Perfect timing? When it comes to conceiving a child, your age can be a major factor - For Moms Only

Muscle & Fitness/Hers, August-Sept, 2002 by Kristina Haar

When Amanda Marsh met Alex Michel's family on the season finale of "The Bachelor," much was made of the difference in their ages (she's eight years younger), and one of Alex's sisters pointedly noted that Amanda was "on the baby train." At 23, Amanda may seem a bit young for motherhood, but she's actually in the most fertile stage of her life.

Due in part to advances in birth control and medical technology, many women are choosing to put off motherhood until their 30s and 40s. Just look at celebs like Madonna, Susan Sarandon and Annette Bening, all of whom bore children in their 40s. They and many others make "having it all" look easy -- time to nurture a promising career before adding a fulfilling home life to the mix. But that biological clock really is ticking.

Knowing when the alarm's going to go off is tricky; some women conceive easily after 40, while others in their 20s struggle unsuccessfully for years. Yet earlier is better in the majority of cases, since a woman is born with a finite number of eggs that gradually get ovulated or die off as she grows olden And older eggs, which have less genetic quality and viability than younger ones, have a harder time making it through the fertilization process. Age also affects sperm shape and motility, and male infertility accounts for nearly half of all diagnosed cases of infertility, reports the American Society for Reproductive Medicine (ASPM) in Birmingham, Alabama.

And if your "baby train" doesn't reach the station until you're thirty- or fortysomething, you might find that science doesn't have all the answers. Infertility groups warn that success rates of in vitro fertilization and its variations decline significantly as women age. Those in their 30s have about a 33% chance of conceiving when their own eggs are retrieved, inseminated and fertilized in a lab, then placed in the uterus for potential implantation; after age 43, the success rate drops to well under 10%. Miscarriage also soars as women grow older -- from about 15% in those ages 25-30, to about 40% in women over 40 -- as does the risk of chromosomal birth defects.

Affairs of the Heart

Conceiving a child at an older age isn't the only concern. Pregnancy, childbirth and recovery can all be more difficult, and women who have children after they turn 35 may be at increased risk of some long-term health problems, suggests a nationwide study published in the journal Women's Health Issues. Results showed that after the age of 50, women who had delayed childbearing to age 35 or older were significantly more likely than other women to have high blood pressure and diabetes, both of which have been linked to heart disease.

"[We] didn't conclusively find that having children after age 35 was always bad for long-term health," says Angelo Alonzo, PhD, study author and associate professor of sociology at Ohio State University in Columbus. "However, women should be concerned about the potential long-term consequences of postponing childbearing, especially if they have a family history of cardiovascular diseases,"

The study used data from a comprehensive study of people across America from 1988 to 1994. Volunteers participated in extensive medical examinations, biochemical tests and other physical measures, and surveys of diet and demographic information. Alonzo examined data from more than 6,500 women who reported having children. About 84% had all their children by age 35, nearly 2% gave birth to their first child after age 35, and the remaining 14% had children both before and after age 35.

Of the 24 different health indicators studied, four of them -- high blood pressure, diabetes and doctor assessment of health and mobility -- were significantly worse in those who had children after the age of 35. Nine other health indicators showed at least some trend toward negative health consequences after age 50 for women who delivered babies after they turned 35.

Protecting Fertility

So, what if you don't find Mr. Right and start a family in your 20s or early 30s? While you can't turn back the clock, the ASRM notes that the actions you take long before you may be ready to have children can impact your ability to eventually conceive. Here's what you should know:

* Don't smoke. A study in Great Britain showed that up to 13% of female infertility is caused by cigarette smoking.

* Maintain a healthy weight through proper nutrition and exercise. Twelve percent of all infertility cases are a result of a woman being either underweight or overweight.

* Practice safe sex now. Sexually transmitted infections such as chlamydia and gonorrhea are a leading cause of infertility, often have no symptoms, and can be prevented by always using condoms.

* Make sure you get an annual exam. Pay attention to your medical procedures, and work with your doctor to prevent inappropriate medical treatment (such as surgery done prematurely that could later affect your fertility). If you have irregular or painful menstrual cycles, see your doctor.

For more information on infertility, including male infertility risks and treatment options, visit the ASRM website at www.protectyourfertility.org. The American Infertility Association website at www.americaninfertility.org and Resolve: The National Infertility Association website at www.resolve.org may also be helpful.