Top fertility experts staunchly at odds with delaying parenthood-warning of the fertility risks and reliability of IVF in older women
Geeta Nargund, Britain’s top fertility specialist, is staunchly at odds with women over 30 delaying parenthood. Have children too late, and you could miss out completely is the message Professor Nargund recently conveyed.
Professor Nargund’s no-nonsense position that women should “start trying for a baby before 30 – or risk never having children” was conveyed in a frank letter addressed to education secretary Nicky Morgan. In the letter, which was published on Daily Mail, Professor Nargund demanded that teenagers be taught the “dangers of delaying parenthood because of the spiraling cost to the taxpayer of IVF for women in their late 30s and 40s.”
Her letter cited the devastation and regret by women who realize they are too late to start a family. She also argued that many young people were poorly informed about the impact of age on fertility.
When is a woman’s “best” reproductive age?
According to a 2012 guide on age and fertility by the American Society for Reproductive Medicine, a women’s best reproductive years are in her 20’s. Fertility gradually declines in the 30’s, particularly until 35 – after which point it sharply declines.
“Each month that she tries, a healthy fertile 30 year old women has a 20% chance of getting pregnant per cycle, by age 40 a women’s chance is less than 5% per cycle,” the guide states.
These percentages are true if conception occurs by natural conception, fertility treatments or IVF. “Fertility does not last until menopause,” the guide makes clear. “The average age of menopause is 51 but most women become unable to have successful pregnancies sometime in their mid-40’s.”
How reliable is IVF in older women?
Dr. Marta Devasa, gynecologist at Dexeus Women’s Health, recently presented her research on IVF fertility rates in older women at the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE).
The data came from a Spanish clinic that treated 4,195 women and 5,841 cycles with IVF. The clinic calculated the cumulative live birth rate using one fresh and any subsequent frozen embryo transfers over 12 years.
The study showcased the difficulty of getting pregnant through In-Vitro-Fertilization (IVF) for women over 44 using their own ovules, with a treatment success rate for IVF cycles of only 1.3%.
The results demonstrated that fertility begins to significantly drop after 38. The rate of live births after IVF using their own ovules, is 23.6% for women between 38 and 39 years, 15.6% aged 40-41 and dropping as low as 6.6% in those between 42 and 43 years.
The conclusion drawn from the study was that by the age of 35, women should be urged to freeze their eggs and women over 44 should choose donated oocytes in order to increase their success rate as the “chances of success with their own ones are scarce.”
“And it is true”, Dr. Devasa argued, “Pregnancies in older women and celebrities don’t help us because many people don’t know that most of the time they have gone for egg donation.”
The dangers of “fertility security”
An increasing amount of young women may be being lulled into a false sense of “fertility security”. A study published in the journal Human Reproduction found entrenched fertility myths among University Israeli students.
According to the authors, these myths included in particular “the false belief in the possibility of late (beyond 35 years) and very late genetic motherhood. This can be explained by the technological ‘hype’ and favorable media coverage of very late pregnancies.”
Perhaps, the media’s infatuation with celebrity baby bumps may have become a “raison d’être” for delaying parenting. The media has” glamorized the “40 is the new 30” frenzy of celebrities with children, including Salma Hayak, age 41, Halle Barre, age 42, Kelley Preston with her third child at age 47, and Laura Linny welcoming her first child at age 49.
Other scholars such Elizabeth Gregory, author of “Ready, Why Women Are Embracing the Later Motherhood”, argue “the national media have tended to focus on the individual and on the negative, leaving us with a skewed sense of what’s going on or what’s at stake.”
In an opinion piece for The New York Times, Gregory, who is also director of women’s studies at the University of Houston and research fellow on the Council on Contemporary Families, pointed out that women are delaying conception globally.
“The ‘experts’ are just catching up to explain why. Women figured out early that delay provides a shadow benefits system in our family-unfriendly world: higher salaries, more flexibility and higher marriage rates, as well as more interest in staying home at night,” she wrote.
“Along with personal benefits, delay has been an engine of feminist social change because it allows women – who for millennia were kept busy, uneducated and out of decision-making circles by early and unending fertility – to begin to have a voice in policy. Change creates pushback, as today’s harsh fertility politics demonstrate,” Gregory added.
Her work has explored why so many women are making this choice and what the effects are for fertility, the individual women involved and on society at large.
Costly fertility treatments
And for women who intentionally delay pregnancies or marriage to pursue their education, careers or other personal goals, insuring their fertility can be cost prohibitive.
Egg donation costs around $10,000 per egg freezing cycle and $500 per year to maintain frozen eggs – such costs can be prohibitive, if not out of the question financially for some women or couples. Plus, there’s no guarantee that they will result in viable pregnancies.
Perhaps the best message is that women need to weigh up the benefits and risks of having children later in life themselves and be responsible for their choices. We can fight the fertility war without the media’s constant “tick tock” narrative.