Later, Baby?

Delaying Motherhood
Can Be a Mistake

Conception is Easier for Younger Women

By Iris Winston

“The women’s movement is a ruse.”
This is the view of Dr. Paul Claman, a founding partner of the Ottawa Fertility Centre and a professor of obstetrics and gynecology who  heads the Division of Reproductive Medicine at the University of Ottawa.
“In western countries, women can do anything they want professionally,” he says. “There are no limitations any more and that is a good thing. The problem is that the way society is currently structured, if a woman wants to be professionally successful, she risks being unable to enjoy family life. If she has children, it is harder for her to be competitive professionally.”
Career advancement is one reason that many women delay having children until they have completed post-secondary education and  established themselves in the workplace.
“Delaying the decision to have children results in a lot more fertility problems,” warns Dr. Claman. “Unlike men, who grow new sperm all their lives, women are born with all the eggs they are ever going to have — a few 100,000 or so — at birth.
“Astoundingly,” he goes on, “every month a 15-year-old girl starts to mature between 500 and 1,000 eggs. They all die except the one that is released in that menstrual cycle. By the time a woman is 30, that cohort decreases exponentially. It is such that a 25-year-old woman who has normal fertility every month she is with her man — a normal fertile man — has a 25 per cent chance of pregnancy. By the time she is 30, it goes to 20 per cent per month. By the time she is 35, it is 10 per cent and, at 40, there is under five per cent a month chance of conception.”
Ovarian aging, he emphasizes, is one of the major causes of fertility problems. “Basically, if a woman is running out of eggs, there is little you can do.”
Apart from ovarian aging, the three causes of infertility are ovulation disorders (demonstrated by irregular menstrual cycles), blocked or damaged fallopian tubes, and problems with sperm production and quality. The major problem for men aiming to have a family is low sperm count, points out Beverly Hanck, executive director of the Infertility Awareness Association of Canada. (A man is considered to have a low sperm count when he has less than 20 million spermatozoa per millilitre of ejaculate.)
“Over the last couple of decades, the average sperm count has dropped substantially, so it’s a big issue,” she says. There are a variety of reasons for this, including heredity, testicular injury and disease, malnutrition, obesity, certain prescribed medications, drug use, excessive alcohol consumption, smoking, overheating (such as the effect of staying in a hot tub or sauna too long), stress and environmental toxins.
“My educated guess — and I have been studying fertility issues for the last nine years — is that the environment is the biggest problem,” she says. “Environmental factors such as pollution can have a major impact on sperm.”
Beverly agrees with Dr. Claman that the societal sea change that leads women to delay childbirth is the single biggest factor in the sharp increase in infertility rates.
“I would really like to see young ladies starting their families in their twenties,” she says. “It’s healthier for them and they are less likely to miscarry. At 30 years of age, you have a 15 per cent chance of a miscarriage. At 40, it’s 50 per cent and there is a much greater chance of having a child with a problem.
“If we really mean what we say about families being important to us, we would structure a society that has proper daycare and encourages women to couple or marry in their late teenage years and early twenties, have their children and then enter the higher educational environment. There should be daycare there and wherever women are employed, so that they can return to the workplace early after
having children and not feel they are abandoning their kids.”
“My generation is the first in world history where it became normal for women not to start having children until their late twenties,” Dr. Claman adds. “In our children’s generation, a woman who has kids at 20 or 21 is thought to be too young. That is counter to the biology, resulting in a lot of people getting into trouble with serious fertility problems. The biggest problem facing couples today seems to be their fertility and the biggest risk is that women are delaying childbearing.”

Fertility treatments
The types of fertility treatments available today include:
Fertility drugs
Such drugs as Clomid (clomiphene citrate) are used to regulate abnormal ovulation.
Surgery
Laparosopic surgery may be employed to repair or unblock a woman’s fallopian tubes or correct problems with the lining of the uterus.
Assisted reproductive technologies
In vitro fertilization is the best-known procedure. Eggs are extracted from the woman and fertilized with the man’s sperm outside her body. A fertilized embryo is then inserted into the woman’s uterus. Intracytoplasmic sperm injection (ICSI) is used to insert a single sperm into an egg when there are significant problems with sperm quality.
Inauterine insemination (artificial insemination) involves placing specially washed sperm directly into the uterus. (This treatment may be used for donor sperm.)

For further information, including the fees for fertility procedures, see the Ottawa Fertility Centre website at www.conceive.ca.

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