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Social trends and advances in reproductive science have led women to have “false optimism” about getting pregnant later in life, according to a new set of guidelines published last month by the Society of Obstetricians and Gynaecologists of Canada (SOGC). (See link below.)

In a review of published literature on women’s age and ability to conceive, the Reproductive Endocrinology and Infertility Committee concluded that many women are fooled into believing “they can delay pregnancy while pursuing their education and careers with the expectation that ART will help them conceive if they have difficulty conceiving later.”

The report highlights statistics showing that the success of ART cycles is significantly impacted by a woman’s age—younger women often conceive more quickly and more cycles are needed for women over 35.

In Canada, the 2007 live birth rate after ART treatments was just under 40% for women under 35 and slightly over 10% for women 40 or older.

“Age-associated infertility appears to be primarily related to ovarian aging and the diminishing ovarian follicle count,” the paper states, and goes on to conclude that the only effective treatment for age-related infertility and declining egg quality is egg donation.

However, in Canada, the 2004 Assisted Human Reproduction Act prohibits the sale of eggs, sperm or surrogacy services—therefore, Canadian women are left to rely on “altruistic” egg donors who may only be compensated for items such as “medications or parking.”

Under the existing regulations many infertile older women are just out of luck or—if they can afford it—have the option to “turn to reproductive tourism and seek treatment in the U.S. or Europe”.

The report recommends that women in their 20’s and 30’s should be counseled about the age-related risk of infertility as part of Canada’s existing primary well-woman healthcare program. Women over 35 should be referred for an infertility work-up after 6 months of trying to conceive.

It does not account for any data on the thousands of women who do conceive naturally or via IVF after 40 (as in my case). Nor does it review the long term implications of more recent scientific improvements in cryogenics in which younger women’s unfertilized eggs can now be harvested during peak reproductive years and successfully frozen (http://www NULL.vogue NULL.com/magazine/article/time-to-chill-egg-freezing-technology-offers-a-chance-to-extend-fertility/) (oocyte cryopreservation) for use at a later date.

Notes for this blog:

Society of Obstetricians and Gynaecologists of Canada (SOGC): http://www.sogc.org/about/index_e.asp (http://www NULL.sogc NULL.org/about/index_e NULL.asp)

“Advanced Reproductive Age and Fertility”: http://www.sogc.org/guidelines/documents/gui269CPG1111E.pdf (http://www NULL.sogc NULL.org/guidelines/documents/gui269CPG1111E NULL.pdf)

Angel La Liberte is the founder of the website Flower Power Mom.com—The Truth About Motherhood After 40 (http://www NULL.achildafter40 NULL.com/) (www.flowerpowermom.com (http://www NULL.achildafter40 NULL.com/)), featuring commentary, real mom stories and expert advice about motherhood after 40. She actively advocates for more supportive attitudes towards women having children in midlife and to raise awareness of the real issues related to later life motherhood.

Angel also hosts “A Child After 40”, an online community to empower all women on the journey of motherhood after 40. She gave birth to her children at 41 and 44 after conceiving naturally. For Angel’s full story, go to: http://www.achildafter40.com/my-story/ (http://www NULL.achildafter40 NULL.com/my-story/)

9 Responses to Canada Recommends Age-Related Fertility Counseling

  1. Nina Dolden says:

    hi Angel,

    I definitely think this information should be shared by doctors, not just heard on the media. Actually I’m pregnant naturally now at age 42, going for my eight-week ultrasound on December 22nd. I had a miscarriage after my first round of IVF two years ago so I’m very nervous! anyway, when I got married at age 39, I had no idea I might have fertility problems. I had heard the statistics, but I honestly thought I would be pregnant after 1-3 months. someone should have told me!

  2. Magic and Mayhem (http://magicandmayhem NULL.homeschooljournal NULL.net/) says:

    I wonder if it’s easier to conceive after 40 if you have already had some children, because I know many women with larger families who naturally conceived after 40 and that was the case with me.

    I had a dozen miscarriages in my 20’s. I was then prescribed daily aspirin and weekly Pregnyl shots during the first trimester of my pregnancies and I was able to carry healthy babies from then on. For my last child, the doctors said my hormone levels were so good that they couldn’t justify the Pregnyl shots and I carried a healthy baby to term without them.

    In my case, it was much harder to have kids in my 20’s than in my 30’s or 40’s.

    I gave birth to my kids (all conceived without assistance) at 29, 31, 34, 38 and 42. Both of my last two children were happy accidents, conceived during the two times we failed to use protection and at the “wrong” time of the month. :)

  3. Brooke says:

    I have told my doctor how disappointed I am that she did not at a minimum test my FSH during any of my annual physicals. She knew I wanted children. She said that it’s just not something they test until someone who is trying finds they are having difficulty getting pregnant. I think it is a huge failure and would encourage women starting at about 30, in my opinion, to get their FSH tested on their own if their doctor will not test it – just to know where they stand. I know that high FSH does not preclude someone from getting pregnant, but it is a good indicator of difficulty with ovarian reserve, even if you’ve had children before. I had a baby when I was 18 and gave her up for adoption. When I turned 40 and realized I’d somehow forgotten to get married and have kids, I set up a consult with an RE to evaluate my fertility and my FSH was 30.3. I didn’t even know what FSH was until it tested so high and was too late. I tried two IVF cycles for my own eggs – first one resulted in a single non-viable egg, the second one was cancelled because the two follicles I had would not grow. If my FSH had been tested when I was 30 and each year at my physical, if it was rising I feel I would have at least been able to make an informed decision about whether or not to freeze my eggs or go ahead and try to have kids. Both of my grandmothers had children at 40 so I thought that I basically had hit the ovary jackpot genetically. Between that, already having a child and all the media that really is misleading, it never occurred to me that I would have issues. Giant mistake.

