Changes in physical qualities with age are quite individual. You can meet middle-aged and elderly people whose neuromuscular system shows obvious signs of decline, while other people of the same age have high functional indicators. For example, in some individuals, muscle strength decreases after 20-25 years, when the progressive biological development of the body ends; for others - after 40-45 years. First of all, speed, flexibility and agility deteriorate with age; better preserved - strength and endurance, especially aerobic. Significant adjustments to the age-related dynamics of motor qualities are made by physical education and sports, which delay the onset of involutionary processes.
Speed deteriorates with age in all its constituent parameters (latent period of sensorimotor reactions, speed of a single movement and tempo of movements). From 20 to 60 years, the latent period increases by 1.5-2 times. The greatest drop in movement speed is observed between the ages of 50 and 60 years, and some stabilization occurs in the period of 60-70 years. The pace of movement decreases most noticeably between the ages of 30 and 60; in the period of 60–70 years it changes little, and at older ages it slows down significantly. It seems that at the age of 60-70 years, some new level of vital activity arises, which provides a certain, albeit somewhat reduced, speed of movement. Streets that regularly perform physical activity, a decrease in all
Rice. 64. Hand strength in adulthood
(after: Asmussen E., 1968)
speed indicators are progressing at a slower pace. For example, in trained individuals aged 50-60 years, the decrease in speed is
20-40%, and for untrained people - 25-60% of the initial values obtained at 18-20 years of age.
The strength of various muscle groups reaches maximum values by the age of 18-20, remains at a high level until 40-45 years, and by the age of 60 it decreases by approximately 25% (Fig. 64). The involution of strength as a physical quality can be assessed by its indicators in individual movements and by the restructuring of the topography of various muscle groups. By the age of 60, the strength of the trunk muscles decreases to a large extent, which is primarily due to a violation of the trophism of the neuromuscular system and the development of destructive changes in it.
In people who do not engage in physical exercise, the greatest decrease in strength is observed between the ages of 40 and 50 years, and in those who regularly exercise, from 50 to 60 years. The advantage of trained people becomes most noticeable at the age of 50-60 years and older. For example, street people involved in sports or physical labor, the strength of the hands when measured by dynamometry, even at the age of 75 years, is 40-45 kg, which corresponds to the average level of a 40-year-old person. A decrease in muscle strength is associated with a weakening of the functions of the sympathetic-adrenal system and gonads (the formation of androgens decreases). These age-related changes lead to a deterioration in the neurohumoral regulation of muscles and a decrease in the level of metabolism in them.
Speed-strength qualities also decrease with age, but the contribution of one or another quality (strength, speed) to the overall
motor reaction depends on the nature of the exercises. For example, when long jumping, strength decreases more with age, and when throwing, speed decreases more. When performing most physical exercises, speed and strength qualities are interrelated and influence each other. Speed-strength training develops these human qualities to a greater extent and has little effect on the development of endurance. Conversely, endurance training causes its increase, little affecting the systems and mechanisms responsible for the manifestations of muscle strength. That is why people of mature and elderly age, when engaging in physical exercises, should use their various complexes, which make it possible to counteract involutional changes in most organs and systems.
Endurance, compared to other physical qualities, lasts longer with age. It is believed that its decline begins after 55 years, and when working at moderate power (with aerobic energy supply), it often remains quite high at 70-75 years. This is confirmed by the widely known facts of the participation of people of this age in long runs, swims, and hiking trips. When performing speed, strength and speed-strength exercises (with anaerobic energy supply), endurance decreases after 40-45 years. This is due to the fact that the development of endurance depends, first of all, on the functional usefulness of the circulatory, respiratory and blood system, i.e., on the oxygen transport system, which is not trained enough when performing the above exercises. Regular exercise for endurance (running, skiing, swimming) significantly delays its decline; strength exercises (weights, dumbbells, expanders) have little effect on the age-related dynamics of endurance.
Flexibility is characterized by the ability to perform movements with maximum amplitude. Without special training, this quality begins to decline from the age of 15-20, which impairs mobility and coordination in various forms of complex movements. In older people, as a rule, the flexibility of the body (especially the spine) is significantly reduced. Training allows you to maintain this quality for many years. When trying to restore flexibility, the best results are observed in those who have good physical fitness.
