The older woman wishing to conceive

Introduction Over the past two decades, predominantly in the developed world, many women have chosen to postpone having children for a number of reasons. In many countries the age at which women deliver their first child is reaching or surpassing the age of 30 years. This happened in the first place because optimal versatile safe contraceptive methods became available which were widely accepted. Second, and probably not unrelated to the progressive availability of contraceptives, came the movement of women's liberation and emancipatory awareness which led women to become much more keen to pursue a career instead of taking care of the household and raising children. Consequently, today a number of particular issues in relation to the child wish and having children in later life are of current concern. In the following chapter, the most salient points to consider for older women and for those responsible for their health, their well-being and that of their future offspring are discussed. These include the influence of ageing on the natural decline of fertility, on the increased chance of natural twinning, and also on the rate of early pregnancy loss and chromosomal and congenital abnormalities. Also, the limited success rates when fertility treatment is required and the limitations of tests that could predict reproductive consequences after both natural and assisted conception are addressed. Furthermore, the consequences of being an older mother with regard to the course of the pregnancy and delivery, and effects on general health are presented.