Studies Show Having a Baby in Your Thirties

How Long Can You Expect to Have a Baby?

Deep anxiety about the power to accept children later in life plagues many women. Just the turn down in fertility over the course of a woman's 30s has been oversold. Here's what the statistics actually tell us—and what they don't.

Geof Kern

Editor's Note: Read more stories in our series almost women and political power.

In the tentative, post-9/xi jump of 2002, I was, at 30, in the midst of extricating myself from my commencement union. My husband and I had met in graduate school but couldn't find two academic jobs in the aforementioned identify, so nosotros spent the three years of our marriage living in unlike states. Afterwards I accepted a tenure-track position in California and he turned downward a postdoctoral research position nearby—the job wasn't skillful enough, he said—it seemed clear that our living situation was not going to alter.

I put off telling my parents about the split for weeks, hesitant to disappoint them. When I finally broke the news, they were, to my relief, supportive and understanding. Then my female parent said, "Have yous read Time magazine this week? I know you want to have kids."

Time'due south cover that week had a baby on it. "Listen to a successful woman discuss her failure to bear a kid, and the grief comes in layers of bitterness and regret," the story within began. A generation of women who had waited to start a family was starting time to grapple with that decision, and 1 media outlet subsequently another was wringing its easily about the steep decline in women'south fertility with historic period: "When It's Too Tardily to Have a Infant," lamented the U.K.'due south Observer; "Baby Panic," New York magazine announced on its cover.

The panic stemmed from the April 2002 publication of Sylvia Ann Hewlett's headline-grabbing book, Creating a Life, which counseled that women should have their children while they're immature or risk having none at all. Within corporate America, 42 percent of the professional women interviewed by Hewlett had no children at age 40, and most said they securely regretted information technology. Only as y'all plan for a corner office, Hewlett advised her readers, you lot should programme for grandchildren.

The previous fall, an advertizement entrada sponsored past the American Society for Reproductive Medicine (ASRM) had warned, "Advancing age decreases your power to accept children." 1 advertizement was illustrated with a baby bottle shaped similar an hourglass that was—just to brand the indicate glaringly obvious—running out of milk. Female person fertility, the grouping announced, begins to decline at 27. "Should yous accept your babe now?" asked Newsweek in response.

For me, that was no longer a viable option.

I had always wanted children. Even when I was decorated with my postdoctoral research, I volunteered to babysit a friend's preschooler. I frequently passed the time in airports by chatting upward frazzled mothers and babbling toddlers—a two-yr-old, quite to my surprise, once crawled into my lap. At a wedding ceremony I attended in my late 20s, I played with the groom'south preschool-age nephews, often on the floor, during the unabridged rehearsal and most of the reception. ("Do you fart?" one of them asked me in an overly loud vocalism during the rehearsal. "Everyone does," I replied solemnly, as his granddad laughed quietly in the adjacent pew.)

But, suddenly single at xxx, I seemed destined to remain childless until at least my mid-30s, and possibly always. Flying to a friend's wedding in May 2002, I finally forced myself to read the Time article. It upset me and so much that I began doubting my divorce for the starting time fourth dimension. "And God, what if I want to have two?," I wrote in my journal every bit the cold plane sped over the Rockies. "First at 35, and if you wait until the kid is 2 to try, more than likely yous accept the 2d at 38 or 39. If at all." To reassure myself near the divorce, I wrote, "Aught I did would take inverse the situation." I underlined that.

I was lucky: within a few years, I married again, and this fourth dimension the lucifer was much better. But my new husband and I seemed to face frightening odds against having children. About books and Spider web sites I read said that one in three women ages 35 to 39 would not become pregnant within a twelvemonth of starting to try. The showtime page of the ASRM's 2003 guide for patients noted that women in their tardily 30s had a 30 percent gamble of remaining childless altogether. The guide likewise included statistics that I'd seen repeated in many other places: a woman's take a chance of pregnancy was 20 per centum each month at age 30, dwindling to 5 percent by historic period forty.

Every time I read these statistics, my stomach dropped like a stone, heavy and foreboding. Had I already missed my chance to be a mother?