The main manifestation of dexterity is the accuracy of motor orientation in space. This quality also decreases quite early (from 18-20 years); special training slows down the decline in agility and it remains at a high level for many years.
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Today I want to expand a little on the topic of decreased motivation and procrastination in the context of age. Many people complain that the older you get, the less energy and desire to achieve your goals, the enthusiasm and fighting spirit disappear. Not for everyone, and not always, but there is a certain tendency. However, the thirst for change, the thirst for more, our dreams do not go away, that is, the desire to receive remains, and the desire to achieve becomes weaker over time.
What are the reasons for such changes? Where does the former courage, ambition, determination and willingness to act go?
1⃣ As we age, we have more worries and responsibilities, we perform different roles, and we take on much more responsibility than in our youth. All this depletes us, takes energy, reduces willpower resources, so ambitious goals that seemed quite achievable in the early years can be perceived as empty dreams and fantasies with age. It seems to us that we cannot cope, that we do not have enough strength and abilities, that we are no longer the same.
2⃣ Our willingness to take risks decreases significantly, we tend to be more careful in our decisions, we have something to lose. In addition, we are already responsible not only for ourselves, but also for our children, and sometimes even the parents we care about and who count on us. The tendency to take risks and make bold decisions is also reduced because we can more fully assess the possible consequences of our choice, we already have experience, and not always positive, not to mention limiting beliefs and attitudes that do not allow us to follow our dreams .
3⃣ The older we get, the more we value stability, comfort and the usual order of things. This happens partly due to the fact that in this way, unconsciously, we try to conserve energy, our internal resources, to complete current tasks and solve endless problems and life challenges. In addition, we often neglect sleep and quality rest, we cannot find time for sports and our hobbies, that is, we take away the opportunity to recover and replenish our reserves of vitality.
4⃣ We tend to draw conclusions about the future based on our past: if we couldn’t achieve our goals before, then we’re unlikely to succeed in the future. Do not forget about the influence of the environment, which does not always support our endeavors, and sometimes openly suppresses our desire to change something. The role of stereotypes and all sorts of folk wisdom also adds fuel to the fire: “it’s too late to change anything, the train has left”, “chasing a crane you will miss a tit”, “where you were born, you will come in handy”, “those born to crawl cannot fly” and so on.
👉Write in the comments how you are doing with motivation, energy, have you noticed changes with age in your readiness to achieve ambitious goals?
Useful tips
Even in ancient times, people knew that with age, the amount of hormones in the human body begins to decrease. People from ancient Greece, India and Egypt took extracts from male gonads belonging to animals.
Today we know that the decline in hormones can be explained by the development in humans of various diseases that invariably accompany the aging process (osteoporosis, cancer, cardiovascular diseases).
Some hormonal imbalances can be triggered by other age-related changes, such as obesity, muscle loss, or mental decline.
Most of these changes occur not only because the amount of hormones changes, but also because the balance shifts between different hormones.
All hormones in the human body belong to two groups: anabolic and catabolic.
Anabolic hormones are responsible for the formation and growth of tissues, they are responsible for strong bones and strong muscles. This group of hormones includes growth hormones, sex hormones, DHEA (dehydroepiandrosterone), melatonin, and their levels always begin to fall after the end of reproductive age.
Catabolic hormones, on the contrary, are responsible for tissue destruction. The main catabolic hormone is cortisol, a stress hormone produced by the adrenal glands.
Insulin, which is produced by the pancreas, and estrogen in men behave to a certain extent like other catabolic hormones. Unlike anabolic hormones, both cortisol and estrogen-insulin levels almost always do not decline with age.
Insulin begins to be produced if blood sugar increases, however, insulin does not always work as a catabolic hormone; a small amount of this hormone acts as an anabolic and promotes the growth of certain tissues in the body.
When a person consumes sweets in large quantities or eats foods with a high glycemic index, insulin stimulates the growth of adipose tissue. Over time, the sensitivity of cells to insulin begins to decrease, and hormone levels increase. This is the reason for gaining extra pounds during aging. With age, there are more catabolics in the body.
