On the whole, people in society today want more before they start their families--financial stability, strong careers. This is turn has started a trend towards delaying having children until later on in life. However, both men and women’s fertility decreases as they age. Couples should therefore get all the facts on their fertility and their options before they decide to start (or delay starting) their families.
In this article, we’ll take a look at:
Starting a family is much different today than it was 50 years ago. The dynamics of families, the age at which people start families and the fertility treatments available for when they do are wildly more well thought out. Some things, however, don’t change--like having hurdles to jump when it comes to your fertility. Here are some of the numbers, just to get an idea of what the fertility game actually looks like.
There are a number of cultural and societal factors influencing the current trend in fertility in the U.S.--and that trend is going downward. Women are having less children--hitting a historic low of 60.2 births per 1000 women in 2017 (of women aged 15-44). Interestingly, the age groups at which women are having the most children has shifted as well.
Women in their mid-childbearing years have the highest birth rates now. Specifically, women aged 30 to 34 are having the most children (at 103 births per 1000 women in 2016), moving away from women aged 25 to 29, who had until 2016 had the highest birth rate.
Mothers aged 35 and up are soaring, while teen pregnancies are plummeting. Since 2003, the birth rate for women aged 35 to 39 has been higher than the birth rate of women aged 15 to 19.
Why are women waiting now? The 2008 recession was a large influence on women delaying having children, as the economic situation was unsteady. However, there are distinct social and cultural shifts that have contributed to women waiting, such as more women in the workforce, increased education and delayed marriage.
The proof is in the pudding (or, you know, lofty research papers): Healthline's State of Fertility Report 2017 found that more than half of millenial women and men are delaying becoming parents for financial reasons and career stability.
What complications does waiting propose then? Biological ones.
Short answer: not very well. You (as a woman) are born with all the eggs you are ever going to have. At birth, it’s maybe 1 million; at 25, 300,000. At 35, your egg count drops off steeply, meaning you could lose a higher amount every month until you start menopause.
It’s a common misconception that when a woman ovulates, she releases one egg and the rest are held up in “storage”. What actually happens is that one egg does take center stage to be fertilized,while the “understudy” egg follicles are "reabsorbed" by the body (and essentially lost).
The probability of complications such as miscarriage, chromosomal abnormalities and genetic disorders increases as a woman ages. For a list of statistics and when to seek fertility help, check this article out.
But fertility problems aren’t all accounted for by infertility on the woman’s part--in an estimated 1 in 5 couples with fertility issue, the problem lies solely in the male. About two thirds of infertile men have a problem with making sperm in the testes. 1 in 5 infertile men have trouble with sperm transport. Other less common problems include erection and ejaculation problems, hormonal problems and problems with sperm antibodies.
There are a number of options for couples with fertility issues. Those include:
IUI is a way of giving sperm a head start--it is usually used in cases of a low sperm count or low sperm mobility, and is less invasive (and expensive) than in vitro fertilization. It works through insertion of semen (washed of its seminal fluid by a lab) with a catheter into the uterus of the woman 24-36 hours before she ovulates. This process enhances the number of sperm cells that are in the uterus during ovulation, which increases the probability of getting pregnant.
If the couple has the IUI procedure performed every month, the likelihood of success could be as high as 20% per cycle, depending on variables such as the female’s age, the reasons for infertility and whether fertility drugs were used.
IVF is a fertility option for many couples with fertility issues such as advanced age, fallopian tube damage or blockage, ovulation disorders and endometriosis, among other things. During IVF, mature eggs are taken from your ovaries (or donated eggs are used), and fertilized with sperm from a lab. The fertilized egg (or eggs) are then implanted in your uterus.
Success rates vary on factors such as age, previous pregnancies, type of fertility problem, use of donor eggs, and lifestyle habits, but can be as high as 40%.
Also known as mature oocyte cryopreservation, egg freezing is a good option for women who want to preserve their reproductive potential if they know they want to wait to have children later on. Women also freeze their eggs if they’re about to undergo treatment for a serious illness such as cancer or if they’re undergoing IVF and their partner can’t produce sperm that day.
About 90% of eggs survive freezing and 75% will successfully be fertilized. Chances of getting pregnant are around 30 to 60 percent depending on age. It is worthy to note that the likelihood of pregnancy may be less than if you were using fresh eggs or frozen embryos.
Also called carrier screening, this test will not directly assist with fertility but will determine if other treatment measures, such as IVF, should be taken. As a part of pre-pregnancy planning, both prospective parents are tested for a multitude of genetic diseases and syndromes.
If one of the parents is found to be a carrier of a disease, the couple has the option of using IVF to avoid passing that disease onto their children.
Even Kim Kardashion did it! Surrogacy is the process by which a woman carries the child of a couple who is struggling with fertility problems, or the woman is medically unable to carry a child to term. IVF would be performed, except the fertilized egg would be placed in the surrogate, rather than the biological mother.
The chance of success is around 55 to 75%, for a young donated egg and a healthy surrogate.
Just as important as a good doctor to treat infertility problems is a good fertility lab. Embryos are made in the lab, by the hand of an embryologist. How do you know which labs are good, though?
The Society of Assisted Reproductive Technology gathers data on the success rates of fertility clinics. While it’s not totally accurate, because the type of patients a clinic sees can influence the statistics, it’s still a good place to start.
High live-birth rates from an infertility clinic are a good indicator that the embryology lab has constructed the ideal environment in which embryos are able to thrive. There may be other factors that go into the likelihood of a patient getting pregnant, such as age and lifestyle, but if the lab can’t grow good embryos, the success rates of these infertility clinics will never be good. So it’s important to find a clinic with a high success rate.
There are a lot of options for women who have fertility issues, or want to wait to have children, as is the current trend. With many ways to go about fertility and great fertility clinics to choose from, you couples (or single ladies, or men) out there are sure to have beautiful offspring (when the time is right).