It saddens me to know couples in their late thirties trying unsuccessfully to conceive. The notion that it is easy to conceive at any age under 40and perhaps beyond thathas taken firm, but mistaken, hold in our culture. The American College of Obstetrics and Gynecology recently published a meta-analysis concluding that womens fertility begins to drop significantly at 32 and drops rapidly at 37. This study reaffirms a similar 2008 statement by the American Society for Reproductive Medicine.
Most have not heard of these studies. Many who know the general concept discount it. The broad postponement of parenthood rests on a series of dubious cultural notions.
Initially, the belief that one has at least until one is 40 to conceive probably gained currency because 40 is a round number. It provides a defined amount of prospective liberty to sample the companion field, develop ones career, travel and pursue other personal interests. But the body is calibrated to nature, not round numbers or the fulfillment of bucket lists. Many of us procrastinate in many aspects of our lives. Americans manage conception as they do money or weight: they focus on the present and leave little margin for the future.
Americans have widely internalized the notion that, despite many millennia of human history, biology has recently changed and they are suddenly aging better than their parents; fifty is the new forty, etc. Our parents generation may have smoked more, eaten less carefully, not gone to the gym as much, dyed their hair less, not dressed as fashionably and listened to less hip music through their thirties than do their modern counterparts. But looking slightly younger, having Jay-Z on your I-Pod or being able to run 5Ks does not reset the biological clock or enhance reproductive function.
Further, most Americans are exceptionalists; we think that rules about risk and failure that apply to others dont apply to us. Our books and movies foster the belief that the individual is the master of his/her own destiny, and that the force of will can surmount any challenge. Those who have heard of the biological clock think that they will have exceptional reproductive longevity. Or the exception can become the rule: some think that because their 41 year old neighborwho has had her first child years beforeis pregnant, a first time pregnancy is virtually guaranteed at 38.
Our culture has also developed the dubious notion that it is never too late to try anything. From the 80-year-old skydiver on down, the Man Bites Dog media feeds the notion that any age-based limits on conduct are intrinsically suspect. Mothers or grandmothers who hint at a fertility end date are dismissed as archaic and insensitive. But science bears out their concerns.
Our culture also encourages us to believe we can all have it all. Many men and women postpone childbearing in order to obtain advanced degrees in our formal education-intensive culture, build a career and save money. But doing so projects parental material desires onto kids, who are as happy playing with a kitchen pan as with a store bought toy and care little about the kind of dwelling they inhabit. Perhaps some money-making can wait. It may also be that we can have it all, just not all at one time. It may also be that we can’t have it all.
Perhaps most fundamentally, the willingness to postpone conception until ones late thirties is based on the culturally encouraged, but mistaken feminist notion that women and men are equal. Laws and cultural messages can advance gender equality, but biology need not conform to these notions.
Though it seems paradoxical, because they were so widely touted as boons to women, synthetic birth control and abortion have placed women at a great disadvantage to men. As both Pope Paul VI prophesied in 1968 and as current Fed Chair/then college professor Janet Yellen chronicled in 1992, these technologies have given full, consequence free (save for STIs) access to multiple womens bodies for decades. As long as women remain sexually available, men can outwait women looking critically for Mr. Right and cause her to accept Mr. Right Now in her late thirties. Men can wait considerably longer for Mrs. Right Now. Its not fair, but this scenario plays out frequently.
When fertility is lost to time, Americans rely, as they do in other realms, on technology and public subsidies. But IVF is fraught with significant, glossed over problems, from the pain and risk of treatments to the complicated pregnancies, embryo surplusesboth in utero and lab frozeneugenic embryo selection, post-implantation selective reduction, and increased risk of birth defects, as well as great cost to personal and societal medical and insurance resources.
And IVF often fails for those over 35. By then, a womans egg supply and quality have lessened. Thus, the process is ramped up: eggs are frozen, or harvested from well-pedigreed college students, who risk their health and may endanger their own fertility to enable older women to do what our society typically considers indecent: allow their husbands to have the child of another woman. Like many commercial processes, surrogacy allows child-bearing to be outsourced to low income women in the US and abroad.
Postponing parenthood is a high stakes risk. Americans should carefully examine the cultural notions and technologies enabling this growing trend.