What needs to be done to maintain the correct balance between the two types of hormones for as long as possible? Let's talk about how to reverse the process of accumulating catabolics in the body.
Aging hormones
Cortisol
In response to stress, the adrenal glands release cortisol into the blood, which leads to increased work of the cardiovascular system and lungs, a slowdown in digestion, a decrease in reproductive function, and suppressed immunity.
A powerful surge of cortisol allows a person to run very quickly, increases the heart rate, allows for better vision and improves mental abilities, increasing blood sugar levels.
However, regular releases of this hormone significantly accelerate the aging process, destroy bones (osteoporosis) and muscle tissue (sarcopenia), promote the development of diseases, increase blood pressure, retain sodium in the body, destroy human immunity and increase blood sugar.
There is such a problem as Cushing's disease, which is associated with an excess of the hormone cortisol in the body. People suffering from it, as well as those who have been taking a synthetic form of cortisol for a long time, experience weak bones and significant loss of muscle mass.
Moreover, fear has been shown to increase the production of this hormone, which is known to lead to disruption of brain activity. When a person is in a state of chronic stress, cortisol is produced due to the hormones of youth, testosterone, estrogen and DHEA.
During the normal aging process, cortisol levels gradually increase, and the production of youth hormones gradually decreases.
The easiest way to determine how well your youth hormones fight the age hormones is to find out your cortisol to DHEA ratio. This can be found out by checking the adrenal glands; at the same time, this will show how healthy this organ is.
It is not necessary to donate blood to be tested. There are special kits with which you can carry out the test at home by collecting your saliva 4 times a day (after waking up, at lunch, at dinner and before going to bed).
The normal result is higher cortisol levels in the morning and a gradual decrease throughout the day. Under the influence of chronic stress, the level of cortisol remains virtually unchanged throughout the day; as a result, instead of a falling line, we see a straight line. In such stress tests, you can calculate the ratio of DHEA and cortisol. In young people this ratio is high, and with age there is a tendency to decrease.
To help even out your hormone levels a little, it is recommended to take supplements containing DEA, and also not to forget about herbs such as natural licorice and ashwagandha. Of course, it is necessary to adopt a lifestyle that will help reduce cortisol levels, as well as eating foods with a low glycemic index, exercising regularly and getting enough sleep.
Insulin
If there were a competition between cortisol and insulin to see who destroys the human body faster, insulin would most likely win. Many experts call insulin the ticket to accelerated aging.
Excess insulin is accompanied by the development of numerous problems, including an increase in body fat, an increased risk of developing heart disease, accelerated development of atherosclerosis, increased cortisol levels, and interference with the functioning of youth hormones.
Insulin begins to be produced when an excessive amount of calories is absorbed by a person. When you eat sugar or foods with a high glycemic index, you stimulate the production of the hormone in such quantities that the body begins to separate sugar from the blood. And with an increase in insulin levels, glucose in the blood immediately turns into fat.
Insulin and cortisol interact with each other in a direct relationship. Increasing the level of one of them inevitably leads to increasing the level of the other.
Among other things, insulin affects the hormones of youth, reducing their effectiveness, which, in turn, accelerates the aging process. For this reason, foods rich in sugar and foods with a high glycemic index cause our body to age faster than usual.
Hormones of youth
A decrease in the amount of catabolic hormones leads to an equalization of their ratio in relation to the level of anabolic hormones of youth. Hormone replacement has long been considered the most acceptable way to equalize the balance. Hormone replacement therapy is used for sex hormones: testosterone, progesterone and estrogen. Below we will talk about equally important hormones of youth: DHEA, melatonin and growth hormone.
DEA
It is the most common steroid hormone produced by the human body. Previously, it was believed that DHEA is only the ancestor of other hormones, and in itself does not have any specific properties.
However, renowned practitioner William Regelson later came to the conclusion that DHEA is the superstar of hormones. The peak of this hormone in the body occurs at the age of 25, gradually beginning to decline with age. By the age of 40, it is 50 percent less, and by the age of 80, the level of its content in the body is approximately 5 percent of the level in youth.
