This post was updated on May 20th, 2019
Why Every Woman Over 30 Needs a Plan
Are you over 30 and have yet to start a family? Well if so this article is for you.
I don’t want to freak you out, but if you haven’t heard or seen this elsewhere, here are some facts that might surprise you:
- 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy (CDC 2015).
- Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained (ASRM 2015).
With a bit of a ‘back of the envelope’ check, it didn’t take me long to figure out that there are millions of women online who were going to be wanting to learn a whole lot more about this subject, so I couldn’t help myself once I started writing this blog article.
The media’s lack of transparency about fertility
Every time I see a celebrity above the age of 40 announcing she’s pregnant or has just had a child I get pissed. And it’s not because I’m jealous, or I don’t like celebrities. It’s because my BS detector starts wailing like a banshee when the story behind how they managed this feat of biological improbability is seldom, if ever even given mention amongst the glamour shots and brightly coloured text.
Thanks to botox, air brushing and personal trainers these women in their 40’s look to be about 20 years old. So isn’t it just natural to assume that their bodies should also still work like a 20 year old’s when it comes to fertility?
And after doing a LOT of research on the subject of age related fertility decline, I can tell you right now that those “miracle babies” will almost always be thanks to an egg donor or their own frozen eggs from a younger age. Not to mention they would have spent a fortune on IVF. So where is all that vital information in the magazine interview?
But what about a healthy diet and lifestyle to extend fertility?
Yes, I agree that through a healthy diet and lifestyle you can definitely extend your fertility but unfortunately our health can only extend our biological clock so far, and unfortunately it is not all that much. A woman’s egg quality has been biologically created in such a way that no matter how healthy we are and how careful, it will always dramatically decline after the age of 35.
While society is trending towards having children at older ages, unfortunately our biological clock cannot evolve fast enough to keep up with the trend and because of this, a frustrating and ominous gap has developed between when we WANT to have children and when we CAN have children.
While less than 15% of women will retain the biological ability to have children naturally after their early forties and less than 6% of women succeed with IVF after this age (see “Misleading IVF Success Rates” blog post) clearly these statistics do not apply if you are famous in Hollywood…
Not a tin-foil hat wearing conspiracy
I am of the opinion that our contemporary culture towards woman’s fertility is moving toward normalising what is possible at the extremes of medical accomplishment at the expense of the physiological reality of how a woman’s body has worked for the 10,000 years leading up to the invention of IVF.
I’m not a tin-foil hat wearing conspiracy theorist, claiming that “the man” is behind this, and I don’t even really think the media is to blame because let’s face it, amazing stories about women having babies in their 40’s, and 50’s even, are well.. amazing. They make great headlines, and commercial media organisations are just doing what they were born to do… to make a buck for their shareholders and who could begrudge them that?
BUT I am going to point out some hard hitting facts because I think it’s easy for all of us to become mislead unless we make an intentional effort to find the truth.
I am not trying to be an alarmist about your fertility
This article is NOT an alarmist view about age related fertility decline intended to stress you out. It is an educational resource for you written with the intent of helping you make more informed decisions about what is best for you. What you do with this information is totally up to you and I respect everyone’s own opinions and experiences. All I want to do here is give you the scientific information I have come across and tell you about the conclusions I have drawn from this information.
My goal is to be your trusted, independent source of reproductive medical information so in order to do that I have curated the best scientific information that I could find that was available and have applied a good dose of old-fashioned common sense to provide you with the knowledge you need to make your own, informed choices about your fertility.
Unprotected Sex = Fun + Baby?
I just read the most amazing, and tragic story, by an anonymous author who identifies herself as Jane Everywoman and I will covered her story in a recent podcast episode. Jane was a school teacher and academic researcher who although married at age 27, decided to delay trying to start her family.
She had made a massive sacrifice and investment in gaining several higher degrees and professional qualifications, and it wasn’t until she was 32 that she felt her financial position and lifestyle was “right” for starting her family. This story might sound familiar to many.
…it was to me.
But by age 37, Jane was shocked that no baby had been conceived. Like many of us, Jane had subconsciously grown up with the understanding that “all acts of unprotected intercourse would inevitably result in a live birth.” (Everywoman 2013).
The consequences of leaving it too long to have a baby
Jane’s story of getting terrible advice from doctors, and “haemorrhaging” £18,000 (~US$30,000) and even more tears ultimately led Jane to resign from work in order to fully recover from her experiences which exacerbated her sense of loss of control.
Reading Jane’s article made me incredibly sad for this woman, who from her writing I could tell was a caring and sensitive individual who had dedicated her career to educating people no less! Even though she was terribly bright and educated Jane was duped by the system and while struggling to fall pregnant through her 30’s, unfortunately, ran out of time.
