specialized Clinic”, and many couples of “advanced age” have come to us for consultation. Due to the policy at that time, many couples had undergone birth control surgery (tubal or vasectomy) and requested IVF to help them conceive after the failed reversal. However, the fertility of older couples must be treated with caution, as statistics show that the rate of both perinatal complications and fetal birth defects increases significantly after the maternal age of 35 and with age. For those who have a more urgent desire to have a second child, those need to be considered carefully? 1. Advanced age. Women over 45 years of age have already entered the perimenopause, when ovarian function has seriously decreased. If you are mentally prepared, make sure to have a health assessment before preparing for pregnancy, mainly including sex hormone levels (on the third day of menstruation), anti-Mullerian hormone measurement, ultrasound (uterine and ovarian conditions), etc. In addition, the risk of fetal chromosomal abnormalities increases greatly at advanced age, with a risk of delivering a Down’s child <1/1000 for women at age 25, 1/365 at age 35, 1/85 at age 40, and up to 1/30 at age 45. 2.
Women with a history of cesarean delivery or uterine surgery For women with a history of uterine surgery who may have uterine scar defects and weak uterine walls, it is important for these women to have a uterine condition assessment test to see if they are suitable for pregnancy before preparing for pregnancy. If you prepare for pregnancy hastily, you may have risks such as uterine rupture in the middle and late stages of pregnancy, which may even be life-threatening. Even if the previous delivery was normal, the probability of obstructed labor requiring forceps, suction cups or even cesarean section is greatly increased, and the risk of postpartum hemorrhage is also increased. For those couples with a history of recurrent miscarriages and chromosomal abnormalities in the parents, it is not recommended to have a second child if there is a history of recurrent miscarriages in early pregnancy preparation and chromosomal abnormalities are found in either sex. Although it is possible to have a normal child with chromosomal abnormalities, the probability of early miscarriage is still very high, and the risk is even greater if combined with factors such as advanced age. 4. Women with combined hypertension, diabetes, heart disease, liver and kidney insufficiency During the second pregnancy clinic, we often see women who are eager to have a second child repeatedly emphasize that they also had these problems during their first pregnancy, does that mean that there is no problem with the second child as well? First of all, the combination of these diseases is not 100% dangerous, but the probability of risk is significantly increased for the mother and the fetus. Secondly, these diseases are chronic and theoretically very unlikely to be cured, and they can be further aggravated, so the combination of age factors doubles the risk of another pregnancy. These women we also do not recommend having another child, and if they insist, they must also be fully evaluated in cardiology and endocrinology. The question of whether to have or not to have a second child is a question of “Here comes the second child”? But whether it is suitable or not is a more serious issue. Therefore, women who are planning to have a second child must pay great attention to it and must not be paralyzed. It is best to go to the hospital for a comprehensive assessment before preparing for pregnancy, so that you can take precautions and consider the situation according to your own.