Yahoo Lifestyle How Long Can You Wait To Have A Baby?
In the tentative, post-9/11 spring of 2002, I was, at 30, in the midst of extricating myself from my first marriage. I put off telling my parents about the split for weeks, hesitant to disappoint them. When I finally broke the news, they were, to my relief, supportive and understanding. Then my mother said, “Have you read Time magazine this week? I know you want to have kids.”
Time’s cover that week had a baby on it. “Listen to a successful woman discuss her failure to bear a child, and the grief comes in layers of bitterness and regret...” the story inside began. A generation of women who had waited to start a family was beginning to grapple with that decision, and one media outlet after another was wringing its hands about the steep decline in women’s fertility with age: “When It’s Too Late to Have a Baby,” lamented the UK’s ; “Baby Panic,” New York magazine announced on its cover.
The panic stemmed from the April 2002 publication of Sylvia Ann Hewlett’s headline-grabbing book, Creating a Life, which counselled that women should have their children while they’re young or risk having none at all. Within corporate America, 42 percent of the professional women interviewed by Hewlett had no children at age 40, and most said they deeply regretted it. Just as you plan for a corner office, Hewlett advised her readers, you should plan for grandchildren.
For me, that was no longer a viable option.
Suddenly single
I had always wanted children. Even when I was busy with my postdoctoral research, I volunteered to babysit a friend’s preschooler. I frequently passed the time in airports by chatting up frazzled mothers and babbling toddlers — a two-year-old, quite to my surprise, once crawled into my lap.
But, suddenly single at 30, I seemed destined to remain childless until at least my mid-30s, and perhaps always. Flying to a friend’s wedding in May 2002, I finally forced myself to read the Time article. It upset me so much that I began doubting my divorce for the first time. “And God, what if I want to have two?,” I wrote in my journal as the cold plane sped over the Rockies. “First at 35, and if you wait until the kid is two to try, more than likely you have the second at 38 or 39. If at all.” To reassure myself about the divorce, I wrote, “Nothing I did would have changed the situation.” I underlined that.
I was lucky: within a few years, I married again, and this time the match was much better. But my new husband and I seemed to face frightening odds against having children. Most books and websites I read said that one in three women ages 35 to 39 would not get pregnant within a year of starting to try. Or that women in their late 30s had a 30 percent chance of remaining childless altogether. And statistics I saw repeated in many places declared that a woman’s chance of pregnancy was 20 percent each month at age 30, dwindling to 5 percent by age 40.
Every time I read these statistics, my stomach dropped like a stone, heavy and foreboding. Had I already missed my chance to be a mother?
As a psychology researcher, I knew that many scientific findings are very different from what the public hears about them. Soon after my second wedding, I decided to go to the source: I scoured medical-research databases, and quickly learned that the statistics on women’s age and fertility — used by many to make decisions about relationships, careers, and when to have children — were one of the more spectacular examples of the mainstream media’s failure to correctly report on and interpret scientific research.
The widely cited statistic that one in three women ages 35 to 39 will not be pregnant after a year of trying, for instance, is based on an article published in 2004 in the journal Human Reproduction. Rarely mentioned is the source of the data: French birth records from 1670 to 1830. The chance of remaining childless — 30 percent — was also calculated based on historical populations.
In other words, millions of women are being told when to get pregnant based on statistics from a time before electricity, antibiotics, or fertility treatment. Most people assume these numbers are based on large, well-conducted studies of modern women, but they are not. When I mention this to friends and associates, by far the most common reaction is: “No...No way. Really?”
The few well-designed studies that have been done on fertility in women born in the 20th century tend to paint a more optimistic picture. One study, published in Obstetrics & Gynaecology in 2004 and headed by David Dunson, examined the chances of pregnancy among 770 European women.
It found that with sex at least twice a week, 82 percent of 35-to-39-year-old women conceive within a year, compared with 86 per cent of 27-to-34-year-olds. (The fertility of women in their late 20s and early 30s was almost identical — news in and of itself.)
Another study*, in 2013, followed more than 2000 Danish women as they tried to get pregnant. Among women having sex during their fertile times, 78 percent of 35-to-40-year-olds got pregnant within a year, compared with 84 percent of 20-to-34-year-olds.
Even some studies based on historical birth records are more optimistic than the press normally reports: One found that, in the days before birth control, 89 percent of 38-year-old women were still fertile. Yet these more encouraging numbers are rarely mentioned.
Is baby panic all a lie?
In short, the “baby panic” is based largely on some questionable data. We’ve rearranged our lives, worried endlessly, and forgone countless career opportunities based on a few statistics about women who resided in thatched-roof huts and never saw a lightbulb. Fertility does decrease with age, but the decline is not steep enough to keep the vast majority of women in their late 30s from having a child (it’s true, however, that individual factors such as weight, reproductive health and general level of fertility do come into the picture).
