Don’t Buy the Fertility Lies

 

I love babies and pregnant women; I have devoted my life to them.  Until recently, I worked in one of Cape Town’s busiest government-funded hospitals and every day of the week, I would start work with an antenatal clinic.  Roughly a hundred ladies would stream through those doors for their check-ups. I would measure tummies, listen to fetal heartbeats and do ultrasounds. I would issue antenatal vitamins, reassure mommies and empathize with all the complaints pregnancy brings.  Twice a week, that same clinic that was filled in the morning with happy, but tired, wobbling pregnant ladies and the laughter of children soon to be older siblings, would turn into a desperate, quiet infertility clinic in the afternoon.

Recently Brigitte Nielsen announced her fifth pregnancy at the age of fifty-four. Janet Jackson was fifty when she had her first baby. Many celebrities are now having children in their late forties, and few acknowledge the truth that led them there – some even declare their pregnancies to be absolute miracles.  Now, although I also believe in miracles, I have seen thousands upon thousands of pregnant women and have personally never seen a spontaneous pregnancy in anyone over the age of forty-five. In fact, any healthy, spontaneous pregnancy in a woman over the age of 42 is by itself, a miracle.  

Of course every woman has the right to privacy and of course these celebrities do not have to disclose any details of their pregnancies, but this causes a fertility illusion.  The fantasy that women are somehow able to become pregnant without any medical intervention at very late ages.

At my clinic, infertility patients have a characteristic way of speaking – desperately.   Some are even regretful. They regret years of contraception when in a stable relationship.  They regret putting their careers first, and they regret the terminations they might have had in their youth.  Unfortunately, after the age of forty, these patients aren’t even referred for further intervention anymore. Their chance of success is low, and there is a limited budget and too few resources. Upon hearing this, the couple is usually taken aback – obviously forty “isn’t old” – this is where I start to blame celebrity culture.  Every time I have to tell a couple that adoption is an option and I can see their hearts breaking at the thought of never having biological children, I feel angered by celebrities who keep quiet about the interventions they have received. I feel angered about the eggs they froze years ago and the fertility lie they are spreading.  Most of all I feel angered that society now believes that we are somehow able to escape the biological clock that keeps ticking while we “decide when the right time is”.

The pain of reproductive failure can be utterly destructive to a couple.  Some people live in a state of mourning, like they have suffered through a death.  If earlier intervention could have avoided the issue, it would spare these people such unbearable pain.  Does that mean that celebrities have a responsibility to talk about their reproductive interventions? No.  But it would be damn kind if they did.

Some important points of fertility:

  • Infertility is a couple’s problem.  Half of the time the cause is related to the male and the other half, female.  Keep in mind that sperm analysis is usually cheaper and less invasive than female partner testing, and should be done early on.
  • If planning to have children after the age of 35, please harvest your eggs before then.
  • Research the costs of IVF before deciding that that is the path you would like to take later in life.
  • If you struggle to conceive do not wait longer than a year after contraception cessation to see a fertility specialist.
  • You should at least be having active intercourse three times a week when trying to conceive.
  • You do not have to have a biological child to be a parent.

 

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  1. RightAngles Member
    RightAngles
    @RightAngles

    Qoumidan (View Comment):

    Can I assume you are referring to first time pregnancies? As others have noted, I know several women who had unassisted pregnancies in their mid 40s but that was after a long string of pregnancies starting in their 20s.

    I was technically infertile for half my 20s. I was never able to see anyone for it though, so I just… toughed it out, I guess. At 38 with Sixlet surprise on the way, I’m wondering where that infertility went. I suspect my case may not be normal.

    When my neighbor heard I was pregnant she told me it was like this tree she’d heard of which, just before it dies out, sends out one last blast of seeds. (Thanks?)

    • #31
  2. JudithannCampbell Member
    JudithannCampbell
    @

    RightAngles (View Comment):

    Qoumidan (View Comment):

    Can I assume you are referring to first time pregnancies? As others have noted, I know several women who had unassisted pregnancies in their mid 40s but that was after a long string of pregnancies starting in their 20s.

    I was technically infertile for half my 20s. I was never able to see anyone for it though, so I just… toughed it out, I guess. At 38 with Sixlet surprise on the way, I’m wondering where that infertility went. I suspect my case may not be normal.

