More People are Having Babies Later in Life
The number of births is the United States is at its lowest level in 30 years. The National Center for Health Statistics reports that US fertility rates fell in every reproductive age group, except in people age 40-44. This reflects a new generation of people who are delaying marriage, pursuing more education and climbing the corporate ladder. In just one generation we moved from childbearing in our 20s to having the kids in our late 30s or even early 40s, and this change has resulted in more people having difficulty building their ideal families.
Did you know that by 40, more than 50% of women have difficulty conceiving?
It’s just one more thing in the long list of gender inequities--sperm are produced every day, but people are born with all of the eggs they will ever have. By 35, half a the eggs are abnormal and by 40 this statistic approaches 80%. This means if someone is waiting until the late 30s to start trying for a family, each egg is less likely to result in a pregnancy, there may be an increase in time needed to achieve pregnancy, and the risk of miscarriage increases.
What this also means is that people are trying for baby number one at a time where it is already more difficult to achieve pregnancy. It is at this juncture that I ask my patients to consider their family building goal. It is not uncommon for this goal to be, “We want two, maybe three kids some day, but we are just focusing on this first one.” I would be doing my patients a disservice if we didn’t discuss options at this point for not only fertility treatment for their immediate goal of pregnancy, but also fertility preservation, for the children they hope to have in the future at an even later age.
Very few patients are focused on their overall family building goal.
Most of us are of course focused on--“How will I get pregnant with number one, ASAP?!!”
With the wide spread use of the fast-freezing method called vitrification, and pre-implantation genetic testing of embryos for aneuploidy (PGT-A) making IVF success rates better than ever before, we are moving to a different era of family planning. While family planning has traditionally referred to birth control methods to prevent pregnancy and access to abortion, the definition of family planning by the US Health Department is now “the educational, comprehensive medical or social activities which enable individuals to determine freely the number and spacing of their children and to select the means by which this may be achieved.” Just like a person can proactively prevent pregnancy, they can also freeze their eggs or embryos to achieve pregnancy at a later time in life.
We spend a lifetime learning and planning for our financial and educational future.
It is time to do the same for your fertility future.
Being a fertility patient when you are ready to have a baby is very traumatic. I see every day how frustrated people feel after spending a lifetime preventing pregnancy, only to find out that it can be harder to achieve pregnancy than they ever imagined. If you are already having difficulty conceiving or if you are planning to wait until mid to late 30s, achieving pregnancy doesn’t get easier with age. The conversation then becomes one concerning fertility treatment for that initial child followed by fertility preservation for any future children. This increases the time to pregnancy as patients often need to do IVF to save healthy (chromosomally normal) embryos for future children. No one thinks achieving pregnancy will be difficult for them, but looking young and being healthy doesn’t equal good fertility. Know the statistics, consider your family building goals and learn about your options.
Below are some things can you do to get ahead of your fertility:
- Ask your doctor for fertility testing at your yearly well-woman visit. This is an AMH level that can be followed over time and is a little window into your fertility. It doesn’t tell you if it will be hard to achieve pregnancy, but it does tell you if you have eggs left. Every person is different, and you don’t want to find out when it is too late that you are out of eggs.
- Take care of your health. Minimize alcohol and eliminate marijuana, minimize reproductive toxins in your life, and protect yourself from sexually transmitted infections that can cause infertility.
- Talk to a fertility specialist and learn about your options. Consider if preserving your fertility with egg freezing or embryo freezing is right for you.
What can you do when you are in the middle of fertility treatments:
- Know your fertility. Understand how age and your ovarian reserve effect your chances of conceiving now versus when you will be ready for a second or a third child.
- Define your over-all family building goal. Allow yourself to dream big. Be honest with yourself: Is your goal just one baby or have you convinced yourself that it is too overwhelming to think past the idea of more than one pregnancy?
- Make a Plan. Talk to your fertility specialist and make a treatment plan that is right for you to meet your family building goals. This could involve saving eggs or embryos for future pregnancy attempts.
- Don’t compare. Every patient is different, and no plan is the same, and that is okay. Everyone’s resources--physical, emotional, financial--are limited in different ways. Allow yourself to feel confident in yourself, your doctor and your plan for your future family.
The Fertility Experts' Guide to Egg Freezing!
Dr. Julie Lamb and Emily Gray, RN, BSN published a book called "The Fertility Experts’ Guide to Egg Freezing: Everything You Need to Know About Putting Your Fertility on Ice" for learning about the process of egg freezing from start to finish! It's a quick field guide to everything you need to know about the process, boiled down by an expert doctor and nurse team. Together, the duo lay out—step-by-step—exactly how egg freezing works, what to plan for and expect from the fertility treatments, and invaluable tips and tricks for anyone going through an egg freezing cycle—or even just considering if egg freezing is the right step to take for their family-building goals. At a critical time when women are taking more control over their careers and their futures, this book empowers women to learn about their fertility and all the options they have available to them. You already plan for your financial future—now it’s time to plan for your future fertility and the family you'd like to have. This book is a must-have resource that will help you decide if egg freezing is right for you!
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