Pride Angel

The telegraph has recently reported that women could remain fertile indefinitely, after successful ovarian transplants has lead to births delaying the menopause, doctors have told a conference.

A technique to remove pieces of ovary, store it for decades and then replace it with delicate surgery could effectively put a woman's menopause 'on ice', doctors said. The only thing preventing them from having babies into their old age would be their physical ability to carry a pregnancy, they said.

The controversial notion would allow career women peace of mind with a fertility insurance policy so they can find a partner, settle down and become financially secure before starting a family. By delaying the menopause they could also avoid the increased risk of osteoporosis and heart disease that come with the end of their fertile life but may raise the risk of breast and womb cancer.

A conference heard how more than 20 babies have been born worldwide to patients who either had their own ovarian tissue removed before treatment that would have left them infertile, and replaced afterwards, or twins where one donated tissue to the other. Most of the children have been conceived naturally without the need for IVF for drugs.

Dr Sherman Silber, an American surgeon, has been involved in transplants for 11 women at St Luke’s Hospital in St Louis, Missouri, US. He said: "A woman born today has a 50 per cent chance of living to 100. That means they are going to be spending half of their lives post-menopause. “But you could have grafts removed as a young woman and then have the first replaced as you approach menopausal age. You could then put a slice back every decade.

“Some women might want to go through the menopause, but others might not.” That would mean women would not have to “watch their body clocks”, he said, and would only be physically limited by their ability to carry a baby and give birth.

The telegraph undertook a poll to decide ‘Should women be able to have a baby in later life?’ The answers from their readers where as follows:

No - the natural body clock exists for a reason and it is not fair on the child. 67.39% (1,833 votes)

Yes - there is no reason why mature women would not be excellent mothers. 32.61% (887 votes)

Total Votes: 2,720

Article extracts: 9th July 2012 www.telgraph.co.uk

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Older mums who wait until after they have a career, are more likely to 'over-prepare' for their first-born and struggle when things don't go as planned, a study suggest; often leading to an increase in postnatal depression. The findings are of great significance in the UK, where an increasing number of women are choosing to delay becoming a mum until they are more financially secure.

Research leader Silje Marie Haga, from the University of Oslo, in Norway, said: 'There are some indications that older, first-time mums are vulnerable to postpartum depression, perhaps because they are used to being in control of their own lives: they have completed a long education and established a career before they have children.

'But you can’t control a baby; on the contrary, you have to be extremely flexible. 'Several of the women I interviewed said themselves that this contributed to the huge feeling of letdown when things did not turn out as they had planned.'

In the UK, there were 26,976 babies born to mothers of 40 and over in 2009, compared with 9,336 in 1989, according to the Office for National Statistics figures. The latest study analysed surveys from around 350 new mothers as well as in-depth interviews with 12 first-time mothers. It found 16.5 per cent reported suffering from depression for up to six months after giving birth.

Ms Haga said the interviews highlighted a number of risk factors apart from biological ones. 'It’s not the need for control in itself, but rather the failure to achieve specific expectations that can trigger a depression,' she said. 'In contrast, women who take a more relaxed approach to motherhood with more undefined expectations cope better with unexpected challenges.'

Other women struggled after the delivery left them 'feeling like a failure'. One new mother told Ms Haga she struggled after having an unplanned caesarean section: 'That wasn’t how I was supposed to have a baby. I was so tired and so disappointed, I was so sad,' she said.

'I hadn’t been able to give birth to my baby; someone had to do it for me.' 'In my study the women who had the greatest need for control often had the strongest wish to have a natural birth,' Ms Haga noted.

She added that difficulties with breast feeding could also trigger baby blues as there is a huge societal pressure to choose breast over bottle. Ms Haga said new mums needed both practical and emotional support - particularly from their partner - as well as an understanding that life can be exhausting for them.

