Go Ahead and Wait to Have Babies!

[rward]

Turns out, my 37 year old ovaries are quite all right. (Dammit!)

http://www.slate.com/blogs/xx_factor/20 ... antic.html

(not broken, slate don't care)

Facts that I remember parroting to my husband—that I had a 20 percent chance of conceiving each time I ovulated—turn out to be based on no specific published medical literature. The study that Twenge did discover, by biostatistician David Dunson who is now at Duke University, found that:

ntercourse two days before ovulation resulted in pregnancy 29 percent of the time for 35-to-39-year-old women, compared with about 42 percent 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.

Even more shocking is that a lot of the statistics we hear about modern fertility are based on historical data from French birth records from 1670 to 1830. According to Dunson’s research on contemporary women, there is only a four percent drop in pregnancy rates from age 28 to age 37. This comes as a huge shock because almost everything I’ve read takes it as a given that age 35 is a huge cliff that you will fall off of with a resounding splat.

Anybody remember what French women were doing during the highlighted time period? Oh, right, starving.

So go to college, pursue a career, wait for the right man, woman or no one at all. Your ovaries are fine.

[2xx1xy1JD]

I'll still take the word of my reproductive endocrinologist over a psychologist writing in The Atlantic.

This is not a scientific article. It starts by addressing overblown fears in the popular media - basically, it's a straw man argument. OF COURSE it's possible for plenty of women 35 and over to have babies. No legitimate science has suggested otherwise. What the current medical literature does say is that:

- older eggs are less likely to be healthy and the risks of chromosomal disorders increases significantly

- miscarriage risks are higher

- fewer total eggs are available

- IVF is less likely to be successful

- certain conditions are likely to cause more fertility problems with age, such as premature menopause

[rward]

The article doesn't really address miscarriage and IVF, or premature menopause, just healthy women without other issues. Of course, maintaining pregnancy is an issue with age, I don't think anyone has disputed that 20 year olds have a tad more energy than 40 year olds.

There's also the issue, which rarely gets discussed, that older sperm is more of a problem than older eggs. A lot of chromosomal and other issues are highly correlated with older fathers, but nobody suggests that men should get with the baby making now and put education and careers on hold until later.

[crawfishgirl]

I gave birth at ages 36 and 38 without any issues getting pregnant - we got pregnant almost immediately when we started trying. My grandmother had an accidental pregnancy at age 45 (that was in the early 1960's). All were normal and healthy. I've always thought that there are too many scare tactics out there, condemning women for waiting too long. In my case, I wasn't really waiting to have kids for any particular reason other than I didn't meet 'Mr Right' until I was in my 30's, and I didn't want to have kids with 'Mr Wrong'.

I remember watching a show on the Health channel a few years back, covering some of the age-related fertility issues. It mentioned that age can affect fertility, but that the media likes to sensationalize it and make it seem much worse than it is.

I am not trying to negate people's experiences with infertility - I know that it can be a sad experience.

[2xx1xy1JD]

The article doesn't really address miscarriage and IVF, or premature menopause, just healthy women without other issues. Of course, maintaining pregnancy is an issue with age, I don't think anyone has disputed that 20 year olds have a tad more energy than 40 year olds.

There's also the issue, which rarely gets discussed, that older sperm is more of a problem than older eggs. A lot of chromosomal and other issues are highly correlated with older fathers, but nobody suggests that men should get with the baby making now and put education and careers on hold until later.

The New York Times published an article about a study linking higher paternal age to an increased risk of autism and schizophrenia:

http://www.nytimes.com/2012/08/23/healt ... .html?_r=0

[2xx1xy1JD]

I gave birth at ages 36 and 38 without any issues getting pregnant - we got pregnant almost immediately when we started trying. My grandmother had an accidental pregnancy at age 45 (that was in the early 1960's). All were normal and healthy. I've always thought that there are too many scare tactics out there, condemning women for waiting too long. In my case, I wasn't really waiting to have kids for any particular reason other than I didn't meet 'Mr Right' until I was in my 30's, and I didn't want to have kids with 'Mr Wrong'.

I remember watching a show on the Health channel a few years back, covering some of the age-related fertility issues. It mentioned that age can affect fertility, but that the media likes to sensationalize it and make it seem much worse than it is.

I am not trying to negate people's experiences with infertility - I know that it can be a sad experience.

No medical organization has ever suggested that your experience isn't possible.

