At the age of 48, actress Rachel Weisz has just given birth to a baby girl and first child with husband, James Bond actor Daniel Craig. Two years ago, singer Janet Jackson made headlines when she gave birth to her son, Eissa, now 19 months, at the age of 50.
However, she was upstaged by Daljinder Kaur who gave birth at age 70+ (she’s unsure of her exact age) in Amritsar, India. While Jackson and Weisz are tight-lipped about how they got pregnant, Daljinder Kaur and her husband openly praise IVF and donor eggs for their son.
While it’s your right to delay child-bearing, the truth is, the longer you wait, the tougher it is to conceive. Along the way, you might even uncover existing medical issues in your own body as well as your eggs, which would make your journey towards motherhood that much more challenging.
Age is not just a number when it comes to fertility, notes Dr Kelly Loi, a gynaecologist and fertility specialist. “Women today are postponing motherhood because they want to secure their careers and finances, but this comes at a personal cost.”
In her late 20s, a woman has a 20 per cent chance of conceiving every month. By the time she’s in late 30s, this figure has halved to 10 per cent. This is because the number and quality of eggs produced diminishes with age, Dr Loi explains. While infertility can hit a woman at any age for a number of reasons — including irregular ovulation, non-ovulation, damaged or blocked fallopian tubes, fibroids, cysts and endometriosis (abnormal cell growth outside of the uterus) — such problems are usually detected only after you’ve decided to have a baby.
As for male infertility, this can be caused by low sperm count, poor motility (the sperm’s ability to swim towards an egg), irregularly-shaped sperm, or erectile dysfunction, notes Dr Jothi Kumar, an infertility and in vitro fertilisation (IVF) specialist at O & G Partners Clinic for Women and Fertility Centre.
“Women today are postponing motherhood because they want to secure their careers and finances, but this comes at a personal cost.”
Still, all is not lost. Assisted reproductive treatments have given fertility-challenged couples an alternative route to becoming parents. These include intrauterine insemination (IUI) — injecting sperm directly into the uterus, as well as IVF, when the egg and the sperm are fertilised in a dish, then implanted back into the uterus. This trend of conceiving with the help of fertility treatment is on the rise, too.
Health Ministry figures show that the number of babies conceived in Singapore through IVF has nearly doubled, from 720 in 2006 to 1,308 in 2010. And from 2009 to 2013, 11,979 fresh cycles of IVF were performed for Singaporean couples, and the success rate was 22 per cent, reports the ministry.
One IVF story
Michelle Jones-White, was 30 when she married Alan White, then 43, a decade ago. Two years into their union, the Whites tried for a baby, but realised that something was wrong when four years had passed and their efforts had not paid off.
Jones-White, who used to publish a magazine, recalls, “I took a blood test and found out that I had Hashimoto’s hypothyroidism. So, my thyroid was producing more oestrogen than necessary and this affected my hormones, which subsequently affected my menstrual cycle.” She then started acupuncture to regulate her blood flow and menstrual cycle.
“Women younger than 35 stand a 40 per cent chance. Past 40, you only have a 10 to 15 per cent chance that it will work out.”
Several months later, Jones-White tried IUI. Though she fell pregnant on the fourth round, her joy was short-lived when she miscarried at seven weeks. “It was a horrific time. Even Alan, who was at that point resigned to not having a child, realised just how much he wanted one after we lost the baby.”
After eight more rounds of IUI, Jones-White took a break to focus on getting her health back on track. Four months later, in November 2011, she underwent IVF at the age of 38.
Dr Loi notes that IVF’s success rate dips with age, just like natural fertility. “Women younger than 35 stand a 40 per cent chance. When they are over 35, it falls to 30 per cent. Past 40, you only have a 10 to 15 per cent chance that it will work out.”
Though her chances were slim, Jones-White was optimistic. After seven of the nine eggs retrieved were fertilised, four grew into embryos. After two were transferred into her uterus, one egg was implanted successfully. Nine months later, the Whites welcomed their son, Callum Pip Ernest.
How your lifestyle factors in
While age plays a pivotal role in determining your success in conceiving, your lifestyle may also be another factor. When 35-year-old Ava Styles tried to have a baby three years ago, she suspected that her fertility might have even affected by the eating disorder she’d been battling since she was 11 years old. “Because of my bulimia, they found borderline cancerous endometrial cells and cysts, which I removed right before marriage.”
