Delaying Childbearing: How Old is Too Old?

By Randy Morris, MD

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Preimplantation Genetic Diagnosis
An older woman who wants to attempt pregnancy using her own eggs can reduce the risks associated with older eggs by attempting pregnancy using in vitro fertilization with preimplantation genetic diagnosis (PGD). PGD can screen out most of the chromosomal abnormalities which may occur in older eggs.

Compared to in vitro fertilization without PGD, the chance for pregnancy can be increased 15 to 20 percent and the risk for miscarriage decreased by 50 percent or more. The risk for delivering a baby with Down Syndrome can almost be eliminated.

Alternatively, older women can use eggs donated from a younger woman. Pregnancy rates among older women who choose this route are excellent, with the risks of both miscarriage and chromosomal abnormalities consistent with the age of the donor, rather than the recipient. These women are still subjected to the same "carrier" risks however, consistent with their own age.

So how can we advise young career-minded women when she asks about her choices in regard to fertility?

What Age Is Ideal?
Generally speaking, the decade between 25 and 35 years of age would seem to be ideal. A woman's education is typically complete, she has usually gained some experience in her professional arena, and pregnancy is at its safest.

For women between 35 and 45 years of age for whom earlier childbearing is not an option, this decade remains safe enough that maternal age alone should not be a contraindication to childbearing. However, women do face decreasing fertility and an increase in the risks of miscarriage and chromosomal abnormalities. Perimenopausal and postmenopausal pregnancy remains an option for those women who are lucky enough to find themselves healthy and sufficiently wealthy to pursue it, and who are willing to assume the risks involved.

About the Author: Randy Morris, MD, is one of the nation's top reproductive endocrinologists specializing in infertility and reproductive medicine and medical director of IVF1. With offices located in Naperville and Chicago, Illinois, Dr Morris is a leader and innovator among his peers in IVF treatment, egg and embryo donation and preimplantation genetic diagnosis (PGD). He is board certified in both reproductive infertility and obstetrics and gynecology. Dr Morris serves as an Associate Clinical Professor for the Division of Reproductive Endocrinology at the University of Illinois School of Medicine in Chicago. He is also a nationally recognized presenter and speaker on new techniques and procedures in his field. In addition, Dr Morris is the recipient of the President's Award from the Society for Gynecologic Investigation. Dr. Morris is a graduate of Northwestern University and University of Illinois School of Medicine at Chicago. Visit him online at www.ivf1.com.

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