Bad eggs
Liu Chi-hong, a nationally famous specialist in infertility, believes that when you get to the roots of explaining why the public has such a poor knowledge about fertility issues, with an understanding that deviates so greatly from reality, the media can't escape some blame for spreading inaccurate information.
"Many women are 'tricked' by reports in mainstream media about celebrities giving birth at an advanced age," says Liu, who notes that patients often come to his clinic and get right to the point: If Betty Wu had a daughter at 44, and Bridgette Lin had a second girl at 46, and the wife of industrialist Chen Youhao had boy-girl twins at 56, "then of course I can still give birth at 40."
But is that really the way it is? Of course not! First of all, asks Liu, who knows how much money these famous individuals poured into infertility treatments? (Artificial insemination costs about NT$20,000 per attempt, and in-vitro fertilization about NT$100,000.) Could middle-income people bear the costs of failing repeatedly before finally achieving success?
There is another key point that is rarely discussed about these famous cases of older women giving birth: They quite possibly "weren't using their own eggs."
Citing statistics from the US Centers for Disease Control and Prevention, Liu points out that 42-year-old women who receive IVF treatments have only a 15.1% chance of pregnancy, but because they have low-quality eggs, they are more likely to miscarry, so that only about half of their pregnancies result in live births (bringing the success rate down to 8.4%). Two years later, at 44, the figures stand respectively at 8.3% and 2.6%. At 47, success at getting pregnant falls to 1.1% and success at giving birth drops to 0%. For most women, as these numbers make starkly clear, getting pregnant with one's own eggs after 45 is a mission impossible.
"Yet anecdotal media reports about these celebrities never mention suspicions that they may be carrying someone else's eggs," he says. "It naturally leads to misperceptions."
Estimating "fertility limits"
Liu Chi-hong emphasizes that every woman's reproductive capacity is different, but typically five years before it ends their periods will start to become irregular, and their fertility would have begun to drop markedly about four or five years before this irregularity.
"So clinically speaking, it is certainly not the case that because 'so-and-so and so-and-so gave birth when they were 40, I can too.'" Liu says. "It may well be that 50 is the end of the line for them, but it's bye-bye for you at 45." Smiling wryly, Liu says that this way of putting things may sound heartless, but it's true.
Although there is no test yet that can accurately determine a woman's "last birth year," there are a few simple benchmarks that can help a woman make her own estimate. First of all, a woman should observe her own periods, Liu suggests. If she has a 28-30-day cycle and then it suddenly becomes 25-26 days after the age of 35, that's a warning sign. "When the menstrual cycle begins to shrink that often means that your ovaries are aging and their functionality is beginning to go downhill."
A woman's mother and sisters are also important indicators. If one of them has lost fertility at an early age, there's a one-in-three chance that she'll follow in their footsteps. What's more, if she smokes, has had uterine surgery, or has a history of malignant tumors with chemotherapy or radiation, she should be prepared: her fertility is likely to decline faster than most.
"The general state of your health, family history, and surrounding environment can all provide clues. If you study them carefully you may well get early warning signs about the race against your biological clock."
Be that as it may, Liu urges every woman: If you want to have your own bundle of joy in order to complete your life, then by all means don't dillydally or assume that you'll get lucky later in life. Getting to work at the right time is the best way to prevent future regrets!