Actual risks of having a child after 40, esp. with health condition?
May 10, 2020 2:01 AM   Subscribe

I am a cis woman, happily married with one child. I had my kiddo when I was 34, and had a very easy pregnancy and delivery. I love being a mom. I'm considering having another child. I'm also agonizing over all the social/political/personal reasons about having another kid (collapsing state of the earth, financial costs, career risks, my own anxiety issues,) but these answers are pretty personal and not this question: right now I want some SCIENCE.

Snowflake. A few years ago, I was diagnosed with a slow-growing b-cell lymphoma. I had immunotherapy and some radiation, and though it may recur, the doctors have told me generally that if I keep an eye on it it is probably not life-shortening. (Survival rate is really high, prognosis is "excellent.") That said, I have had a couple of PET scans (all clear after initial diagnosis and treatment) and because of the immunotherapy have been counselled not to get pregnant for at least another 6 months.

My real worry about having a kid is not my own health but the chances of a healthy pregnancy/healthy baby in my situation. What really is the risk of having a child with, for example, autism after 40? Or other genetic diseases? Does this cancer change this analysis?

I don't put this out there as if having a child with special needs would the worst thing in the world -- I know I would 100 percent love the child and adapt -- I just really want to get a sense of the risks beforehand. I have a few friends and family members with children with serious intellectual disabilitie, for example -- and life is not easy.

I'm also worried about what damage the cancer could have caused my body (and eggs?). I mean, I've had two PET scans and radiotherapy (so radiation.) No one knows where my kind of lymphoma came from, but it's rare and especially rare in people under 60 and studies have hypothesised that it is linked to inflammation. That sounds . . . bad for pregnancy. I just wonder whether I would produce healthy eggs now and be able to carry a healthy baby.

Obviously, I may not be able to get pregnant, but that's a separate question, really.

I have an appt with my hematologist coming up, and though he told me briefly all this shouldn't affect my fertility if I didn't have to have chemo (I didn't), we didn't have a big conversation about it. I'd love to give this thought and maybe read some research before I meet with him.

Of course, you are not my doctor, but I've found so much expertise/wisdom on these boards that I would love to hear your thoughts on any of this.
posted by anonymous to Health & Fitness (4 answers total) 5 users marked this as a favorite
 
I would advise consulting either a high-risk obstetrician or a reproductive endocrinologist (fertility specialist) on this because of two things. One is that your health situation sounds specialized, and the second is that the research information seems to change a lot, or did when I was reproducing.

I had a whack of fertility issues I won’t get into as they weren’t age related, and my youngest son at 40. We did some extra testing (amniocentesis, placental study), and he was near-term after lots of threatened pre-term labour drama and bed rest (34 weeks.) anecdata of one, he’s fantastic. It was a crazy year. You probably have experienced a crazier one just now.

I am hoping other people will have more advice as all my research would now be pretty old. But I can share that a lot of having a higher-risk pregnancy of any kind is knowing your capacity to handle the emotions and decisions. For example, my spouse and I were agreed that we would not terminate a pregnancy for Down Syndrome, but we did want to know. Being on the same page was critical.
posted by warriorqueen at 5:07 AM on May 10, 2020 [5 favorites]


I don't have anything to offer regarding your particular health situation but here are a few links:

a page with a chart showing how the likelihood of chromosomal abnormalities changes with maternal age

an article about how paternal and maternal age affect the likelihood of autism

an article about one study that showed a lower risk of fetal anomalies (other than those that are caused by an abnormal number of chromosomes, like Down syndrome) with higher maternal age
posted by Redstart at 8:20 AM on May 10, 2020 [1 favorite]


I had my only child after age 40. I'd like to share my very relevant experiences with you privately so please either send a memail or ask the mods to add a throwaway email for you, if you're interested.
posted by Kangaroo at 4:01 PM on May 10, 2020


I had my only child at 42, although no history of cancer. We did have to have help conceiving, although it was partially on his end and not totally due to advanced maternal age. Our daughter turns 3 in June and is by all indications neurotypical.

I would also urge you to see a reproductive endocrinologist. They can do a lot to give you advice on the odds of a healthy pregnancy after 40 as well as specific counseling about your lymphoma.

Good luck!
posted by weathergal at 8:22 PM on May 10, 2020 [1 favorite]


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