As a psychology researcher who'd published articles in scientific journals, some covered in the popular printing, I knew that many scientific findings differ significantly from what the public hears about them. Soon subsequently my second wedding, I decided to go to the source: I scoured medical-research databases, and quickly learned that the statistics on women's historic period and fertility—used by many to make decisions nearly relationships, careers, and when to have children—were 1 of the more spectacular examples of the mainstream media's failure to correctly report on and translate scientific enquiry.

The widely cited statistic that one in three women ages 35 to 39 will non be pregnant later a year of trying, for example, is based on an commodity published in 2004 in the journal Human being Reproduction. Rarely mentioned is the source of the data: French nativity records from 1670 to 1830. The take chances of remaining childless—xxx percent—was also calculated based on historical populations.

In other words, millions of women are being told when to become significant based on statistics from a time earlier electricity, antibiotics, or fertility treatment. Most people assume these numbers are based on large, well-conducted studies of modern women, but they are not. When I mention this to friends and associates, past far the most common reaction is: "No … No mode. Really?"

Surprisingly few well-designed studies of female historic period and natural fertility include women born in the 20th century—but those that practice tend to paint a more optimistic picture. One study, published in Obstetrics & Gynecology in 2004 and headed by David Dunson (now of Duke University), examined the chances of pregnancy among 770 European women. Information technology found that with sex at least twice a week, 82 percent of 35-to-39-year-old women excogitate inside a twelvemonth, compared with 86 percent of 27-to-34-yr-olds. (The fertility of women in their late 20s and early on 30s was almost identical—news in and of itself.) Another report, released this March in Fertility and Sterility and led past Kenneth Rothman of Boston Academy, followed 2,820 Danish women as they tried to go meaning. Amid women having sex during their fertile times, 78 percent of 35-to-40-year-olds got significant inside a year, compared with 84 percent of 20-to-34-yr-olds. A study headed by Anne Steiner, an associate professor at the Academy of North Carolina Schoolhouse of Medicine, the results of which were presented in June, found that among 38- and 39-year-olds who had been pregnant earlier, fourscore percent of white women of normal weight got pregnant naturally inside half-dozen months (although that percentage was lower among other races and among the overweight). "In our information, we're not seeing huge drops until age 40," she told me.

Even some studies based on historical nascence records are more optimistic than what the press normally reports: One found that, in the days before nascence control, 89 percent of 38-year-one-time women were still fertile. Another ended that the typical adult female was able to get significant until somewhere betwixt ages 40 and 45. Yet these more encouraging numbers are rarely mentioned—none of these figures appear in the American Society for Reproductive Medicine'southward 2008 committee opinion on female age and fertility, which instead relies on the nigh-ominous historical data.

In brusk, the "baby panic"—which has by no means abated since information technology hit me personally—is based largely on questionable data. We've rearranged our lives, worried endlessly, and forgone countless career opportunities based on a few statistics about women who resided in thatched-roof huts and never saw a lightbulb. In Dunson's study of modern women, the deviation in pregnancy rates at age 28 versus 37 is just most 4 pct points. Fertility does decrease with age, but the pass up is non steep enough to keep the vast majority of women in their late 30s from having a child. And that, subsequently all, is the whole betoken.

I am now the female parent of iii children, all born afterward I turned 35. My oldest started kindergarten on my 40th altogether; my youngest was born five months later. All were conceived naturally inside a few months. The toddler in my lap at the airport is at present mine.

Instead of worrying most my fertility, I now worry about paying for kid intendance and getting 3 children to bed on time. These are good issues to have.

