According to an article published in the Nov. 4, 2005 issue of the New England Journal of Medicine , the past decade has seen a remarkable shift in the demographics of childbearing in the United States. The number of
Randy Morris, MD

According to an article published in the Nov. 4, 2005 issue of the New England Journal of Medicine, the past decade has seen a remarkable shift in the demographics of childbearing in the United States. The number of first births per 1,000 women 35 to 39 years of age increased by 36 percent between 1991 and 2001, and the rate among women 40 to 44 years of age increased by a remarkable 70 percent. Additionally, in 2002, 263 births were reported in women between 50 and 54 years of age. Most media attention paid to older moms has been favorable, inspiring a female business-school student who declared on a nationally televised segment of CBS's 60 Minutes (entitled "The Biological Clock"), "I plan to be super fit, super in shape when I'm 40, 50. And if I'm physically able to do it, then I will have a child at 55."

Yet, how old is too old, and how realistic is it for a young woman today to expect to delay her childbearing into the later decades of her life?

You can be healthy, but fertility still decreases
Women tend to think that if they go to the gym, eat healthy, take vitamins and really take care of themselves properly, then they should be able to have a baby. Women need to separate general health and reproductive health and be aware that fertility DOES decrease with age no matter how well you take care of yourself.

Yes we do have the technology to help older women achieve pregnancy, yet there are much higher risks associated with advanced maternal age.

The effect of maternal age on the outcome of pregnancy is best assessed by examining the source of the risks: those associated with using older eggs and those from having an older "carrier." Egg issues result in declining fertility, miscarriage and babies with chromosomal abnormalities such as Down's syndrome. Carrier issues include gestational diabetes, hypertensive complications and stillbirth.

So what about the notion of delaying childbirth until a maternal age of 45, 50 or older?

In my program there is currently no cut-off age for a woman requesting assisted reproductive procedures to get pregnant. Many programs do use a cutoff age which is usually arbitrarily determined by the doctor. I feel that this is age discrimination since there are no studies that indicate that there is a specific age beyond which pregnancy should not be attempted.

If a program has a cutoff age of 45, can the doctor tell the 46 year old that her risks are appreciable different from the 45 year old? They can't.

Patients and their partners should be informed about the potential risks and allowed to make their own decisions about treatment just like they do in all other areas of medicine.

An older woman who wants to attempt pregnancy using her own eggs can reduce the risks associated with older eggs by attempting pregnancy using in vitro fertilization with preimplantation genetic diagnosis (PGD). PGD can screen out most of the chromosomal abnormalities which may occur in older eggs.

Compared to in vitro fertilization without PGD, the chance for pregnancy can be increased 15 to 20 percent and the risk for miscarriage decreased by 50 percent or more. The risk for delivering a baby with Down Syndrome can almost be eliminated.

Alternatively, older women can use eggs donated from a younger woman. Pregnancy rates among older women who choose this route are excellent, with the risks of both miscarriage and chromosomal abnormalities consistent with the age of the donor, rather than the recipient. These women are still subjected to the same "carrier" risks however, consistent with their own age.

So how can we advise young career-minded women when she asks about her choices in regard to fertility?

Generally speaking, the decade between 25 and 35 years of age would seem to be ideal. A woman's education is typically complete, she has usually gained some experience in her professional arena, and pregnancy is at its safest.

For women between 35 and 45 years of age for whom earlier childbearing is not an option, this decade remains safe enough that maternal age alone should not be a contraindication to childbearing. However, women do face decreasing fertility and an increase in the risks of miscarriage and chromosomal abnormalities. Perimenopausal and postmenopausal pregnancy remains an option for those women who are lucky enough to find themselves healthy and sufficiently wealthy to pursue it, and who are willing to assume the risks

