India, July 16 -- Women aged 35 and above are considered to be of advanced maternal age, says Dr Varshali Mali. Fertility gradually declines as egg quantity and quality reduce, while the chances of miscarriage, chromosomal conditions, gestational diabetes and hypertension rise. However, medical guidance and screening can support a pregnancy. Tests such as AMH, early-cycle FSH and an ultrasound-based antral follicle count can help assess egg supply and guide family-planning decisions. "AMH reflects egg quantity, not quality, and should guide planning rather than create panic," says Dr Mali. Thyroid imbalance can affect ovulation and increase the risk of miscarriage. A thyroid profile may be advised, particularly for those with irregular cycles, previous pregnancy loss, unexplained fatigue or weight changes. HbA1c, fasting glucose and blood-pressure checks can identify diabetes, prediabetes or hypertension before conception, reducing the risk of complications such as preeclampsia, preterm birth and fetal-growth concerns. Haemoglobin, ferritin, vitamin D and B12 tests can detect deficiencies linked to anaemia and fatigue. Dr Mali also recommends 400mcg of folic acid daily before conception to lower the risk of neural-tube defects. A pelvic examination and ultrasound can identify fibroids, cysts, endometriosis or uterine concerns. Immunity to rubella and varicella, along with screening for HIV, hepatitis B and C, syphilis and other infections, may also be considered....