The desire to become a mother remains strong, but the path to pregnancy has grown longer for many women in Paraguay. The phenomenon, dubbed “waiting moms,” reflects a social shift that prioritizes education, financial stability, and career growth, postponing motherhood until after age 35—an age fertility specialist Gustavo Manavella calls the “reproductive hinge.”
In an interview with the program Residentas on GEN, Manavella explained that a woman’s ovarian reserve, or reproductive potential, begins to decline rapidly after age 35, with an even steeper drop after 40. “The ideal time to get pregnant is between 20 and 35. After that, the chances decrease,” he said.
The doctor stressed that misinformation is one of the biggest obstacles. Many women arrive late at clinics because they never received guidance on fertility or on diseases that can compromise pregnancy. “Women should have ovarian reserve tests even before age 30 to know their reproductive potential,” he recommended.
Among the most common and silent conditions is endometriosis, which affects 10% to 12% of women and can lead to infertility in up to half of cases. “The main symptom is incapacitating menstrual pain, which for years was normalized,” Manavella recalled. “Before, a mother would take her daughter to the gynecologist and hear: ‘When you get pregnant, it will go away.’ Today we know that pain is not normal.”
The specialist also noted that infertility is not exclusively a female problem. “The male factor accounts for half of the issue,” he said, pointing out that environmental factors, stress, alcohol, tobacco, and heat contribute to rising male infertility worldwide.
Manavella clarified that infertility is defined as the absence of pregnancy after 12 months of unprotected sex, but not all cases require complex treatments. “Sometimes it’s hormonal problems or intercourse outside the fertile window. With information and follow-up, many pregnancies happen naturally.”
Assisted reproduction techniques, such as in vitro fertilization, improve the odds: the natural pregnancy rate is about 20%, while the first cycle of assisted treatment can reach 50%. However, the doctor warned that current practice prioritizes transferring a single embryo to reduce the risks of multiple pregnancy, which is considered high-risk.
The psychological impact of the process is also significant. All fertility clinics have psychology teams to deal with the guilt, anguish, and frustration that the diagnosis can generate. “Stress does not cause infertility, but it can affect the ovulatory cycle,” Manavella explained.
In June, fertility preservation campaigns are planned, focusing on egg freezing, a practice gaining ground among women who wish to postpone motherhood without giving up the future possibility. “Medicine supports women and couples in this process. Information is the most important tool,” the specialist concluded.