By Elizabeth Stein, CNM, MSN, MPH
Midwife & Leading Women’s Health Expert
Most women want a baby, later if not sooner. Once you catch baby lust, nothing will satisfy baby lust except a baby. But only 7,349 (0.6%) of over 4 million babies born (4,317,119) in 2007 were to women 45 and older – that’s only 7,349 babies!
A few years ago the AARP published an article describing a woman looking back with sadness and regret at the babies she never had and never wanted. Planning ahead might avoid this situation.
Women always seem to be waiting for something – to complete an education, find a better job, loose 10 pounds, make more money, get a bigger or better apartment, or meet Mr. Perfect. Years can go by in the waiting game.
Even though she may be accomplishing much of what she dreams of, her eggs are aging. The expiration date of eggs is finite. Aging is the most significant factor influencing her ability to conceive. This waiting game is the biggest risk factor in a woman’s ability to conceive a child.
Women who merely assume their fertility will be there when they are “ready” present the greatest challenge. Most women aren’t even aware this is a problem. There seems to be little understanding of the biology involved. Women are born with their lifetime allotment of eggs (follicles) for reproduction. By the time a young woman has her first menstrual cycle between the age of 9-14, there are about 300,000-500,000 eggs. The average woman will ovulate for 35-40 years: 400-500 eggs (follicles) will be selected to ovulate (about one per month), but for every follicle that matures to the point of ovulation close to 1,000 others will be consumed in the process. The childbearing years are from 15-44. The average age of menopause is 51 years.
In the ten to fifteen years prior to menopause there is an increased loss of follicles, so that by menopause only a few hundred remain. The follicles that are left have decreased quality and capacity to mature. Many are not perfect: older eggs have a greater chance of being damaged with Down's Syndrome or other chromosomal abnormalities such as trisomies 13, 18 and 21.