Nonetheless the memory of my abject terror about historic period-related infertility still lingers. Every time I tried to get pregnant, I was consumed by anxiety that my age meant doom. I was not alone. Women on Net message boards write of scaling back their careers or having fewer children than they'd like to, because they can't bear the thought of trying to go pregnant after 35. Those who take already passed the dreaded birthday enquire for tips on how to stay calm when trying to become significant, constantly worrying—merely as I did—that they will never have a child. "I'm scared because I am 35 and everyone keeps reminding me that my 'clock is ticking.' My grandmother even reminded me of this at my wedding reception," one newly married woman wrote to me subsequently reading my 2012 advice volume, The Impatient Woman'south Guide to Getting Pregnant, based in role on my ain experience. It'southward not but grandmothers sounding this note. "What science tells us about the aging parental body should alert usa more it does," wrote the announcer Judith Shulevitz in a New Republic cover story belatedly concluding year that focused, light amplification by stimulated emission of radiation-like, on the downsides of delayed parenthood.

How did the baby panic happen in the first identify? And why hasn't there been more than public pushback from fertility experts?

I possibility is the "availability heuristic": when making judgments, people rely on what's right in front of them. Fertility doctors encounter the effects of age on the success charge per unit of fertility treatment every mean solar day. That's particularly truthful for in vitro fertilization, which relies on the extraction of a large number of eggs from the ovaries, because some eggs are lost at every stage of the difficult procedure. Younger women'due south ovaries respond better to the drugs used to excerpt the eggs, and younger women's eggs are more likely to be chromosomally normal. As a event, younger women's IVF success rates are indeed much higher—nearly 42 pct of those younger than 35 will give birth to a live babe after i IVF cycle, versus 27 per centum for those ages 35 to 40, and only 12 percent for those ages 41 to 42. Many studies have examined how IVF success declines with age, and these statistics are cited in many research articles and online forums.

Yet just about ane percent of babies born each year in the U.Due south. are a result of IVF, and most of their mothers used the technique not because of their age, but to overcome blocked fallopian tubes, male person infertility, or other issues: about 80 percent of IVF patients are xl or younger. And the IVF statistics tell us very little about natural formulation, which requires just one egg rather than a dozen or more, amid other differences.

Studies of natural formulation are surprisingly hard to acquit—that'due south ane reason both IVF statistics and historical records play an outsize role in fertility reporting. Modern birth records are uninformative, because most women have their children in their 20s and so employ birth control or sterilization surgery to forestall pregnancy during their 30s and 40s. Studies asking couples how long it took them to conceive or how long they have been trying to go pregnant are every bit unreliable as human memory. And finding and studying women who are trying to get pregnant is challenging, as at that place's such a narrow window between when they kickoff trying and when some will succeed.

Millions of women are being told when to become meaning based on statistics from a time before electricity, antibiotics, or fertility treatment.

Another problem looms fifty-fifty larger: women who are actively trying to get pregnant at historic period 35 or afterwards might be less fertile than the boilerplate over-35 woman. Some highly fertile women will go pregnant accidentally when they are younger, and others volition get pregnant apace whenever they effort, completing their families at a younger age. Those who are left are, unduly, the less fertile. Thus, "the observed lower fertility rates among older women presumably overestimate the effect of biological aging," says Dr. Allen Wilcox, who leads the Reproductive Epidemiology Group at the National Institute of Environmental Wellness Sciences. "If we're overestimating the biological turn down of fertility with historic period, this will only be practiced news to women who have been virtually fastidious in their nascency-control use, and may be more than fertile at older ages, on boilerplate, than our data would atomic number 82 them to await."

These modern-day research issues help explain why historical data from an age before birth control are so tempting. However, the downsides of a historical approach are numerous. Advanced medical care, antibiotics, and fifty-fifty a reliable food supply were unavailable hundreds of years agone. And the pass up in fertility in the historical information may also stem from older couples' having sex less frequently than younger ones. Less-frequent sex might have been especially likely if couples had been married for a long time, or had many children, or both. (Having more children of course makes it more difficult to fit in sex, and some couples surely realized—eureka!—that they could avoid having some other rima oris to feed by scaling back their nocturnal activities.) Some historical studies try to control for these bug in diverse means—such equally looking only at just-married couples—but many of the same problems remain.

