After 23 Years of Battling Infertility, Failed IVF, I Conceived Twins Naturally – 49-Year-Old School Proprietor
After 23 Years of Battling Infertility, Failed IVF, I Conceived Twins Naturally – 49-Year-Old School Proprietor
While it’s not impossible to become pregnant naturally in the late 40s or 50s, it is, nevertheless, rare with experts always warning that conceiving at such age can increase the risk of some health problems for the baby and the mother.
Mrs. Modupe Gabriel, a school proprietress in Lagos, however, defied the odds by conceiving naturally at age 49 and giving birth to twins.
The feat was also remarkable because Mrs. Gabriel had battled infertility for over 23 years and even had a failed IVF. LARA ADEJORO writes on the remarkable story of Mrs. Gabriel and the contentious medical issues about women with late pregnancies.
An overwhelming joy lit up her face the first time she saw her twin children – a boy and a girl. Carrying a pregnancy without any reproductive assistance during her run-up to the fifth decade is a big deal for her.
Mrs. Modupe Gabriel had no plan to have children late but things ended up that way for her as she had to battle infertility for 23 years.
While she peers intently at her ‘miracle babies’, her mind flashed back to the years she was fervently expectant and battling infertility.
She visited several hospitals in her quest to get a solution to her fertility problem and even had a failed In vitro fertilisation treatment.
She recalled how she had to put on a brave face while with family and friends. Mrs. Gabriel, however, says she never slipped into a panic because of her condition but rather remained hopeful.
As a school proprietress in Lagos, she kept on with her work and responsibilities as a wife. She made up her mind never to compromise her faith despite the challenges.
Fortunately, she was confirmed pregnant a few months after her 49th birthday.
“I had been advised by people to go diabolical to have a child, I spent a lot of money going to hospitals, I’ve had a failed IVF but I’ve kept on trusting only in God.
“I’ve always believed that anything God cannot give me, I don’t want. We waited patiently and it is indeed worth it, though it seems so tough and discouraging, however, with God by our side, it became a thing of the past,” the delighted mother said.
For Mrs. Gabriel, being older didn’t mean biting her nails with worry through the pregnancy despite the risks involved.
“I was told I had gotten to my menopausal stage but I was still menstruating. When I was confirmed pregnant, my doctor told me I needed to be on bed rest but I was strong and I was able to do my job in my school, I wasn’t idle or lazy, I was up and doing,” she said.
After 23 Years of Battling Infertility, Failed IVF, I Conceived Twins Naturally – 49-Year-Old School Proprietor
Her children arrived in the New Year – January 25, 2022.
Pregnancy after age 45 is likely, but rare
Her late pregnancy is rare, but she is certainly not alone. While there is no national data on women with late pregnancy without reproductive assistance, findings show that few women in their late 50s have natural conception and deliver healthy babies.
Experts say pregnancy after age 45 years is considered high risk for the mother and baby.
A Professor of Obstetrics & Gynaecology at the Lagos State University Teaching Hospital, Ikeja, Rotimi Akinola said it is out of the ordinary to have a baby in the late 40s or 50s but nothing is impossible.
“In medicine, you never say never. So, if somebody has late menopause, she still has eggs to shed, so it’s not impossible for that person to get pregnant, maybe accidentally.”
“The only thing is that the eggs that will be shed at 49 have a high risk of genetic abnormality,” Akinola said.
According to him, conceiving a child without IVF or other interventions presents an increased risk of certain chromosomal problems with age.
“For people from the age of 37, they begin to have that risk so I won’t be surprised if, at 49, you have a risk of about 1 in 60 that it might be genetically abnormal, chromosomal abnormal like Down syndrome.”
Prof. Akinola, however, noted that most times, women with late pregnancy are not honest with the method of pregnancy.
“When you are hearing that 60 years old give birth, they often do with assistance and often, that assistance is with donated eggs.
