Become a mother after 35 years: because the time factor is decisive
The delay of starting in vitro fertilization causes a reduction in successful possibilities. The experts of the Italian Society of Human Reproduction (SIU) launch the alarm: appropriate guidelines are lacking and the related diagnostic and therapeutic welfare paths (Pdta)
Becoming a mother after 35 can take time. But it is proper time the key factor for couples who wish to be parents. According to a study published on Human Reproductionthe delay in the start of in vitro fertilization causes a reduction in successful possibilities. An effect that bears itself Especially when the maternal age advances and in the presence of an infertility known cause. The experts of Italian society human reproduction (Siru) launch the alarm: they are missing Appropriate guidelines and the related diagnostic and therapeutic welfare paths (Pdta).
Mom Over 35: the time factor and the possibilities of success
« The average age of couples who turn to the medically assisted procreation centers in Italy is 36.7 years – he explains Antonino Guglielminofounder of the Siru -. However, access to therapies often takes place with a 4-5 years delay, incompatible with biological timing of fertility. And it should be noted that a delay of only 6 months in the start of in vitro fertilization determines a reduction in the births of the 5.6% between 36-37 yearsof 9.5% between 38-39 and of the11.8% between 40-42 years. These numbers double almost in case of a delay of 12 months ». I am alarming data, Considering that the increase in age and the duration of infertility they can compromise the possibilities of success of care.
The lack of guidelines and PDTA
« Currently Italy does not have updated national guidelines and the absence of diagnostic -therapeutic welfare paths (Pdta), which represent a health protection belt for couples, translates into years of disorientation -continues Guglielmino -. On average they are estimated from 5 to 6 years of economic expenditure and organizational chaosduring which many couples do not know who to turn, face unsuitable treatments and reach the specialist centers too late. These routes should start from the general practitioner or the consultancy, already integrated with the Centers of RMA, to offer diagnosis and Useful therapies to quickly reach the objective of conception of a child».
The difference between the regions and the failure of the implementation of the Lea
Despite the insertion of the RMA in the essential levels of assistance (Lea) since 2017and the official definition of the new Lea with 3.4 billion euros allocated from 2017 to 2024 (for 2025 scheduled 781 million euros), The implementation remains fragmentary and dysomogeneous. « We must be able to eliminate the geographical and census differences that unfortunately exist right now -underlines Guglielmino -. The regional gap is evident: in Tuscany and Lombardy, where access is facilitated, the PMA covers up to 7% of births. In Sicily, however, the National Health Service manages to satisfy just 8.7% of the applicationwith waiting lists of over 2 years for heterologist and prohibitive costs. Until December 2024, in fact, the cost of the ticket was 2,774 euros, then reduced to 800 euros starting from 2025. It is absolutely necessary, therefore, to make the offer of the regions homogeneous ».
A paradigm change is urgent
«If a couple tries to have a child in a natural way, where the future mother has already turned 35, in one year he has to carry out all the diagnostic exams and and be immediately addressed to the center of RMA. If the woman is younger, however, you can wait 2 years to naturally try to undertake pregnancy, but then it will be directed towards an adequate path. In fact, it should be considered that, Over time, oocytes lose their competence And pregnancy becomes an increasingly difficult goal to pursue. In a country with one of the lowest birth rate in Europe, of 1.18 children per woman, against a replacement threshold of 2.1intervening on assisted reproduction will not solve the demographic problem, but it will certainly be able to represent an important signal and a first step towards the reversal of the trend, « he concludes.
