Well & Good
More couples are seeking fertility treatment, partly because young women are delaying motherhood, writes Dr SARAH WAKEMAN.
I am often asked why so many couples today are going through fertility treatment and if I have seen an increase?
The answer is simple, yet the solution is not so straightforward.
Yes, we are seeing more women seeking fertility assistance; however, this is not because our fertility rates are declining. Rather it is an outcome of our lifestyle changes that we are frequently delaying motherhood.
It is no longer a luxury for young women to gain a higher education. It is a necessity to ensure they can provide a stable income over what is becoming today a 50-year working life. Today's women are often future-thinking and focusing on education and training themselves in a career that will provide security to their family in the future and, if they are very lucky, secure a mortgage. This can mean that the timing for motherhood is often being delayed.
For some, the need to experience overseas travel before settling down is a prerequisite, including working overseas. Hopefully Mr Right (or Mr Almost Right) will be in their sights by the time they reach their mid-30s. However, what we are seeing is that these best-laid plans of starting a family in the late 30s are not always working out as intended.
The father's age is also significant, affecting both the chance of pregnancy per month and the risk of certain abnormalities. However this effect of male age is small compared to the effect of a woman's age on creating a baby.
Last year's census showed for the first time the number of children born per 1000 women were higher in the 35-39 year age group compared to the 20-24 year age group. This highlights that more women are enjoying motherhood later in life, and also means they are more likely to need some sort of reproductive assistance.
Unfortunately with age, the chance of miscarriage and abnormalities also increases. At Fertility Associates, approximately 20 per cent of women having IVF are now over the age of 40 and we are pleased that new technology can give some of these couples a chance at having a baby; however what we are also seeing is that people assume that IVF will deliver where Mother Nature could not.
Technology has changed the landscape of life as we know it in many ways, but one area that Mother Nature still holds a strong influence is reproduction and the ability to produce a viable embryo.
We do the very best we can with technology, however as a woman ages her chances to conceive naturally decrease and with IVF you will also see a decrease. A woman at the age of 42 will have about a 15 per cent chance of having a baby per attempt whereas a woman aged 35 will have a 42 per cent chance.
A technology that has entered the assisted fertility realm is egg freezing. Egg freezing is a technique that allows women to freeze their eggs and preserve them for use at a later stage. The younger the woman is at the time of freezing her eggs the more likely she is to produce viable embryos.
This option is available at Fertility Associates for women who are not quite ready to have a baby, or are not in a position to start a family but want to preserve the quality of their eggs for later use. This has also been a very useful technique for people going through cancer treatment who want to preserve their fertility until a later date.
There are some tests available that can help a woman understand her fertility in the future. The Anti-Mullerian Hormone (AMH) test is a simple blood test that highlights hormone levels and can suggest when a woman might have lower fertility than expected for her age. So if a woman has the AMH test in her early 30s and finds out that she will have a lower than average fertility rate, she can then make some decisions around timing and the option of preserving eggs for future use.
An AMH test does not exclude other possible causes of reduced fertility. But it is a step towards being informed earlier.
The best advice that we can give to women in their 30s is to talk to your GP, and work through all of the options. Understanding your own unique fertility situation and the options you have available is a much better solution than waiting until life falls into place.
Dr Sarah Wakeman is medical director of Fertility Associates Christchurch.
- The Press
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