It is common that three-four days after the birth women experience what can be referred to as postpartum blues, i.e. they cry very easily without quite knowing the reason. This can last up to a week, but in some cases it continues. If this is so, there may be talk of postpartum depression, which resembles other kinds of depression with feelings of hopelessness, sadness, exhaustion and sleep problems also when the child is asleep.

'These women are unable to enjoy having a baby. Being depressed at precisely this period is an extra emotional burden to bear because of expectations that you should be happy,' Ms Haga said.

She added that women are often reluctant to ask for help because they still think there is a stigma attached to depression. Ms Haga is now developing a web-based program with a mental health centre in Norway that will monitor pregnant and new mums from the 22nd week of pregnancy and up to six months after the birth.

They hope that the program will support women during this very sensitive phase and potentially prevent postpartum depression.

Article: 20th March 2012 www.dailymail.co.uk

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Desperate housewife star Marcia Cross began fertility treatment aged 44 and went on to give birth to twin daughters Eden and Savannah. But despite hailing her girls as 'a miracle', she has no illusions about having children later in life. When asked about being the 'poster girl' for older mothers, Marcia, who had a difficult pregnancy, revealed it is not a good idea.

She told Easy Living: 'Are you kidding? It's a miracle I have these two daughters. 'Your forties is not the time to be thinking about getting pregnant.' The 49-year-old, who looked stunning in a 1920's-themed shoot for the magazine, also revealed she began fertility treatment the day after her wedding to businessman Tom Mahoney - and didn't even go on honeymoon.

But while she became pregnant quickly, Marcia suffered from high blood pressure and was ordered to stay in bed in the last stages. She also developed pre-eclampsia and had to undergo an emergency C-Section.

The actress said:' I didn't have time to be scared. It all happened so quickly. But it worked out and I love being a mother. 'I like bringing the girls on set, but if I can't do that then the next day I feel I have to be uber-mum to make up for it. 'Then I'm exhausted and feel like I'm running in fumes. What I lack in energy, I have in wisdom.'

Marcia, who plays Bree Van de Kamp, was recently busy filming the last episodes of Desperate Housewives after eight seasons and will not be taking any acting roles in the near future so she can concentrate on motherhood - and eating. She said: 'I've had to watch my weight for the show and am looking forward to not having to think about it anymore.'

And despite turning 50 this year, Marcia's looks show little sign of waning. She credits her flawless skin to always removing her make-up and religiously wearing sun-screen. But she also revealed since having children, she rarely has time to exercise.

She doesn't however, rule out surgery. She said: 'We (on the set of Desperate Housewives) say we'll do anything as long as it doesn't involve a knife! 'I'd never say no to surgery in the future, because I feel like, as I get older, I'm going to face temptation more.' 'Turning 50 is huge... it's monumental. But not in terms of beauty. 'It's about recognising how precious time is.'

Article: 30th January 2012 www.dailymail.co.uk

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Kasey Edwards had only gone for a routine smear test, but her gynaecologist offered to check her ovaries while she was there. One turned out to be polycystic – it was producing eggs that were faulty. The other was riddled with endometriosis. On top of that, her fallopian tubes were blocked. In terms of fertility, this was bad news: the doctor told Edwards she had only 12 months to conceive.

It was a huge shock. Edwards was 32. She liked her life as it was. "I've never been maternal. I didn't grow up wanting to be a mummy. The whole idea of motherhood seemed like a bad deal. Why would anyone do it?" A management consultant, she had seen what having a baby did to the careers of her colleagues. "And you don't have to Google very long to find out what it does to marriage and mental health."

She had been with her boyfriend, Chris, for less than a year. Only two weeks before seeing the doctor they had agreed not to discuss babies unless they were still together a year later.

But it was now or never. When her boyfriend arrived home from work that evening, she asked, "Can you love a barren woman?" He listened to her "talk in circles for a couple of hours" trying to come to a decision and then announced that he knew what to do: he wanted a baby. "What, just like that?" Yes, he replied. But because of his Catholic upbringing, he had a condition: it must be a natural conception – no IVF.