Does this mean that this hormone can help increase life expectancy? Experiments on animals have shown that DHEA supplements slow down the aging process and prolong youth.
It has been proven that men whose bodies contain more of this hormone are significantly less likely to suffer from cardiovascular diseases. DHEA has good anti-inflammatory functions and can reduce the number of dangerous pathogens in the body.
Dr. Regelson also emphasizes that this hormone protects us from uncontrolled cell division, which is a clear sign of cancer development.
Useful functions of DEA:
Increases the amount of lean body mass
Increases insulin sensitivity and tolerance to sugar and glucose
Saves bones from weakness
Strengthens libido
Relieves symptoms of depression
Relieves symptoms of menopause
Improves memory and actively fights stress
Improves immune system function
Reduces the risk of developing cardiovascular diseases
We can say that DHEA, to some extent, tame the hormone cortisol. During times of stress, your body produces a huge amount of insulin, which negatively affects the functioning of the immune system, and this already leads to the development of diseases and accelerated aging.
Research has revealed a connection between suppression of the immune system and an imbalance in the ratio of cortisol and DHEA. By taking DHEA supplements, it is possible to improve the cortisol-suppressed immune system.
It is important to note that since DHEA is the grandfather of testosterone, it has a positive effect on libido, and also helps burn excess weight and transform food into energy.
Before you start taking DHEA supplements, you should definitely check your levels, and then check them every one and a half to two months to understand that you are moving in the right direction. It is important to remember that since DHEA is an androgenic hormone that has more male characteristics, it can be converted into testosterone.
DHEA supplements often also increase prostate specific antigen levels, which is an important marker of prostate cancer. Therefore, when starting to take these hormones, men should check the level of this antigen, and during use, checks should be performed every six months.
A growth hormone
In the 1990s, there was a stir around the importance of growth hormone in the fight against aging. This began with a publication by Medical College of Wisconsin researcher Daniel Rudman.
He described a placebo group study involving 21 men aged 61-81 years. Among other positive effects of growth hormone, it also showed improved bone health and increased insulin sensitivity, increased muscle mass and improved cholesterol levels, and a decrease in body fat.
Similar studies carried out after this came to similar results. However, it is important to emphasize that without physical activity and an appropriate diet, growth hormone therapy will not help in gaining muscle mass.
Growth hormone affects the functioning of the cardiovascular system, blood pressure and lipid metabolism. Patients treated with this hormone for 7 years showed excellent results in reducing sensitivity to insulin, which necessarily comes with age. For these people, this process was reversed.
Although the positive effects of growth hormone therapy are evident, there are still dark sides to it. Firstly, the treatment is expensive, from 2 to 8 thousand dollars a year, depending on the dosage. The treatment process involves daily injections, and the benefits of this for healthy people are extremely controversial.
In 2002, the US National Institutes of Health conducted a study involving 121 people undergoing growth hormone therapy. The results obtained by Rudman were confirmed, but among other things, some very serious side effects were also identified:
24 percent of men developed diabetes or glucose intolerance;
39 percent of women developed dropsy;
41 percent of participants complained of joint pain;
Thirty-two percent of participants developed carpal tunnel syndrome.
Since growth hormone therapy in the fight against aging is a fairly new phenomenon, it is very important to be aware of side effects, while understanding that long-term studies regarding the safety of growth hormone injections are still to come.
However, we have the power to make our lifestyle such that we can achieve good results without injections. What should be done?
1) High-glycemic carbohydrates and sugar help reduce the production of growth hormone in the pituitary gland, and a protein diet increases its production. Thus, by eating less sugar and foods with a high glycemic load, you can increase the level of growth hormone in your body.
2) There are two main factors for the production of growth hormone in healthy people - deep healthy sleep and anaerobic exercise. People who exercise throughout their lives maintain intact muscle mass, and with it, high levels of growth hormone.
3) In order to stimulate the pituitary gland to produce more of this hormone, you need to consume certain amino acids, such as glutamine, arginine, glycine and ornithine. Supplements with varying amounts of these amino acids are freely available.
Most people who would like to experience the anti-aging effects of growth hormone are advised to follow the above tips. Until final conclusions are reached, injections should only be given to people with certain diagnoses.