What they will say is that when we look at all women, the odds of getting pregnant quickly and carrying to term and giving birth to a baby who is healthy are higher if the woman is in her 20s, instead of being 36 or 38 or 45. That doesn't mean that things can't go wrong for women who are younger (I had miscarriages at 26, 29 and 30, plus difficulty conceiving at 29), or that older women can't have successful outcomes. It just means that risks increase.

[clone]

Arbitrary cut off are arbitrary. ^^ I had kids at 35 and 39. No problems getting pregnant and staying that way. My kids have no health issues. But during my first pregnancy, one day I was "normal", the next day (after my birthday), I was bumped up into a higher risk group. I spoke to my doctor about the ridiculousness of that. It's a guideline that I think was sensationalized by everyone, probably in part due to bias, but also to err on the conservative side of things as doctors will do. It's all anecdotal evidence, but I personally know plenty of women who got pregnant without intervention and gave birth without complications in their late 30s, early 40s. I also know quite a few women in their 20s who had issues with it.

[docmom]

I think everyone is right! Fertility does drop off as you age but it's not a sudden drop at age 35 and plenty of women do become pregnant in their late 30s and even early 40s. I agree that the media sensationalizes these things and the fundies, with their love of anything (fact or made-up) that supports their beliefs, have run with it. It is also the fact that both aging eggs and aging sperm can be an issue. However, it's important to look at the numbers the right way. When I had my (surprise) 3rd child at 42 I was quoted a 1/30 risk of Down Syndrome. That sounds pretty bad until you consider that it means that 29/30 times the child won't be affected. With modern screening techniques my risk went down to 1/300 (or 299/300 the baby is unaffected) and I elected not to have an amnio.

[fundyfunland]

There's also the issue, which rarely gets discussed, that older sperm is more of a problem than older eggs. A lot of chromosomal and other issues are highly correlated with older fathers, but nobody suggests that men should get with the baby making now and put education and careers on hold until later.

Ya, it annoys me that there isn't as much attention paid to the men's contribution to all this. The older the male, especially if he is over 35 years old, the greater the likelihood of his offspring being born with autism, hemophilia A, neurofibromatosis, Marfan syndrome, and polycystic kidney disease. There's also evidence that when the man and the women are over 35 years old, there is an increased risk of a baby being born with Down's Syndrome. Likely due to the quality of men's sperm and women's eggs after this age. It's also been suggested however, that if a man procreates with a woman who is younger than 35 years old, this doesn't seem to increase the likelihood of a baby being born with DS, most likely because the woman is better able to detect and expel an embryo with genetic problems. As for schizophrenia, can't remember where I read that, but based on my own observations on the mental health unit where I work, it doesn't surprise the staff at all when a patient's much older father and much younger mother walk into the unit.

There's also the issue that men's ability to produce and maintain an erection decreases, and his quantity of sperm and semen decrease with age, obviously affecting the ability of a woman to become pregnant.

What bothers me is the media's emphasis on women's ability to reproduce after 35 years old, whilst paying little attention to the contributions of men in this department. There have been some articles about this over the past few years, but the vast majority still focus solely on women's age. Maclean's magazine in Canada just recently did an article on the reproductive "crisis" - the sole focus of the article being about the increased age of women who are attempting to conceive

www2.macleans.ca/2012/10/27/thirty-seven-and-counting/

ETA: Apparently Maclean's magazine likely got a lot slack for focusing on women only. They published an article about 6 months later focusing on men's contribution to the issue:

www2.macleans.ca/2012/10/27/thirty-seven-and-counting/

[docmom]

Ya, it annoys me that there isn't as much attention paid to the men's contribution to all this. The older the male, especially if he is over 35 years old, the greater the likelihood of his offspring being born with autism, hemophilia A, neurofibromatosis, Marfan syndrome, and polycystic kidney disease.

Can you cite where you got this information from because, at least for the hemophilia claim, it doesn't make sense? The gene for factor VIII (which is missing or non-functional in hemophilia A) is on the X-chromosone. Boys have hemophilia when they inherit a mutated factor 8 gene from their mothers (or they develop a spontaneous mutation very early in embryonic life). Boys don't get an X-chromosone from their fathers so it is difficult to see how a boy could get hemophilia from his father no matter how old he was (discouning Kleinfelters and other rare genetic conditions). Daughters of men who have hemophilia (or a spontaneously mutated factor 8 gene) or mothers who carry hemophilia can have severe symptomatic hemophilia but this is rare due to the fact that women have two copies of the factor 8 gene and can make enough factor 8 not to bleed except under exceptional circumstances. The sons of a carrier daughter have a 50:50 chance of having hemophilia but this wouldn't show up until the next generation- linking it back to an older grandfather would be difficult. I'm pretty up on the hemophilia literature and would like to know where this paper is.

