June 6th, 2008
02:26 PM ET

Fertility questions differ with decades

By Val Willingham
CNN Medical Producer

I'm not wild about babies. Don't get me wrong – it's not that I dislike them – I'm just not like a lot of my female friends who oooh and ahhh every time an infant enters the room. But I wanted to be a mom, so in my early 30s I did have a child. A beautiful little girl, who, even at the age of 21, still is my baby. My husband and I wanted our daughter. She was planned. We started thinking about having a child in September 1986. She was born in July 1987. We were blessed, and if you look at statistics, we also were lucky.

According to the American Fertility Association more than 15 percent of couples in the U.S. have difficulty conceiving a child. Many people are delaying having children – about 20 percent of women in the United States now have their first child after age 35. And as we age, it becomes more and more difficult to conceive. According to Dr. Robert Stillman, director of the Shady Grove Fertility Reproductive Science Center in Rockville, Maryland, "It's just the natural aging process, and women can make that worse by smoking, alcohol abuse, excessive weights - both high and low."

In her 30s and 40s, a female's reproductive cycle begins to change. As a woman ages, her eggs are more likely to develop abnormalities The probability of having a baby drops between 3 and 5 percent per year after the age of 30, a rate that can be even higher after 40. In fact a woman in her 40s faces a 50 percent risk of suffering from a miscarriage, and there can be other problems. "As women age, they can end up with uterine problems, such as fibroid tumors, ovarian cysts or growths endometriosis," Stillman adds. Many couples turn to expensive, state-of-the-art procedures such as in-vitro fertilization in order to have children.

When women get into their 50s, typically menstruation and ovulation cease with menopause. But you wouldn't necessarily know that by looking at Hollywood. Many stars are having kids well into midlife. Stillman says there is nothing wrong with that, but many older people come into his office wanting to get pregnant with their own eggs, because aging Celebrity X just had twins. Stillman knows that's not possible and says these actresses need to be honest. He feels it's frustrating. "If they are going to be on the cover of People, they have a responsibility to their following, not to mislead people that fertility is easy at 52. It's not. They are (using) donor eggs."

So yes, there really is a biological clock. And while it keeps tick, tick ticking, couples need to think about their odds when it comes to having little ones later in life.

Are you thinking of having a child? Are you having problems? Are you someone who was successful giving birth at a later age? Tell us your story. We'd like to hear about it.

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

soundoff (38 Responses)
  1. Rose Collette

    You should not assume that all women having children after 30 or so "delayed" having them – for some couples, it takes years to conceive. They may have started trying to have a baby in the woman's 20s and simply not had the luck of conceiving easily. It's often not a choice to "delay," but rather, an ongoing and painful struggle.

    June 7, 2008 at 13:56 | Report abuse | Reply
  2. Deborah

    I had my 3 children right after getting married, but then had a miscarriage when my children were 3,2, and 1. I was upset but not too worried. After 8 years, I had pretty much given up when I discovered I was pregnant again. I miscarried twins that time. I'm now 45 yrs old, and I'm thinking I'm probably not going to be having any more children. When I asked my OB-GYN who also happens to be a fertility specialist why I am infertile, the only response I ever got over the years was that with 5 pregnancies, I'm not infertile...it's a little frustrating!

    June 8, 2008 at 20:46 | Report abuse | Reply
  3. Kelley

    I have polycystic ovaries and I know my chances of conceiving without some form of fertility treatment are low. I'm lucky enough to have found this out ahead of time so when I am ready for children I can't put those things into place. It doesn't mean that it won't take a long time, but at least I know my options.

    From personally experience it's more heartbreaking to think that it's my fault that my body was not made the way it should be. It's really hard to get past that sometimes. We should be thankful for all the advances that have been made that have allowed so many to have children they never might have had. Furthermore, there are so many children who need a loving parent or two and adoption is a very good option.

    To Rose (previous comment) - I believe the writer meant couples are not even starting the process for having a child until later. I don't believe she meant to offend the status of those starting early and trying for years.

