To wonder about people's awareness of fertility decline

[Orangeblossom78]

decline I mean, in late 30s/40s. I know someone who on trying to get pregnant for the first time in their early 40s is shocked and devastated to be told of their fertility being low at this stage. AIBU but is is not usually apparent that our fertility declines after mid 30s and you can't just expect to have an easy time getting pregnant in early 40s.

It's interesting how the fatger's age hasn't come up that I can see in this thread. I had out youngest just before my 42nd birthday. Baby was nearly 9 years younger than her older sibling. We'd just presumed we weren't getting a 2nd baby and had got on with our lives with the one child.

DH was 49 when she was born. The miscarriage rates for me as a mum over 40, with no morning sickness, and a DH nearly 50 was over 40%. Dad's age does also have a bearing on pregnancy success at this age.

There are two reasons for this; Indian women in their forties don’t tend to suffer low egg reserve problems like white women do,

That’s interesting. Is that for Indian women in India, or for women of Indian ethnicity living in other countries? Is it still the case if you’ve got grandparents who were born in India but you and your parents were born in England?

Interesting to see if it’s environmental or due to physiological differences.

I think it's not just about educating people about the medical side of it, though (and I do agree men need this and don't often get it).

It's about wider changes that would make it more possible to have a baby earlier.

In my line of work, you're unlikely to have a permanent job before you're 30 as a minimum, more likely mid-30s. This means that it's a big debate, because obviously you get a lot of pressure on women not to have babies during a short-term contract. Lots of 'how selfish, she shouldn't have a baby now, she's only here for a year anyway'. And some short-term contracts don't provide much by way of maternity support, though others do.

And then there's housing.

Lots of concrete reasons why people leave it later, that don't have to do with not knowing it's risky or not thinking that medical issues will affect you personally.

It's a structural change that is needed, not just individual choices.

@ nolongersurprised - across the board (indian residents and people of Indian ethnicity). Before India started offering IVF the failure rates for Indian women in other countries was high and people assumed IVF treatments didn’t work. Actually it was because older Indian women tend to be more likely to suffer from ‘reversible’ fertility conditions that don’t have anything to do with low egg reserve or when they do it tends to be conditions related to high egg reserve. It’s fascinating stuff

Hasn't there been a stark increase over the last decade in the number of terminations performed on women in their forties? Women who have internalised this message so much that they don't think they need to bother with contraception because the chances of conceiving are apparently virtually nil.

If this is true then it only serves to emphasise the need for education on fertility imo. Providing actual evidence based accurate statistics. So women understand that while it is statistically less and less likely they will end up with a healthy baby when TTC as they move through their late thirties and early forties, that doesn’t guarantee you’re infertile in your forties and still need to use protection!

@GrumpyHoonMain, that is absolutely fascinating! You don't happen to have any reading recommendations on the subject? I know I can google and I will, just curious in case. I'm studying something related to this and interested for that reason.

What I don’t think people are genuinely aware of is how high their risk of chromosome disorders is

This, or the increasing evidence that autism is linked to parental age (and that cannot be screened for).

I think people are aware but do that whole "it won't happen to me" thing. I'm ttc a second child at 37 and am frustrated that it's taking a while, even though deep down I know there's no reason to assume I'm even able to have a second now (had my first at 35 after first starting ttc at 33).

OP I think you're conflating two issues.

I could try to have a baby now if I wanted to: married, good career, big salary, house, investment property, lots of savings, in good health. I appreciate now (age 32) would be an ideal time to start trying and I am not fully appraised of fertility in the way a biologist or doctor would be but its fair to say i appreciate the evidence and risks.

But I just don't want a child now.

I might change my mind and I'm also aware that if/when I do I might struggle to conceive. If that happens I am sure I will say 'I'm so gutted, if I'd known thus would happen I would have started trying on my honeymoon'.

That doesn't mean I didn't understand fertility, it's just the age old 'I never thought it would happen to me' line.

I suspect the friend you're referring to is just mourning that the dice rolled against her, not that she didn't know that's how the game worked.

Fortunately my friends and family know me better than to try and lecture me about leaving it too late - they know I'm not daft. But I'd still appreciate their sympathy if I failed to conceive later and was sad about it, I wouldn't expect them to take the attitude that 'well even though we'll never know because we have no time machine, you might have conceived a child naturally at 32 and you had no excuse not to so now you're struggling it's your own fault for not bringing a child into the world that you didn't want then'.

If they don't want to try when their biological conditions are better you don't begrudge them that surely? You can't be suggesting we should all just mate for the sake of it in case we try but fail later?

One of my mummy friends had her DS at the same time as i had DD, just days in it. Me in my mid twenties, her in mid forties.

They had 6 rounds of IVF to get him, several miscarriages prior to that, and a TFMR. Now her DS is being assessed for some developmental delays that may point to some other issues. They have really beem through it.