After trying to conceive for nine months without any success, Styles and her 37-year-old husband, both business owners, turned to fertility treatment. After two unsuccessful rounds of IUI, they tried IVF. When that attempt failed, too, a deeply saddened Styles took a two-month break before her second shot at IVF. She decided that this time, “I had to put myself first”.
So, right after implantation, she not only rested in the hospital for six hours, she subsequently checked into a luxurious hotel and spent the next three days sleeping, ordering room service and vegging out. This time, Styles fell pregnant — welcoming baby Evita in December.
Styles does not regret postponing being a mother, “Yes, it was a highly-stressful journey. But because I’m older, I can give my daughter the very best. I’m also wiser, so I’ll be a better mum than I would have been if I was younger.”
“Not everyone wants to go through the stress of IVF. Nor is it the end of the world, there are always other options, such as adoption.”
Secondary infertility — when you want more than one
While primary infertility gets lots of attention, secondary infertility is just as common. This happens when a couple, who already have one child, struggles to conceive a second time. No national figures are available but gynae and M&B expert Dr Christopher Chong sees about five to 10 per cent of couples facing secondary infertility in his practice.
Dr Jothi Kumar reckons that this is usually due to an already existing problem, such as a problem with ovulating, or it could be due to an issue that resulted after the first pregnancy, like a pelvic infection that might have damaged the fallopian tube. The issue could also lie with the husband.
When Nur Arissa, 32, a teacher, conceived quickly at 24, she thought it was going to be a breeze the second time round. It was not to be. “After seven years of infertility and fearing that age was catching up, my husband and I decided to get checks.”
Tests revealed that her 37-year-old husband has azoospermia, the lack of sperm in the semen. Low sperm count is usually linked to poor nutrition, diabetes, high blood pressure and poor lifestyle choices, such as smoking. The couple did IVF after Nur Arissa’s husband’s sperm was retrieved manually. She fell pregnant on the first attempt and gave birth to a baby girl, Arwen, earlier this year.
What IVF costs — cash, strain and stress
The Ministry of Health’s co-funding policy for Assisted Reproduction Technology (ART) treatment — in public hospitals only — was enhanced in January 2013 and also extended to cover frozen cycles. In that year, more than 80 per cent of IVF treatment cycles for Singaporean couples in the National University Hospital, Singapore General Hospital and KK Women’s and Children’s Hospital benefited.
While IVF brings hope to couples, the treatment can take a physical and emotional toll on you both. So, it’s wise to thrash out the issues, as well as support each other, from the get-go.
According to Ho Shee Wai, a psychologist at The Counselling Place, infertility can either bring couples closer or tear them apart, depending on how well they handle the crisis. “Men tend to be emotionally detached from the situation and approach it as a project. Whereas women blame themselves — regardless of who is infertile — since they are naturally programmed to procreate, and see it as an inadequacy on their part.”
“Men tend to be emotionally detached from the situation and approach it as a project. Whereas women blame themselves — regardless of who is infertile…”
Melinda Tan, 33, certainly felt that way. After trying for almost a year, she couldn’t understand why she wasn’t pregnant. “Everyone else around me was conceiving in a snap — I never thought I would be on the other side.”
Tan, who eventually conceived her first son, Colin, 2, via IVF and her second son, Elliot, 6 months, naturally, reckons this experience brought her closer to her husband. “IVF really took a toll on me. The mood swings, the bloating and cramping, plus the gruelling wait to find out if I’d produced enough eggs and if I was pregnant, was a nerve-wracking experience. I couldn’t have done it without my supportive husband.”
Ho urges couples to cope together (never separately), refrain from blaming one another and communicate with each other. “Don’t just discuss the logistics, rather, tap into your emotions. Share your hopes and dreams of conceiving and even the grief of a miscarriage, or an unsuccessful pregnancy.”
And never rush to fix things. Once you’ve received bad news, don’t be too focused on “what’s next”. Rushing it prevents you from being in touch with exactly how you feel about the situation. So, the decision you make at this point may not reflect what you actually want.
Ho advises, “Attend to your reactions as individuals and as a couple. Then come together and decide what’s best for both of you. Not everyone wants to go through the stress of IVF. Nor is it the end of the world, there are always other options, such as adoption,” she says.