    June 8, 2008 at 23:39 | Report abuse | Reply
  4. neil terry

    i would like to hear more about mens biological clock as they age

    June 9, 2008 at 02:22 | Report abuse | Reply
  5. Rebecca Chandler

    This story offers no new insights into fertility after the age of 30–we've heard it all before. It would entirely refreshing if a fertility expert actually posted information with a positive message. Yes, getting pregnant after age 30 CAN BE a challenge. Yes, those of us who are beyond age 30 understand that – unless we've been living under a rock. But quite honestly I'm tired of being told by the establishment that my time is up, that I'm going to have tremendous hurdles to overcome to get pregnant now that I'm in my 30's. A little balance would be refreshing. How about a story that reflects success? I'm an American living in Africa and working in public health and, like it or not, women all over the poor, "developing" world manage to have babies well beyond 30 despite their hardships and a lack of "fertility experts"...why is getting pregnant such a phenomenon in the West? Perhaps instead of blaming women's bodies and age, Western men and women should reflect on their hectic schedules, rampant obesity/unhealthy lifestyle, and food heavily-laden with immeasurable hormones that are creating the fertility dilemma in the West thus creating unnatural barriers to a perfectly natural process.

    June 9, 2008 at 04:19 | Report abuse | Reply
  6. Marge W

    After two years of failed efforts to conceive and enduring countless fertility tests, my husband and I weighed our options and decided to adopt a child. Our original plan was to birth our first child and adopt our second, so moving up adoption on the timeline was a fairly easy decision. If a couple decides to delay starting a family, that decision has to be respected because parenting is a lifetime commitment that should not be entered lightly. At the same time, every woman should make herself aware of the problems she might encounter and she should definitely check for any family history of reproductive disorders. It's all about learning to make informed, responsible decisions, which is a vital skill for any parent-to-be.

    June 9, 2008 at 09:24 | Report abuse | Reply
  7. cb

    What this story and many others like it forget or fail to realize is in todays world it is very difficult for women in their 20s who would like to have families when they are young and more fertile to meet mature men who want to and are able to settle down and start families. These articles blame women for waiting to long when for many women there is no choice but to wait because their options for a mate are not there.

    June 9, 2008 at 10:37 | Report abuse | Reply
  8. NZD

    I conceived very quick, I was 32. My sister is having ongoing issues, and it's on her husband's side. Dr's have told him that he has no sperm & that's something we don't usually hear about, male infertility. It's always the woman we hear about, this has left them confused & very frustrated. Why don't dr's talk about that situation?? It's a real issue that needs to be addressed.

    June 9, 2008 at 11:32 | Report abuse | Reply
  9. WIlla

    A healthy woman, with a balanced life should have no difficulty concieving. When a woman is mentally and physically stressed, her body isn't going to add to that with a pregnancy, if it can help it. Mecine foucses on the health of the reproductive tract and that simply isn't enough. If women want children, this should be focus of their early adulthood. Ideally, they should plan to be finished having children before age 30. That means that you don't have the time to launch a career, become successful and extablished at it, find a mate, spend a few years really bonding to that mate, and then start a family. If you do the first three of these things correctly, on will have invested 10-15 years. Regardless of the wrong message women have been spoon-fed from birth, being a career woman and a mommy are completely incompatible. When women begin to undersand this, most of the fertility problems in this coungtry will disappear. We know this to be the case, since significant firtility problems in women are seen only in modern Western cultures wherein women have careers andthe stresses that come with them.

    June 9, 2008 at 12:01 | Report abuse | Reply
  10. Marge W

    Willa's comments (posted 6/9/08 at 12:01pm) reflect the majority of commonly held misconceptions about infertility. In my case, my husband and I are "perfectly healthy" and there's no reason we haven't conceived. We are in the minority of couples unable to conceive because we were diagnosed with unexplained infertility. Willa also stated that being a career woman and a mommy are completely incompatible, and I couldn't disagree more. After a 4-month maternity leave to bond with my adopted son, I am back at work full time. Contrary to what Willa posted, it IS possible to balance a career with motherhood. Instead of looking at the past with rose-colored glasses and wishing that all moms can stay home and raise their kids, we should look forward and figure out how to support families with two working parents, not to mention single moms and grandparents who struggle to raise children every day.

