The modern lifestyle has led to a growing trend of young women delaying childbirth or choosing to remain childless. This, coupled with the rising popularity of singlehood among the younger generation, has significant implications for Vietnam's demographics.
As women age past 35, their fertility naturally declines. After 40, natural conception becomes increasingly difficult, making childbirth at this stage a challenge. Despite advancements in medical technology, delayed childbirth is associated with increased health risks for both mother and child, not to mention the added time and costs of fertility treatments.
Paradoxically, many couples find themselves facing numerous challenges when they are ready to start a family later in life. N.T.T.T., a 45-year-old woman from District 12 of HCMC and her partner began dating at 30 but did not marry until they were 40.
“I and my partner were so focused on my career that I forgot about marriage and children,” T. shared. In 2018, T.'s father passed away. “Before he took his last breath, he expressed his wish for me to get married and have children,” T. recounted. The grief led her to re-evaluate her life, and two years later, she tied the knot and decided to start a family.
After undergoing fertility tests at a major maternity hospital in the city, T. was informed that her ovarian reserve was critically low. At 45, her age had significantly reduced her ovarian function. "I felt so regretful," she admitted.
Determined to have a child, T. and her husband sought treatment at IVF Tam Anh, a fertility center in HCMC. After a thorough examination, Giang Huynh Nhu, MD – Director of IVF Tam Anh, concluded that T. was of advanced maternal age with very few eggs. The clinic developed a personalized treatment plan involving multiple cycles of egg retrieval to increase the chances of a successful pregnancy using her own eggs. After nearly three years of perseverance, T. gave birth to a healthy baby boy weighing over 3 kilograms.
Q.L.C., a 45-year-old woman from District 5 of HCMC, married at 34, which was considered late compared to her peers. After a year, the couple still had not conceived. Following the advice of friends, they underwent IVF treatment at a local maternity hospital but were unsuccessful after three attempts.
The pressure of work, coupled with the emotional toll of multiple failed IVF cycles, led the couple to temporarily put their plans to have a child on hold. Seven years later, inspired by a friend's wedding invitation, C. felt a renewed urgency to start a family. At 41, she embarked on a race against time to stimulate her ovaries with a suitable protocol. “When the doctor handed me the test results showing a beta-hCG level over 300 IU/L and said 'congratulations,' my husband and I cried tears of joy,” C. recalled.
Director Le Thanh Dung of the Vietnam Population Authority (under the Ministry of Health), Vietnam's birth rate has been declining in recent years, leading to a slower population growth rate (at 0.84 percent in 2023 compared to 0.98 percent in 2022).
If this trend continues, Vietnam could face a declining population after 2054. In other words, the number of people born will decrease, the future working-age population will decrease, while the average life expectancy of Vietnamese people increases rapidly, leading to a very high proportion of the elderly population in the total population and Vietnam will have an aging population structure.
T. and C. are just two of the many older women who, after delaying motherhood to focus on their careers, are now seeking fertility treatments. Nguyen Ba My Nhi, Level-II Specialist – former Deputy Director of Tu Du Hospital and current Director of the Obstetrics and Gynecology Center (Tam Anh General Hospital), recommends that women have children before the age of 35.
For women over 35 who are struggling to conceive, early medical intervention is crucial. The longer the treatment is delayed, the more the quantity and quality of eggs and sperm will decrease, which means the ability to create embryos will be low, while the risk of abnormal embryos will be high, not to mention that the conception rate will decrease, the risk of miscarriage, stillbirth, and birth defects will increase.
According to Giang Huynh Nhu, MMed, the trend of women delaying marriage and childbirth, or choosing to remain single, is becoming increasingly prevalent in society. The primary effect from this is the depletion of ovarian reserves. From birth, female infants have approximately one million egg follicles in their ovaries. This number gradually decreases to around 300,000-500,000 by puberty. Throughout a woman's reproductive years, these follicles undergo a continuous process of development, degeneration, and selection.
The second adverse impact is the declining quality of eggs. As women age, their eggs become more susceptible to genetic abnormalities. Older women have a higher rate of chromosomal abnormalities in their eggs, making it more difficult to conceive and increasing the risk of miscarriage and birth defects.
Therefore, the ideal age for women to become a mother, according to Assoc Prof Hoang Thi Diem Tuyet, MD PhD – Director of Hung Vuong Hospital, is from 25-35. However, for women who are unable to conceive within this age range due to unforeseen circumstances, egg freezing can be a viable option.
Nevertheless, egg freezing requires careful consideration and preparation, including psychological and financial factors. While the cost of egg freezing in Vietnam is relatively lower compared to other countries, it can still be expensive for the average woman.
Studies have shown that frozen eggs can be stored indefinitely, allowing women to delay childbearing until they are ready. However, the woman's overall health at the time of embryo transfer is crucial for a successful pregnancy.
According to the Ministry of Health, the average age at first marriage in Vietnam has been increasing. In 2019, the average age for women was 25.2, compared to 24.1 in 1999. At present, this figure is 27.2. Urban women tend to marry later and have fewer children than rural women. The average age of first marriage is 29.3 and 25.1 for men and women respectively.
Experts warn that low fertility rates can have significant consequences, as seen in countries like Japan. An aging population can lead to a shortage of the workforce, increased social and healthcare costs, and a decline in economic growth. If Vietnam continues to experience low fertility rates, it could face similar challenges in the future. It is forecast that in 2069, in Vietnam, for every 2 children, there will be 3 elderly people (60 years old and over).
