It’s too late, baby

12 01 2015

Not only am I lazy, I am also a bossy broad.

Bossy and lazy: and I wonder why I don’t date!

Anyway, Amy Klein writes in aeon about her reluctance to tell her 42-year-old friend that it’s too late to begin thinking about freezing her eggs:

What I really want to tell my friend is that if she is serious about having a baby, her best bet would be to go out to the nearest bar and hook up with a stranger – during her 36-hour ovulation window, of course. But I won’t tell her to sleep with a random guy, I won’t ask if she ovulates regularly, nor will I say anything else about the state of her ticking – nearly stopped – biological clock: it’s too delicate a subject.

To which I can only say: if someone brings up her ovaries to me, then I’ma gonna go ahead and tell her that thinking and freezing are not going to get the job done—although I’d recommend a sperm bank rather than the local pub.

Will I also tell her that chances are she’s already infertile? That would depend on the course of the conversation, and, in any case, I’d tell her to talk to her OB-GYN.

Klein is right, however, that most women don’t know that, for most of them, the fertility window is closed by the early forties, and that it begins closing in the late-twenties/early-thirties. Fertility rates do decline throughout the thirties (entering a period of greater variability in the late thirties), but, again after 40 the decline is precipitous.

And IVF won’t help—not if you didn’t create embryos before entering your fifth decade. Yes, some women do conceive their own children throughout their forties, but, as Klein points out, all of those well-known women birthin’ babies at 48 or 50 are either using embryos frozen some time ago or someone else’s eggs. Liza Mundy has more about this in her terrific book, Everything Conceivable:

Studies show that among ART [assisted reproductive technologies] patients who are forty years old and using their own eggs, there is a 25 percent chance of pregnancy over the course of three IVF cycles. The chances diminish to around 18 percent at forty-one and forty-two, 10 percent at forty three, and zero at forty-six.

In 2005, a group of doctors at Cornell surveyed IVF patients over forty-five who had attempted to conceive using their own eggs. Among women between forty-six and forty-nine, not one get pregnant using her own eggs. (p. 42)

And, it should be noted, the odds are even worse for poorer and non-insured women of every age, who may have had untreated medical problems which interfere with or nullify their fertility.

Mundy and Klein both note that a previous attempt by the American Society for Reproductive Medicine to raise awareness that the biological clock only has so many ticks in its tocks caused controversy among (hangs her head in sorrow) some feminist groups (well, the National Organization for Women), for the “pressure” such information would place on women, making them “anxious about their bodies and guilty about their choices”.

(Do I mention here that loooooong ago I was a member of the Sheboygan chapter of NOW? Those women, who fought to bring Planned Parenthood to the county, who had been harassed and threatened, would have hooted then-prez Kim Gandy out of the room for thinking they would have been afraid of a little information.)

Klein quotes Naomi Cahn, author of Test Tube Families, who notes that

‘the politics of reproductive technology are deeply intertwined with the politics of reproduction’ but ‘although the reproductive rights issue has a long feminist genealogy, infertility does not’. Discussion of infertility is threatening to feminists on two levels, she contends: ‘First, it reinforces the importance of motherhood in women’s lives, and second, the spectre of infertility reinforces the difficulty of women’s “having it all”.’

That is not any reason, however, not to spread the word as far and wide as possible:

‘Shunning that information about the relationship between fertility and age, however, ignores biological facts and, ultimately, does a disservice to women both in terms of approaching their own fertility and in providing the legal structure necessary to provide meaning to reproductive choice,’ writes Cahn.

. . .

‘It is only with this information that reproductive choice becomes a meaningful concept,’ Cahn writes. ‘Choice cannot mean only legal control over the means not to have a baby, but must include legal control over the means to have a baby.’

Exactamundo.

It is sometimes pointed out that it is unfair that men have no legal say in whether a women chooses to continue or to end a pregnancy—and maybe it is, but it’s also how it is. Similarly, maybe it’s unfair that men remain fertile throughout their lives but women do not—and maybe it is, but it’s also how it is.

So better to say how it is (and the earlier the better) than pretend otherwise, so women have the knowledge, and the time, to make the choices that make sense for them.

And if we’ve got to be a little bossy to get the word out, well, then that’s how it is, too.

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