After trying naturally, Edwards found herself thinking: "Six months of trying and six months of failing. Perhaps I'm already infertile." At her next appointment, the doctor was blunt: "Six months ago you had one and a half ovaries. Now you've only got one. How much longer are you going to wait before you start IVF?" Chris broke and consented to IVF. They had at most a few months left, with poor-quality eggs. Edwards was at her lowest: "I really felt a failure. I cried every time I went to the IVF clinic because it felt like it wasn't the way it was supposed to be. I looked around when I was having the embryo implanted, and I thought, there are five people present for the conception of my child and three of them are wearing surgical masks. It's not the stuff of fairytales."

Violet was born 18 months ago. Chris, 38, is now her husband. They live in Melbourne, Australia but I meet Edwards for coffee in London, where she is promoting a book about her experiences. The book – 30-Something and the Clock is Ticking – has been written to help other women decide whether they want a baby at all and how soon they need to do something about it. But is Edwards really in a position to teach anybody? She only changed her mind about motherhood because her body gave her a sudden, early ultimatum; others, more fortunate with their health, may not feel that her experience holds a lesson for them.

In fact, her story is not unusual. There is a lot of noise around at the moment about giving women a "wake-up call". Earlier this year a study by the Royal College of Obstetricians and Gynaecologists (RCOG) warned couples against waiting. It emphasised that for women aged 35, fertility problems are six times more common than at 25. By the age of 40 a woman is "more likely to have a miscarriage than give birth". Up to 30% of 35-year-olds take a year to get pregnant, compared with 5% of 25-year-olds.

This is brutal news if you're in your 30s – or older – and haven't found a long-term partner. Or if you've just broken up with someone with whom you hoped to have children. But obstetricians and fertility experts can now increasingly be drawn on the optimum age to have a baby. Dr Tony Falconer, president of the RCOG, now says "between 20 and 35." (Dr Miriam Stoppard has said, hilariously, or perhaps not so hilariously, "Physiologically, the best age is 15".)

Of course, there is no such thing as the right age. But the point is, all the statistics point to a conundrum for young women. Despite all the advances in technology and the workplace, that ticking clock is still there and if you don't have its existence at the back of your mind, you may miss the chance to have a family.

The IVF expert Dr Gedis Grudzinskas says it's more difficult after the age of 27: "When women have got used to having a lot of freedom to run their lives as they wish, they do not want to hear that they may not be able to conceive. They perhaps need to compromise, find Mr Good Enough and have a family earlier."

With the benefit of hindsight – and having had the good fortune to have a man in tow at the time – Edwards agrees. "I think it's partly our own fault. We don't start our search soon enough. We get to 35 and think, better start looking around for a father. That will take six months at least. Then maybe 18 months to two years before you can bring up the baby subject. And before you know it you're 40 and have a 5% chance of having a baby."

While accepting that her own condition was unusual, she still feels there's a message for Everywoman. "It was a big hit to how I saw my relationship with the world. A lot of women don't understand how fragile their fertility is because they don't want to hear it. People always say to me, 'I know someone who had a baby at 39.' But I sat in IVF clinics with women who had been trying for years, and many of them were not going to get babies at the end of it."

Unwelcome though it may be, her analysis of the medical picture is broadly accurate. A 30-year-old woman stands a 22% chance of getting pregnant in any given month. By 35, that drops to 18%. By 40, it's 5%. By 45 you're down to 1%. By 25, women have lost 80% of the eggs they were born with. By 35 that has dropped to a 95% loss. (Maybe Miriam Stoppard was right after all.)

One reason women are willing to gamble over their fertility is that many are not even sure they want a baby at all. This is a bigger issue in Edwards's native Australia, where parental leave has only just been introduced. Edwards lost her job when she was pregnant, as did half of her mothers' group.

