Individuals can feel ready to become parents at any age. However, for women 35 years or older, the period is known as “advanced maternal age,” according to Dr Varshali Mali.
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“At this stage, the chances of certain pregnancy-related complications rise, including miscarriage, genetic disorders, chromosomal conditions in the baby and diabetes and hypertension in the mother,” Dr Mali shared with HT Lifestyle.
“Fertility also declines gradually with age as both egg quantity and egg quality reduce. After 35, the chance of conception is about 15 to 20 percent per menstrual cycle, while the risk of miscarriage is around 20 per cent at age 35.”
However, that does not mean that it is unlikely to have a healthy pregnancy above the age of 35. As per the gynaecologist, early medical guidance, preconception checks and appropriate screening can help identify possible risks, detect certain congenital conditions, and support better planning through the pregnancy journey.
She went on to share five health checks that are necessary for women to go through while considering pregnancy after the age of 35. They are presented as follows.
1. Fertility and ovarian reserve
An ovarian reserve assessment, usually through AMH (Anti-Müllerian Hormone), early-cycle FSH (Follicle-Stimulating Hormone) and an ultrasound-based antral follicle count, helps understand how much time and flexibility a couple may have.
AMH reflects egg supply, not egg quality, so it should guide planning rather than create panic, noted Dr Mali.
2. Thyroid and hormonal health
A thyroid imbalance can quietly disturb ovulation and make it harder to conceive. If left untreated, it may also increase the risk of miscarriage and affect the baby’s early brain development.
A simple thyroid profile, including TSH, T3 and T4, is often advised before pregnancy, particularly for women above 30, those with irregular cycles, previous pregnancy loss, fertility concerns, unexplained weight changes, fatigue or other symptoms.
3. Diabetes and blood pressure screening
Blood sugar and blood pressure should be checked before trying to conceive, especially after 35. Tests such as HbA1c and fasting glucose can show whether diabetes or prediabetes needs attention. Regular blood pressure readings can help pick up hypertension early.
If these conditions are missed, they can raise the risk of gestational diabetes, preeclampsia, preterm birth and growth-related concerns for the baby. Managing them before pregnancy gives both mother and child a safer start.
4. Nutrition and deficiency checks
Ferritin, haemoglobin, vitamin D and B12 testing can reveal deficiencies that may worsen fatigue, anaemia or fetal growth concerns during pregnancy.
“Women planning pregnancy should also start taking folic acid, as it is recommended to consume 400 mcg daily to reduce the risk of neural tube defects,” stated the gynaecologist.
5. Reproductive health, infection, and immunity review
A pelvic examination and ultrasound can help detect fibroids, ovarian cysts, endometriosis or uterine lining concerns that may affect implantation or pregnancy. Immunity to rubella and varicella, along with STI screening for infections such as HIV, hepatitis B, hepatitis C and syphilis, should also be considered before conception.
“Planning pregnancy after 35 should begin with a frank, unhurried conversation with a gynaecologist,” shared Dr Mali. “These checks do not predict everything, but they help identify risks early, correct what can be corrected, and guide the couple on timing, treatment and care.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Dr Varshali Mali is a senior consultant in the department of Obstetrics and Gynaecology at Surya Mother & Child Super Speciality Hospital, Pune.