    When my neighbor heard I was pregnant she told me it was like this tree she’d heard of which, just before it dies out, send out one last blast of seeds. (Thanks?)

    lol, not sure how to take that one :)

    One of my cousins had two babies by the time she was 21, then nothing for 7 or 8 years, they weren’t using birth control or trying not to get pregnant, but nothing was happening. Since they already had 2 kids, they weren’t worried, and didn’t seek help: in her late twenties she started getting pregnant again and had three more children.

    • #32
  3. AltarGirl Member
    AltarGirl
    @CM

    RightAngles (View Comment):

    Qoumidan (View Comment):

    Can I assume you are referring to first time pregnancies? As others have noted, I know several women who had unassisted pregnancies in their mid 40s but that was after a long string of pregnancies starting in their 20s.

    I was technically infertile for half my 20s. I was never able to see anyone for it though, so I just… toughed it out, I guess. At 38 with Sixlet surprise on the way, I’m wondering where that infertility went. I suspect my case may not be normal.

    When my neighbor heard I was pregnant she told me it was like this tree she’d heard of which, just before it dies out, send out one last blast of seeds. (Thanks?)

    Lol… older women who get pregnant have a naturally higher chance for multiples because the egg basket is, indeed, tossing them out faster.

    When I was a kid, I had disordered cycles and I had an ultrasound done showing I was releasing multiple eggs at a time. Kicked in my research bug…

    I kinda think pregnancy is like the Big O… once you’ve had one, it’s like your body knows better how to accomplish the next one :p

    • #33
  4. JudithannCampbell Member
    JudithannCampbell
    @

    Qoumidan (View Comment):
    I was technically infertile for half my 20s. I was never able to see anyone for it though, so I just… toughed it out, I guess. At 38 with Sixlet surprise on the way, I’m wondering where that infertility went. I suspect my case may not be normal.

    Congratulations! 

    • #34
  5. Miffed White Male Member
    Miffed White Male
    @MiffedWhiteMale

    RightAngles (View Comment):
    The above is very important. I didn’t get married till I was 34. We didn’t start trying til I was 39, and when nothing happened in 6 months, we saw a doctor. I went on fertility drugs for two years and still nothing happened. I stopped when I turned 42 because the safety of taking them any longer was unknown. We decided to be the cool aunt and uncle instead. God had other plans, though. My daughter was born when I was 45, no fertility drugs or any other medical intervention, and she is perfect.

    Had a roommate in college who was two years younger than me who’s mom was somewhere in her sixties.  And he had at least one younger brother.

    • #35
  6. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    Maggie Swart:

    At my clinic, infertility patients have a characteristic way of speaking – desperately. Some are even regretful. ..

    Some important points of fertility:

    • Infertility is a couple’s problem. Half of the time the cause is related to the male and the other half, female. Keep in mind that sperm analysis is usually cheaper and less invasive than female partner testing, and should be done early on.
    • If planning to have children after the age of 35, please harvest your eggs before then.
    • Research the costs of IVF before deciding that that is the path you would like to take later in life.
    • If you struggle to conceive do not wait longer than a year after contraception cessation to see a fertility specialist.
    • You should at least be having active intercourse three times a week when trying to conceive.
    • You do not have to have a biological child to be a parent.

    Bravo Maggie!  Thank you for pointing out these important truths.

    I sometimes comment to other Docs, only half jokingly, that in my infertility practice half the ladies are 40 year olds with BMIs of 25 and the other half are 25 year olds with BMIs of 40.  Age and general health, especially including weight, are very important determinants of fertility.

    Again, thank you, especially for your last point.

     

    • #36
  7. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    CarolJoy (View Comment):

    Skyler (View Comment):

    You left off, don’t live in a country that rations medical care to only people the government deems worthy.

    I am often amazed at how much money the insurance companies spend on various fertility procedures, with some couples getting 60K to 100K to attempt to get pregnant.

    Why not?  They paid their premiums.  Insurers certainly know how to limit services when they choose to do so.

    • #37
  8. Doctor Robert Member
    Doctor Robert
    @DoctorRobert

    Annefy (View Comment):
    Anyway, a woman in her 30s was interviewed on the show and she said, “I get up every morning and wonder how many eggs have died.” My dad found that hilarious and quoted it often to his “old maid” daughters.

    And it’s true.  The number of primordial follicles in human ovaries peaks at about 20 weeks of gestation and then falls in a semi-log line to near zero at about age 50.  Every day, a few hundred eggs die, even while pre-adolescent or pregnant or on birth control pills.

