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The Truth About Fertility

Sarah Preston Gorenstein

Admit it: Seeing celeb moms of Advanced Maternal Age glorified on the covers of tabloid magazines and on reality TV shows has given you false hope that getting pregnant well into your 30s (and 40s) is not only possible, it’s common!

I can name at least 10 celebrities off the top of my head that either conceived or gave birth in their late 30s and 40s (with or without fertility help): Kelly Preston, 48; Susan Sarandon, 45; Nicole Kidman, 43; Celine Dion, 42; Mariah Carey, 42; Halle Berry, 41; Madonna, 41; Julianne Moore, 41; Courteney Cox, 40; Jennifer Garner, 39; Jennifer Lopez, 38; Reese Witherspoon, 36; the list goes on.

Advanced Maternal Age = women over the age of 35. Advanced Maternal Age = me.

“There is an alarming misconception about fertility among women,” said Dr. Pasquale Patrizio, professor in the Department of Obstetrics & Gynecology at Yale School of Medicine and director of the Yale Fertility Center. Yale researchers recently reported in an issue of Fertility and Sterility that more women are seeking fertility help at the age of 43, or older, expecting to achieve pregnancy, and are actually disappointed to learn that it’s not quite that easy. “Their typical reaction is, What do you mean you cannot help me? I am healthy, I exercise, and I cannot have my own baby?”

According to the March of Dimes, one in five American women have their first baby at the age of 35, or older.

It's no secret women are having kids later in their lives now—among other things, their careers are taking precedence over starting families. At least that’s part of the reason why I didn’t even think of settling down until my early 30s; I was too busy hustling in the workforce and climbing the corporate ladder; running around with my single friends; having “fun.” But at what cost?

It wasn’t until I experienced infertility did “fertility” even cross my mind. Why would I have known that more than seven million women in the U.S. suffered from infertility? Why would I have cared? To be totally honest, I don’t even think I realized that there were only 5-6 days a month (at best) that a woman could actually get pregnant until I started paying attention to my own ovulation cycle. Did you?

The growing popularity of assisted reproductive technologies (ART) has given women the impression that female fertility may be manipulated at any stage in life, notes Patrizio. (After all, look at all the celebs it’s helped.)

But the truth is, it's not that simple, is it? The one thing you can’t control is the aging process, and that's one of the leading causes of infertility in women.

Sometimes I think, What would I tell my younger self? Perhaps if I’d been more informed about fertility, I might not have been so cavalier about “settling down.”

“As clinicians, we should begin educating women more aggressively,” Patrizio said. “Women should be given the appropriate information about postponing fertility, obstetric risks, and the limited success of ART in advanced age to allow them to make informed decisions about when, if at all, they hope to become pregnant.”

I couldn’t agree more. I wish my then-OB would have been more forthcoming with information about fertility, asking questions like, Do you want children some day? Did you know that women are born with all their eggs, and every month they lose them in both quantity and quality? Have you thought about freezing your eggs, if you plan on waiting to start a family? 

I'm not saying I would've necessarily considered that option in my naive 20s, but it would've given me something to think about.

“Even though the number of women turning to ART has increased,” said Petrizio, “the number of IVF cycles resulting in pregnancy in women above age 42 mostly remained static at 9% in 2009.” 

Do you think the responsibility is on OB/GYNs to be more proactive with their patients about discussing fertility at a younger age? It's not like single twentysomethings are going to run out and get knocked up because their eggs are going bad, but wouldn't we all be better off if we were a little more informed?

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