Tags: age

recommended for you


carpinteyroypw November 13, 2014
锘縣eir mom and dad could pay a visit to Liverpool, Paris, europe ,, and also Paris a few.Brewster proclaimed, ever since the college process wasn interested in hardly any money switching hands and wrists, it wasn't a school section sponsored function.He stated mothers and fathers composed bank checks straight away to The European Start, the Massachusetts primarily based educational travel agent containing possessed a phone shut off and is not moving back e-mails.The Pulaski Area sheriff place of work can also be analyzing, Brewster explained.Within an message directed May Seventh within the a couple professors whom structured this day at moms and dads, it all starts off by conveying "We really need to reveal quite a few really disconcerting headlines on hand virtually all."It procedes to repeat the course instructors approached a Boston Attorney at law Typical Office environment, and the Somerville, Mummy police force department soon after devices while using travel agency abruptly halted.From the electronic mail, the particular lecturers<a href=>nike shox leather ugg</a> demonstrate they checked out the agency when using the Eee as well as educator testimonials and referrals.An individual parent required, with whom declined to get surveyed for camera, advised WSLS 13 the girl's loved ones could be outside just about $10,A thousand.Enjoy WSLS 12 from 5 various Half-dozen this evening with regard to additional during this account.Lynchburg types gather to talk about current violenceLynchburg organizations obtain to express current violenceMore than two dozen people harvested Saturday morning hours within the Hunton Randolph Community Facility to call with regard to alter right after the taking pictures passing for Sean Moss.More than 24 persons collected Friday morning hours along at the Hunton Randolph Neighborhood Centre to call designed for transform after the shooting death of Sean Moss.Upgrade: Armed service airplane collisions within Augusta CountyUPDATE: Armed service plane fails throughout Augusta CountyUPDATE: Military services jet collisions within Augusta CountyDowntown Pulaski to have makeoverDowntown Pulaski to have makeoverDowntown Pulaski rapidly receive a makeover, as a consequence of expense coming from Western world Most important Development.Downtown Pulaski will soon acquire a remodel, due to expense through Western side Significant Enhancement.Danville doctor documents EEOC criticism alongside Chatham home facilityDanville healthcare professional files EEOC gripe versus Chatham housing facilityA Danville breastfeed documents the pay

<a href=>nike shox online guitar</a>
<a href=>Moncler Branson Dames Down Jassen 9995 Dark Blauw Nieuwste Verkoop Online</a>
<a href=>nike shox toddler development</a>
<a href=>nike shox tl3 fake</a>
<a href=>nike shox green hope</a>
Joettk November 04, 2014
锘縣t about his particular 6 shoe, One fifty nine pound physique, despite drinking big McDonald's vanilla flavour milkshakes before going to bed. They power by way of schooling never ever less than seven kms on a dail<a href=>Nike Free 3.0 V5 Women Beige Orange</a>y basis, around 75 kilometres one week without the need of getting to sleep such as a common hero. as well as midnight. exercise routine after which you can not necessarily snooze throughout the day. "I decided to go a couple weeks where it was, for instance, simply no sleep at night with regard to a number of days or weeks, and after that I'd really, really overeat sleep at night, and then I would not slumber for three days,In . Weinberger explained. "It am difficult utilizing schooling."<Photos> Rich Weinberger swims that will brown honor inside to locate 10km marathon]Still, Weinberger makes it seem quick. Their coach, John Jacks, explained he's got your ability with regard to recognizing wherever most people are inside battle and receiving a feel for the pace the guy must fixed. He or she is as well consequently relaxed and thus hyper he / she loves to talk to the competitors through the competition.Certainly. In between moves, this individual look over and enquire of an individual how it is proceeding, psyching these folks out there."It will not hassle him or her in the least, but it may possibly travel everybody else in the wall surface,In . Jacks mentioned. "I will not trainer a person to do that, when it is something that is definitely easier for these phones conduct, I think it can usually get in the skin tone of individuals."Last Sept, Weinberger earned test function inside Courbe, the lake with London's Hyde Recreation area, along with visualized the course everyday afterward. Competition once ethnic background, he finished in the top 3. He won one more Earth Drink celebration before the Olympic games.After which it came Friday or even Thursday night, to become precise. yesterday evening,Half inch he said.<Also> Quite a few Canada sports athletes say Birmingham Activities shall be their very own remaining Olympics]Weinberger mentioned this individual hardly ever beds down previous to a big kind, which means that they has not been falling asleep prior to the greatest rush involving his everyday living. Not much of a wink. He or she attempted to relaxed him or her self. He / she signed on top of their laptop computer in a Getaway Motel close to Hyde Park your car and giggled on stupid pet cat video tutorials."It simply just crevices my family right up,In he was quoted saying. plus got into your ocean in afternoon. It is really an pretty much not one but two 60 minutes swim. To get that inside mindset, a long pool bath, the fir,400 free of charge, will take virtually Fifteen minutes. Any sports athletes need to ingest on the fly, just like demonstration ru

<a href=>Nike Roshe Run Dyn FW Men Carbon Cyan White</a>
<a href=>Men adidas ClimaCool Fresh Ride</a>
<a href=>Nike Air Max 2012 Men Black Silver White</a>
<a href=>Nike Roshe Run Woven Men Colors</a>
<a href=>Nike Roshe Run Men Black HotRed</a>