    • #38
  9. :thinking: Member
    :thinking:
    @TheRoyalFamily

    AltarGirl (View Comment):

    :thinking: (View Comment):
    There’s probably a reason many cultures, especially more ancient cultures, started marrying their girls off around that age.

    I thought it had to do with life expectancy and health in high risk environments.

    Societies that are more developed, with better hygiene, and longer life expectancies seem to adjust to later ages rather naturally.

    Better hygiene and longer life expectancies didn’t really come to be until less than 200 years ago. Not much of a sample size, even if true. 

    What I think is more likely is the rise of public education. Just off the top of my head, people generally didn’t get married until their education, whatever it happened to be, was complete. Poor people married earlier than the wealthy generally, because they didn’t have as much education to get through. Girls married earlier than boys, generally, because they also didn’t have near as much education. It could get pretty extreme at some points, with wealthy men (especially the oldest sons, and thus heirs) not getting married until their 30’s, to girls (of the same social class, mind) of 16-18 typically. With public schools, boys and girls of all social classes generally got similar levels of basic education, then more on average, and then even more. 

    • #39
  10. JustmeinAZ Member
    JustmeinAZ
    @JustmeinAZ

    My daughter turns 50 this year and is the mother of an 11 year old only child. Both she and her husband have lucrative careers and I think they realized that at age 38 it was now or never. 

    Likewise my brother and his wife (she is 13 years younger than he) had a surprise pregnancy when she was 38. They had tried for years and finally gave up. So now he is 64 with a 12 year old.

    Both sound like a fate worse than death to me. Both my kids were out of the house by the time I was 45 and I’ve been having a great time ever since. But I was one of those people who didn’t care if I had kids or not. Too bad I couldn’t have passed my ability to someone who really wanted them.

    • #40
  11. CB Toder aka Mama Toad Member
    CB Toder aka Mama Toad
    @CBToderakaMamaToad

    Good information and discussion.

    However, to share a different perspective, let me say that Catholics and others who have studied Catholic moral teaching, including the exciting thought of Pope John Paul II on the theology of the body, find that there are serious moral problems with some of the fertility technologies you mention, and there are alternatives. 

    I haven’t taught in five or so years, but I used to teach natural family planning with my husband through this organization.

    A more medically based approach is offered by this wonderful organization.

    We know many children who were born as a result of the knowledge about their mutual fertility that we shared with the parents. One is my godson, one is my nephew.

     

     

    • #41
  12. Hartmann von Aue Member
    Hartmann von Aue
    @HartmannvonAue

    Annefy (View Comment):

    My dad watched some show on TV in the 70s (I think) about infertility (which is really the first I’d ever even heard of it. In Scotland you don’t get pregnant; you “fall” pregnant. As in: Och, it’s a sin. Did you hear she fell again?) I’d never known or heard of anyone who tried to get pregnant and couldn’t.

     

    Now you have. 

    • #42
  13. The Whether Man Inactive
    The Whether Man
    @TheWhetherMan

    I really question how much educated, professional women are buying these “fertility lies.”  I think people who didn’t find anyone in high school, church, or college by about 25 get stuck in the misery that is the 20s-30s dating circuit, and the old 35 red line for not being a geriatric pregnancy looms very, very bright.  The celebrity cases are still not all that common, and I don’t think anyone thinks Janet Jackson conceived naturally.

    All the great advice about having kids early only works if you’re lucky enough to meet your spouse early.  If you’re not lucky there, you have to pray you get lucky in the fertility department.  The spouse and I met at 35 and 37, married at 37 and 39, then got lucky and had a baby at 39 and 41 (though by the time she was three months old, we were 40 and 42).  Neither of us had any delusions about our fertility, and we both dated like crazy to try to find someone worth marrying for the decade before we met each other.  Like all things, luck is the biggest factor in our eventual happy outcome.

    It is hard being in your early 40s with a little baby, but I wouldn’t trade it for anything. And luckily, we’re both well established in our careers, so we have the disposable income to buy new books on how to get your baby to sleep on the Amazon app in the middle of the night pretty much every other night. (One more month until the pediatrician says we can sleep train.  I sort of can’t wait.)  