Vestigial human organs
As soon as science comes to the invention of a technology that will maintain the necessary nutrients in the blood at the required level, a person will no longer need the organs that are today responsible for the production of enzymes, chemicals and hormones.
In the future human body, hormones and related substances will be delivered by nanorobots, and an ideal biofeedback system will control the production of chemicals and maintain the necessary balance between them.
MRI scan, in order from top to bottom: 40-year-old triathlete, 74-year-old inactive person, 74-year-old triathlete. Nice plump - muscles. The ugly white thing is fat.
Sarcopenia is an age-related atrophic degenerative change in skeletal muscles, leading to a gradual loss of muscle mass and strength.
With insufficient physical activity after 30 years, from 3 to 5% of muscle mass can be lost every 10 years (different sources give different figures, but they all show that the trend is negative). According to the American Center for Disease Control and Prevention (CDC), sarcopenia is recognized as one of the five main risk factors for morbidity and mortality in people over 65 years of age.
The loss of muscle quantity and quality with age is a consequence of age-related hormonal changes, changes in the central and peripheral nervous system, systemic inflammatory reactions and a decrease in the density of the capillary network of skeletal muscles.
On average, by age 50, about 10% of muscle mass is lost and by age 80, another 30%.
What’s most disgusting is that the muscle mass of the lower extremities is lost more actively and intensively than the total muscle mass. Of course, this affects mobility, increases the risk of falls, fractures and the inability to get out of a chair and walk to the toilet on your own. Plus, osteoarthritis processes and other degradation occur in the hip and knee joints.
Strength also decreases with age. This study showed that in the USA, 40% of women aged 55-64 years, almost 45% of women aged 65-74 years and 65% of women aged 75-84 years are not able to lift a weight of 4.5 kg with an outstretched arm .
Comparisons of quadriceps strength in young and older healthy adults revealed an age-related decrease in strength ranging from 20 to 40% in the seventh to eighth decades of life compared to younger adults. Even more significant declines in muscle strength were observed in people in the ninth decade of life and later (50% or more).
Muscle contraction in response to electrical stimulation also slows down.
Unfortunately, muscle innervation does not improve with age either.
About hormones
Testosterone levels decrease with age. Which does not have the best effect on MM in men. Estrogens, which also do not increase during postmenopause, do have some anabolic effects on muscle in women.
Menopause is associated with a decrease in circulating levels of 17β-estradiol in middle-aged and elderly women. Deterioration in muscle function is observed in perimenopausal women and correlates with a sharp drop in the hormone-producing function of the ovaries. These observations indicate that female sex hormones play an important role in regulating the functioning of the muscular system in middle-aged and elderly women. Perhaps hormone replacement therapy in combination with exercise may be the optimal solution in the early stages of menopause.
A recent randomized, placebo-controlled trial showed increases in total body weight, non-leg weight, and arm and leg strength after six months of testosterone replacement therapy in older men to maintain normal plasma concentrations. These changes were accompanied by an increase in the level of somatomedin-C (insulin-like growth factor 1 or IGF-1 for short), which suggests the significance of the anabolic effect of this hormone on the skeletal muscle of older people.
Growth hormone and somatomedin-C levels decline with age and, given their anabolic effects, their potential therapeutic effects in sarcopenia are being explored. It has been shown that the administration of somatotropin in pharmacological doses (without physical activity) increases muscle mass, but not strength. For example, a monthly course of somatotropic hormone or somatomedin-C in elderly women increased nitrogen balance, protein metabolism and protein synthesis in muscles.
In general, regardless of the mechanism, muscle atrophy develops when the breakdown of muscle proteins begins to dominate the synthesis.
Protein consumption decreases with age (a large number of people over 60 years of age consume less than 75% of the recommended daily amount of protein. And in old age, even more is desirable. And even if in old age and in a kcal deficit). Adequate protein intake is necessary to provide skeletal muscle with the necessary anabolic support.
Under conditions of starvation (and lack of protein), amino acids are released from muscles that do not experience sufficient physical stress in a given life situation. Muscles that are not involved in physical activity synthesize the hormone myostatin, which at the paracrine and systemic level allows the initiation of catabolic processes in less active muscles.
