Women delay childbirth due to false fertility expectations

by jeeg 18. October 2010 23:37

Women are delaying childbirth until later and later in life partly because they have an exaggerated belief that fertility treatments will help them get pregnant well into middle age, suggests new Canadian research.

Media accounts of older celebrity mothers and even advice from ill-informed family doctors is fuelling unrealistic expectations about in vitro fertilization (IVF) and other reproductive technology, said Judith Daniluk, a psychology professor at the University of British Columbia.

Women who responded to a recent survey by Prof. Daniluk suggested they expected to delay childbirth until much later than even they considered ideal, and that they believed fertility treatments were far more effective later in life than is really the case.

In fact, the efficacy of treatments for infertile women declines precipitously after the age of about 34, with the technology-aided birth rate hitting barely 1% for those age 46.

“There is an assumption that if women are in good shape, if they’re physicially fit, they can turn to IVF,” said Prof. Daniluk, who counsels fertility patients. “Most people don’t know that, No. 1, IVF is expensive ... and, No. 2, it can’t fully compensate for age-related fertility decline.”

She said more education is needed to drive home the limits of the technology.

She also said that labour policies should be changed to make it easier for women to get pregnant in their peak child-bearing years, without sacrificing careers.

Other experts agreed on Tuesday that misconceptions about reproductive science are helping fuel the steady increase in the age at which Canadian women have children. Close to 49% of women who gave birth in 2005 were over age 30, almost 2½ times the rate in 1974, according to Statistics Canada.

Often, perceptions about fertility medicine seem to arise from the pages of supermarket tabloids, said Dr. Roger Pierson, a Saskatoon physician and spokesman for the Canadian Fertility and Andrology Society.

Fertility clinics constantly encounter women who have read about an actress in her late 40s or 50s who just got pregnant, and wonder, “can you do it for me?” he said.

A 49-year-old patient asked during an appointment recently if she could have eggs frozen for when “she might want to use them.”

“Women are, I think, bombarded with misinformation,” Dr. Pierson said. “What we hear is medicine and science can solve anything, and that simply isn’t true.... It’s sad. These are desperate people who have made incorrect decisions”

Prof. Daniluk said she has seen a dramatic change in the make-up of fertility-clinic patients since the mid-1990s, when most were heterosexual couples who needed treatment because of male fertility problems. Now a third are single women, many of whom have waited too long to get pregnant.

In a presentation to the society’s recent conference in Vancouver, Prof. Daniluk offered up preliminary results of an online, self-administered survey that received more than 1,000 responses between April and June this year.

About 86% thought the ideal age for having their first child was between 20 and 30, but 44% expected to wait until the were between 31 and 35, and 28% until they were over 36.

Most said they would undergo in vitro fertilzation and close to 30% said they would use a surrogate mother if necessary to have a baby.

Knowledge of the reality of delayed pregnancy, and the value of fertility treatments was lacking, however. Most indicated, inaccurately, that overall fitness was a better indicator of fertility than age, while almost half either did not know or refuted the fact that a woman’s eggs are as old as she is.

About 63% said they thought reproductive technology could help most women get pregnant before the onset of menopause, which occurs at an average age of 51.

Prof. Daniluk said it appears to her that family doctors, struggling to keep up with rapid advances in numerous fields of medicine, can also be misinformed about the efficacy of fertility treatment. Patients who delayed child-bearing sometimes say their physician assured them “Don’t worry, you have time,” she said.

Many people do not realize “there is not a technological fix” for age-related infertility, echoed Abby Lippman, an epidemiologist at McGill University and former head of the Canadian Women’s Health Network.

She also called for employers to change their attitudes so women who want children can progress at a different pace than others.

BY Tom Blackwell, National Post 



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