As I contemplate planning for a second child (at age 36), I am reminded that although no blaring alarms are sounding…I do need to be cognizant that my fertility is rapidly changing with age. I mean…who knew that a simple mathematical concept could be so meaningful and relevant to your life…beyond 8th grade algebra class? Seriously, the slope of that chart is no joke.
Of course, many women today are choosing to have children later in life (I did)…and the reasons why are not exactly “Breaking News”. Females now account for 58 per cent of the nation’s college students, sex discrimination (on average) is fading, and job opportunities are widening each year. And so, more women are pursuing professional endeavors in their 20s and having children in their mid-to-late 30s and early 40s. Census numbers are supporting that shift. In the year 2000, the rate of birth among women 35 to 39 years old was up 30 percent from 1990. In women ages 40 to 45, the increase was 47 percent, and for those ages 45 to 49, the rate was 190 percent higher. Furthermore, 20% of women in the US are delaying their first child until after age 35, and an even larger group is delivering #2 and #3 beyond the “Advanced Maternal Age”. So what does this all mean? How much is your fertility changing above 35? And how do you balance spacing children with a shrinking fertility window?
First of all, let me say that 35 is not a magic number. Many women have perfectly healthy babies at age 35 and beyond. However, while the miracle of life is often described by words like “Complex”, “Amazing”, and “Divine”…the truth about our biology is simple. Getting older decreases a woman’s chances of having a baby. Period.
- Her ovaries become less able to release eggs.
- She has a smaller number of eggs left.
- Her eggs are not as healthy.
- She is more likely to have health conditions that can cause fertility problems.
- She is more likely to have a miscarriage.
I agree… that is not particularly cheery news. However, let’s look at some of the numbers…so that we can make informed decisions about our family planning. Here they go:
Fertility rates for women, without the aid of fertility drugs:
- At age 30, 75% will get pregnant within one year, 91% within four years.
- At age 35, 66% will get pregnant within one year, 84% within four years.
- At age 40, 44% will get pregnant within one year, 64% within four years
- About 10% of pregnancies end in miscarriage for women in their early 20s.
- By the early 30s, 12% of women experience miscarriages.
- After age 35, 18% of pregnancies will end in miscarriage.
- And in the early 40s, 34% of pregnancies end in miscarriage.
The risk of Down’s Syndrome:
- Women under age 23—1 in 2,000 births
- Women at age 30—1 in 1,300 births
- Women at age 35—1 in 400 births
- Women at age 40—1 in 90 births
- Women at age 45—1 in 32 births
- Women at age 50—1 in 8 births
Though I can see the trend, I can’t really wrap my mind around “odds”. So here is a better way to present the data:
- At age twenty, you had a 99.95 percent chance of not delivering a baby with Down syndrome, and at age thirty-five your chances of not delivering a baby with Down Syndrome are 99.75 percent. That sounds better.
Men and Fertility
While your husband might like to think that his virility is something akin to partying into his 80’s with Hugh Hefner. The truth is this… every cell in the body ages, including those in a man’s testicles and sperm. Therefore, men over 35 are twice as likely to be infertile as those under 25. Studies also show that (as with older women) older men are more likely to have children with birth defects, due to the decreased genetic quality of their sperm. Finally, one can only imagine what a lifestyle of smoking, alcohol, and drug consumption does to the quality of male sperm.
Spacing between children (Everybody weighs in differently on this topic, so I thought I would share what the experts think):
- According to a study in the Journal of the American Medical Association, “Timing pregnancies less than 18 months or more than five years apart could raise the chances of the second baby being born prematurely, at low birth weight, or small for gestational age”. Mom’s body needs time to replenish valuable nutrients and studies show that a woman’s fertility gradually declines after she delivers.
- Another study published in the New England Journal of Medicine reports that waiting 18 to 23 months after the birth of your last child before conceiving another seems best for the new baby’s health.
- A similar study at the University of California in San Francisco found that the ideal interval between babies is 24 to 35 months.