The best way to assess fertility might be to measure "cycle viability," or the chance of getting pregnant if a couple has sex on the nearly fertile mean solar day of the woman's cycle. Studies based on bike viability utilize a prospective rather than retrospective design—monitoring couples as they endeavor to go pregnant instead of request couples to recall how long it took them to become pregnant or how long they tried. Cycle-viability studies too eliminate the demand to account for older couples' less active sex lives. David Dunson's assay revealed that intercourse two days before ovulation resulted in pregnancy 29 percent of the time for 35-to-39-twelvemonth-old women, compared with about 42 per centum for 27-to-29-yr-olds. So, by this measure, fertility falls past about a tertiary from a woman'south late 20s to her late 30s. However, a 35-to-39-year-quondam'south fertility two days earlier ovulation was the same equally a 19-to-26-yr-erstwhile's fertility 3 days before ovulation: according to Dunson's data, older couples who time sex merely one mean solar day better than younger ones will effectively eliminate the age difference.

Don't these numbers contradict the statistics you lot sometimes see in the pop printing that only 20 percent of xxx-year-old women and 5 percent of 40-year-old women get pregnant per bicycle? They practise, but no journal article I could locate independent these numbers, and none of the experts I contacted could tell me what data ready they were based on. The American Society for Reproductive Medicine's guide provides no citation for these statistics; when I contacted the association'due south press office request where they came from, a representative said they were simplified for a popular audience, and did non provide a specific citation.

Dunson, a biostatistics professor, thought the lower numbers might be averages beyond many cycles rather than the chances of getting pregnant during the starting time cycle of trying. More women will get pregnant during the first cycle than in each subsequent one because the about fertile will conceive chop-chop, and those left will have lower fertility on average.

Nigh fertility problems are not the result of female age. Blocked tubes and endometriosis (a status in which the cells lining the uterus also abound outside it) strike both younger and older women. Almost half of infertility problems trace dorsum to the man, and these seem to be more than common amid older men, although research suggests that men'south fertility declines only gradually with age.

Fertility problems unrelated to female historic period may also explain why, in many studies, fertility at older ages is considerably higher amongst women who take been meaning before. Among couples who haven't had an accidental pregnancy—who, as Dr. Steiner put it, "have never had an 'oops' "—sperm issues and blocked tubes may be more than likely. Thus, the data from women who already take a child may give a more accurate moving picture of the fertility decline due to "ovarian aging." In Kenneth Rothman's study of the Danish women, among those who'd given birth at least once previously, the chance of getting pregnant at historic period 40 was similar to that at age 20.

Older women's fears, of course, extend beyond the power to become pregnant. The rates of miscarriages and birth defects rise with age, and worries over both have been well ventilated in the popular press. But how much exercise these risks actually ascent? Many miscarriage statistics come up from—you guessed it—women who undergo IVF or other fertility treatment, who may have a college miscarriage risk regardless of age. Nonetheless, the National Vital Statistics Reports, which describe information from the general population, notice that fifteen percent of women ages 20 to 34, 27 percentage of women 35 to 39, and 26 percent of women xl to 44 study having had a miscarriage. These increases are hardly insignificant, and the true rate of miscarriages is higher, since many miscarriages occur extremely early in a pregnancy—before a missed menstruation or pregnancy test. Even so it should exist noted that fifty-fifty for older women, the likelihood of a pregnancy's continuing is nearly iii times that of having a known miscarriage.

What about nativity defects? The gamble of chromosomal abnormalities such as Down's syndrome does rise with a woman'south age—such abnormalities are the source of many of those very early, undetected miscarriages. However, the probability of having a kid with a chromosomal abnormality remains extremely low. Even at early fetal testing (known every bit chorionic villus sampling), 99 pct of fetuses are chromosomally normal among 35-twelvemonth-one-time significant women, and 97 percentage among forty-year-olds. At 45, when most women tin no longer go pregnant, 87 percent of fetuses are still normal. (Many of those that are not will subsequently be miscarried.) In the virtually future, fetal genetic testing volition be washed with a simple claret exam, making it fifty-fifty easier than it is today for women to get early on information about possible genetic issues.

Due westhat does all this mean for a woman trying to decide when to take children? More specifically, how long can she safely wait?