[EmiGirl]

Someone should post this on Lori's facebook.

[ThrK]

I think everyone is right! Fertility does drop off as you age but it's not a sudden drop at age 35 and plenty of women do become pregnant in their late 30s and even early 40s. I agree that the media sensationalizes these things and the fundies, with their love of anything (fact or made-up) that supports their beliefs, have run with it. It is also the fact that both aging eggs and aging sperm can be an issue. However, it's important to look at the numbers the right way. When I had my (surprise) 3rd child at 42 I was quoted a 1/30 risk of Down Syndrome. That sounds pretty bad until you consider that it means that 29/30 times the child won't be affected. With modern screening techniques my risk went down to 1/300 (or 299/300 the baby is unaffected) and I elected not to have an amnio.

How could screening lower your risk of Down Syndrome? :oops:

Unless you mean lower your risk of surprise and hence un-terminated...?

[OkToBeTakei]

How could screening lower your risk of Down Syndrome? :oops:

Unless you mean lower your risk of surprise and hence un-terminated...?

Nuchal ultrasound screening and blood testing on the mother combined with age can lower the risk result.

That is, purely by age the OP was in a risk factor of 1/30. But after say relatively non-invasive scanning if no significant findings regarding nuchal translucency (indication of downs.) The risk factor becomes far less. That say coupled with blood testing which looks for certain markers in the maternal blood will further lessen the risk. So from 1/30 risk to 1/300 with two relatively non-invasive tests. Definitively would be CVS and amnio.

[docmom]

Nuchal ultrasound screening and blood testing on the mother combined with age can lower the risk result.

That is, purely by age the OP was in a risk factor of 1/30. But after say relatively non-invasive scanning if no significant findings regarding nuchal translucency (indication of downs.) The risk factor becomes far less. That say coupled with blood testing which looks for certain markers in the maternal blood will further lessen the risk. So from 1/30 risk to 1/300 with two relatively non-invasive tests. Definitively would be CVS and amnio.

Exactly! ThrK could also look up "pre and post- test probability" for an explanation of how testing changes odds. Not quite sure what ThrK meant by "un-terminated". An amnio is a test not an abortion.

[August]

Given that you don't know how fertile you are until you test it I would put more stock in those charts than this article, they are not from french peasants, they're from modern IVF clinics. There is a big downtrn in success rates at 38, and a bigger one at 40. If you count on having better timing than those twenty somethings and so wait until you're 37 to start trying, after a year of trying when you turn to IVF you have a fraction of the pregnancy rates of a thirty year old. And a good third of the women in these charts are healthy with no other issues, they have male factor or tubal infertility.

No one really cares if you take two or six months to get pregnant by sex. Two vs six IVF cycles is a big deal.

http://www.advancedfertility.com/ivf-age.htm

[twinmama]

I think the media tends to focus on the "oops you waited too long" type of infertility as a way to blame women for their choices and for their own infertility. Of course as you get older you get less fertile, but there are TONS of reasons why you may have trouble conceiving that have nothing to do with your age. I had PCOS and my husband had some male factor, thus we had to do IVF. Thank god it worked the first time because that mother fucker cost around $12,000 total and wasn't covered by insurance.

Plus, people saying they got pregnant at 45 with no problems doesn't mean everyone can get pregnant at 45, it just means they were lucky (or unlucky!).

[Nothing2CHere]

I have a friend who is the same age as me, only three months older. My husband & I started trying to conceive in July 2011, when I turned 36. By that point, Friend & her husband had been trying to conceive for a year, year & a half with no results. Based on what was going on with her, I assumed that it would take a while for my husband & me to conceive, too. I got pregnant in September 2011. My son's now 1 year old. Friend just gave birth this month.

All that to say, it doesn't matter what all the statistics in the world are, every situation has so many different variables and factors that some people, like me, get lucky and get pregnant while 36 and hardly trying, and other people, like Friend, needed to enlist fertility experts to help them along.

[twinmama]

So true Nothing2CHere, just before my IVF cycle my good friend who is 4 years older than me (35 at the time) got pregnant her first cycle trying! Some people are just way fertile and others of us need some help.