In old age, physical activity sharply decreases, which also does not have the best effect on the condition of the muscles.
To correct developed sarcopenia, hypertrophy of existing muscle fibers is necessary. Hypertrophy is impossible without physical activity (strength training!).
The effectiveness of physical activity in counteracting sarcopenia exceeds the results of other approaches used without combination with physical activity, such as various options for hormone replacement therapy, nutritional correction, etc. Even relatively short courses of training, usually 10-12 weeks with sessions 2-3 times per week resulted in significant increases in strength in older men and women. It is significant that an increase in strength and muscle mass through training was achieved even by very elderly people (over 90 years old). In men and women aged 60-70 years, the effect of training was especially high if immediately after training (over the next 20-60 minutes) a protein meal was followed at the rate of 0.4 g of protein per kilogram of dry body mass.
Traditionally, the emphasis has been on aerobic exercise, which is beneficial for improving cardiac and respiratory health and has a positive effect on the ratio of lean to fat body mass. However, anaerobic strength training has been found to have a greater impact on the musculoskeletal system, preventing osteoporosis and sarcopenia. It was shown that strength training of elderly people, carried out for 6 months, partially restored the spectrum of mRNA synthesized by myofibrils to the state characteristic of 30-year-olds, i.e. For the first time, the real rejuvenating effect of strength training has been proven at the molecular level.
(Before training, the older participants were 59% weaker than the younger controls, but after six months of training, the results improved and they were only 38% weaker. The expression of some genes also changed and became more like the pattern of younger people).
Placebo-controlled studies have found that during strength training in recreational physical education, increased protein nutrition leads even in very elderly men and women to significantly greater increases in strength and muscle mass compared to placebo.
The beneficial effects of strength training can be achieved in two to three 15-20 minute workouts per week.
Power training:
- improve anabolic hormonal status;
- reduce the level of pro-inflammatory cytokines;
- increase physical endurance;
- normalize high blood pressure;
- reduce insulin resistance;
- reduce general and visceral (most associated with age-related diseases) fat deposits;
- increase the level of basal metabolism in older people;
- prevent age-related bone loss;
- the risk of falls and, accordingly, fractures is reduced;
- reduce pain and improve the functional state of patients suffering from arthrosis, in particular * arthrosis of the lower extremities (coxarthrosis, gonarthrosis).
In general, if you just “diet” and, for example, run on a treadmill, ride a stationary bike, etc. – muscles will continue to be lost, and you will like your figure less and less. In addition, after menopause, the hormonal profile changes - and fat begins to be deposited not according to the female type (on the hips), but according to the male type (on the stomach and sides) - which does not contribute to the beauty of the figure and is dangerous for the cardiovascular system. That is, if you follow the standard female scheme - gain 2-3-5 kg in winter, and lose them in summer, then more and more muscles will be lost. Strength training will allow you to even out the imbalance and, if desired, look something like this:
(Ernestine Sheppard, born in 1937, began bodybuilding at age 56).
The influence of a woman’s age on the ability to conceive and successfully complete pregnancy
Epigraph
“This scoundrel! How dare he shout PATHOP?!
look, LOOK, it’s him himself standing in a PUDDLE!”
hissed an aging lady in a coat and with a dog,
and walked away into the unknown.
(from personal experience)
Introduction
Passport age itself has an impact on fertility. It is obvious to everyone that over the years a woman’s ability to conceive changes. Historical data confirms that among populations not using contraception, fertility rates decline as women age. However, there are still brave souls who want to challenge this fact.
It is also clear that in the two extreme age categories, before the first menstruation and after the last, a woman who does not demonstrate cyclical functional activity is not capable of conceiving, and therefore, of bearing a pregnancy. And if the first category of women, gradually maturing from menarche to the peak of their fertility, is not of practical interest from the position of bearing a pregnancy, since it is protected by moral norms and the criminal code. With the opposite category of women, who gradually decline from the peak of fertility to menopause, everything is not at all simple. Unfortunately, the majority of women have only meager, subjective ideas about the connection between age and the ability to realize the reproductive function. Often taking as a guiding principle statements like: “My grandmother had an abortion at age 49.”
