Your nagging mother may be right about one thing: If you want to have children, you should tune into your biological clock.
A new study appearing in the U.K. journal Human Reproduction says that university-aged young adults who plan to have children don't know the facts about how fertility declines with age, and overestimate the success rates of assisted-reproductive technologies they may be counting on as a back-up plan.
The study showed that 67 per cent of women and 81 per cent of men inaccurately believe that female fertility markedly declines after age 40, with 31 per cent of women and 52 per cent of men believing this decline takes place after the age of 44. The reality: Women start to experience a marked decrease in fertility from age 35-39.
Fifty-two per cent of women and 64 per cent of men also overestimated the chances that a couple undergoing one treatment of in vitro fertilization would be successful 40-100 per cent of the time – the actual success rate is 30 per cent. After age 44, the success rate is 3 per cent.
A Canadian study in 2010 found similar patterns among Canadian women, who overestimated women's fertility at age 35 and older.
Researchers haven't pinpointed exactly why misinformation is so prevalent, but experts say a number of factors could be at play, including family doctors not broaching the topic of fertility until there are problems conceiving. High-profile media stories about celebrity moms having children later in life (actress Kelly Preston gave birth to a son last year at the age of 48) add to the perception that fertility comes easy at any age.
And, as one woman experiencing trouble conceiving puts it, we may have too much faith in reproductive specialists expected to "work miracles."
"Sure they can do more than 20 years ago, but those 'miracles' come at the end of a long, hard, incredibly invasive road that has as much devastation as it does joy," says Julia, 37. (Julia asked to not have her last name published for privacy reasons). The Toronto mother and communications specialist, who turned to fertility treatments after finding it difficult to conceive a second child after 35, said she wasn't aware the drop in fertility would come so suddenly at that age.
"Daily blood work and trans-vaginal ultrasounds … Injections of several different synthetic hormones, sometimes three different shots in a day … Bloating, cramping, mood swings … I had no idea, and I'm pretty sure most of the people holding off on starting a family don't know what they're in for with fertility treatments."
Brennan Peterson, author of the U.K. study, says the findings – based on a survey of about 150 students whose average age was 20 – suggest a need for better fertility awareness, via sex-education programs and, later on, family doctors.
"If you plan to have children, you need to have those data points in your future life planning. That's a simple thing to do but it could make a big difference in the future lives of a lot of men and women," says Prof. Peterson, an associate professor of psychology at Chapman University in Orange, Calif..
With the age at which women give birth for the first time continuing to shift upward, "it's more critical to have this information available," says Vancouver-based Karla Bretherick, who published the 2010 Canadian paper. The genetics researcher points to recent U.S. figures that say 8 per cent of first-time mothers there are over 35. In both B.C. and Ontario, that percentage topped 21 per cent in 2007. The national Canadian average is 18 per cent, up from 14.8 per cent in 1998.
Toronto mother Alanna Fox says she could have used more cold hard facts long before she ventured into the world of reproductive technologies in her mid-30s. After multiple procedures, including in vitro fertilization, Ms. Fox, who is 42, gave birth to a daughter this February.
"Once you have problems getting pregnant, that's when you start really understanding the science behind getting pregnant," she says, adding that in hindsight, she wonders why young women aren't offered certain blood tests and other checks on various markers of fertility long before infertility rears its head.
Then there are other reasons why choosing to delay pregnancy may be drowning out the risks. Recent Canadian research on our awareness of the health risks involved in later births found that concerns about career and permanent employment influences childbearing decisions for more than 60 per cent of men and women.
Toronto fertility lawyer Sara Cohen says workplaces have been slow to offer women a viable way to have a family at a younger age and not lose out on a career. "Many women hear that message loud and clear but don't know what to do about it," she says. "… As long as employers and society at large push women to hold off on having children, women are going to feel that they realistically have no other choice but to wait and rely on IVF and other assisted-reproductive technologies to conceive children as necessary."
Prof. Peterson, who is also a practising psychologist, says he's most concerned with the psychological effects that invasive and expensive fertility treatments and involuntary childlessness has on women and their partners. A single IVF round can cost between $10,000 and $15,000.
"You have the finances, the interruption to one's life, doctor's appointments constantly, being injected with hormones, her moods are changing. The top reason people drop out of treatments prematurely is because of psychological stress."
As a therapist, he says the hardest moment to help people through occurs when a couple realizes they're not going to have their own biological child.
"That is so difficult to watch a couple have to face that. It's not something they ever thought they'd have to face. It blindsides them."