    June 9, 2008 at 13:09 | Report abuse | Reply
  11. JPOR

    In the 80's all the fashionalble women's magazines encouraged women to go out and work on their career in their 20's and 30's because there was plenty of time to have babies in your late 30's and 40's. Well I found out the hard way that was not the case. Fortunately, we adopted and found the perfect child for us. My infertility was both a blessing and a curse, but I wouldn't trade my child for any other child.

    June 9, 2008 at 13:29 | Report abuse | Reply
  12. Sandy

    OK. What about the problem that most Men are not interested in having children? I am 34-years-old and while I was dating in my 20's and early 30's I can not tell you how many men I came across that stated in one way or another that they had absolutly no interest in having children or getting married until after 35. Men are not only afraid of committment, they are also afraid of babies and responsibility. So my only choice was to have a career until I found a man who not just loved me but also wanted children. So finally, I marry Mr. Right and he claims he wants children. I waited for three years for him to be "really ready" to have kids and now it is every excuse in the book not to have them. He absolutly refuses to try and I am 34! How do you think it feels every time someone asks if we have kids or when we plan to have kids? Like a knife twisting in my stomach. My husband seems to think that, due to medical advances, it is no problem to wait until I am 40 to have kids. So my point is, for many women, it is not a CHOICE to delay having kids. It is a painful stab to the heart when women realize that it is actually their boyfriends and husbands who are forcing them to wait.

    June 9, 2008 at 13:52 | Report abuse | Reply
  13. SVL

    "... being a career woman and a mommy are completely incompatible."

    A over-generalization at best. I assume by career, you mean a job that requires a college education. Living means stress.

    My working class parents managed to have 3 children while both worked wage jobs. The last one was conceived when Mom was well into her 30's. My grandmother had her children at 20, 32, 37, and 40, all while working as a farm laborer.

    You can make all the plans you want, but life happens while you're making plans. If having a child is more important than finding the right person to be your partner in raising this child, then, sure, go out and get pregnant. But don't expect our taxes dollars to help you raise the kid.

    I spent the time looking for a mature and family focussed man to be my life partner. Along the way, I established my career, got my Master's Degree, and led a healthy, active lifestyle. We got married, bought a house, and bonded for a few years before we decided to start a family (after I turned 30). The first one was easy, the second one was conceived a month after I stopped stressing about being 34.

    I work with many women who "have it all": husband, children, house, AND a career.

    I feel for people who struggle with infertility. Some of my friends had good results and others adopted. Both groups are happy with their families.

    Bottom line: each case is unique and there is no single root cause.

    June 9, 2008 at 14:41 | Report abuse | Reply
  14. Vivian Letizia

    I agree with svl – every sitaution is unique. I was diagnosed with idiopathic infertility (they don't know what is causing me not to concieve)
    I think NOW it's probably for the best because of the course my life has taken. It was heartbreaking at the time but now I live every day to it's fulllest (won't get into it here). So Willa should rethink her comments and SVL... yay to you.

    June 9, 2008 at 16:08 | Report abuse | Reply
  15. Karin A

    For Rebecca, another success story: I delayed having children. Shorty before my 36th birthday, we started trying. After hearing all of this bad press about aging, I was in a panic when I didn't get pregnant very quickly. In actuality, I got pregnant in the 10th month of trying – not bad. As quickly as possible after our beautiful healthy, full-term boy was born, we started trying for another. Voila – at 38 I am pregnant again, with a due date exactly two years after my first son was born. I mean this as encouragement for those who haven't started trying yet.

    For those who are trying, and are not having luck, I am so sorry. I did feel some of the pain – I found myself crying when I saw a pregnant woman, when I saw someone carrying a baby, walking past a children's store. I found that suddenly I was so desperate to have a child. I was so sad for every month that it didn't happen and so afraid that it never would happen, It was a horrible emotional rollercoaster in the months we were "trying" and my heart goes out to every woman who feels this pain.