“Plenty of women in their 40s have children but have a high risk of genetic abnormality. As long as you’re not menopausal, it’s possible that they still have a few eggs and those eggs can still yield children but from 59, most women in that age group will be menopausal and menopause simply means no more eggs. If such a person menstruates, it will send panic to the doctors because the person might be dealing with tumors.
“When the eggs are no longer there, the only way that person can conceive is through assisted reproduction with the help of donated eggs.”
Risk for complications increases
The gynaecologist said it will be challenging for such a woman to maintain her health because of the chance of becoming hypertensive or diabetic.
He noted that the older an egg, the more likely it is to have chromosomal issues, which can increase the child’s risk for birth defects.
“Everything that happens to somebody who is old – hypertension, diabetes are problems they can have and once they come in, they affect the outcome of the pregnancy. A woman who has late pregnancy has a chance of developing hypertension, gestational diabetes which can create a problem for the mother and baby.”
Akinola recommends adoption for women who battle fertility for a long time instead of risking their lives.
Fertility in women after age 45
In a study published in the International Journal of Fertility, the researchers say pregnancy after age 45 years is infrequent and noted also that the mother and baby should be considered as a high risk.
According to them, there is a greater incidence of spontaneous abortion, gestational trophoblastic disease, and chromosomal abnormalities in the fetus.
“Birth control practices should be discontinued after 49 years of age in the best interest of the woman’s sexuality if abortion is acceptable to her. The patient should be completely informed of the risks and, in the event of pregnancy, abortion should be advised.
The researchers obtained data of 72,005 pregnant individuals age 45 years and older at Columbia Hospital for Women in Washington.
The women were contrasted according to age, gravidity, parity, abortions, outcome of pregnancy, complications, and birth control practices. 10 patients menstruated to age 55 with an occasional missed period, 63 patients menstruated regularly to age 50, and the remainder had irregular menses before complete cessation of menstruation.
None of these patients after age 49 years used contraception or hormone replacement therapy. 25 of this group had endometrial biopsies as an office procedure or hospital dilatation and curettage for irregular bleeding. Eight of the 25 demonstrated secretory endometrium with evidence of ovulation. There were no pregnancies in this group of women.
“There were 82 pregnancies that occurred in women 45 years of age and older. The oldest in this group delivered 6 days after her 49th birthday and one week beyond her expected date of confinement. This was her 10th pregnancy.
“There were 24,779 abortions in the study period. The total number of induced abortions during the period was 17,869 with 31 patients 45-51 years of age. There were four patients 48-49 years of age and one patient 51 years. The data collected reconfirm that pregnancies in older women are infrequent and must be considered as high risk.”
The researchers emphasised that the gynecologist should counsel the patient realistically as to her chances of becoming pregnant after age 48; the risk of pregnancy in the older woman relative to the risk of various birth control practices must be carefully weighed.
Slowing down menopause
Lead Obstetrician and Gynaecologist at the Irrua Specialist Teaching Hospital, Edo State, Dr. Joseph Okoeguale, said smoking accelerates menopause.
Dr. Okoeguale added that risk factors for early menopause include severe infection of the ovaries, ovarian tumors, exposure to irradiation or use of chemotherapy, ovariectomy, oophorectomy, or post-operative ovarian gangrene.
“The onset of menopause is biologically determined by age. It is relatively constant and not influenced by any factor.
“However, female smokers are known to attain menopause earlier than non-smokers and this effect is unrelated to body weight or the number of cigarettes smoked. Smoking has been said to induce hepatic metabolism of estrogen thereby leading to an earlier drop in its levels.
The average age of menopause in industrialised countries is 51 years. Early menopause is said to occur when menstruation ceases before age 45 years. Age remains an independent factor for menopause; gene plays little or no role,” Okoeguale said.
According to the expert, nothing can be done to prevent, postpone or slow down physiological menopause but artificial menopause can be prevented by clinicians by protecting the ovaries from radiation exposure, elective ovarian removal, cautious pelvic surgeries, avoiding cigarette smoking.