However, this whole topic is of interest not only to those who did not have time, and most often simply did not want to think about pregnancy in the time interval optimally calculated for this by nature. Today's society, with the only promoted value in the form of various forms of manifestations of selfishness, has practically destroyed the principle of the selfless gift of life, and devalues the status of a merciful mother, implying the limitations, inconsistency and inferiority of the personality of a woman with a child, and the child himself as a source of suffering. This could not but lead to a decrease in the birth rate, a delay in the first birth and the abandonment of a complete family (with children). This is a fact that no one wants to admit. By prioritizing the socio-economic factor and imagining the world around us as an object of use and satisfaction of needs, we still sometimes have to comment on our life choices, and at such moments it is much more pleasant to hide behind illusions, suddenly noticing the features of ugliness and inferiority in the same shabby world:
“Where can I find a NORMAL man??”
“How will I live with this child, because I only have an apartment in Moscow??”
“I have no time for this yet!”
“This country doesn’t care about ME!”
Well, so be it...
However, there is another category of women, among which anyone may be, these are those women whose life plans have changed or required to give birth again. There are many life situations here, from major personal and family changes, including the creation of a new family, to the newly awakened simple but strong desire to have a child.
In fact, it turns out that every woman should have an objective idea of her current fertile status and the prospects that await her in the near future, so that the reproductive steps she takes are measured and not reckless.
Increasing women's awareness of the impact of age on fertility is necessary in counseling patients who want to achieve pregnancy and are considering the range of options for assisted reproductive technologies.
But what actually happens, how does a woman’s fertility change during her conscious life from the point of view of starting a family?
The ability to bear children in women does indeed gradually decrease, but acquires a clear downward trend from the age of 32. The negative dynamics are especially noticeable after 37 years of age, and after 41 years of age the vast majority of women are no longer capable of conceiving and successfully completing pregnancy (Spira et al., 1998). It is necessary to pay special attention that there is still quite a lot of time left before the onset of menopause and the beginning of real aging of the female body (on average about 10 years), but all these years of life no longer have a reproductive role. It is important to understand that you will have to rejoice and educate previously born children or devote the rest of your adult life only to yourself and the dog.
Why does a woman's fertility decrease with age?
1. The sexual activity of women, just like men, is quite naturally suppressed with age. In general, if you think about it, it is quite difficult to isolate and weigh the factor of sexual behavior in the process of decline of general reproductive function. However, based on one classic French study (Schwartz D. et al., 1982), it is possible to fairly objectively separate the significance of sexual behavior from true age effects. Researchers assessed pregnancy rates in healthy women with azoospermic husbands. In this case, the factor of sexual activity was excluded, since each woman underwent artificial insemination with donor sperm on the optimal day of the menstrual cycle. The authors noted that the likelihood of pregnancy decreased with increasing age of the patient (Schwartz D. et al., 1982). The cumulative pregnancy rates over 12 insemination cycles (calendar year model) were as follows:
- 74% in patients under 31 years of age
- 62% in patients aged 31-35 years
- 54% in patients over 35 years of age
2. A woman’s age is associated with an obvious risk of the onset and progression of diseases and conditions that can affect the ability to realize reproductive function. Such diseases are usually classified as
- purely gynecological nosologies, such as uterine fibroids, endometriosis, and pathology of the fallopian tubes
- physical diseases, such as conditions requiring cytotoxic therapy
- as well as environmental and lifestyle factors, the most relevant example being smoking
The maximum number of oocytes (6-7 million) is observed at 20 weeks of intrauterine development of a female fetus. From this moment on, the total number of oocytes decreases, reaching 1-2 million by the time of birth and only 300 thousand-500 thousand by the time of puberty. At the age of 37 years, only 25 thousand oocytes are in the ovaries and 1000 by the time of menopause, which usually begins after 50 years (Baker T.G. et al., 1963; Block E. et al., 1952; Faddy M.J. et al., 1992).
