A 74-year-old woman from Andhra Pradesh gives birth to twins: Why pregnancy after menopause isn’t as safe for everyone

Erramatti Mangayamma, 74, became the oldest woman in the world to give birth to twins on Thursday in a nursing home in Guntur city, Andhra Pradesh. Already 30 years past menopause, Mangayamma had an in vitro fertilisation (IVF) procedure — a form of assisted reproductive technology (ART) — to conceive after trying naturally for more than 50 years. Reportedly, the mother and babies are safe, though Mangayamma is being kept in the intensive care unit to help her cope with the stress of childbirth. [caption id=“attachment_5283931” align=“alignleft” width=“380”] Representational image. Reuters[/caption] Mangayamma may be the oldest one yet, but she is not the first Indian septuagenarian to give birth through IVF. In 2016, Punjab’s Daljinder Kaur — then 70 — gave birth to a baby boy. Data show that there has been a rise in the number of people opting for ART in the past few years - especially in India, where couples who do not have children can be taunted as being infertile. In many parts of the country, having one’s “own” child is a condition for social acceptance. In an interview to a local newspaper, Mangayamma said that no one would call her infertile now. IVF, though safe, is not completely free of risks for older women. Here’s a quick look at what happens in IVF, why there’s a high chance of conceiving twins through IVF and the risks of IVF for older moms. Birth science IVF is a form of ART in which an egg is retrieved from the mother-to-be’s ovaries in an outpatient procedure and fertilised outside her body, in an artificial environment. Once this is done, the doctor “injects” the embryo back into the mother-to-be’s uterus. In a successful IVF procedure, the fertilized egg gets attached to the mother-to-be’s uterus in about a week. Though there are other forms of ART like fertility medication, doctors usually recommend IVF for post-menopausal women who have stopped producing their own eggs every month. According to the American Society for Reproductive Medicine, embryo transfer and ART should be discouraged in women after the age of 50. This is because older women are at higher risk for hypertension, fibroids and ovarian cysts during pregnancy and their foetuses are more likely to have congenital malformations. Some other risks associated with older-age pregnancies include ectopic pregnancy, miscarriage and chromosomal disorders or disability in the child. A complete physical evaluation is usually done before a postmenopausal woman is declared fit for IVF, including evaluating the risk for conditions such as hypertension or diabetes. Ignoring any of the possible complications may not only lead to stillbirths but also poses a threat to the woman’s life. IVF also has a risk of premature births, low birth weight and multiple childbirths. This is because multiple fertilised eggs are introduced into the womb at the same time to increase the chances of conception - the more the number of eggs, the higher the chances of multiple pregnancies. That’s why more IVF births result in twin babies. Surprisingly, though, experts suggest that if the mother is healthy, most twins born to older women are at a much lower risk of fetal or infant death than twins born to younger mothers. However, multiple pregnancies themselves are much more complicated than a single birth. “Multiple pregnancies normally have a higher risk of complications than a single birth. A woman with multiple pregnancies has more chance of having a preterm delivery, low birth weight baby, gestational diabetes, preeclampsia, and other pregnancy complications,” said Dr Archana Nirula, a healthcare practitioner associated with myUpchar.com. “Though it is easier to control these complications in younger women, what increases the health risk for older women is the presence of comorbidities such as diabetes, hypertension, and heart disease,” she added. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. To know more on this topic, please visit https://www.myupchar.com/en/disease/gestational-hypertension