I am now the mother of three children, all born after I turned 35. My oldest started kindergarten on my 40th birthday; my youngest was born five months later. All were conceived naturally within a few months. The toddler in my lap at the airport is now mine.
Instead of worrying about my fertility, I now worry about paying for child care and getting three children to bed on time. These are good problems to have.
Yet the memory of my abject terror about age-related infertility still lingers. Every time I tried to get pregnant, I was consumed by anxiety that my age meant doom. I was not alone. Women on Internet message boards write of caling back their careers or having fewer children than they’d like to, because they can’t bear the thought of trying to get pregnant after 35.
Egging on the panic
How did the baby panic happen in the first place? And why hasn’t there been more public pushback from fertility experts?
One possibility is that, when making judgements, people rely on what’s right in front of them. Fertility doctors see the effects of age on the success rate of fertility treatment every day. That’s particularly true for in vitro fertilisation. Younger women’s ovaries respond better to the drugs used to extract the eggs, and younger women’s eggs are more likely to be chromosomally normal. As a result, younger women’s IVF success rates are indeed much higher.
Yet only a tiny percentage of babies born each year are a result of IVF, and most of their mothers used the technique not because of their age, but to overcome blocked fallopian tubes, male infertility, or other issues: about 80 percent of IVF patients are 40 or younger. And the IVF statistics tell us very little about natural conception, which requires just one egg rather than a dozen or more, among other differences.
Studies of natural conception are surprisingly difficult to conduct — that’s one reason both IVF statistics and historical records play an outsize role in fertility reporting. (Modern birth records don’t help much, because most women use birth control to prevent unwanted pregnancy). Studies asking couples how long it took them to conceive are as unreliable as human memory.
Another problem looms even larger: women who are actively trying to get pregnant at age 35 or later might be less fertile than the average over-35 woman. Highly fertile women will get pregnant accidentally when they are younger, and others will get pregnant quickly whenever they try, completing their families at a younger age. Those who are left are, disproportionately, the less fertile. In other words, it’s not so much biological ageing in itself that’s the problem but a lower fertility rate to begin with.
Sex: it’s all in the timing
The best way to assess fertility might be to measure the chance of getting pregnant if a couple has sex on the most fertile day of the woman’s cycle. David Dunson’s analysis revealed that intercourse two days before ovulation resulted in pregnancy 29 per cent of the time for 35-to-39-year-old women, compared with about 42 per cent for 27-to-29-year-olds. So, by this measure, fertility falls by about a third from a woman’s late 20s to her late 30s.
However, a 35-to-39-year-old’s fertility two days before ovulation was the same as a 19-to-26-year-old’s fertility three days before ovulation: according to Dunson’s data, older couples who time sex just one day better than younger ones will effectively eliminate the age difference.
Don’t these numbers contradict the statistics you sometimes see in the popular press that only 20 percent of 30-year-old women and 5 percent of 40-year-old women get pregnant per cycle? They do, but no journal article I could locate contained these numbers, and none of the experts I contacted could tell me what data set they were based on.
It’s not the clock; it’s the body
Most fertility problems are not solely the result of female age. Blocked tubes and endometriosis (a condition in which the cells lining the uterus also grow outside it) strike both younger and older women. Almost half of infertility problems trace back to the man, and these seem to be more common among older men, although research suggests that men’s fertility declines only gradually with age.
Older women’s fears, of course, extend beyond the ability to get pregnant. The rates of miscarriages and birth defects rise with age, and worries over both have been well ventilated in the popular press. But how much do these risks actually rise? Many miscarriage statistics come from women who undergo IVF or other fertility treatment, who may have a higher miscarriage risk regardless of age. Even so, the risk does increase with age among the general population. These increases are not insignificant, and the true rate of miscarriages is higher, since many miscarriages occur extremely early in a pregnancy — before a missed period or pregnancy test. On the upside, however, even for older women, the likelihood of a pregnancy’s continuing is nearly three times that of having a known miscarriage.
What about birth defects? The risk of chromosomal abnormalities such as Down syndrome does rise with a woman’s age. However, the probability of having a child with a chromosomal abnormality remains extremely low. Even at early fetal testing (known as chorionic villus sampling), 99 percent of fetuses are chromosomally normal among 35-year-old pregnant women, and 97 percent among 40-year-olds. At 45, when most women can no longer get pregnant, 87 percent of fetuses are still normal. (Many of those that are not will later be miscarried.)
So, how long have I got?
What does all this mean for a woman trying to decide when to have children? More specifically, how long can she safely wait?