4. Similar to the reduction in quantity, the quality of eggs stored in the ovaries also decreases with age. Statistical studies evaluating data on the effectiveness of in vitro fertilization (IVF) cycles have quite clearly demonstrated the dynamics of the qualitative and quantitative characteristics of the resulting oocytes (ASRM, 2013). When a live birth was registered in
- 42% in women under 35 years of age
- 32% of women aged 35 to 37 years
- 22% of women aged between 38 and 40 years
- 12% of women aged 41-42 years
- 5% of women aged 43-44 years
- 1% in women over 44 years of age
5. With increasing age, the frequency of spontaneous abortions as a result of aneuploidy increases steadily (Balasch J. et al., 2012). It has been shown that even in IVF, when transferring visually selected morphologically normal embryos, the prevalence of aneuploidy increases in direct proportion to the patient’s age and in the extreme age group always remains very high (Munne S. et al., 1995). The increased frequency of aneuploidy is associated, at least in part, with changes in the meiotic spindle (Battaglia D.E. et al., 1996), which leads to chromosome nondisjunction (Pellestor F. et al., 2003).
The frequency of fetal losses increases steadily with increasing age of the patient. So Farr S.L. et al., 2007 showed that the probability of pregnancy loss, depending on the age of the woman receiving embryos in an IVF cycle, reached:
- 9.9% for women under 33 years of age
- 11.4% for women aged 33 to 34
- 13.7% for women aged 35 to 37 years
- 19.8% for women aged 38 to 40
- 29.9% for women aged 41 to 42
- 36.6% of women are over 42 years old.
Similar data were obtained in another large national study, which showed that the rate of pregnancy loss progressively increased with age, from 13% in women under 35 years of age to 54% in women 44 years of age and older (Centers for Disease Control and Prevention, American Society for Reproductive Medicine Society for Assisted Reproductive Technology. 2010 assisted reproductive technology: fertility clinic success rates report. Atlanta (GA): CDC; 2012. Available at: INTER REF http://www.cdc.gov/art/ART2010/PDFs/ART_2010_Clinic_Report -Full.pdf. Retrieved September 13, 2013).
Summary
Women's fertility declines progressively during their reproductive years, a process that is steady and cannot be slowed down. As a result of two main factors (a reduction in the number of oocytes through atresia and oocyte aging) and a complex of additional factors, a fairly young and often somatically unburdened woman practically loses her potential for procreation long before the cessation of menstrual cyclicity; as a rule, about 10 years pass between these two events .
Our society with the slogan “I don’t owe anyone anything, let me live a little longer, and I’ll have time to give birth, I’m a healthy person!!!” with clear examples of pseudo-idols establishing socio-cultural values, and also trying to justify their own childless choice, therefore elevating absurdity to moral standards, actually misleading both women and men, instilling an imaginary sense of limitless possibilities.
Taking into account that the possibility of conceiving and carrying a pregnancy is the main and unique mission of a woman, fully revealing its content, allowing one to feel and experience the amazing roles and abilities hidden in the depths of consciousness. Everyone who wants to become a mother should have an objective idea of her fertility and the contribution to this ability of the main factor - passport age, in order to be able to objectively plan the solution of her reproductive problems. It is very important to realize that the cost of error here is very high.
Every gynecologist or specialist involved in reproductive medicine within the framework of his practice is obliged to:
- Ensure that women are fully informed about the impact of age on fertility.
- Do not mislead women who, due to age, have lost the chance to conceive and carry a pregnancy using their own oocytes. It is necessary to realize that this is fraud, since it is carried out for the sake of profit, and the patient is biased by definition and is always inclined to consider medical actions correct (Criminal Code of the Russian Federation. Article 159. p. 3. Fraud committed by a person using his official position, as well as on a large scale ).
- Women over 35 years of age who apply for family planning should be offered more expedited examination and more effective methods of achieving pregnancy if their unsuccessful attempts to conceive have exceeded 6 calendar months or immediately if there are other clinical indications.
- Women over 40 years of age should be immediately offered examination and treatment with highly effective methods of achieving pregnancy.
- Women over 33 years of age who do not plan to conceive in the coming years should be informed about the possibility of safety cryopreservation of their own oocytes or embryos.
