If only our bodies kept in time with our choices. It’s no secret that the past several decades have brought forth a seismic shift in childbearing practices, particularly in the area of maternal and paternal age, worldwide.
In the United States, from Colonial times through to the late nineteenth century, the vast majority of Americans chose to marry and have children by their early to mid-twenties. Young marriage and parenthood were rational choices for people living in a society dependent upon family production, where children typically worked on family-run farms or businesses and family was necessary for survival. Societal mores and lifestyles have changed dramatically since that time, yielding a luxury of personal choices for women in areas of their lives as diverse as the paths their careers will take, and also as to the age they will be when they opt to consider marriage and/or motherhood.
Unfortunately, evolution has not kept pace with our choices, and all too often, women realize too late that despite society’s nod to the contrary, our bodies’ biological clocks are still ticking in time to the mores that were more common a century ago.
It’s also true that fertility potential varies from woman to woman. There are women who conceive naturally in their forties, and these stories often fuel widespread misperceptions that every woman will be thus blessed. However, for the vast majority of us, fertility potential will take its first subtle dip at around age 27 and then accelerate downwards beginning at around age 35. For most women, conceiving naturally without some sort of outside medical support will be almost impossible after age forty. And this does not take into account other underlying causes of infertility that might be occurring simultaneously as we get older, such as fibroids, endometriosis, or polycystic ovarian syndrome.
It’s important to note that there’s a lot we can do to keep ourselves healthy, and we should do those things. Eating intelligently, exercising, not smoking, avoiding environmental toxins and sexually transmitted infections simply makes good sense. But no matter how healthy you are on the inside, or how fabulous you look on the outside, your ovaries are going to continue to get older as will your ever-diminishing egg supply. Aging eggs may also create higher miscarriage rates for some women, due to chromosomal damage. And existing conditions that you may have, such as tubal damage, pelvic infections, endometriosis, fibroids, ovulation and hormonal issues, often escalate and become exacerbated as you get older.
But there is good news. First off, facing the truth about your body and your choices is empowering. Learn about your own biological clock And if more than three or four months go by without a positive YES showing up on that little stick, consider seeing a specialist. If your current doctor is uncomfortable talking to you honestly and frankly about your biological clock and fertility potential, then this is the time to consider making a change.
What seems to make sense as a first step is to find an infertility specialist you trust, and be prepared to discuss the following:
- Reproductive history
- Medical and surgical history, including current medications
- Family health history
- Home and workplace environment
- Your weight and lifestyle
Your doctor will also perform a physical exam including a pelvic exam, blood tests and sonogram as well as a 3-day FSH test, an anti-Mullerian hormone test and/or a clomiphene challenge test in order to evaluate your remaining ovarian reserve.
This is the time to ask any questions that you may have. You might also want to consider talking to your doctor about egg freezing. While not an iron-clad insurance policy, for many women, freezing their eggs now will offer real potential for conception and pregnancy later on in life. Discuss the pros and cons of this technique as it pertains to your particular case, your age, and your current egg quality and quantity.
Remember that egg or embryo donation can also provide viable routes to motherhood when you are ready, as will various types of adoption, including domestic, international, or foster care adoption.
Women’s options for conception, pregnancy, and motherhood are more varied and better than ever before. The odds are still on your side. It’s up to you to keep them that way. .
The American Fertility Association Fact Sheet series