Standing in the line at the supermarket, it’s hard to miss the tabloid covers that scream back at me. While I don’t normally care what the cast of Jersey Shore is up to or who’s divorcing whom, one story seems to be repeating itself over and over—celebrities over age 40 having babies.
Actress Kelly Preston, wife of John Travolta, just gave birth to her third child at the age of 48. She claims to have conceived the baby naturally, but Scott & White infertility specialist Jose F. Pliego, MD said the chances of a woman getting pregnant after the age of 40 are pretty slim.
“It’s really not an ideal time to have a child,” he said. “If the patient has already made the decision that she wants to have a child, then she needs to act upon that desire and try to conceive early.”
Dr. Pliego said if the patient is trying to wait for economic stability or to get established in the work force and the woman is over 35, that’s a real problem when it comes to fertility.
Even though it is more difficult to have children later in life, the doctor said more and more women are choosing to put off pregnancy.
“Today, approximately 20 percent of women wait until over the age of 35 to begin planning their pregnancy,” he said. “We didn’t used to have this problem in the old days. Women had children young and stayed at home to raise them. One reason patients wait to have children could be that we have many methods of contraception that are readily available.”
Another reason women are choosing to postpone pregnancy is because they are trying to compete with men in the workplace.
“[Women] feel like for them to be up to par, they need to be assertive, focused and give it 100 percent,” Dr. Pliego said. “It’s hard to give it 100 percent when you’re pregnant. So, they try to postpone it until the promotion comes.”
Many people think that if they haven’t gone through menopause, then they should be able to get pregnant. But that’s really not the case, the doctor said.
“A woman in her 40s only has a three to five percent chance of getting pregnant per month, where a 30-year-old woman has approximately a 20 percent chance of getting pregnant per month,” he said.
The reason for this jump in infertility is not because of the age of the fallopian tubes or the uterus; it is because of the age of the patient’s eggs.
“Girls are born with all of the eggs that they’re going to have throughout their lives,” Dr. Pliego said. “So, they cannot create or form additional eggs [later in life].”
A degenerative process called atresia slowly eliminates the eggs in a woman’s uterus. At birth, a woman has about two to four million eggs, but enters puberty with about 400,000. Over the years, the woman will lose about 350 eggs through ovulation.
So, the older the patient, the more difficult ovulation and fertilization become.
“Patients are going to use all of their good eggs when they’re young—in their 20s and early 30s,” Dr. Pliego said. “Then after the age of 35 fertility declines. And accelerates again after the age of 40.”
Because there are fewer “good” eggs to fertilize in an older woman, the higher her chances are of having a child with a genetic or chromosomal disorder. One of those disorders, that has been linked to maternal age, is Down Syndrome.
“The chances of a 25-year-old woman having a baby with Down Syndrome are 1 in 1250. But if you look at a patient that’s 45, her chances of having a baby with Down Syndrome are 1 in 30.”
There is also a high risk of miscarriage in older mothers because of the increased chances of genetic abnormalities. Over the age of 40, the probability of a miscarriage increases 40 to 50 percent.
“Many of these genetic disorders are not compatible with life and Mother nature will arrest the development of that life at a very early stage and doesn’t allow a baby to continue to grow,” the doctor said.
However, there is some hope for a good outcome for women wanting to become pregnant later in life.
“One way to help a woman over the age of 40 conceive a child is to use Invitro Fertilization and a donor’s egg,” Dr. Pliego said. “We can aspirate eggs from the ovaries of the 25-year-old and then fertilize them in-vitro with the sperm of the patient’s husband. The developed embryos are then placed in the uterus of the older patient. Now her chances of getting pregnant are the same chances of somebody who is 25-years-old.”
Even though there are some methods of assisting an older patient in conceiving a child, Dr. Pliego does not recommend waiting to have a child.
“Seek infertility evaluation and assistance early,” he said. “If the patient is already over the age of 35, that patient cannot wait a year to try to conceive on her own. That patient should be assessed by a physician as soon as possible.”
For more information, go to http://www.asrm.org/ or ask your primary care physician to refer you to a Scott & White infertility specialist.