Delaying Childbearing: How Old is Too Old?
According to an article published in the Nov. 4, 2005 issue of the New England Journal of Medicine, the past decade has seen a remarkable shift in the demographics of childbearing in the United States. The number of first births per 1,000 women 35 to 39 years of age increased by 36 percent between 1991 and 2001, and the rate among women 40 to 44 years of age increased by a remarkable 70 percent. Additionally, in 2002, 263 births were reported in women between 50 and 54 years of age.
Most media attention paid to older moms has been favorable, inspiring a female business-school student who declared on a nationally televised segment of CBS's "60 Minutes" (entitled "The Biological Clock"), "I plan to be super fit, super in shape when I'm 40, 50. And if I'm physically able to do it, then I will have a child at 55."
Yet, how old is too old, and how realistic is it for a young woman today to expect to delay her childbearing into the later decades of her life?
You Can Be Healthy, But Fertility Still Decreases
Women tend to think that if they go to the gym, eat
healthy, take vitamins and really take care of themselves
properly, then they should be able to have a baby. Women need
to separate general health and reproductive health and be aware
that fertility DOES decrease with age no matter how well you
take care of yourself.
Yes we do have the technology to help older women achieve pregnancy, yet there are much higher risks associated with advanced maternal age.
The effect of maternal age on the outcome of pregnancy is best assessed by examining the source of the risks: those associated with using older eggs and those from having an older "carrier." Egg issues result in declining fertility, miscarriage and babies with chromosomal abnormalities such as Down's syndrome. Carrier issues include gestational diabetes, hypertensive complications and stillbirth.
So what about the notion of delaying childbirth until a maternal age of 45, 50 or older?
Is a "Cutoff Age" Discrimination?
In my program there is currently no cut-off age for a woman
requesting assisted reproductive procedures to get pregnant.
Many programs do use a cutoff age which is usually arbitrarily
determined by the doctor. I feel that this is age
discrimination since there are no studies that indicate that
there is a specific age beyond which pregnancy should not be
attempted.
If a program has a cutoff age of 45, can the doctor tell the 46 year old that her risks are appreciable different from the 45 year old? They can't.
Patients and their partners should be informed about the potential risks and allowed to make their own decisions about treatment just like they do in all other areas of medicine.
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Member Comments On...
Delaying Childbearing: How Old is Too Old?
16 |
I didn't start my period until I was almost 18 years old. So I didn't loose a ton eggs in my youth even though they were aging right along with me. I didn't plan to wait to have kids. But not meeting my hubby until I was 28 and getting married at 30 made having baby #1 at age 32 and baby #2 at age 34 just part of our life. I didn't have any pregnancy complications and neither did the kids. I did end up with a C-section for both due to each one getting "stuck". Now at almost 36 we are have been trying for # 3 for 11 months with no luck. I start a cycle of Clomid this month. So we shall see how it goes. if no pregnancy within the 6 months they allow then I will just have to resolve myself that the 2 gorgeous kids I have are fulfilling enough. I can't complain when my sister is going through her 4th cycle of Clomid at age 38 and has had 2 miscarriages.
21 |
We waited until I was 30 to get pregnant with our first. I think that was generally ok timing except when it took a long time to conceive the next one. You dont realize how much you will worry about the aging of your eggs and health of the fetus until you're in the middle of it. Then again, we had a lot of fun in our 20s so its hard to say I wish I would have had kids earlier. But I'd start no later than 30 if possible.
