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The Reality of Conceiving in Your Forties

It seems like every month there is a forty-plus-year-old celebrity gracing the cover of a magazine holding her new baby in her perfectly sculpted arms, who is of course resting against her mommy’s remarkably flat abs. Not only does this image torture real moms who are still fighting their last fifteen pounds of baby weight, but it actually misleads women about their chances of conceiving naturally as they age. Just this past weekend I had a conversation with an extremely intelligent woman in her mid-thirties who said to me, “Brooke Shields did it—I still have time (to get pregnant naturally) right?”

Experts would say, “perhaps.” But as the years go by, your chances will fall dramatically. What the media isn’t telling you is that most celebrities in their forties had more than a little help getting pregnant. And I don’t mean from their personal trainers, yoga masters, and nutritionists.

To shed light on this issue, I spoke with one of the most experienced fertility specialists in the country: Carlene W. Elsner, M.D. of Reproductive Biological Associates (RBA), a full-service infertility treatment center in Atlanta, Georgia. Not only has Carlene helped hundreds of women get pregnant over the past thirty years, she boasts achieving the “first frozen egg baby in the world,” revolutionizing the now- common practice of freezing eggs and embryos to conceive at a later date.

Carlene has personal insight about some celebrity pregnancies. “What the public doesn’t know is that these women in their mid-to-late forties get pregnant by using donor eggs. Just because you personally may be fit and in great shape, doesn’t mean that your eggs still are.”

Hence the rub. If you are in your thirties or forties and want to have a baby, this story is for you. Perhaps you are in your mid-to-late thirties and haven’t found Mister Right yet. Perhaps you are in your forties and want to conceive with your new partner. And, sadly, maybe you or your partner are about to undergo radiation treatment for cancer and want to conceive at a later date.

The good news is that in all cases, the remarkable advances in fertility medicine may make your dream possible. (For more information, see: Fertility Treatments, De-mystified.) Elsner says that in the old days, fertility specialists could help maybe half the people who came to them. Today, a staggering 90 to 95 percent of her patients can achieve a pregnancy.

There are many options to explore, however. The couple undergoing radiation may want to freeze an embryo since radiation can render them sterile. The woman waiting for Mister Right, who wants to conceive with her own egg at a future date, may opt to freeze eggs. If you are trying to get pregnant in your forties, you may want to explore conceiving using donor eggs. Younger same sex couples or single women who want to conceive may do the opposite via in vitro fertilization (IVF) using their own eggs with donor sperm.

Carlene explains that it’s critical to not only understand your options, but also to know what your chances are at your given age. Not all fertility treatments have high success rates for women in their forties because egg quality diminishes with age. For instance, IVF, which uses a woman’s eggs and mixes them with sperm, only has a 10 percent success rate for women over forty-three. If you take the same woman and use donor eggs from a much younger woman (say a twenty-seven-year-old) her chance of having a baby jumps to between 70 and 80 percent.

“Twenty-seven is the age at which a woman’s chance (of conceiving naturally) begins to decline. At age thirty-five, your miscarriage risk has just doubled,” Carlene says. But she adds that this should not discourage a woman who wants to have a baby. In fact, she noted many examples of her patients, including a fifty-three-year-old grandmother who carried her grandchild for her daughter, as well as a woman in her mid-forties who carried a child via donor egg and donor sperm.

There are options, but the best ones may not include using your own eggs. If this is something very important to you, Carlene says there are a few things to consider. If you are younger than thirty, you may want to freeze eggs—a technique that her clinic specializes in.

For patients who are uncertain, Carlene advises them to really think about what is important in a relaxed setting. She advises her patients to go home, have a glass of wine or a bath to relax and to envision their life at sixty, not now at thirty or forty.

“If they feel they can’t have children now due to work demands or lack of a partner, but definitely want them in their lives later, I say, it’s time to get busy and make a plan,” Carlene says. And to make that plan, she advises them to consider what is most important in order to determine the best fertility treatment options to explore or not.

Here are some questions Carlene suggests considering:

*Is it important that the child be genetically linked to you? Meaning, that the baby is conceived with your egg and your partner’s sperm?

*If it is more important to have a child regardless of whether it is genetically linked, how critical is it that you experience pregnancy and labor?

*How do you feel about adoption?

*How do you and your partner feel about using donor eggs or donor sperm?

*How would you feel about using a donor embryo?

Since fertility treatments aren’t cheap, and not all will be as successful for you as others, discuss all your options and their potential with your physician. If, in the final analysis, having a baby is more important than having a baby genetically linked to you—you will most likely achieve your goal. And that likelihood, just thirty years ago, would have seemed like a pipe dream.

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