Doctors told her nothing was wrong and to just keep trying and because of a few subsequent miscarriages and having to recover from those, time just kept slipping by.
It also freaked me out a bit. What if I’m Jane Everywoman? This experience could happen to any of us who are in their 30’s and yet to start their families. “Trying” to get pregnant can take years and miscarriages really do take significant time to recover both psychically and mentally. I know this from experience, having already had two miscarriages myself. And let me tell you, miscarriages are much more common than people believe – it’s just that nobody talks about them.
Many of us make this same fertility mistake
Researchers from the University of California interviewed a large number of women between 2009 and 2011 that had delivered their first child following IVF at age 40 or older (Mac Dougall et. al 2013). Half of the women interviewed reported that they had expected to get pregnant without difficulty at the age of 40 with this mistaken belief being due to:
- ongoing messages about pregnancy prevention starting in adolescence
- healthy lifestyle and family history of fertility,
- incorrect information from friends, physicians, and
- misleading media reports of pregnancies in older celebrity women (!!)
You can’t make this stuff up! It seems I’m not the only one that has been fooled!
Even the experts are concerned
Nichole Wyndham from the Centre for Bioethics at Yale University summed up the situation beautifully when she said:
“Delaying motherhood should be a free choice made in full knowledge of all the consequences, but modern women have alarming misconceptions about their own reproductive systems and the effectiveness of assisted reproductive technologies…Preventing age-related infertility is the responsibility not only of doctors and medical practitioners but also of society at large. Social, economic, and personal pressures are causing women to decide to conceive later in life, yet those who choose to delay motherhood are stigmatized as being selfish and unconcerned about starting a family. This stigma must be banished, and age-related infertility should be faced as a medical problem.” (Wyndham et. al 2012).
It’s a fact that woman are having children later in life
Check out this graph. There’s nothing surprising here and you already knew this: since the 1970’s women have been choosing to have babies later.
Figure 1. Average Age of Mother at First Birth (Mathews et. al 2009)
It’s normal to struggle with fertility
What was really interesting about Jane’s story was how relatable, and common it is for many women, yet how utterly unique it was that it was being published at all.
According to some experts infertility issues affect around one in six of the population (Templeton, 1992), while others estimate that as many as half of women in their thirties will have some sort of fertility problem (Gustaffson 2001).
And as I will demonstrate in my next blog post, it is well understood in medical circles that 30% of women who start trying to have a family between the ages of 35-39 will remain childless in the absence of medical intervention.
IVF is not a “cure-all” or fall back safety net
If you have read my blog post on misleading IVF success rates then you will know that approximately 40% of women under the age of 35 fail to have a baby with IVF, and that this rate goes up to 80% by the time women are in their early 40’s. Unfortunately after this age, things just get worse, with less than 6% of women 43 years old or more receiving IVF successfully fall pregnant and have a baby (Brown et. al 2012).
What this means, is that even with IVF treatment, more women fail to have children after the age of 34 than succeed.
To me, those seem like reasonably unfavourable odds but that is not how IVF is perceived by the general public. Especially when we see all of these beautiful celebrities giving birth at ages above 40. We might be tempted to think “well if I don’t fall pregnant by this time, I’ll just do IVF and everything will be fine”.
Actual IVF success rates for “older women”
I have blogged previously about IVF success rates and have even developed an IVF success rate calculator for your convenience.
This FREE IVF Success Rates Calculator will help you to quickly and easily calculate what the actual IVF outcomes where for real women relevant to your similar situation (age, specific fertility problems, your chosen IVF treatment method, etc) using the most recently published population statistics for IVF.
My husband spent literally about a month putting it together using mathematical equations to calculate out my own possible success rates. My hope is that this calculator may help you, like me, feel more knowledgeable and prepared for the journey.
What the experts are telling doctors about your fertility
The American College of Gynaecologists and Obstetricians and the American Society for Reproductive Medicine regularly release collaborative “Committee Opinions” to communicate the emerging clinical and scientific advances in reproductive medicine to practitioners in this field. Here is the advice they gave in March 2014 with regards to age-related fertility decline (ACGO and ASRM 2014)
- Education and enhanced awareness of the effect of age on fertility is essential in counselling the patient who desires pregnancy.
- Women who are older than 35 should receive expedited evaluation and treatment after 6 months of failed attempts to conceive, or earlier if clinical indicated.
- In women older than 40 years, immediate evaluation and treatment is warranted.
That’s about as strong worded as you’ll get when a massive group of the world’s leading experts collaborate to form a recommendation, but the message is clear. If you’re in your early-thirties, you need start making a fertility plan for when you’re in your mid to late thirties.
