The number of births is the United States is at its lowest level in 30 years. The National Center for Health Statistics reports that US fertility rate fell in every reproductive age group, except in people age 40-44. This reflects a new generation of people who are delaying marriage, pursuing more education and climbing the corporate later. In just one generation we moved from childbearing in our 20s to having the kids in our late 30s or even early 40s, and this change has resulted in more people having difficulty building their ideal families.
It’s just one more thing in the long list of gender inequities--sperm are produced every day, but people are born with all of the eggs they will ever have. By 35, half a the eggs are abnormal and by 40 this statistic approaches 80%. This means if someone is waiting until the late 30s to start trying for a family, each egg is less likely to result in a pregnancy, there may be an increase in time needed to achieve pregnancy, and the risk of miscarriage increases.
What this also means is that people are trying for baby number one at a time where it is already more difficult to achieve pregnancy. It is at this juncture that I ask my patients to consider their family building goal. It is not uncommon for this goal to be, “We want two, maybe three kids some day, but we are just focusing on this first one.” I would be doing my patients a disservice if we didn’t discuss options at this point for not only fertility treatment for their immediate goal of pregnancy, but also fertility preservation, for the children they hope to have in the future at an even later age.
Most of us are of course focused on--“How will I get pregnant with number one, ASAP?!!”
With the wide spread use of the fast-freezing method called vitrification, and pre-implantation genetic testing of embryos for aneuploidy (PGT-A) making IVF success rates better than ever before, we are moving to a different era of family planning. While family planning has traditionally referred to birth control methods to prevent pregnancy and access to abortion, the definition of family planning by the US Health Department is now “the educational, comprehensive medical or social activities which enable individuals to determine freely the number and spacing of their children and to select the means by which this may be achieved.” Just like a person can proactively prevent pregnancy, they can also freeze their eggs or embryos to achieve pregnancy at a later time in life.
It is time to do the same for your fertility future.
Being a fertility patient when you are ready to have a baby is very traumatic. I see every day how frustrated people feel after spending a lifetime preventing pregnancy, only to find out that it can be harder to achieve pregnancy than they ever imagined. If you are already having difficulty conceiving or if you are planning to wait until mid to late 30s, achieving pregnancy doesn’t get easier with age. The conversation then becomes one concerning fertility treatment for that initial child followed by fertility preservation for any future children. This increases the time to pregnancy as patients often need to do IVF to save healthy (chromosomally normal) embryos for future children. No one thinks achieving pregnancy will be difficult for them, but looking young and being healthy doesn’t equal good fertility. Know the statistics, consider your family building goals and learn about your options.
Julie Lamb, MD FACOG
*Director of Fertility Preservation
*Director of the New Center of Excellence for Family Building at Advanced Reproductive Age
*Pacific NW Fertility and IVF Specialists
Julie Lamb, M.D., F.A.C.O.G., has worked with thousands of fertility patients over the last 10 years and she is gifted at combining attentive, personal care with advanced reproductive technology. “Helping build families is an incredible privilege and responsibility. My goal is to help people build families with a safe, compassionate, yet optimized approach.”
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