It's a touchy topic: broaching the issue of having children. But OB-GYNs say they are increasingly making it as routine as asking about contraception during annual visits. They are educating patients about fertility rates, which gradually begin to decline around age 32 and then rapidly decline after age 37. And they are discussing the risks of miscarriage and chromosomal abnormalities, which increase at age 35 and above.
About 20% of U.S. women—a growing share—wait until after age 35 to begin their families, according to data compiled by the American Congress of Obstetricians and Gynecologists. Even with significant advances in assisted-reproductive technology, or ART, a woman's age can be a factor in getting pregnant. A healthy 30-year-old has about a 20% chance each month of getting pregnant, while a healthy 40-year-old has about a 5% chance each month—in many cases, even when using ART, the data show.
Doctors say advances in fertility treatments and media coverage of women conceiving in their 40s and even 50s have led some people to believe they can beat the biological clock. And though more women are pursuing fertility treatments, such as in vitro fertilization, using egg donors and freezing eggs and embryos, experts note that such procedures are expensive, rarely covered by insurance, and offer no guarantee for conception. Nationally, the mean age of first-time mothers was 25.4 years in 2010, up from 24.9 years a decade earlier, according to the latest data from the Centers for Disease Control and Prevention.
"I hear many people say 40 is the new 30. But not reproductively, it's not the new 30," says Cynthia Austin, medical director of in vitro fertilization at the Cleveland Clinic. "Our ovaries are aging at the same rate they did 50 years ago."
Image: Doctor talking with female patient, via Shutterstock