Planning ahead when parenthood comes later

According to Vietnam’s 2024 mid-term Population and Housing Census, the average age at first marriage was 27.3, up 2.1 years from 2019.

In urban areas, the average was 28.5, two years higher than in rural areas. As marriage happens later, plans to have children may also be pushed back.

Dr. Nguyen Quoc Anh, director of the Center for Assisted Reproduction and Andrology at Viet My General Hospital, said women are born with a finite number of eggs, which gradually declines over time.

As women age, both the number and quality of their eggs tend to decrease. This reduces the likelihood of becoming pregnant naturally while increasing the risks of miscarriage and chromosomal abnormalities in embryos.

Assisted reproductive technologies can treat many causes of infertility, but they cannot reverse the biological aging of eggs.

For men, fertility does not decline according to the same clearly defined timeline as it does for women. However, advancing age can be associated with changes in some sperm parameters, increased sperm DNA damage and a longer time to achieve pregnancy.

“Delaying parenthood is a choice for each individual and each family. But if you already plan to postpone having children, you should learn about your fertility beforehand rather than waiting until you want a child to start thinking about it,” Anh said.

Taking a preventive approach to reproductive health

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Taking steps to understand and preserve fertility can be an important part of reproductive planning. Photo: Linh Nguyen

Preventive fertility care has traditionally received relatively little attention.

Anh said greater use of premarital health checkups could provide couples with a broader picture of their health before marriage and help them prepare for future parenthood.

Not everyone needs extensive fertility testing. What is appropriate depends on factors including age, medical history and individual plans for having children.

Anh also emphasized that fertility assessment should not focus solely on women.

In infertility treatment, there are cases in which a wife has undergone repeated examinations while her husband has never had his reproductive health checked or undergone a semen analysis.

For people planning to have children after 35, particularly those who may wait until close to 40 or beyond, Anh said early fertility counseling can provide additional information to help them consider an appropriate timeline.

For women, an assessment may take into account age, menstrual cycles and obstetric and gynecological history.

Doctors may also use ovarian ultrasound, antral follicle counts and, in some cases, anti-Mullerian hormone, or AMH, testing to help assess ovarian reserve. The rate at which ovarian reserve declines, however, differs from one woman to another.

Egg freezing is one fertility-preservation option for women who are not yet planning a pregnancy. It can preserve an opportunity to have biological children later, but does not guarantee a future pregnancy.

Vietnam’s Population Law No. 113/2025/QH15, which took effect on July 1, 2026, stipulates that infertility prevention is governed by laws on disease prevention, while infertility treatment is covered by legislation on disease prevention, medical examination and treatment, and health insurance.

For people choosing to marry and have children later, learning about reproductive health in advance is not intended to create additional pressure to become parents sooner.

Rather, doctors say it can provide people with more information when deciding when - and whether - the time is right to start a family.

Phuong Thuy