Fertility Tips (And so… if you are over 35 and trying to conceive, here are some mildly humorous tips to help you along your journey):
- See your Doctor. Visit an OB/GYN and thoroughly review your medical history. Warning! Your physician’s questions will be very personal in nature, however do not omit any pertinent information (to include previous pregnancies, miscarriages, medicinal marijuana, STDs, etc.). Just know that they have “seen it all” and address any health issues that could affect your ability to conceive, carry, or deliver a healthy baby.
- Make Folic Acid your friend. Folic acid is a synthetic form of folate, a vitamin that can help reduce the risk of serious birth defects (particularly those affecting the brain and spinal cord). These defects can occur in the embryo before a mother even knows she is pregnant. Food sources that are rich in folate (generally make you fart- that’s how I remember what to eat): lentils; dried beans and peas; dark green vegetables such as broccoli, spinach, collard or turnip greens, okra, and asparagus; and citrus fruit and juice. Fortified cereals, such as Total, and pre-natal vitamins offer 100% of your daily allowance of folic acid.
- Stop using Birth Control pills. Using condoms, a cervical cap, or a diaphragm will seem like a drag on your marital intimacy. However, it might be the best decision that you can make for enhancing your fertility. The American College of Obstetrics and Gynecology recommends that if you are taking birth control pills, continue to the end of your current cycle before stopping the pills, then start trying to conceive the next month (some doctors recommend waiting an additional month or more). Also, what about lube? Many specialists recommend not using synthetic lubricants when trying to conceive. Normally, the acidic secretions from the vagina kill sperm, however the alkalinity of cervical mucus produced just before ovulation protects the sperm. Artificial lubricants can prevent the sperm from reaching the cervical mucus quickly, so they die in the acidic environment of the vagina before getting inside the uterus (and the miracle of life can’t happen).
- Quit drinking, smoking and taking drugs. This one sounds like a no-brainer for Mom, however drinking, smoking, and drugs dramatically affect male fertility, too. It takes two to tango…and two to make a healthy baby.
- Track your periods by putting big “P’s” on your calendar. If your menstrual cycle (counted from the first day of bleeding, not spotting) is 28 days long, that makes day 14 (counting from the first day of your last period) your most fertile day. However, if you have a 30-day cycle, day 16 is the most fertile, and so forth. So put a BIG P on your calendar every time you get your period and insert that date into a web-based ovulation calendar for instant conception calculations.
- Watch for clear vaginal mucus, with the consistency of egg whites. When ovulation occurs, your body produces a slippery, thin substance called cervical mucus. This cervical mucus is like a slip n‘ slide for your man’s swimmers. If you examine yourself daily, you’ll notice a vaginal discharge that’s transparent and stretchy between your fingers, like egg whites, on your most fertile days.
- Chart your basal body temperature. A basal thermometer (found in most drugstores for $10), measures your body’s natural resting temperature, and can help determine when you are most fertile… by detecting a temperature rise that occurs during ovulation.
- Use an ovulation predictor kit. Available in drugstores and grocery stores without a prescription (found next to pregnancy tests), ovulation predictor kits can detect when your LH, or luteinizing hormone, surges. This generally occurs 36 hours before ovulation, so when you have an LH surge, you get a positive result on your testing stick, and then you know it’s time to get down to business. How does it work exactly? A “kit” holds several testing sticks. Therefore, you can plan to pee on a stick every day at the same time, starting on day 11 of your cycle. The major drawback with predictor kits? They can be expensive, especially if you use them month after month and surge later than expected (using more sticks than expected).
- Ditch the tighty whities. Make sure your man knows that sperm count drops — sometimes drastically — when the testicles are constricted or overheated (sperm is meant to be 2-4 degrees cooler than the body; that is why his fruit basket is displayed externally). So (if you are really trying hard to get pregnant), keep his underwear cool and loose and tell him to avoid hot tubs, saunas, and long runs (hot showers and moderate exercise are okay).
- Let gravity do the work. Don’t be too quick to hop up after lovemaking. While you don’t need to prop your legs against the wall (though you could), you might want to do a slight pelvic tilt (with a pillow aid) just to keep the swim team moving in the right direction.
Finally, if you are 35 or older, and you are having trouble conceiving… you shouldn’t keep trying on your own for longer than six months without talking with your Doctor. The sooner you get help from medical professionals, the better your chances for success!