This question can’t be answered with absolutely certainty. Fertility varies tremendously, even among healthy women.
“Fertility is relatively stable until the late 30s, with the inflection point somewhere around 38 or 39,” Anne Steiner, from the University of North Carolina School of Medicine told me. “Women in their early 30s can think about years, but in their late 30s, they need to be thinking about months.” That’s also why many experts advise that women older than 35 should see a fertility specialist if they haven’t conceived after six months — particularly if it’s been six months of sex during fertile times.
There is no single best time to have a child. Some women and couples will find that starting — and finishing— their families in their 20s is what’s best for them, all things considered. They just shouldn’t let alarmist rhetoric push them to become parents before they’re ready. Having children at a young age slightly lowers the risks of infertility and chromosomal abnormalities, and moderately lowers the risk of miscarriage. But it also carries costs for relationships and careers. Literally: an analysis by one economist found that, on average, every year a woman postpones having children leads to a 10 percent increase in career earnings.
At home, couples should recognise that having sex at the most fertile time of the cycle matters enormously, and can make the difference between an easy conception in the bedroom and expensive fertility treatment in a clinic.
I wish I had known all this back in the spring of 2002, when the media coverage of age and infertility was deafening. I did, though, find some relief from the smart women of Saturday Night Live.
“According to author Sylvia Hewlett, career women shouldn’t wait to have babies, because our fertility takes a steep drop-off after age 27,” Tina Fey said during a “Weekend Update” sketch. “And Sylvia’s right; I definitely should have had a baby when I was 27, living in Chicago over a biker bar, pulling down a cool $12,000 a year. That would have worked out great.” Rachel Dratch said, “Yeah. Sylvia, um, thanks for reminding me that I have to hurry up and have a baby. Uh, me and my four cats will get right on that.”
“My neighbour has this adorable, cute little Chinese baby that speaks Italian,” noted Amy Poehler. “So, you know, I’ll just buy one of those.” Maya Rudolph rounded out the rant: “Yeah, Sylvia, maybe your next book should tell men our age to stop playing Grand Theft Auto III and holding out for the chick from Alias.” (“You’re not gonna get the chick from Alias,” Fey advised.)
Eleven years later, these four women have eight children among them, all but one born when they were older than 35. It’s good to be right.
Finding the right time
There are a couple of points to bear in mind before you wait too long, warns one Australian expert. There’s no denying that age can be a factor in health complications that can affect your chances of falling pregnant and ending up with a healthy baby.
"Women are more likely to develop fibroids or endometriosis as they get older," says Dr Caroline de Costa, Professor of Obstetrics and Gynaecology at James Cook University, Queensland. "Both are much more common in women over 35.
"Given the general trend in the population, older women are also more likely to be overweight or even obese, and therefore more likely to suffer from type 2 diabetes or hypertension. That doesn't mean they won't fall pregnant necessarily, but all of these things can complicate a pregnancy."
Young women can have these problems, too, but the earlier they try to conceive, the longer they give themselves to have a successful pregnancy.
Do you have fertility paranoia?
One consequence of all of the obsessive talk about women having babies later? The rise of so-called “fertility paranoia”. In Australia, some women as young as 21 are now having fertility check-ups, investigating the possibility of freezing their eggs and are making lifestyle choices to improve egg health because they are so worried about whether they will be able to get pregnant, according to Rebecca Huntley from research firm Ipsos Mackay. The flurry of media reports about infertility, often sourced from commercial IVF clinics, may be fuelling the alarm.
“There’s an active conversation amongst women in their early 20s with this sense of ‘Oh my god, 31 or 32 is too late’. Clearly, that is not the case.”
Still, in many cases it never gets past the ‘conversation’ stage. Egg freezing costs between $8000 and $12,000 a cycle and carries rare but potentially serious side-effects.
Dr Mark Bowman, Medical Director of fertility group Genoa and President of the Fertility Society of Australia, says women are more aware than ever of the impact age can have on fertility and many are investigating medical options, but that may be as far as it goes. And while it’s an option, it’s not a promise. “Unfortunately, egg freezing isn’t a guarantee or an insurance policy that promises a healthy baby whenever you’re ready.” Techniques have improved, he says, but still can’t match fresh eggs for quality. He argues that a more reliable option, for those who have a life partner and have concerns about their fertility, is to freeze an embryo.
“Whether you decide to freeze your eggs or embryos, both processes require a commitment of both time and emotional energy,” says Bowman. You need to undergo ovarian stimulation which involves a series of hormone injections. Patients then have an egg retrieval procedure before their eggs are frozen and stored in a laboratory. Cost is also a factor to consider, if you have treatment for non-medical reasons there is no Medicare rebate and the average cost is $10,000.”
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