A lot of mothers she interviewed admitted regretting having children. "They said they preferred their lives before. It is such a huge sacrifice and it changes your life so much. There is a difference between loving your kids and loving the lifestyle that motherhood imposes. How could you possibly love cleaning up poo and vomit 24 hours a day? Can you love just being a mother? Not being promoted at work? Earning less money? I really struggle with the idea of being on duty all the time. I didn't realise that about motherhood."

Edwards has two more embryos in the freezer but is not sure she wants another child. "I noticed that all the women I spoke to who said they wished they didn't have kids had more than one. Is that the tipping point? Is that when it all becomes too hard and it's not worth it?"

Maybe this is a shift, Edwards implies, towards more women choosing to be child-free, or choosing younger motherhood. We often forget that having a first child over the age of 35 is a relatively recent social trend. The number of mothers giving birth after their 40th birthday has trebled in the last 20 years: 27,000 babies born to mothers over 40 last year compared with 9,336 in 1989. We now think of "older motherhood" as mid- to late-40s, maybe even later.

The "ticking clock" dominated the cultural conversation for a while a decade ago when Sylvia Ann Hewlett's Baby Hunger: The New Battle for Motherhood came out. Baby Hunger carried many of the same messages as Edwards: "Don't delay, you'll regret it." It created a media firestorm in the US, but the book didn't sell. Women didn't want to read about the babies they wouldn't have. In this country, Kate Figes wrote in May 2002 that it was "another polemic, telling what we already know". Figes quoted a local bookshop manager, who said: "If women want to get pregnant in their 30s it's much too scary and depressing to read something that says they might not achieve it. It's a mission for them to get pregnant, so they buy technical, practical books on infertility."

Then the mood moved on. There was a backlash and Hewlett's warnings were seen as scaremongering. Stories about advances in egg freezing and "Bridget Jones babies" became popular, peddling the idea that if you froze your eggs in your 20s you could wait as long as you like. (That technology, if it will ever exist, is still light years away.)

Positive-thinking books such as Elizabeth Gregory's Ready: Why Women Are Embracing the New Later Motherhood became popular, with chapter titles such as Fifty is the New Thirty.

Now with Edwards's "now or never" mantra we've come full circle. There is even an alarm clock on a woman's stomach on the front cover. The book is cleverly marketed, and it's a fun read. But I can't help wondering if Edwards is asking the impossible: for other women to make themselves face a decision that she only faced because her gynaecologist forced her to. "When I found out, I felt really angry. A bit like a spoilt brat. It was the first time in my life that I couldn't do what I wanted. We grow up thinking our life is full of endless opportunities and possibilities."

Her message is that life isn't. But don't we all have to discover that for ourselves?

Article: 7th May 2011 guardian.co.uk

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A baby boom among older women has trebled the number giving birth after their 40th birthday. Almost 27,000 babies were born to mothers over 40 last year, figures revealed yesterday. The unprecedented level is nearly three times the total of 20 years ago and up by 50 per cent over the past decade.

Britain now has one of the highest birth rates for older women in the world, with 3.8 per cent of all babies born to mothers over 40. Only Italy has a higher level in Europe. But the trend has led medical experts to warn that older women face greater risks of miscarriages and complications - with calls for the NHS to spend more on specialised services for those expecting children as they approach middle age. More and more Britons are delaying motherhood following the rise in women enjoying well-paid careers, as well as the growing need for both partners in a couple to have an income. An increasing number of live-in relationships also means many young women are uncertain they have the stability they need to raise a child.

The waiting and uncertainty has also left a record number of women childless - latest estimates say that one in five is likely to go through life without having children. Office for National Statistics figures yesterday revealed there were 26,976 babies born to mothers of 40 and over last year, compared with 9,336 in 1989. And 12.9 in every 1,000 women of 40 and over in England and Wales had a child in 2009, up from 8.1 in every 1,000 ten years earlier.

Because the ONS does not give a detailed breakdown of the figures, many mothers could be over 45, 50 or even older. At the same time the number of children born to mothers in their 30s has dropped - almost certainly as a result of the impact of recession on incomes. Numbers of children born to women aged between 35 and 39 fell for the first time in a decade, and babies for women aged 30 to 34 were down for the first time in five years.

