Dear Dr. G,

Houston, we have a problem; my wife is pregnant again!

Don’t get me wrong. We are overjoyed with the good news of the pregnancy.

However, things are clearly not going to be straightforward.

I am 47 years old and my wife is 45. My wife has been on the pill since the birth of my daughter 14 years ago. However, my wife has been less compliant with contraception as we assumed the chance of pregnancy is minimal and we are less and less intimate lately.

That said, I also must accept some responsibility, as I am not a big fan of condoms. I often assume the quality of a man’s sperm depreciates at my age and the withdrawal technique has served us well over the last few years.

Truthfully, I thought she was peri-menopausal but a test has confirmed that she is two months pregnant.

As such, we have a dilemma, and really would like to put Dr. G on the spot for direction.

Shall we keep the baby? What are the risks of the pregnancy to the mother? What are the chances of deformities with the baby?

Besides, I hear older fathers will have higher risks of abnormal children. Is that true?

My other worry is the age gap between the child and my two children is more than 15 years. Isn’t that embarrassing.

On the other hand, if Mick Jagger can be so cool and father a child in his late seventies, why don’t more of us “breed” like Mick Jagger?

Rolling Stone Roland

The fourth decade in the journey of life is often labelled the “fabulous forties” and I guess this is because men and women feel better than ever with a stable career, income, marriage and are almost done with raising their children. Despite the fact many career couples these days would choose to have children in their early forties, the reality of pregnancy in the forties is not straightforward.

The most important prognostic factor in pregnancy is the women’s age. The egg quality in women diminishes slowly over time and by the age of 43, the supply of eggs has basically dwindled to absolute minimal levels. Even with the help of assisted reproductive technology (ART), the successful pregnancy for women at the age of 40 is 25% and plummets to 1.6% at the age of 44.

Although the chance of natural pregnancy is near impossible beyond the age of 45, couples still must “face the music” when pregnancy occurs by accident.

When pregnancy occurs with advanced maternal age, the risks impact both the mother and the child. These include diabetes, placenta previa and preeclampsia for the mother. The child may also face the complications of genetic disorder, low birth weight, premature delivery, and miscarriage. The percentage of miscarriage at the age of 40 in a woman can be as high as 34% and rises to 53% at the age of 45 years old. In addition, the potential complications of chromosomal defects such as Down’s syndrome increases dramatically from 1 in 106 at the age of 40 to 1 in 30 by the age of 45 years old!

Although men would argue nature allows men to “breed” like Mick Jagger and continue to father children well into the seventh and eight decades of their life, recent studies also highlighted risk of births associated with older fathers.

Studies revealed the offspring of men over 40 years old faces an increased risk of miscarriage, increased frequency of autism and birth defects. Although the overall risk is comparatively low, older men are more likely to father babies who have disorders such as achondroplasia. Children born to older men are also noted to be more likely to develop mental illnesses such as schizophrenia and depression as published in other studies.

Despite statistics of all the adversities that seem to be stacked against having a child at an older age, it should also be pointed out most babies are born completely healthy, with the technology of prenatal screening. Indeed, Mick Jagger made such an announcement when he was 73 five years ago; his 29-year-old ballerina girlfriend Melanie Hamrick gave birth to a healthy child.

Indeed, Mick Jagger has eight other children with ages ranging from 17 to 45-years-old and he once said that “anything worth doing is worth overdoing!” To this, when a man of “certain seniority” is faced with the prospect of parenthood again is putting Dr. G on the spot by asking whether he should leap in joy into this journey of dreams or shiver in fear that

we are about to lose our minds, Dr. G simply borrows another quote from Jagger.

He says that it’s “all right letting yourself go, as long as you can get yourself back.”

When it comes to “breeding like Jagger”, I guess the same principle also applies that letting go is all right, if one has the stamina and will when it comes to getting your life back after parenthood!

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