    June 9, 2008 at 16:22 | Report abuse | Reply
  16. Jenn

    I think that by just completing college and waiting a couple years to try to have children most couples find themselves in their late 20's like my husband and I did. Our first child was conceived 3 months after we began trying. I then became pregnant again when our son was 18 months old, only to miscarry at 10 weeks.

    Three years later I did invitro (after doing everything else first) which resulted in premature rupture of membranes at 21 weeks and a stillborn birth. The doctors do not know what happened.

    Now I'm 32, grieving over my recent loss and clueless as to what to do next. I'm frustrated at modern medicine, wishing they would have caught my ovulation problem earlier. I'm frustrated that I did the most advanced form of infertility treatment to have it end tragically (for all of those considering invitro- the specialist says that the invitro did not cause the breakage although statistics say there is an increased 1%-2% chance of things like that happening). I'm frustrated that I will probably never know what happened and am scared to try and get pregnant again!

    June 9, 2008 at 17:20 | Report abuse | Reply
  17. Amanda

    We adopted our wonderful little boy after 2 years of infertility treatments, including IVF. We were in our late 20's. No one ever told me that hey, those irregular menstrual cycles you have always had might be an indication of a problem, or hey mom and grandma had miscarriages but din't think it was appropriate to tell you... If I had been more aware of my medical history, I think the process would have been a lot less emotionally painful. Along with teaching our daughters to be more confident, we need to also be honest with them about our medical history.

    Our situation had nothing to do with my career, how long I chose to wait to have children, how stressed I was. It was about genetics, family history, and I guess fate. I couldn't imagine any other life without my son.

    After 2 years of mood swings, daily blood tests and doctor visits, we decided we just wanted a baby and it did not matter whether he was biologically ours or not.

    Everyone has to find the path that is right for them.

    June 9, 2008 at 18:21 | Report abuse | Reply
  18. Zahir

    As a 37 year old woman who does have a career I would encourage Willa to investigate his view a little more carefully. The issue may not be incompatibility between motherhood and career but fatherhood and career. The overly simplified acceptance that men can begin families when they choose well beyond their 30's coupled with the assumption that their partner of choice can have children well into their 30's many MEN are delaying marriage and starting families.

    I think the original piece sought to share a message that is not well understood by either sex. The limitations to conceiving are real even with the presence of assisted reproductive technology. In many instances success rates for those techniques are well below 50% and are still significantly influeced by the age of the woman.

    While we all like to hear the success stories and for many couples success comes in the form of adoption, it is important for people to have a reality check. The reality is there are more failed or redirected attempts to start families than there are miraculous stories of 45 year old celebrities starting families.

    Not to mention that the process itself of determining if there is in fact a problem, followed by testing, and surgery etc all take time and an emotional toll on would be parents.

    I know I'm recouperating from surgery now and I've been dealing with this issue for several years now. I wanted to begin a family in my early 30's but finding a suitable partner who didn't want to wait 5-10 years to start a family can be difficult. And in light of all the healthcare cost concerns testing for infertility is not automatically covered. So there is a financial component as well. This is just no a simple issue no matter how you look at it and it should not be taken for granted

    June 9, 2008 at 18:35 | Report abuse | Reply
  19. Elizabeth

    I have been mentally and emotionally destroyed by my battle with infertility. After surgery, medicines, in vitro, praying and countless tears...nothing works. It is a horrible thing that creates a layer of sadness very near the surface. It is a cruel punishment – and I truly empathize with anyone going through this nightmare. I have a congetical reproductive birth defect, and the doctors simply cannot fix what Mother Nature failed to develop correctly. I wish I could fix it for you all going through this. Big hug and best of luck on your journey.

    June 10, 2008 at 00:32 | Report abuse | Reply
  20. Mina

    I don't buy for one minute that 35 is too late to start having children. I met my husband in my early 20's and I had already decided that children would come later, when I was 35. So despite having met the right guy and being married for 9 years, I didn't even try to get pregnant until I was 34, simply because that was my plan all along. I did get pregnant within 6 months and thoroughly enjoyed parenting my little girl while continuing to work full time. I had a lot of help from my husband who worked from home. I even nursed her for 3 years.
    I put off a second child because I lacked health insurance, and 7 years later I got a job with benefits and at 43 had my second child, despite having one working fallopian tube. So this is a success story. I grew up around women who had children over a long span of years and never thought about it as a race against time. So I had less stress in that one area that's for sure.
    I do think our environment may have a lot to do with increasing infertility problems, but there are so many sources of pollution and toxins that it's impossible to know where to start.