This question tin can't be answered with absolutely certainty, for two big reasons. First, while the data on natural fertility amidst modern women are proliferating, they are still thin. Collectively, the three modern studies by Dunson, Rothman, and Steiner included just about 400 women 35 or older, and they might not exist representative of all such women trying to conceive.

2d, statistics, of class, tin tell us just about probabilities and averages—they offering no guarantees to whatsoever detail person. "Even if nosotros had proficient estimates for the average biological decline in fertility with age, that is still of relatively limited apply to individuals, given the large range of fertility establish in good for you women," says Allen Wilcox of the NIH.

So what is a woman—and her partner—to do?

The data, imperfect as they are, propose two conclusions. No. ane: fertility declines with age. No. two, and much more relevant: the vast majority of women in their late 30s will be able to get pregnant on their own. The lesser line for women, in my view, is: programme to take your last child by the time you turn 40. Beyond that, you're rolling the dice, though they may still come up in your favor. "Fertility is relatively stable until the late 30s, with the inflection point somewhere around 38 or 39," Steiner told me. "Women in their early 30s can retrieve about years, but in their late 30s, they need to be thinking about months." That's also why many experts advise that women older than 35 should see a fertility specialist if they haven't conceived afterward vi months—particularly if it'south been six months of sex during fertile times.

There is no unmarried all-time time to have a child. Some women and couples volition observe that starting—and finishing—their families in their 20s is what'due south best for them, all things considered. They just shouldn't let alarmist rhetoric push button them to become parents before they're ready. Having children at a young age slightly lowers the risks of infertility and chromosomal abnormalities, and moderately lowers the take a chance of miscarriage. But it likewise carries costs for relationships and careers. Literally: an analysis past one economist found that, on boilerplate, every year a adult female postpones having children leads to a 10 percent increase in career earnings.

For women who aren't ready for children in their early 30s but are notwithstanding worried nearly waiting, new technologies—admitting imperfect ones—offer a 3rd option. Some women choose to freeze their eggs, having a fertility doctor extract eggs when they are withal young (say, early 30s) and cryogenically preserve them. And so, if they haven't had children by their self-imposed deadline, they tin thaw the eggs, fertilize them, and implant the embryos using IVF. Because the eggs will be younger, success rates are theoretically higher. The downsides are the expense—perhaps $10,000 for the egg freezing and an average of more than $12,000 per cycle for IVF—and having to use IVF to become significant. Women who already accept a partner can, alternatively, freeze embryos, a more mutual procedure that also uses IVF technology.

At home, couples should recognize that having sex at the most fertile time of the bicycle matters enormously, potentially making the deviation between an easy formulation in the sleeping room and expensive fertility handling in a clinic. Rothman's report found that timing sexual activity around ovulation narrowed the fertility gap between younger and older women. Women older than 35 who want to get pregnant should consider recapturing the glory of their 20‑something sex activity lives, or learning to predict ovulation by charting their cycles or using a fertility monitor.

I wish I had known all this back in the spring of 2002, when the media coverage of historic period and infertility was deafening. I did, though, find some relief from the smart women of Saturday Night Alive.

"According to author Sylvia Hewlett, career women shouldn't wait to have babies, considering our fertility takes a steep drop-off subsequently historic period 27," Tina Fey said during a "Weekend Update" sketch. "And Sylvia's correct; I definitely should have had a baby when I was 27, living in Chicago over a biker bar, pulling down a cool $12,000 a yr. That would have worked out dandy." Rachel Dratch said, "Yep. Sylvia, um, thanks for reminding me that I accept to hurry upwards and accept a babe. Uh, me and my four cats will become right on that."

"My neighbor has this adorable, beautiful little Chinese infant that speaks Italian," noted Amy Poehler. "So, you know, I'll just buy i of those." Maya Rudolph rounded out the rant: "Yeah, Sylvia, maybe your side by side book should tell men our historic period to terminate playing G Theft Auto Three and holding out for the chick from Alias." ("You're non gonna become the chick from Alias," Fey advised.)

Eleven years later, these iv women have viii children among them, all but one born when they were older than 35. Information technology'southward good to be right.

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Source: https://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-a-baby/309374/

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