Speaking of Infertility Awareness: The Question of Age + Pregnancy = Never-Ending Confusion?

Advanced maternal age and how it gets in the way of pregnancy is in the news again. This time, the focus is on how so many women have the misunderstanding that assisted reproductive technology can defeat age as a barrier to conception.

How many times have I heard, "Dr. Kristiansen -- I hate that term! Can't we use something different to refer to my age?" Sorry -- it's a rather tacky-sounding medical terminology shortcut that means "chronologically older than average for optimal fertility".

Here's a message that needs to be heard during this National Infertility Awareness Week:

The fact: Without intervention, most women in their 40's (and many in their 30's) would not get pregnant.

Another fact: Yes, IVF is incredible technology worth marveling at, and one of the reasons is its ability to facilitate conception in women who otherwise would not get pregnant.

The Big Myth: IVF is so effective, you can wait until you're of "advanced maternal age" to try and get pregnant -- and have a high likelihood of succeeding by way of fertility treatment.

That myth IS a fact for some women. But only for some women. Are you one of them? There's a good chance that a thorough diagnostic workup by a reproductive endocrinologist can provide clues to answer that question. Can we guarantee it? No.

I don't think either the media or fertility experts intend to confuse women about the question of age and pregnancy. But the confusion among women is apparently prevalent and ongoing.

Just as it would be overkill to suggest that all women in their teens or early 20's run out and get fertility testing to prepare for the future, it is unreasonable to recommend women put all their eggs into that future basket by expecting ART to be their surefire answer to pregnancy. (There is the option of freezing your eggs, a different but related story...)

So, the simple truth: If you're delaying conception until your late 30's or older with the intention of simply walking into any fertility center and getting pregnant easily on the first try, you're automatically decreasing your odds.

If you're like many of my patients and have delayed pregnancy for lifestyle reasons like not finding Mr. Right, wanting to give your all to your career before parenthood, or because your finances aren't in order yet, you can take heart in knowing that virtually any safe and effective technique will be made available to you here at Houston Fertility Center. Not only that, but the treatment will be delivered by a team of experienced, compassionate women.

We know how much you want a baby. We applaud your courage and tenacity in the pursuit of parenthood. We'll educate you about every treatment option. We'll be your cheerleaders in the journey. And we'll be honest with you, too.

~ Dr. Sonja Kristiansen M.D.




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Is Putting Off Pregnancy The Best Idea?

An article in the Los Angeles Times recently touted the benefits of the economic recession in terms of women delaying pregnancy.

While I believe that there are certainly advantages (as described by the author) to later-aged motherhood, I think we need to tread carefully when discussing the impact of age on fertility in general.

The majority of women (and men) have no idea what their body's fertility status is until they try to conceive. Unfortunately for some, the news is not only alarming but comes too late for them to take advantage of treatment in an optimal way.

Of the many causes for infertility, many (perhaps most) are not age-related, it's true. But that rosy perspective can work in reverse -- if a woman's not ovulating or if her tubes are blocked, it doesn't matter how old she is: she won't get pregnant without assistance.

While we're looking for silver linings to the recession's dark cloud, let's not throw the baby out with the bathwater.

How Old Is Too Old?

Recently, a local colleague of mine was quoted in the media about having an "an age cutoff" for fertility treatment, specifically IVF. I thought I'd enter the field to air my own thoughts on the question of "how old is too old" for becoming a mom.

In my practice at Houston Fertility Center, I don't use any particular age to determine whether a woman is "too old" to use IVF. Mother Nature will determine when a patient's body is unable to conceive. So we explore the same related variables -- egg reserve, uterine health, hormone levels -- with every patient.

Our primary emphasis is on the health of the hopeful mother-to-be.

As for IVF using donor eggs, which allows women with low ovarian reserve to become pregnant, I find that women in the age range of 48 to 50 are starting to think again about the impact (of carrying a pregnancy) on both their health and the outcome for the baby. We presently don't have enough data to clearly determine all health issues for women over 50 years old who become pregnant. Research has clarified, however, that children born to mothers in their later years have a higher risk of a number of health conditions.

As with virtually every other facet of the conception picture, a woman's age must be taken into consideration, but primarily in the context of her present health condition.

For more of my thoughts on a woman's age and her fertility, see these blogposts, too:

The Other Side of the Age & Fertility Message


Trying to Get Pregnant After 30 - Time to Panic?


ASRM Embryo Guidelines Should Improve Overall Picture for Fertility Patients