MAIN RESULTS AND THE ROLE OF CHANCE Of the women, 30% expected their fertility to decline gradually until menopause at around 50 years and 31% reported that they expected to get pregnant without difficulty at the age of 40. Reasons for a mistaken belief in robust fertility included recollections of persistent and ongoing messaging about pregnancy prevention starting in adolescence (23%), healthy lifestyle and family history of fertility (26%), and incorrect information from friends, physicians or misleading media reports of pregnancies in older celebrity women (28%). Participants had not anticipated the possibility that they would need IVF to conceive with 44% reporting being ‘shocked’ and ‘alarmed’ to discover that their understanding of the rapidity of age-related reproductive decline was inaccurate’. In retrospect, their belated recognition of the effect of age on fertility led 72% of the women to state that they felt ‘lucky’ or had ‘beaten the odds’ in successfully conceiving after IVF. Of the women, 28% advocated better fertility education earlier in life and 23% indicated that with more information about declining fertility, they might have attempted conception at an earlier age. Yet 46% of women acknowledged that even if they had possessed better information, their life circumstances would not have permitted them to begin childbearing earlier.
Dr. Fisch and his colleagues found that the rate of Down syndrome steadily increased with advancing paternal age for the maternal age group of 35 to 39 years. The greatest increase, however, was seen in the maternal age group of 40 years and older with increasing paternal age. The rate of Down syndrome for both maternal and paternal age greater than 40 years is approximately 60 per 10,000 births, which is a six-fold increase compared with maternal and paternal ages less than 35 years of age. In this age group, the paternal contribution to Down syndrome was 50 percent. Men over age 40 were twice as likely to have a Down syndrome child than men less than 20 years old, notes Dr. Fisch. Since older women tend to be have children with older men, the increased incidence of this genetic abnormality in women older than 35 is likely to be the result of a combination effect of maternal and paternal age, rather than the result of maternal age only. This interaction would explain the dramatic increase in Down syndrome that is seen in women older than 35, he points out.
Panic aside, Shulevitz raises some good questions. Though not as scary as it might sound, many parents are indeed having kids later, and many parents are also using fertility drugs and treatments to get pregnant. These procedures are relatively new, and we should pay attention to how they might affect kids and society at large. However, waiting to become a parent has its pros just like having babies at a younger age has its cons, and vice versa. And yes, examining this change in parenting is important, and it obviously caught my (and my ovaries') attention. But I'm still waiting for the article about how society has changed to support women in all parenting (or non!) decisions. And I'm still waiting to have kids, too.
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