So what’s up with cultural taboo?
Regardless of the way you want to look at it, there are a heck of a lot of women who know what Jane Everywoman went through and can relate. But where are these stories in mainstream media? I sure didn’t know about all the infertility problems of all the women around me in my life until I started opening up and being honest about my own struggles. I had no idea how many women I knew had had miscarriages until I told them about mine. Why is this something we need to hide? We don’t have anything to be ASHAMED of.
It’s not our fault we’re in the minor but still large percentage of the population whose bodies just aren’t quite working the way we want them to. Do people with other health problems take their condition so personally? The last time I met someone with a peanut allergy, or diabetes they didn’t feel the need to conceal the fact, so why do we? Talking about it with others really helps build an emotional support network, and yet within our western culture it is very uncommon for people to feel comfortable enough to talk about their struggles.
Can you cut to the chase, please Kym?
The point of this article is to support the efforts of people like Jane, who are putting pen to paper to try and overcome the myths and misunderstandings many of us have developed concerning age related fertility decline. The three key points I want you to come to terms with are:
- It doesn’t matter how healthy you are, how great you feel, and definitely not how great you look, your fertility begins to decline by your mid 30’s.
- Your natural reproductive capacity is most likely to end by the time you’re 42.
- IVF can improve your odds, and can extend the age at which you may be able to have a child, but the success rates are low and they get worse at an increasing pace the older you get.
Once you’re down with these ideas you’ll be ready for the take-home messages: Don’t assume you’re fertile because there is a chance that you may need help getting pregnant.
Make a plan and find out what your fertility status is. If the results don’t look good then take action and never put up with half-baked solutions – not all doctors are as good as they pretend to be. A sense of considered urgency on your behalf may be required if you’re delaying having children until “the right time”.
But the good news is that along with this sense of “urgency” are some really great management strategies and ways to defy nature and your biological clock. I know that we can’t all find our perfect relationship or job at the exact time that is convenient for our biological clock. And I am not saying that you have to give up any of this in order to have children.
What I AM saying is know the facts and know what options are available to you. And because I’m not that mean to tell you that you need a fertility plan and then not give you one I have put together a super comprehensive and free Fertility Plan Checklist to get you started. I’ve put hours and hours into it so I really hope it helps!
Why do I need a fertility plan by age 30 and not age 35?
I debated a lot about how to title this article and whether or not to use age 30 or age 35 in the title. And I decided most definitely 30! Why?
- Because this article is about PLANNING! Look at people like Jane Everywoman and myself. We both started trying in our early 30’s. The early you start to educate yourself and plan, the better your chances. This article is about being aware of the facts and making better decisions EARLIER than you would have otherwise done based on knowing more about your fertility than the average person.
- It takes TIME between learning what you need to do and implementation. I can tell you that from experience! Especially when it comes to basic fertility “musts” like putting into practice a healthy diet and lifestyle.
In saying this, it is never too late to make these implementations. So no matter where you are this is important information. It just means you need to implement things faster and prioritize making important fertility choices.
So I have done my darndest to provide you with the FACTS concerning the inevitable reality of all women’s declining ability to start a family as they age into their mid to late thirties. Whether you are in a stable relationship and just aren’t “ready” to make babies, or you’re still looking for “Mr-Right”, if you’re older than 30, you would be wise to start making plans. “Making Plans” may be as simple as getting your fertility tested, or as big a decision as having your eggs (or embryos if you are in a long term relationship) frozen once you hit 35-37. Whatever is best for you, I hope what I have said calls you to action, or helps you make smarter fertility choices. Again to get you started you can download this very comprehensive and free Fertility Plan Checklist I have put together to get you started.
Kym Campbell is a Health Coach and PCOS expert with a strong passion for using evidence-based lifestyle interventions to manage this disorder. Kym combines rigorous scientific analysis with the advice from leading clinicians to disseminate the most helpful PCOS patient-centric information you can find online. You can read more about Kym and her team here.
If you are interested in understanding more about what causes fertility to decline with age I will soon be writing another post explaining why “baby-making” gets harder with age.
Mathews TJ, Hamilton BE, Delayed Childbearing: More Women are Having Their First Child Later in Life, NCHS Data Brief, US Department of Health and Human Services, Centres for Disease Control and Prevention, 2009.
Luke B, Brown MB, Wantman E, Lederman A, Gibbons W, Schattman GL, Lobo RA, Leach RE, Stern JE, Cumulative Birth Rates with Linked Assisted Reproductive Technology Cycles, The New England Journal of Medicine, 2012.