The trend means Britain has the second highest birth rate among older women in Europe, behind Italy. That country's prosperous northern cities, education and career opportunities are leading women to delay motherhood in the same way as in Britain, while in poorer rural areas a tradition of women who stay at home has also encouraged pregnancies later in life. In America, births to mothers over 40 are running higher than at any time since the Sixties - but British over-40s are still a third more likely to have a child.

The average age of a new mother in the UK is now 29.4 years, a year older than the average in 1999. Among married mothers, the typical age of childbirth is even older, and married mothers on average have their first child at 31. Researcher and author on family life Patricia Morgan said women delaying children until they feel financially secure are in danger of putting motherhood off for too long.

She said: 'It comes to a point where you can never afford children. What is happening is that women in their 20s and 30s are delaying families because they have to pay the mortgage, and you need two earners for that these days. Women are also in relationships they do not trust to last.

'People wait endlessly and more and more people are not having children until their 40s.' Women who choose motherhood at a later age also run much greater health risks for themselves and their baby. Over the age of 35, the possibility of infertility rises, and for those who become pregnant there are greater chances of miscarriage or complications during pregnancy or labour.

Children of older mothers also run a greater risk of ill-health or abnormalities such as Down's syndrome. Last year the Royal College of Obstetricians and Gynaecologists said a woman over 40 was two or three times more likely to lose her baby than a younger mother.

Its president Professor Sir Sabaratnam Arulkumaran said the NHS should be better equipped to care for older mothers. He said: 'Later pregnancy is associated-with more complications and specialised obstetric help is required to care for this growing group of women. Later maternal age is now a fact of life and something which the NHS must prepare for.' Overall, the numbers of children born last year were down in England and Wales, from 708,711 in 2008 to 706,248.

Birth rates stayed high largely because immigrant mothers are having more children than mothers who were born in Britain. Nearly a quarter of all children born last year, 24.7 per cent, had mothers who were born abroad. The proportion of children born to foreign-born mothers has gone up from 14.3 per cent ten years ago. Births outside marriage also continued to go up last year with 46.2 per cent of babies born to unmarried parents, around a fifth more than in the late 1990s. The figure is higher among mothers born in Britain, more than half of whom were unmarried when they gave birth last year.

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Article 26th May 2010 www.dailymail.co.uk

A 59 year-old woman has backed out of IVF (in vitro fertilisation) treatment at the last minute, as she feels the risks at her age are too great. Susan Tollefsen said she was worried after she nearly died following ill-effects from her previous IVF-enabled birth.

'We've basically decided the risks are too great and I'm too old. My advice to older women wanting children is don't risk it', said Mrs Tollefsen, a retired teacher.

Mrs Tollefsen already has a daughter, Freya, conceived through IVF when she was 57. However, she had to travel to a Russian clinic for IVF using a donor egg after being refused treatment in the UK because of her age. A burst ulcer in her stomach after the birth nearly killed her.

'We want a sibling for Freya for when we are not around but we had to seriously reconsider it. The doctors didn't have any problems treating me but I know there are huge risks. I wish I was 35 again but I'm not - and I've got to realise that, however hard it is. I had hoped to set a precedent for older women but that's not going to happen.'

Peter Bowen-Simpkins, medical director of the London Women's Clinic in Harley Street, said: 'I would very strongly agree with the view that in general women over 50 should not have IVF treatments. While in some cases there are compelling reasons, I think it is unlikely we will see anyone else of 59 attempting IVF, and there are a lot of medical reasons they shouldn't.'

Michaela Aston of the pro-life charity Life, which offers counselling for women considering abortion and fertility treatment, said offering IVF to post-menopausal women was a deeply worrying development. 'Women of this age do not conceive naturally for a reason, we should be guided by Mother Nature on this.'

Article 24th May 2010 Bionews 559

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