    • #43
  14. Qoumidan Coolidge
    Qoumidan
    @Qoumidan

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months.  I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    • #44
  15. RightAngles Member
    RightAngles
    @RightAngles

    JustmeinAZ (View Comment):

    My daughter turns 50 this year and is the mother of an 11 year old only child. Both she and her husband have lucrative careers and I think they realized that at age 38 it was now or never.

    Likewise my brother and his wife (she is 13 years younger than he) had a surprise pregnancy when she was 38. They had tried for years and finally gave up. So now he is 64 with a 12 year old.

    Both sound like a fate worse than death to me. Both my kids were out of the house by the time I was 45 and I’ve been having a great time ever since. But I was one of those people who didn’t care if I had kids or not. Too bad I couldn’t have passed my ability to someone who really wanted them.

    It sounded like that to me too, which is why we stopped trying. I thought women over 40 having a baby on purpose were out of their minds. But when it was taken out of my hands and I did end up being in my 60s with a child in high school, I realized it can be a good thing. You don’t dare grow old, because somebody needs you. You don’t dare even sit down and rest haha.

    • #45
  16. AltarGirl Member
    AltarGirl
    @CM

    The Whether Man (View Comment):
    I really question how much educated, professional women are buying these “fertility lies.” I think people who didn’t find anyone in high school, church, or college by about 25 get stuck in the misery that is the 20s-30s dating circuit, and the old 35 red line for not being a geriatric pregnancy looms very, very bright. The celebrity cases are still not all that common, and I don’t think anyone thinks Janet Jackson conceived naturally.

    You should read pregnancy boards (kidding, its torture).

    Baby Center has a board for those trying to conceive and the older moms who make the jump to preggo boards are incredible defensive of their choices, almost to the point of denial.

    You can’t actually even present hard scientific information on high risk pregnancies without triggering some 40 year old FTM into defending her life’s choices, which invariably devolve into sniping at 20 somethings for being to immature to handle such a committment.

    Now they are pregnancy boards and full of hormonal women, but they are a cross section of a wide group of women.

    • #46
  17. Nick H Coolidge
    Nick H
    @NickH

    Qoumidan (View Comment):

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months. I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    Having your kids spend their first few weeks in the NICU makes them great sleepers. They learn to sleep through alarms, other babies crying, everything. A bit expensive though. And they do get conditioned to wake up and eat every three hours. But the rigid schedule works well with twins.

    Seriously, if you’re buying books about sleeping, try On Becoming Baby Wise. Highly recommend it. The twins were sleeping through the night as soon as they were old enough to go that long without a meal.

    • #47
  18. Miffed White Male Member
    Miffed White Male
    @MiffedWhiteMale

    RightAngles (View Comment):
    But when it was taken out of my hands and I did end up being in my 60s with a child in high school, I realized it can be a good thing. You don’t dare grow old because somebody needs you. You don’t dare even sit down and rest haha.

    I’ll be 66 when my youngest graduates High School.

    I just gotta stay alive until then (and not kill the older one).

    • #48
  19. Skyler Coolidge
    Skyler
    @Skyler

    Qoumidan (View Comment):

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months. I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    Sleep training? Who invented that?  

    We were lucky.  Our daughter slept through the night from the day we brought her home.  All kids are different of course, and that’s why “sleep training” sounds like something some idiot celebrity would be endorsing.

    • #49
  20. RightAngles Member
    RightAngles
    @RightAngles

    Skyler (View Comment):

    Qoumidan (View Comment):

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months. I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    Sleep training? Who invented that?

    We were lucky. Our daughter slept through the night from the day we brought her home. All kids are different of course, and that’s why “sleep training” sounds like something some idiot celebrity would be endorsing.

    Ours slept through the night within days of being brought home. That first morning when we woke up and realized we’d slept all night, we both gasped and raced to her room to make sure she was alive!

    • #50
  21. The Whether Man Inactive
    The Whether Man
    @TheWhetherMan

    Skyler (View Comment):

    Qoumidan (View Comment):

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months. I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    Sleep training? Who invented that?

    We were lucky. Our daughter slept through the night from the day we brought her home. All kids are different of course, and that’s why “sleep training” sounds like something some idiot celebrity would be endorsing.

    Sleep training is pretty much just a euphemism for crying it out.  And look, if you baby slept through the night from the get go, then you were lucky. We’re not all lucky.  We are willing to let her cry it out, but doing so leads to night weaning, and our daughter was born petite, lost too much weight in her first four days, and had a really hard time fighting her way up to birth weight.  So our pediatrician thinks she still needs the overnight calories and asked us not to let her cry it out until she was at least six months.  One month to go.

