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Friday, January 27, 2012

Watching Dr Oz 1/27/12: When Are You Too Old To Have a Baby?, The Science of Fertility, Risks of Fertility Treatments, Silence About and Judgment of Older Moms

The Dr. Oz Show
Airdate: January 27, 2012
Dr. Oz: Is 40 Too Old to Have a Baby?
  • When is too old to have a baby?
  • Fertility treatment risks to mom and baby
  • Breaking the code of silence surround older moms

Can women really have it all? Women have been told to wait to have a baby, to build a career first, gain financial stability first and then have children. As a result, one in five women today postpone having baby until after 35, and that number is rising. It's a trend that continues to rise. Could waiting too long be a mistake? How old is too old to have a baby?


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Dr. Oz: Is 40 Too Old to Have a Baby?

Aging causes decreased fertility and an increase in health risks for both mom and baby. Is having children earlier the answer? Is relying on science to increase fertility over age 40 the answer?

Jennifer Lahl, RN, M.A., President of the Center for Bioethics and Culture, wants to warn women that delay pregnancy is a huge risk. The reality is that fertility is limited and as women age their risks during pregnancy increases. Ms. Lahl explained that over the age of 40, 50% of women will lose the baby if they get pregnant. Age absolutely has an impact on the health of the baby as well. Fertility drugs have cancer risks and they present risks to the baby.

Ms. Lahl said she wants to apologize to young women who've been told they can have it all and wait to have baby. She says don't wait, have your children when you're young.

Reproductive endocrinologist John Jain, MD, is on the other side of the issue. He says that over four million babies born through Invetro Fertilization in the last 30 years. He has treated a 56 year old woman to help her have a baby and most of his patients are in their early 50's. Women using their own eggs for fertility treatments are often around age 46.

Dr. Oz asked his viewers online what age they thought was too old to have a baby.
13% said age 35 is too old to have a baby;
28% said 40 is too old;
34% said 45 is too old;
21% said age 50 is too old;
4% said you're never too old to have a baby.

Nicole, form the audience, is 40 and shared that she isn't trying right now to have a baby but she doesn't feel like she is 40 and doesn't think she'll have a problem conceiving.

Arabella, age 39 and pregnant, says it took a great deal of time and $90,000 to get pregnant. She told Nicole that despite how she feels, her eggs are 40 years old, they are still aging even though your staying healthy. Arabella says her fertility journey has taken over 2 years and six different fertility procedures, a loss of a baby and says her story is not unusual.

Ob/Gyn Evelyn Minaya, MD says that women have to be realistic that the biological clock exists and is ticking. She explained that in the 20's women can get pregnant 50% of the time, in the 30's it goes down to 20%, and in the 40's there is only a 5% pregnancy rate.

Dr. Oz showed an animation of a woman's reproductive system as she ages. Women are born with 2-3 million eggs. By age 40, over over 90% of a woman's eggs are gone, the remainder could be scarred or infected. To further complicate matters, after 40 a woman could have, or had, experienced fibroids making it harder for eggs to imbed into the uterus. If an egg does implant, the blood vessels that grow into the placenta are not as strong as when a woman was younger and could more easily rupture.

Many of the reasons above lead to a 40 year old woman being three times more likely to have a miscarriage than a woman in her 30's. Because of the ravages of age, women over 40 often chose to turn to science to have a baby.

Dr. Oz asks, are we giving women false hope?

Dr. Jain says doctors are giving women information to make their own choices.

Dr. Oz: What can science do for older women?

Sharyn, a police officer waited until her 40's to have a baby. She chose to go to school and build her career. Two years ago, she meet the love of her life and wants to have a baby with her new husband. Now at age 45, she has had numerous fertility treatments, mortgaged her house to pay for them, and did get pregnant only to learn the baby had a terminal birth defect and was terminated. Thoughts of having a baby consume her from the time she wakes until bed, says Sharyn.

Waiting to have a child came with the understanding, to Sharyn, that getting pregnant would be harder. But seeing celebrities having babies in their 40's she thought it would easier then what she has experienced. Tearfully, she said she wants to be a mommy. Sharyn gave a heartfelt plea to see her husbands eyes in her child, to hear her own laugh come from her child, she wants that biological experience.

