Despite decreased fertility and higher risks of fetal abnormalities, older women
still manage to conceive

Veteran TV actress Zoe Tay, who turned 42 in January, is said to be pregnant with her third child.

Her good friend, former colleague Huang Biren, 40, is due to give birth to her third child – a girl – at the end of the month.
 
For biological reasons, women who give birth to children in their 40s are a small group. According to the Immigration and Checkpoints Authority, which maintains all birth records in Singapore, the number of babies born to mothers aged 40 and above last year was 1,295 out of a total of 39,654, or 3.3 per cent. The percentage has been consistent in the last 10 years.

Experts say women in their early 40s are up to 40 per cent less likely to conceive – which makes 43-year-old real estate agent Jessica Lim-Charungchareonvejj’s experience more the exception than the rule.

Within a year of trying for a child immediately after a late marriage at 39, she was pregnant and gave birth to Christian, the first of two sons.

Childcare centre principal Ngiau Suan Lai also has a happy success story to tell. The 44-year-old gave birth to her son last August after trying to conceive for less than six months.

Madam Ngiau, who married her photographer husband Lee Teck Kia, 47, in June 2008, says: “We decided to try for a child only a couple of months after marriage and gave ourselves till the end of that year to do so. If I did not get pregnant by then, we said we would not try for a child anymore.”

They may be considered the lucky ones.

Dr Ann Tan, consultant obstetrician and gynaecologist at The Women and Fetal Centre, says: “Advanced maternal age is when one is 35 and above at the date of delivery. Women are born with a fixed number of eggs and the number diminishes with each passing year. Hence, it is definitely more difficult for older women to conceive.”

Dr Wee Horng Yen, consultant and director of the Women’s Wellness Centre at KK Women’s and Children’s Hospital (KKH), says: “Other things being equal, the chance of having a problem with fertility increases from about 11 per cent in your early 20s to about 33 per cent in your late 30s to almost 40 per cent in your early 40s.

“So if it takes the average younger woman four months to conceive, it may take an older woman twice as long.”

The success rate of in-vitro fertilisation (IVF) also deteriorates with age.

Dr Wee says: “The clinical pregnancy rates after IVF based on age are 56 per cent for those younger than 30 years old, 44 per cent for those aged between 30 and 39 and 18 per cent for women aged 40 to 44.”

Mrs Callie Arai, 47, went through three cycles of IVF before giving birth to her son two years ago. She had her first IVF treatment in 2001 and conceived successfully. Unfortunately, doctors had to remove the foetus after eight weeks because it had stopped growing.

But Mrs Arai, a Singaporean, and her Japanese husband did not give up. Her third IVF treatment in 2007 led to a healthy and ultimately successful pregnancy.

She says: “Our mentality was that if we are blessed to be parents, we will be thankful. But life doesn’t end there if we are not.”

Unlike Mrs Lim-Charungchareonvejj and Madam Ngiau, she did not marry late. She tied the knot with project manager Kiyotaka Arai in 1993 when she was 30.

“I moved to Japan the year I got married and was busy trying to adapt to Japanese lifestyle then. In Japan, you hardly see a childcare centre around because the bosses there expect women employees to resign when they get pregnant, and during that time, my career was on the rise,” says Mrs Arai, who was a project manager in her husband’s company. She is now a housewife.

She and her husband started trying for a baby only when they returned to Singapore in 1999. When they did not succeed after a year, they consulted doctors at KKH who recommended IVF treatment to boost their chances.

Reflecting on her years in Japan, Mrs Arai says: “I could have quit my job so that I could have a baby when I was younger.” But she says she has no regrets.

While her son is healthy, medical science says she had faced increased risk of giving birth to a baby with genetic abnormalities.

Dr Tan says: “At age 35, the risk of a woman giving birth to a baby with Down syndrome is one in 400 and at age 40, it becomes one in 100.

“There is also a 20 to 35 per cent chance of miscarriage for mothers-to-be aged between 35 and 45 compared to 15 per cent for those aged between 20 and 29.”

Mrs Lim-Charungchareonvejj faced the possibility of giving birth to a child with Down Syndrome when she was pregnant with her first son.

She says: “My doctor told me after one of the blood tests that there was a borderline chance that my child would be born with genetic abnormalities and asked if I would like to take the amniocentesis test.”

The test, which scans for birth defects such as Down syndrome, is done by putting a needle through the abdomen of a pregnant woman into her uterus to check the fluid surrounding the baby.

The test is 99 per cent accurate but there is a less than 1 per cent chance of causing a miscarriage – and that was enough to put Mrs Lim-Charungchareonvejj off the test.

“I trust God to grant me his grace to have healthy babies. Besides, no matter what happens, he is still my child,” she says.

Older mothers also have other concerns.

Madam Ngiau says: “I was a little apprehensive about our finances, whether I will be able to keep up with a young child at my age and whether I’ll be able to relate to him when he grows up.”

To make sure their son has something to fall back on, she and her husband bought education and health insurance policies for him. She declines to give the details.

Mrs Lim-Charungchareonvejj has also bought similar policies for Christian and her second son, Christof, who is eight months old.

“I also put money in their bank accounts every month. They are probably richer than me now,” she says with a laugh.

To ensure that she will always have the energy to keep up with her sons as they grow up, Mrs Lim-Charungchareonvejj, who was crowned Mrs Singapore Globe in 2008, keeps fit by “swimming regularly and eating less carbohydrate and more protein”.

“I also refuse to stop working so that I won’t go senile,” she says.