    @AltarGirl  – I’m sure they are defensive about their choices. But that suggests they are keenly aware of how difficult fertility is at their age, not that they had no idea. Being defensive is a coping strategy to justify the fact that it might not work out the way you want it to.  If you want kids and might not have them, that’s a hard thing. 

    • #51
  22. Skyler Coolidge
    Skyler
    @Skyler

    The Whether Man (View Comment):

    Sleep training is pretty much just a euphemism for crying it out. And look, if you baby slept through the night from the get go, then you were lucky. We’re not all lucky. We are willing to let her cry it out, but doing so leads to night weaning, and our daughter was born petite, lost too much weight in her first four days, and had a really hard time fighting her way up to birth weight. So our pediatrician thinks she still needs the overnight calories and asked us not to let her cry it out until she was at least six months. One month to go.

     

    We are definitely lucky and still are.  My point isn’t that children don’t cry or have trouble sleeping, but that it seems strange to me that there is a name for what you describe and they use pseudo educational terms for it.  

     

    • #52
  23. The Whether Man Inactive
    The Whether Man
    @TheWhetherMan

    Skyler (View Comment):

    The Whether Man (View Comment):

    Sleep training is pretty much just a euphemism for crying it out. And look, if you baby slept through the night from the get go, then you were lucky. We’re not all lucky. We are willing to let her cry it out, but doing so leads to night weaning, and our daughter was born petite, lost too much weight in her first four days, and had a really hard time fighting her way up to birth weight. So our pediatrician thinks she still needs the overnight calories and asked us not to let her cry it out until she was at least six months. One month to go.

     

    We are definitely lucky and still are. My point isn’t that children don’t cry or have trouble sleeping, but that it seems strange to me that there is a name for what you describe and they use pseudo educational terms for it.

     

    Really? Because it makes perfect sense to me. Learning to fall asleep independently is a skill. It comes easily to some babies and takes work with others. There are a lot of different theories on how to teach it – mostly variations on crying it out, but with some outliers.

    • #53
  24. Qoumidan Coolidge
    Qoumidan
    @Qoumidan

    The Whether Man (View Comment):

    Skyler (View Comment):

    Qoumidan (View Comment):

    The Whether Man (View Comment):
    (One more month until the pediatrician says we can sleep train. I sort of can’t wait.)

    Mine were sleeping 6-8 at 3 months. I have no idea how one is supposed to train them, but I find ear plugs work wonders.

    Sleep training? Who invented that?

    We were lucky. Our daughter slept through the night from the day we brought her home. All kids are different of course, and that’s why “sleep training” sounds like something some idiot celebrity would be endorsing.

    Sleep training is pretty much just a euphemism for crying it out. And look, if you baby slept through the night from the get go, then you were lucky. We’re not all lucky. We are willing to let her cry it out, but doing so leads to night weaning, and our daughter was born petite, lost too much weight in her first four days, and had a really hard time fighting her way up to birth weight. So our pediatrician thinks she still needs the overnight calories and asked us not to let her cry it out until she was at least six months. One month to go.

     

    Underweight babies need more feedings.  That’s also normal.  I’ve met lots of people who just can’t handle letting the baby cry and thus get up every 2 hours at night for years.  That’s really a different issue.

    • #54
  25. Qoumidan Coolidge
    Qoumidan
    @Qoumidan

    I want to add one thing about biological children.  It seems utterly absurd to me the lengths people to to conceive their own but I do understand it.  During the time we were trying and failing, we considered adoption and wrote it off.  I cannot bond with other people’s children.  I know others are successful but adoption is not for everyone, which makes the points in the op that much more important.

    • #55
  26. Skyler Coolidge
    Skyler
    @Skyler

    Qoumidan (View Comment):

    I want to add one thing about biological children. It seems utterly absurd to me the lengths people to to conceive their own but I do understand it. During the time we were trying and failing, we considered adoption and wrote it off. I cannot bond with other people’s children. I know others are successful but adoption is not for everyone, which makes the points in the op that much more important.

    It’s not politically popular to say it, but that is very true for many people and sometimes I wonder at those that think otherwise.  In my business I see women who seem to want to use the law to steal other women’s children. Since it’s even attested to in the Bible I suppose it’s nothing new.

    • #56
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