    June 10, 2008 at 01:26 | Report abuse | Reply
  21. Wendy

    What the media NEGLECTS to reaffirm for us "old timers" is that REGARDLESS of age, our chances of conceiving a healthy baby are still much greater than not. I'm proud that I waited as long as I did to have my first baby - I lived my young life, I travelled, went to school, worked a great job and then met the man I wanted to be with forever - at 36 years old these articles will make you feel like a dinosaur if you let them. Ladies, let me reiterate...WE ARE RADIANT AND CAPABLE. Don't let this foolishness frighten you. Yes there are exceptions, and they are indeed sad exceptions, but the NORM is and will always be that we have less to fear than the media would like to scare us into believing.

    June 10, 2008 at 08:02 | Report abuse | Reply
  22. susanne

    It's important to know you're compatible with someone, as well as have the same goals in common – like having children, when to have them, financial goals, etc. It's very important that women don't rush into having children unless they are sure these things are in place. Aside from that, a woman, and a man, have to know they are ready, maturity-wise, to be a parent. Telling women to have children before age 30 in this day and age, when women are in school longer & want to work a few years before having children, isn't helpful & won't work for a lot of them. Everyone has to decide what the balance is for them. Being aware of statistics regarding fertility can be helpful, but I believe it should not be the deciding factor.

    June 10, 2008 at 09:29 | Report abuse | Reply
  23. Anonymous

    I, too, did not delay trying to get pregnant. My partner and I were trying to get pregnant while his youngest child was an infant. After sixteen years of every surgery, medication, infertility treatment and procedure, we finally conceived our twins via IVF. So giving birth at 43 was not what I had intended, but I couldn't be more happy with my eventual success. What really is so difficult for me to understand is that you have to have money to take advantage of the fertility treatments that are out there. We would love to have a second pregnancy, but the costs of every cycle are so prohibitive that it is not possible. Why don't more insurance carriers cover procedures that are so commonly used?

    June 10, 2008 at 09:35 | Report abuse | Reply
  24. GF

    At 36 years old and unmarried, I sure hope I have my mother's good genes and still be able to have a child at 40 (age she had me). I agree with CB that it's difficult to meet a man to even be in a committed relationship must less have a family with during my 20's and early 30's. I agree with Willa that having both a successful career and successful family is not possible because one or the other will be neglected.

    June 10, 2008 at 15:15 | Report abuse | Reply
  25. Anon MD

    About "having it all"–the thing is, that women's life expectancies are now so long (~80 years) that there is definitely time to have a family and even a few careers, it's just hard to have a really high-powered career AT THE SAME TIME as raising small children. And yet: more than 50% of the med school and law school classes have been comprised of women for quite some years now, and all those educated women aren't forgoing having kids.

    The solution that many have found is to work part-time while the kids are young, and then scale up afterwards–for example most of my women doctor friends (now in their late 30s) have 2-3 kids (and generally had them during their 30s–right after medical training but before the infertility risk got really high), but most of them work part time and have done so ever since having their first. Granted none of them are super-high-powered academics (generating enough research to get published and tenured really is difficult to balance with finding a partner and raising kids) but part-time doctoring (for GF and Willa) is a perfectly satisfying and doable career with small children, and there are plenty of other careers for women that can be scaled up and down in the same way.

    As there are so many women in the workforce, I hope that more and more employers realize that in order to retain their valuable women employees, they need to structure jobs to be more family-friendly–the burden of elder care generally falls heaviest on women as well, so we are not just talking about having flex time to take care of the kids.

