The Truth About Fertility After 35

If you’re 30 or older and hope to be a mom one day, then a new story in the June issue of The Atlantic is probably already on your radar. Its much-buzzed-about premise: That baby-making panic among 30-something women is overblown, and the fertility cliff you hit during this decade isn’t as steep as you’re led to believe.

The author, Jean Twenge, tears apart some scary statistics. First, an often-cited 2004 study, which shows that one in three women between 35 and 39 will not be able to conceive on their own, turns out to have been based on data from French births that took place from 1670 to 1830. And rather than fertility dipping at 27 before plunging hard at 35, a study of modern women shows only a 4 percent drop in conception rates from ages 28 to 37, reports Twenge.

Reassuring news, right? Well, not quite. While fertility anxiety for women in their early 30s is probably not warranted, well-established research left out of The Atlantic article shows that your ability to conceive a healthy pregnancy really does decline in your mid-30s.

“Most women who want to be moms in their 30s will be able to get pregnant on their own,” says Alyssa Dweck, an ob-gyn in Westchester, New York, and coauthor of V Is for Vagina. “But some won’t, and that fact can’t be brushed aside.”

What triggers the fertility fail? No matter how young you feel at 35, your eggs are more fragile than they were even a few years earlier. Data from the American College of Obstetrics and Gynecology (ACOG) demonstrates this: In analysis done on the embryo transfers that took place in the year 2006, 44.9 percent resulted in live births in women younger than 35 years—compared to 37.3 percent in women 35-37, 26.6 percent in women 38-40, 15.2 percent in women 41-42, and 6.7 percent in women 43-44. When the eggs were donated by healthy young women, however, 54 percent of transfers resulted in live births, no matter what the age of the recipient was (suggesting that eggs become less viable with age).

As you get older, you’re also more likely to deal with health problems that may affect your fertility, according to the Centers for Disease Control. Diabetes, obesity, and even high blood pressure all put a dent in your baby-making ability, says Dweck.

When older moms do conceive, they have higher odds of having a baby with chromosomal damage, which can result in birth defects such as Down Syndrome. They also face an increased risk of  complications in the delivery room, according to a 2007 study that examined data from births between 1980 and 2004 (when more older women started having babies).

The Atlantic article does make some solid points, though. Fertility anxiety may be unintentionally fanned by reproductive specialists who regularly treat fertility-challenged women and don’t take into account all the older moms who pop out a kid problem-free, says Dweck. And the lower bambino rates among post-35 women might be skewed by the fact that in general, older women may be having less sex, she adds.

Finally, the post-35 plunge is just a guideline. Some women will have trouble conceiving in their 20s, while for others, it’ll be smooth sailing past 40. “But since you really can’t predict whether you’ll have problems or not, it’s best to play it safe and start trying to conceive by your early 30s,” says Dweck—if you can, that is.

If you’ve already hit that threshold and your life isn’t settled enough to try for a baby right now, there are some steps you can take to increase your motherhood odds when you are ready. “See your ob-gyn for a pre-conception exam, where she checks your overall health and tests you for conditions that can make it tougher to conceive and carry a child,” says Dweck. “By maintaining good health, you improve your chances of being a mom at any age.”

photo: iStockphoto/Thinkstock

More From Women’s Health:
Should You Get Your Fertility Tested NOW?
Fertility Questions
Fertility Treatments: Is IVF Dangerous?

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Should You Get Your Fertility Tested NOW?