Dr. Jain says the medical community has to give realistic expectations on treatment options to women. There are a variety of treatments, each with a high price tag.

How expensive are these procedures?

Follicle-Stimulating Hormone (FSH) shots can run $3,000

Artificial Insemination costs from $500 to $1,000 per cycle
In Vitro Fertilization (IVF) averages about $15,000 per cycle
Egg Donation starts with the cost of an IVF cycle then adds $15,000-20,000 for compensation of the donor and any agency utilized.

Ms. Lahl said she's sympathetic to to the plight of women struggling to conceive however she also expressed her concern that medical studies have linked fertility medications to uterine and other cancers. Fertility treatments are costly and they don't work more than 50% of the time. The older women are, the greater the risks of not being able to carry a baby to term.

Doctors need to educate their patients about the risks of fertility treatments, says Ms. Lahl. She became angry saying that The Dr. Oz Show focuses on healthy living and, excuse me she says, these fertility drugs are crap that cause harm.

Dr. Jain and Ms. Lahl butted heads on the issue of cancer associated with fertility drugs. Dr. Jain says that the studies Ms. Lahl is referring to did not remove the factor of age which in itself can increase risks for cancer. Ms. Lahl, on the other side, says that yes the studies did in fact account for age and the remaining data shows increased cancer with the use of fertility drugs.

Dr. Oz: Health Risks of Fertility Treatments and Incidence of Down's Syndrome

Dr. Minaya explained that with age, women's cholesterol, blood pressure and other health indicators tend to be higher. She says two variables come more into the play with later aged pregnancies. First, she explained, older women have a greater risk of premature delivery. Second, older eggs, mature eggs, have a greater risk of producing a child with Down's Syndrome.

In their 20's, women have a 1 in 1,400 of having a baby with Down's Syndrome. Reaching the 40's, the rate increases to 1 in 30 and at age 45, the rate is 1 in 12.

Dr. Jain says he is as concerned with health and the healthy babies. He encourages education and counseling and at times, he will tell women that science cannot help them have a baby and that a surrogate is an option.

Ms. Lahl brought up another issue is that babies born by surrogate grow up to be adults who often want to know their biological parents. She is concerned that people are spending all this money in the name of creating a biological child, she called it a commodification of healthcare. She sees medicine shifting from taking care of people and moving toward technology that is used only if you have you have money. If you're poor and trying to get pregnant, Ms. Lahl says, you get nothing.

Sharon, an audience member, shared that she used IVF to get pregnant and tragically lost her baby, similar to the story she showed on the cover of the Daily News – older woman dies after giving birth to twins. Instead of risk her life further, Sharon opted for international adoption of two boys who, she says, have made her family complete.

Arzuna [at least that's how her name sounded], from the audience, agrees with having kids early. She shared that her mom gave birth to her at age 40 and died at 47. A career is great, she says, but have children early and be there for them.

Jessica, from the audience, says the issues comes down to healthcare and the doctor's assessment of the patient's competence. Dr. Oz asked, does a woman really understand what it means to have a baby at an older age, the risks she may be taking.

Dr. Oz: Code of Silence Among Women

Dr. Oz asked the entire audience about who would talk about donor eggs. Only one woman raised her hand. She shared that she has had six rounds of IG and she's going to keep trying. At age 27, she doesn't believe she would have been as good of a mom as she can be now at an older age. She says she would tell her daughter to freeze her eggs at age 27 and wait to have a child until she's older.

Motherhood at midlife is a taboo subject among women. Clinical psychologist Jennifer Hartstein explains that women pass judgment on older moms.

Maddie, age 32, from the audience, shared that she asked her doctor if she had any eggs left to determine where her biological clock was at. Her doctor told her she should be in a good relationship and to not have a baby to keep a guy.

Dr. Oz said while that may be good relationship advice, what medical advice was given about having a baby at a later age. None. That's where, he says, the medical profession is slipping.

