Associate Professor Alex Polyakov, an obstetrician, gynaecologist and Medical Director of Genea Melbourne, was featured in The Age discussing the increasing trend of women giving birth over 40 and the associated risks and challenges.
The article examines how, despite the biological reality that conception chances "approach zero" by a woman's mid-40s, more women are having babies later in life. In Australia, the rate of women giving birth aged 40 or over has increased from less than 1 per cent in 1999 to 5 per cent in 2022, with 80,753 women aged 35 or over giving birth in 2022 alone.
While assisted reproductive technology plays a role, Alex explains it's not the primary driver of this trend. "It's not so much that women choose a career over having a family; it's mostly that they don't have anyone to have a family with," he notes. The most common issue he sees from women looking to freeze their eggs is the unavailability of a suitable partner. He suggests that men's reluctance to settle down early, coupled with dating apps encouraging endless uncommitted opportunities, contributes significantly to this phenomenon.
The article doesn't shy away from the risks. Alex points out that women in their 40s face about a 5 per cent chance of natural conception and a 40 per cent chance of miscarriage, compared to less than 15 per cent for women in their 20s. The risk of chromosomal abnormalities like Down syndrome also increases exponentially.
Alex notes that overall pregnancy risks may be higher today than in previous years, partly due to the rising rates of obesity and chronic disease among older women—creating what he calls a "double whammy" of age and weight-related risk factors. However, he emphasises that while risks like miscarriage and chromosomal abnormalities cannot be modified, women can decrease risks of conditions like gestational diabetes and preeclampsia through exercise, good nutrition, and maintaining a healthy weight.
A/Prof Alex Polyakov
Associate Professor Alex Polyakov is an Obstetrician, Gynaecologist and Fertility specialist practicing in East Melbourne. A/Prof Polyakov is unique among fertility specialists by offering a holistic approach that encompasses surgical, fertility, and obstetric care. This means Alex is highly trained to perform surgical interventions for gynaecological conditions such as fibroids, endometriosis, and intrauterine polyps/adhesions.