Not sure when or where babies fit into your future? Elisabeth Röhm, aka Serena from Law & Order, wasn’t either. At 34, she thought she had time to figure it out—until a visit to her doctor revealed that her odds of her conceiving a baby naturally were close to zilch. Röhm’s new memoir, Baby Steps: Having the Child I Always Wanted (Just Not as I Expected), comes out today. In the book, she shares how in vitro fertilization (IVF) helped make her dreams of being a mother a reality—despite complications along the way. Röhm dishes on the details on the book, along with why it’s important for women to take ownership of their fertility early on:

In your book, you’re telling the full story of your infertility and IVF treatment for the first time. How long had you been trying to have a baby when you found out about your fertility issues?
Well, my fiancé, Ron, and I were open to the idea of having children but weren’t actively trying at the time. Without giving too much of the book away, I was actually encouraged by a person who had missed his opportunity to have children to go to the doctor just to get a fertility status report for myself, which is when I found out things weren’t looking so great.

So what was your particular roadblock, according to the doctor?
My hormone levels were really high, which indicated that my eggs were in an accelerated aging process. My doctor said that it was unlikely I would ever get pregnant naturally, and that I needed to be proactive if I wanted to have a family at all. That was a shock to find out at 34.

No kidding. What was it like to hear the doctor say traditional conception was practically out of the question?
I felt so many things—fear, hopelessness, shame. I was upset that I couldn’t give Ron the fairy tale. Infertility can feel like the greatest disappointment of all time because your ability to make a baby is so tangled up with your identity as a woman. 

That must have been tough to process, especially since it came as such a surprise. How soon after getting the news did you start thinking about the possibility of assisted fertility?
I actually made moves pretty quickly, despite my disappointment. I’ve always wanted to be a parent; even as a teenager, I would fantasize about my future baby.  IVF was really my only option to make that a reality, so I just put my blinders on and said, “Okay, I’m making this baby.”

The IVF process sounds pretty intense. What’s it really like to go through?
There are definitely highs and lows. On one hand, you’re very focused on what you have to do—but there are also feelings of embarrassment that you’re not “enough of a woman” to get pregnant naturally. It takes this beautiful act of love and turns it in to a science project. There’s this guy giving you shots in your butt and you’re thinking to your partner, “I’m sorry we can’t do this the traditional way.”

What advice do you wish someone had given you during your treatment?
To not be so private. I kept a lot of thoughts to myself, but I should have allowed myself to be more vulnerable, especially with Ron. Women need to talk about what they’re going through.

Why do you think many women are hesitant to share their fertility struggles?
We don’t like to talk about things that make us feel like we’ll be judged—but we shouldn’t suffer in silence, either. Women love to talk about pregnancy and baby showers, so why not talk about how you got pregnant? Opening that conversation can help you fully accept and work through your situation, as well.

Your daughter Easton is now 3—so it’s been almost four years since you went through IVF. What made you decide to tell your story now?
I had complicated feelings about my situation. At first, you don’t want to tell anyone because on some level you feel there’s a part of you that’s broken. But after seeing this stigma surrounding infertility, I thought to myself, “Why am I being silent?” I saw an opportunity to speak out and help other women going through what I went through.

Why do you think “fertility awareness” is so important for all women—even if potential baby plans are years away?
You don’t want to find out at 38—once you’ve scaled all your mountains and slain all your dragons—that you’ve run out of options. Unfortunately, time is not on your side, but you can have a baby your way anyway. Be observant with your body, and if you want kids, consider having your hormones and fertility levels checked each year. Think of it as an insurance policy for the future.

Note: While there is no general guideline for when women who aren’t actively trying to have a child should see a fertility specialist, you may want to undergo testing if you notice signs of fertility trouble, says Alice Domar, PhD, the director of mind/body services at Boston IVF. These may include irregular or absent menstrual cycles, very painful periods, or a history of a pelvic infection, a ruptured appendix, or known endometriosis. Of course, having trouble conceiving for several months—or worrying excessively about it—are also signs you might want to get your fertility checked out, regardless of your age.

Buy your copy of Baby Steps, on shelves April 30.
Connect with Elisabeth on Twitter or Facebook.

photo: Da Capo Lifelong Books

More From Women’s Health:
Fertility Treatments: Is IVF Dangerous?
The Sign That Predicts How Long You’ll Stay Fertile
Fertility Questions

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