One of the issues that comes up relatively frequently in many of the blogs I read is female fertility particularly as it pertains to age. I’ve entered the fray on a few occasions, though since I’m getting tired of saying the same things over and over again, so I’m going to dispel some of the less or untrue things that I’ve heard people say here and link to it when the subject comes up.
A few years ago, the problem with misinformation (at least as I heard it) lead to an overconfidence on the part of older couples that they would be able to conceive whenever they wanted. Everybody knew somebody that had children post-35 and fertility treatments were getting better and better so there was no reason to have kids now when you could wait until you were in a better financial position to raise them.
The results were tragic for a lot of people. They simply waited too long and when they were ready they had a lot of difficulty conceiving if it wasn’t outright impossible. As more and more people started trying to conceive for the first time at older ages, everyone started taking a longer look and it became clear that it was a risky proposition.
I found myself getting into regular arguments in college about this. My mother had my brother at 33 and myself at 36 and a miscarriage in between so older parenthood is a subject that I’ve always been interested in. It was impressive the vehemence with which a lot of young women held on to the notion that they could wait as long as they wanted and that my saying otherwise was somehow an indication that I didn’t want it to be true or something like that.
Lately, though, I’ve been butting heads with the opposite contingent. These folks believe not just that it becomes a lot more difficult to conceive the further into one’s thirties a woman goes, but make very bold claims that it’s practically impossible to get pregnant after 35, if you do get pregnant you’ll have a miscarriage, and if you do have the kid it’ll probably be retarded.
If one believes the above, it’s possible to voice these fears in a compassionate and concerned manner. I’d be more patient with these people if that’s how it was being raised. Instead, though, it’s being raised as a bat with which to hit women that have standards. The misinformation is an attempt on the part of some to bully women into lowering their standards or, absent that, as simply a mean thing to say to women that have not sufficiently lowered there standards.
In the general spectrum of things starting at “Settling For Whatever You Can Find” and ending with “Waiting For The One” I have historically falled in the first camp. I think that a lot of people, men and women, are trying too hard to find the perfect person rather than trying to build something good with a good person. That changed somewhat over time as I left a girl that was completely good and found a couple women that were more than just good and found someone that was right. Seeing as how it only takes one, and that I managed to find at least a couple people that could have been a lot better than just good, I’m more open to the idea of waiting for something right.
Men often believe that women are hung up on “alpha males” and won’t date any guy that isn’t a super stud and that’s why so many young men are single. Many women believe that men are hung up on getting some cheerleader-type and are unwilling to accept that the average woman has at least some body fat and some bad days and that this is the ereason that so many young women are single. I think that they’re both right about some people of the opposite gender, but both are wrong to believe that it’s completely and utterly skewed in one direction.
I go into the Settling/Waiting debate because it’s central to what ought to be a biological debate about fertility but often really isn’t. The larger the threat of infertility looms, the stronger the case for settling is. The stronger the case for settling is, the stronger the man’s hand is. We are fertile for longer. If it’s a waiting game until someone becomes desperate to act, then we win.
So when an article comes about like Lori Gottlieb’s a long time ago suggesting that women settle for imperfection so that they can have children, men are generally supportive. Female desperation works to our advantage. The bigger the infertility threat the stronger the desperation the more we win. So a lot of guys are very anxious to believe that women become maritally useless just around the corner and they desperately want women to believe that, too.
It makes me understand why some young women become so hostile when the subject of declining fertility comes up. It’s not so much that they’re in denial (though some are, of course) but that they’re used to men bringing it up in a certain context. A context that implies that a woman’s value is tied tightly to her reproductivity and that she’d better stop being so independent if she wants to “have it all”.
The fact is that a woman’s infertility does indeed begin to decline considerably as she hits her mid-30’s and no amount of wishing that it weren’t true will change that. However, despite what some try to claim, it doesn’t drop like an anvil leaving everyone infertile until much later. It’s all comparative. So while it’s accurate to say that compared to a 25 year old a 35 year old is less fertile, it’s far from accurate to essentially compare a 35 year old to a 45 year old.
Question 1: Do most women become infertile at 35?
The numbers I’ve seen fit in pretty well with the ones here:
Of women trying natural conception:
* At age 30, 75% will get pregnant within one year.
* At age 35, 66% will get pregnant.
* At age 40, 44% will get pregnant.
Within four years after trying to conceive naturally:
* 91% of 30-year-olds will be successful.
* 84% of 35-year-olds will.
* 64% of 40-year-olds will.
Question 2: Do these numbers count when so many women miscarry?
Answer: I don’t know whether the numbers provided count pregnancies or births. The language suggests pregnancies, though the link I followed to it said births.
Let’s assume for a moment, however, that these numbers don’t count miscarriages. The miscarriage rate for women in the 35-39 category is 20%, but raises to 50% for the 40-45 group. So even if assume the worst, that miscarriage rates are 15% at 30, at 20% at 35, and at 50% at 40, the numbers are adjusted to the following:
Of women trying natural conception:
* At age 30, 64% will carry a baby to term within 21-months.
* At age 35, 53% will carry a baby to term.
* At age 40, 22% will carry a baby to term.
Within four years after trying to conceive naturally and carry the baby to term:
* 77% of 30-year-olds will be successful.
* 67% of 35-year-olds will.
* 32% of 40-year-olds will.
Those are some disconcerting statistics for a couple that desperately wants children, but it’s a far cry from pure infertility. Most 35 year old women that want to have children will be pregnant within the first year with a baby that they carry to term.
Question 3: Won’t these kids be mentally handicapped?
Answer: Some certainly will. The older the mother, the greater the likelihood. However, we’re still talking about comparatively remote risks when compared to the risk of not being able to conceive or of miscarriage. Further, a lot of the most serious abnormalities can be screened for if that’s what the parents elect to do.
Downs Syndrome is the most common chromosomal defect, and the numbers go as follows:
* At age 25, a woman has about a 1-in-1,250 chance of having a baby with Down syndrome.
* At age 30, a 1-in-1,000 chance.
* At age 35, a 1-in-400 chance.
* At age 40, a 1-in-100 chance.
* At 45, a 1-in-30 chance.
* At 49, a 1-in-10 chance (1, 4).
These numbers are not actually significant enough to effect the above numbers by a full percentage point at either the 35 or 40 year old milestones.
So in review, the above numbers represent real risk and reason for concern for older would-be parents. They do not, however, represent infertility in any meaningful sense. It is not advisable for a woman to choose to wait until her mid-to-late thirties before having children, but nor should she act with the desperation of someone who believes that it would be impossible.