She was utterly outraged when a family member commented that these things may have happened due to her and her husband's age. It absolutely does not occur to her.

It’s fascinating stuff

I know you’re more likely to survive as an extremely prem neonate if you’re female and non-Caucasian.

it is statistically less and less likely they will end up with a healthy baby when TTC as they move through their late thirties and early forties

This is true but the problem is, we humans just don’t process risk and statistics very well. People read “less and less likely” and round it up to “probably won’t happen”, not “probably will happen but odds are still reduced compared to younger women.”

Yes, though stillbirth rates are much higher for women of colour. Maternal deaths, too.

She was utterly outraged when a family member commented that these things may have happened due to her and her husband's age. It absolutely does not occur to her.

Are you sure this is about it not occurring to her? Rather than her being outraged at such a monumentally rude and tactless remark?

Women who have internalised this message so much that they don't think they need to bother with contraception because the chances of conceiving are apparently virtually nil.

Or they discovered they no longer tolerated hormonal contraception as well in their 40s (this is one the first generations to be using such in their 40) and were using something else or no longer have societal pressure to stay pregnant when they don't want to be.

You know who also suffers from fertility statistics complacency? Doctors.

I knew since I was 15 that something was very wrong. Wildly irregular cycles. Bleeding for 8 weeks, nothing for 90 days, bleeding for a week etc...
I tried to get investigated at 20 and 26. They did an ultrasound for PCOS each time and when it was negative for that? Byeee.

I went to a different GP again at 31, no interest in investigating as they’d ruled out PCOS...

GP again at 32 after I started having abnormal bleeding after quitting the pill five months earlier. Smear up to date so come back if it hasn’t improved in a year...

GP again at 33. It’s been a year of TTC with mad cycles and abnormal bleeding. Finally I get a hospital referral... where they tell me to keep trying for another year. But they agree I’m probably anovulatory 🤔

I went private in Jan and have spent the year having horrible tests to prove I’m physically perfect. It’s taken till this week for them to test my AMH levels... Mine are the average for just over 40’s.

I’m 34 and have very low ovarian function, very low follicle count, low ovarian volume and am anovulatory.
I’ve been acutely aware of my fertility for nearly twenty years and it’s done me fuck all good.

It's not just about getting pregnant though, is it? It's about ending up with a live birth.

In women of 20, around 15% pregnancies will end in miscarriage
In women of 25, around 16% pregnancies will end in miscarriage
In women of 30, around 18% pregnancies will end in miscarriage
In women of 35, around 22% pregnancies will end in miscarriage
In women of 40, around 38% pregnancies will end in miscarriage
In women of 45, around 70% pregnancies will end in miscarriage

www.tommys.org/our-organisation/charity-research/pregnancy-statistics/miscarriage#age

Sarah no, i thought that too - she says she is as healthy as she ever has been, fitter than many women 20 years younger (true), and she doesn't feel 45. Genuinely doesn't attribute their fertlity struggles to their age.

Ouch, @Flashesofrage. That's really shit. I can relate, though. I had a totally useless GP who told me miscarriages were just normal, I was young, and why did I even bother to come in. Lovely. A few years later the consultant I got sent to said they could have investigated me much earlier and might have been able to find out more had I had testing when I miscarried.

I was brought up on the fertility drops over the cliff when you hit 35. It was common to hear people say that statistically you were more likely to be run over by the Queen driving a bus than get pregnant over the age of 40.

I took this as gospel, didn't worry about contraception with new partner at 44 and was pregnant within 4 months. MW said that most of the increasing number of post 40 pregnancies were due to women believing that they couldn't get pregnant and then finding that reality was somewhat different. Secondary infertility was common though.

Oh, gosh, then I feel for her reggae.

I think most people are aware but many simply aren't a position to have kids at the physically ideal time.

I think lots of people also focus on anecdotal success stories to reassure themselves rather than looking at hard data. Which is understandable.

The Tommy’s stats are based on Danish women from the seventies to 1992. Older women have gotten healthier now and it’s more common now for the reasons for miscarriage to be identified and treated sooner. So I would treat this study with a large pinch of salt.

It's quite fashionable/ trendy to have babies later in life. The average age to become a mother in the UK these days is 30! I know I've read fertility begins to decline in the late 20s. And the majority of 40+ mothers are quite snooty and look down on anyone younger than 35. I don't think their attitudehelps. Biologically early-mid 20s is the best time, but as that isn't the average age anymore, I think there's a real lack of education on the matter. I know someone who thinks it's perfectly fine to have babies until you can't anymore due to menopause and doesn't understand the risks of being an older mother.

I've worked with a lot of women who put their city careers first and are now popping out babies in their 40s, seemingly without much effort.

Unless they were very close to you, how do you they had babies without much effort? There are many things women with money do to boost their fertility in later ages - acupuncture, diet, Clomid, endocrinology, hormonal testing, and of course IUI/IVF.