    One more point–I think we do a disservice to young women if we blithely tell them not to worry and they can have kids whenever they want, as some posters have done. If you were able to have kids in your 40's, good for you, we're all happy for you. No one is saying that women can't have their own healthy biological kids in their 40's–but the message needs to be that one can't count on being able to do it. If a young woman really wants to be reasonably sure to be able to have her own kids, she generally needs to try to set up her life to be able to start trying to get pregnant in her early 30's. Men need to understand this as well (about infertility risk). I agree (with several of the previous posters) that family and personal history are helpful additional datapoints in deciding one's individual risk for being able to conceive at any particular age.

    June 11, 2008 at 00:25 | Report abuse | Reply
  26. GF

    @ Anon of course you can have a "successful" career if you're working part time. But that's not really a career in the traditional sense of a person working full time and not leaving during the day to tend to their children. I'm referring to women who think they can work a high level full time position and raise young children at the same time. As a woman, I've observed other women try it without success. They've all quit to become full time moms because the pressure of their job was too great and there quite simply is not enough time in a day. Others who stayed hired nannies or daycare/after school facilities to babysit while they worked so they've in a sense they've chosen to be a part time mom.

    Women need to decide what is more important – becoming a mother or not. Women can always go back to school and build a career but there's no going back on the biological clock to have a baby.

    June 11, 2008 at 14:14 | Report abuse | Reply
  27. Milissa

    My husband and I decided to wait to have children. We had decided we wanted a baby by the time we turned 30, and wouldn't you know it, two months of trying and we were expecting. I turned 30 just 16 days before our son was born. We now have a wonderful 2 1/2 year old. We are now ready for another miracle. It isn't as easy this time. 6 months of trying. We will be trying an ovulation kit this month...wish us luck!!

    June 11, 2008 at 16:29 | Report abuse | Reply
  28. Angela

    I am 39 and found this article interesting. In my own life, all of my friends dealing with infertility dealt with it in their 20's. All of my friends who waited until their 30's conceived within a year of trying. As far as men being the only ones who want to wait...there are more than a few COUPLES in my circle who have chosen not to have children at all or have chosen together to wait until their late 30's.

    My fiance and I have chosen the childfree life even though we know thru testing that we are both fertile. We want to enjoy early retirement and the freedom to travel and move up the corporate ladder -moving cities if need be. I have a truly rewarding and full life without children of my own. We have church, travel, pets, family and friends and rewarding jobs, not to mention a very happy relationship. We enjoy working with young people through social and church activities.Our friends who have waited or decided no have pretty much the same attitude that we have.

    Waiting is NOT a bad thing. Neither is not having children at all.

    June 11, 2008 at 18:18 | Report abuse | Reply
  29. MG

    Unfortunately, we are one of the unlucky couples. We are entering cycle # 25 of trying and we fall into the dreadful "unexplained" category. I'd like to see more stories focus on the fact that infertility causes stress rather than stress causes infertility. The last thing we need after having gone through 7 iui's, a missed miscarriage and now IVF is to hear "just relax, let go of the stress, or stop trying so hard." And this article is correct when it mentions that it's naturally harder to conceive as a woman ages, however, the common misconception people have is that you turn 30 and poof, you can't have a baby. That's inaccurate, it's a gradual process and I educate people every single chance I get.

    June 11, 2008 at 21:50 | Report abuse | Reply
  30. lilian

    This are great article,I was scared when somebody told me that I can never get pregnant again, due to the fact that I have had abortions in the past. I am now in my mid 30's and I have been trying now for some year and nothing seem to be happening although my period are not regular, compared to when I was in my 20's,and I have never had problem conceiving. I do have a 15 year old son though, please advice on what to do.Thanks.

    June 23, 2008 at 13:27 | Report abuse | Reply
  31. Lisa

    I am a little late in posting but why is there no mention of men infertility? I have a 13 month old that was conceived at Shady Grove through IVF because of a genetic issue with my husband. There is nothing wrong with "me" and my body but yet endure all the shots etc. This is a very big misconception for those who have not done their homework that up to 30 – 40% of issues are due to male factor alone. We were lucky to have it work the first time for us and are currently going through round #2 and it will hopefully have the same effect. This article still puts it on the "woman" as having all the issues when that simply isn't true.

    August 19, 2008 at 11:23 | Report abuse | Reply
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