- The Washington Times - Saturday, March 26, 2005

Cara Birrittieri heard all the old wives’ tales when she was trying to conceive her second child at age 42. Her mother told her as long as her cycles were regular, she could conceive. Other women told her that because she had just had a baby, she shouldn’t worry.

As it turned out, much of the advice Ms. Birrittieri, now 45 and a mother of two, received was based on misinformation.

Ms. Birrittieri, author of the book “What Every Woman Should Know About Fertility and Her Biological Clock,” was not alone in hearing vague or incorrect advice.

The American Infertility Association (recently renamed the American Fertility Association) conducted an online survey in 2002. Of the 12,382 women who responded, only one woman was able to correctly answer all the questions about reproduction.

Nearly 90 percent of respondents overestimated by five to 10 years the age at which fertility begins to decline.

Though every woman is different, the standard rule is that fertility begins to decline about age 35. At least one study, published in the May 2002 issue of the journal Human Reproduction, reports that fertility actually may begin to decline at age 27 for women and age 35 for men.

The study, which followed 782 European couples, showed that the women younger than 27 had a greater than 50 percent chance of conceiving in a given month. The women who were 35 to 39 were about half as likely to become pregnant.

Here are some other common myths about trying to conceive after age 40:

• “I have regular cycles, therefore I am fertile.”

Not necessarily so, says Dr. Frank Chang, a reproductive endocrinologist at Shady Grove Fertility Center.

Regular periods mean only that a woman is ovulating but do not indicate what kind of eggs are available. Unless the levels of follicle-stimulating hormone are measured, egg quality cannot be determined, Dr. Chang says.

Furthermore, many women believe they are fertile right up until menopause, which occurs in American women at an average age of 51. Fertility begins a steep decline about 7 to 12 years before menopause, Dr. Chang says.

Dr. Paul Gindoff, division director of the Fertility & IVF Center at George Washington University Medical Center, says it is impossible to predict when the shift will occur.

“You can have regular cycles at age 42, but there is no guarantee they may continue,” he says. “It is impossible to predict. You can have a shift in fertility potential within a few months.”

• “My mom/aunt/cousin had a baby at 43, so I should be OK.”

When considering the fertility window, there is some truth to this, Dr. Gindoff says. The age of menopause does seem to follow familial patterns, he says.

However, there are many other factors to consider: smoking, which seems to age the reproductive system; other health conditions, lifestyle factors, environmental factors, whether the other relatives had previous children.

• “I’ll just freeze my eggs and worry about it later.”

Not so fast, Dr. Chang says. Few fertility centers have had pregnancies with egg freezing. The chance for a pregnancy using a frozen egg is about 1 percent.

“Right now, egg freezing is completely experimental,” he says. “It should not be used in cases where you are just not ready to have a baby in your 20s or 30s.”

• “I’m fit and healthy, and I look 30.”

Of course, physical fitness is an important part of well-being as we age, Dr. Gindoff says, and it would be a plus for a woman to be in good shape if she gets pregnant.

“Anytime you are physically fit, it is to your benefit, and not just to sustain a pregnancy,” Dr. Gindoff says. “You want to be as healthy as possible. Your emotional and physical well-being are important.”

However, no amount of yoga, Pilates, aerobics and carb-counting can change nature’s course when it comes to reproduction.

“The eggs are the eggs,” Dr. Gindoff says. “They are as old as you are.”

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