IVF and the great lie about fertility and the over-40s…

By Charlotte Metcalf, 29th June 2011

My mother was 29 when she had me, and used to joke about what an old mum that made her.

For as long as I can remember, the same message has been drummed into women — your fertility diminishes after 35, so your chances of becoming a mother dwindle, particularly after 40.

Of course nobody can argue with the biological reality that younger women are more fertile than older women. But what if fertility isn’t quite the clear-cut issue we often perceive it to be?

What if women of 38 and over were needlessly spending thousands of pounds on IVF to get pregnant? Or if women who felt their families were already complete were having unwanted pregnancies because of the mistaken belief that their chances of conceiving were negligible?
Recent figures from the Office for National Statistics show that live births to mothers aged 40 and over have nearly doubled in the past decade, and the Mail revealed that the number of women having abortions in their 40s has risen by almost a third in ten years.

People were sympathetic but at no point was it even suggested that, were I to meet a man, I had anything more than an outside chance of conceiving — and only then with the help of IVF.

When I did meet a man and he asked if I wanted a baby, I laughed. Surely he knew I was far too old? Then, at 45, my periods stopped. Assuming I had reached the menopause, I carried on with daily life, irritated that I was putting on weight.

It wasn’t until someone commented on my new cleavage that it occurred to me to take a pregnancy test. I had been so brainwashed into believing that I was too old for motherhood that I had not used contraception. I took four home pregnancy tests — all positive — before I made an appointment to see my GP.

Despite a trouble-free pregnancy, I could sense a feeling of caution whenever I went for a scan or a check-up, as if my pregnancy were a freak accident that was bound to end in tears. In fact my daughter, Deia, was born healthy and well in May 2004. And it seems my experience certainly isn’t unusual.

Jan Andersen, a freelance writer and editor, discovered she was pregnant at 40. She was living with her partner, Mike, and already had a 16-year-old son and two daughters, aged 13 and 12.

Jan, now 52, was horrified to find herself described as a ‘geriatric mother’ by doctors, then, on account of her age, bombarded with information on chromosomal defects, foetal abnormalities, miscarriage, diabetes, placental abruption, pre-eclampsia, placenta previa, prolapse and stillbirth.

In fact she gave birth to a healthy daughter and, 12 years on, has set up www.mothersover40.com, in an attempt to counteract what she sees as the ‘negative brainwashing’ of women over 40.

Relentless: Nicole Klieff had six rounds of IVF, before she fell pregnant with her daughter Lauren. ‘I’ve spoken to so many people in their 40s who’ve been to a fertility clinic and told they had no chance of conceiving naturally,’ Jan says.

‘Only if they’re determined enough to seek a second opinion do they find out they’re perfectly capable of conceiving naturally. I’m not saying IVF doesn’t help lots of couples who need it, but I do think it’s a big, greedy business like any other — and it’s in the interests of clinics to recommend treatment that isn’t always necessary.

‘When I was pregnant, every ache and pain was put down to old age. Yet I heard recently from a woman who lives on an island in the Pacific where everyone waits until their 40s or 50s to have children. Here in the West we are too obsessed with having babies young.’

Deborah Bucknall was 41 when she started a relationship with a man eight years her junior. Various experts had told her that her eggs would be too old or that IVF would represent her only chance of conceiving, but despite that she fell pregnant naturally — twice — once, with twins, that she sadly miscarried, and subsequently with an ectopic pregnancy that resulted in the removal of one of her Fallopian tubes.

‘I was told to give up, that I had virtually no chance of becoming pregnant at 44,’ says Deborah. But a month later she was pregnant again — and in January this year Deborah gave birth to her son, Oliver.

‘I feel so blessed,’ she says. ‘I’m just sorry I was discouraged for being old as I went through so much unnecessary heartache.’

Nicole Klieff started trying for a baby when she was 34. When she didn’t conceive, she was given the fertility drug Clomid and, a year later, had IVF. By the time Nicole was 42, she had been through IVF six times and describes herself as ‘emotionally and financially exhausted’.

Then she read about CARE Fertility in Nottingham, offering fertility treatment for women over 40. She made an appointment — and says it was at the Nottingham clinic that she encountered the first person who actually wanted to find out why she wasn’t conceiving rather than immediately blaming it on her age.

In fact Nicole was diagnosed with a condition where the body’s immune system goes into overdrive, producing killer cells which enter the placenta and attack the embryo. It can affect woman of any age. She was treated for the condition, and went on to have a healthy daughter at the age of 44.

Nicole, whose daughter is now seven, wrote a book called Baby Next Time about the emotional turmoil of going through IVF, and is working on a new website — www.infertility.247.com — providing information to older women who want babies.

Mark Sedler, consultant fertility specialist at CARE Fertility in Manchester, says new treatments may change entrenched attitudes.

‘Advanced female age is the main factor for decreased pregnancy success,’ he says. ‘But new fertility treatments, such as screening for chromosome abnormalities or immune problems, are starting to change that.

In 1985, only 513 babies were born through IVF. By 2005 the number had risen to 11, 268
‘As these techniques develop and healthy babies are born, we hope that attitudes to pregnancies in this age group will also change.’

Christine Hill, who runs ante-natal classes in West London, says it’s time the stigma attached to older mothers was dumped.

‘There’s absolutely no reason women in their 40s shouldn’t be having babies,’ Christine says.‘What makes me cross is that a lot of people think women are leaving motherhood too late for selfish reasons when, in fact, many of them just haven’t met the right man.

‘They can’t adopt in their late 40s, so conceiving becomes the only option. That’s not their fault, and I hate the presumption that they are selfish women who have put their career first.’

‘On the whole older mothers are calmer, less impatient and have more money and support.

‘They tend to be less impulsive and, most importantly, their self-esteem is strong, which has a hugely beneficial effect on the baby.’

Speaking personally as a 52-year-old, I am just one of many women who were so busy being the first generation able to compete with men and climb the career ladder that we turned round at 40 and realised we were childless.

Some of my friends still desperately wish they had tried for a child earlier and, with luck, the next generation will have learnt from our mistakes and not put their career before having a child or wait and wait for a Prince Charming to be the perfect father.

Josephine Quintavalle, founder of public interest group Comment on Reproductive Ethics, says: ‘We women are no longer in charge of our biology. We go to the doctor for a pill to stop us getting pregnant, then we decide we want a baby and go to a doctor for more drugs.

‘We need to start educating women about their own biology.’ I believe we also need to move away from the notion that IVF can provide us with babies on tap, as if they were commodities rather than precious blessings.

But I also think it can only be a good thing that the efficacy of IVF is being questioned by women like Nicole Klieff and Jan Andersen who are showing that it shouldn’t be the first port of call; there are other avenues to explore that could result in pregnancy. The sooner older women realise their failure to conceive is not necessarily just a matter of their age, the better.