  4. Catherine (http://borntolove NULL.com) says:

    My concern would be that it creates such doubt in their natural ability to conceive and you will find more and more people will be relying on medical help in the future.

    It makes me envision a future where everyone thinks that they cannot conceive without medical help, no matter their age or fertility status.

    Big bucks for the reproductive industry. Sort of reminds me of how the infant formula industry almost replaced breastfeeding.

    Maybe they will use the same marketing directors?

  5. Louise says:

    I have always wanted a child (or two or three) and became a teacher (K – 12) in order to be prepared in knowing how to know my child’s developmental process. I have the perfect job, but it’s as a Music specialist, so I did not have an opportunity to do any biology courses in university. I’m mortified that no one told me that, unlike men, women have their eggs since birth and they may not be healthy to conceive (due to environmental exposures, etc. ) the older they get. I had my fibroids removed in 2009 and I was mortified to be discouraged about getting pregnant with my own eggs… Are you sure you want to use your own eggs or donor eggs (?), my fertility specialist said last week …

    I agree with a couple of the other bloggers, in that I just thought I could have a child when I was financially ready with a very secure career. My grandmothers and their mothers had children had children in their forties, as well. I don’t know how much information is taught in the curriculum in the U.S.A., but there should be more information in Canada. I’m not giving up hope just yet, since Angel conceived at forty-four. I’m healthy otherwise, so if anyone has any encouragement for me about being not too ‘scared’ in wanting to fulfil my dream, please do comment.

  6. Samantha says:

    I fully agree with these reccomendations! My husband and I got married this July, we were engaged when we were teenagers, I just turned 44. We were so optomistic about having a baby and then only 2 months before I turned 44 I was told the “magic” age for insurance covering any kind of fertility treatment was 44. I was out of time. I had no idea and it seems everyone I talk too including people working in the healthcare profession did not either. It is heart breaking for me. I wish I knew this information even six months earlier. I am still praying there is still a chance that it may happen naturally but I am having problems with my ovaries.

  7. Kate says:

    I think more research needs to be done on womens fertility. It astounds me how little we actually know. Also someone ought to do a full study of age at conception taking into account different societies ( eg those that don’t have access to contraception as well as those of western societies). This would give a clearer picture of what the norms are. I conceived at 41 but had trouble with the next one.
    personally I think the idea around in the 60’s that women can have it all has given my generation a false view. I just assumed I needed to get qualifications, a stable job , a man then a family IN THAT ORDER! When do things ever go that smoothly? So I ended up with lots of trauma trying to complete my family. I have now but I think young women should be aware they don’t have all the time in the world and have to make some difficult choices – better they make them than have them thrust upon them later by circumstance.
    I would talk with any young lady who wants to listen about this work / family choice and how it is so much different for women (I grew up in the ‘you are just the same’ era – no we ain’t!).
    I think rather than legislation and formal programs women should be out there talking to young ladies about it – sharing their experience (this is so much more empowering).
    Good luck to all those ladies struggling to start or complete their families.

  8. Kathy says:

    I agree with making people aware of their choices, however, I disagree with the discouraging “you are too old” comments. Women have been having babies in their 40s for centuries. Who’s to say that everyone should forget it and use a donor egg by the time they are 40?

    I waited a long time before I brought up kids. I didn’t mean to wait so long. My significant other at the time seemed interested, but when I actually started to talk about trying, he withdrew from me. Our 10-year relationship ended when I realized he never wanted to have children. I had just turned 40.

    I met a man when I was 41. We got engaged, started to not try not to when I was 42. After two miscarriages, I went to a fertility specialist. He told me to give up. I waited too long. I should look into donor eggs. I truly didn’t want any medical intervention. My FsH level was 25.

    I researched and ended up seeing a Chinese Herbalist. She told me if she didn’t help me within six months, she couldn’t. I got pregnant and had another miscarriage.

    Then it happened. Pregnant at 44, had Sammy at 45. Had a health pregnancy, no problems. Sammy is a beautiful growing, healthy 15-month old boy. I didn’t use donor eggs, had no western medical intervention. I took Chinese herbs, stayed active, ate good things and took care of myself. It happened for me, it can for others too.

    Read the book, Inconceivable. Don’t give up hope.

  9. InSeason Mom Cynthia (http://www NULL.inseasonmom NULL.org) says:

    Two things concern me: young women rushing to become mothers before they are mentally ready and I echo Catherine’s concern. “It creates such doubt in their natural ability to conceive. More and more people will be relying on medical help in the future. Big bucks for the reproductive industry!”

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