The Competing Messages Of Pregnancy And Infertility After 40
We all know that women are waiting longer than ever to start a family. They’re concentrating on careers and personal growth first, then considering motherhood. It sounds like a great plan, a stable plan. There’s just one problem. Our bodies aren’t waiting for our modern life choices. At least that’s what we’ve been told.
The facts are this: 98% of women can conceive within a year of trying in their early 20s, 84% in their late 20s. By the 30s, 75% of women can conceive in a year of trying. In your 40s, that success rate plummets to 40 or 50%. Basically, the longer you hold off, the more difficult it will be to get pregnant. And yet, even though the data is pretty straight-forward, the cultural narrative seems to have two competing messages.
First, there’s what I like to think of as the anecdotal route. I think it’s outlined perfectly in this piece from The Stir. It reminds us that Carla Bruni is pregnant for a second time in her 40s, most likely without medical intervention. It brings up all those friends of friends you know who had a surprise pregnancy at 46. Kiri Blakeley, the author of the piece, argues this (emphasis is her’s):
I think there is a big infertility myth that goes on with women over 35. Am I saying that older can get pregnant as easily as younger women? No. (Please read that again.) Am I saying that the risks are not higher? No. (Read that again.) What I am saying is that I believe it’s easier for women over 35 — or even 40 — to get pregnant than they think it is.
I will admit that some people are almost fatalistic when it comes to discussing conception in after 40. We assume that absolutely every woman who had a child that late used medical intervention. We assume that it’s not really possible unless you saw a specialist and got a little modern medicine involved. And Blakeley suggests, that might be just what the reproductive health industry wants you to think. (Again, emphasis is her’s.)
So why would there be an “infertility myth”? Sure, much of it is NOT a myth. Your chances of getting pregnant do decrease with age. But they don’t necessarily decrease to zero — or even decrease to the point where drugs are needed. Let’s think about how many millions of dollars the fertility industry makes — and whether or not it might be to its advantage to perpetuate difficulties beyond what might actually exist.
Blakeley makes an interesting argument, but it contradicts the second and more factual-based story that many women are getting. Either the fertility industry’s messaging is working, or women are really having a hard time getting pregnant. In the UK, in vitro fertilization for women over 40 has increased 500% in the past two decades. And it’s important to note that until May of this year, IVF for women over the age of 39 was not covered by the national healthcare plan. So this increase was occurring in women who paid out-of-pocket for the expensive procedures.
And even with the wonders of modern medicine, there’s only so much that fertility specialists can do. Just 12% of women aged 40 – 42 actually get pregnant through IVF using their own eggs. After 42, the success rate drops to 1.5%.
In vitro fertilization is not cheap and it’s not easy. It’s not really a decision most people take without exploring every other option available to them. The individuals or couples who choose to go through this process obviously want children very badly and exhausted natural methods. And the data shows that more people than ever are using this last-ditch method with increasing rates.
No, fertility isn’t reduced to zero after 40, but it is significantly more difficult. And the stories of celebrities or friends of friends are going to do little to comfort those who find themselves unable to have children when they desperately want to.
Women are getting two stories. There are the celebrity examples and acquaintance assurances that plenty of people have little ones later in life. And then there’s the data, which shows the very real possibility that women who wait could be sitting in the fertility clinic hearing some scary percentages and weighing their chances.