On the subject of waiting, another woman from the audience shared that her mother has a child every decade from age 20 to 40. She got teary saying she has seen how hard it is to be a mom at any age. Her mother was in the audience and said she's not one to judge. Coming form Tanzania, women would have their periods through age 50 and it was common to see women giving birth into their 40's and 50's. She thinks her daughter has good genes and will be fine.

Dr. Oz says the big question for older women is, why do you want a child?
Dr. Hartstein says that women will start thinking about having children when they themselves are just children. Is the desire coming from wanting to fulfill emptiness or is it to bring something to you to share and build a life?

What are you willing to sacrifice to have a baby?
You are going to have to give something up, says Dr. Hartstein. There are great working moms who are sometimes happier then they were before having children but they are also giving up being at functions or events at school with your children. Working women could also be giving up promotions as well as salary with having children. If you want the picture pot-card perfect world but are not understanding what it will take there could be let-downs.

Oz isn't that what women have worked for over the last century? To have it all, career and family? Yes but the reality is that the media portrays having it all is easy and it's not, far from it.

Dr. Oz wants women to understand the risks of waiting to have a baby before they make that decision. Putting off having a baby may be a mistake, says Dr. Oz.

Dr. Oz encourages viewers to break the silence and shame around fertility issues. Understand that the chance of getting pregnant over age 40 is only 5%. He wants women to under that the failure rate of fertility treatments is 85% for women over 40. He says to ask yourself are you willing to sacrifice your financial and personal independence to invest in science to allow you to have a baby?

Dr. Oz's bottom line, he wants women to move having a baby to the top of your priority list before the age of 30.

[Isn't it still about a women's right to choose? I get that Ms. Lahl sees the entire issue of today's show as forced reproduction. Yes, there are a huge amount of children in the adoption system waiting for a family to love both here in the US and international. That biological need to have a baby is a strong emotion.

I've known women who've gone through fertility treatments however they were in their 30's and I've known several women who have given birth well into their 40's yet they conceived naturally. I also have seen many families with adopted children, many are in my own family and I've seen them treated as and cared for as if they were biological. And here I am with two kids having given birth to them at age 29 and the day before my 33rd birthday.

Watching today's Dr. Oz Show and hearing about the time and cost and emotion turmoil associated with fertility treatments I don't see the process being worth the struggle, again that's just me sitting here with my kids it's easy to judge, right? From my perspective, I wonder why more of these couples don't pursue adoption because I've seen it up close and personal and for those families adoption has been amazing.

My bottom line, Dr. Oz is these are tumultuous water. I do agree that education is the smart way to approach it and to understand that hormones and emotions are running extremely high in these situations. In the end, it all comes down to someone's individual my opinion, sitting with my kids.]

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  1. I have friends giving birth at 21 and with all kind of complications. I have friends giving birth over 40 and with the easiest pregnancy and delivery. It all comes down to health.

    1. Thanks for your comment. You are exactly right, it all comes down it health.

  2. I'm curious to know if they touched on the subject of earlier menses? It used to be common for young women to get their periods when they were 15-16, and now it is not uncommon for girls to get their periods before the age of 12. I wonder how this has affected fertility in later years. I mean, it would seem that women would reach menopause earlier, but I wonder if there are other complications.

  3. Thanks for your comment, Misty. There was no discussion of the age of first menses. That's a great point. A woman has a finite amount of eggs so it would stand to reason that with an earlier onset of menses she could then have earlier onset of menopause which would play a role in fertility and overall health of the uterus. Again, a really good point that makes me think! Thanks!

  4. I set my DVR to record this show, and it was a different episode that aired. My concern is did they touch on the topic of those of us who HAVE wanted children from our early 20's but couldn't? I'm 36 and have had three miscarriages. Me and my boyfriends genetic testing was normal. The genetic testing of the baby was "normal" for a miscarriage (the most common chromosomal abnormality for miscarriages, it's one that just "happens"). I have always wanted kids, and am a pediatric nurse, but had never had a relationship at an early age. I wanted kids at 24, but here I am at 36 and no children. It tortures me every day that I still don't have children. And not because I chose to wait -- I just haven't been able to carry a pregnancy. We don't all chose to wait.