Since the days of Adam and Eve, never have so many women deferred childbearing until their mid-30s or later. The Centers for Disease Control and Prevention reported that in 2006, about 1 out of 12 births in the U.S. were to first-time mothers older than 35, compared to 1 out of 100 in 1970. In other words, only about 1% of first-time mothers were 35 or older in 1970; this number increased eightfold to about 8% in 2006.
A groundbreaking study of more than 5,000 couples in the 1940s and 1950s showed that at least 85% conceived within one year of trying for a baby. Historically, this one-year landmark has defined infertility, and many couples postpone evaluation until they have met this milestone.
It never ceases to amaze me how much our fast-paced lifestyles and schedules interfere with conception. I have met so many busy professional couples who are surprised they aren't pregnant, yet they only sleep together in the same bed, let alone on the same continent, once every month or two.
Multiple historical, cultural, and religious forces have led many women (and, conveniently enough, men) to assume that fertility problems almost always arise from the female side. It's not an illogical assumption. After all, a woman's reproductive system is a lot more complicated than a man's, and therefore has more components that can be broken. Case in point: Most infertility specialists (including myself, for full disclosure's sake) are trained first as ob-gyns, not doctors specialized in male anatomy.
There is no question that high stress is associated with infertility, and that infertility is associated with lots of stress. While the exact biology of how stress might come into play is not fully understood, substances such as cortisol, epinephrine, melatonin, opioids, and others are known to affect stress and reproduction. Along these lines, one recent Israeli study of women undergoing in vitro fertilization (IVF) showed higher pregnancy rates in those who saw a 15-minute clown performance after their embryos were transferred.
Nadya Suleman became the poster child for everything scary and reprehensible about fertility treatment when she gave birth to octuplets in 2009. But pursuing fertility treatment does not mean you need to price the newest double strollers and build an addition to your home.
In vitro fertilization is undoubtedly an expensive option for those struggling with infertilityone treatment can cost upwards of $10,000. But because of the strong demand for IVF and its remarkable successes, many commercial insurance plans now include IVF coverage. Several states have even made commercial insurance companies legally obligated to provide some level of IVF coverage in their plans. Furthermore, some fertility practices have implemented sliding-scale payment plans or other financial arrangements to help overcome the economic burdens of treatment. Even pharmaceutical companies have begun offering special programs to make fertility medications more affordable.
While IVF is very successful in younger womennationally, 48% of IVF cycles resulted in a pregnancy in this age range in 2008it cannot ultimately overcome the problem of reproductive aging. In women 43 and older, only 9% of IVF cycles resulted in a pregnancy in 2008, and more than half of these pregnancies ended in miscarriage. Most IVF clinics will not even offer treatment to women 45 or older using their own eggs.