Fertility: Is 45 the new 35?

Published Apr 12, 2013

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London - Halle Berry announced her pregnancy at 46. Model Elaine Irwin, who was married to John Mellencamp for 20 years and is already mother to two teenage sons, is expecting a child with new husband Jay Penske. She is 43.

Uma Thurman was 41. From Salma Hayek and Kelly Preston to Tina Fey and Madonna, the list of celebrities having children in their fifth decade keeps getting longer.

When it comes to having babies, many women in their 30s are used to hearing dire warnings about declining fertility and “advanced maternal age”. But when it comes to childbearing, scientific advances are making 45 the new 35.

“The good news is that if you have to have a baby by whatever means possible, there are ways,” says Dr Jamie Grifo, programme director of the New York University Medical Center.

Grifo has helped many women in their 40s and 50s, and is treating a 46-year-old who got pregnant using the eggs she froze at 42.

In many ways, celebrities have normalised late pregnancy for the rest of us in the same way as plastic surgery. We suspect they may have had some help behind the scenes – and want to know how to achieve the same results.

Berry has called her pregnancy “the biggest surprise of my life”, but for many women post-40 pregnancy can be a challenge. Fertility begins to decline at 30 and accelerates after 35. At 40, the chance of getting pregnant without assisted reproductive technology is around 10 percent, and after 45 it drops to less than 1 percent.

Yet scientific advances mean that more women are falling pregnant later in life.

The US Centers for Disease Control and Prevention reported that births in the 40-44 age range jumped up by 10 percent between 2007 and 2011 – the only age group that increased. So how are they doing it?

IVF can obviously improve the odds. Live birth rates at NYU are around 28 percent after 40, 18 percent after 42 and, Grifo says, less than 2 percent after 44.

Some women put eggs on ice.

Egg freezing (oocyte cryopreservation) was recently reclassified a “standard” rather than an experimental technology by the American Society of Reproductive Medicine, and according to Grifo, it’s now “levelling the playing field”.

Fertility is based on the age that the egg was frozen, rather than the biological age. So a 45-year-old woman using a 35-year-old frozen egg would have roughly the same chance of a successful pregnancy as one using donor eggs – around 50 percent.

Though it’s no guarantee, the technology is so promising that a British fertility expert suggested recently that “egg freezing should be every father’s graduation gift to his daughter”.

What about women over 40 who haven’t already frozen their own eggs? According to a study in The New England Journal of Medicine, donor eggs give a woman in her 40s the same chance of having a baby as a woman in her 20s.

Understandably, many celebs in their 40s and 50s who have used donor eggs keep it quiet. Marcia Cross, who had her twins at age 44, is one of the only celebrities to “come out” about using them.

Women constantly hear about the dangers of waiting to have children, and there are good reasons for caution. Women over 35 have an increased risk of complications including genetic disorders, miscarriage, diabetes and stillbirth.

But what about the upside? Studies show that people who become parents later report having a more established career, financial security and more emotional readiness. While those who start families young view middle age as occurring earlier, becoming a parent later can delay it.

Perhaps the major disadvantage is cost: According to Grifo, one round of IVF is approximately $10 000 (R88 000) in the US, egg freezing runs at around $20 000 and an egg donor comes out to about $28 000. Storage and drugs are often extra.

Nicole Kidman and Sarah Jessica Parker are among the stars who have publicly expressed gratitude to their surrogates or gestational carriers. But subsidising an entire pregnancy comes with a huge bill: with expenses including IVF, lawyer and agency fees and fertility medications, some estimates run between $80 000 and $100 000.

When it comes to fertility, experts advise being smart, staying informed about the risks, and following an anti-ageing diet by eating non-processed food and avoiding stress.

Rod Stewart and Alec Baldwin may be congratulated, but Grifo admits that women face a huge double standard when it comes to later-in-life pregnancies. “If people could stop judging and have empathy for what others are going through, imagine how great the world would be,” he adds.

Grifo advises women to “plan what you can, understand the process, and don’t ignore it”. Sometimes deciding when the right time to have children is like meeting the right person: we can’t control everything. – Daily Mail

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