According to new research, women who wait to have children until they are close to menopause are adversely affecting the fertility of their daughters, writes Angie Mezzetti
IVF has been a great gift to many parents in Ireland, particularly to those who started having children later in life. However, the country will face problems in the future unless women are supported and encouraged to have babies in their 20s, according to experts here and the latest research in the United States.
When the biological clock starts ticking for women in their 30s, it is for a very good reason according to the latest evidence from the US, as it seems there is a best before date for human eggs.
Not only is the female body more fertile in its 20s but the longer women wait to have children, the less fertile they become and the less fertile any future daughters they may have become. This may be because the "egg quality" declines.
A new survey of women attending for infertility treatment at a US clinic found patients had a greater chance of becoming pregnant through IVF the younger their own mothers were at the time they themselves were delivered.
Dr Peter Nagy, a specialist with an infertility treatment centre, surveyed 74 women who were attending the clinic based in Atlanta for IVF treatment.
The survey asked what age the mother of the woman was at the time they were born and what age their father was. It also asked how far from menopause their mother was at their delivery.
"We discovered that of the patients who got pregnant, their mothers had a lower maternal age than the patients who did not become pregnant through IVF," says Nagy.
While the father's age does have a bearing on the chances of a successful pregnancy, it was less influential.
"How near the mother was to menopause is more important than her numerical years as it gives us important information on ovary function," according to Nagy.
While there are no figures for the general population as yet, Nagy believes the findings are relevant to the general population.
"This research should not be interpreted in a way that stops people from trying to become pregnant. People shouldn't get scared as there is already so much pressure on women," he adds. However he says that when it comes to trying for a baby, earlier is better.
"There are strongly accumulating findings that egg quality and potentiality of healthy pregnancy is strongly correlated with age."
According to Dr Anthony Walsh of the Sims Fertility Clinic in Dublin: "These findings are amazing. By women deferring having a baby not only are they compromising having a child themselves, they are also compromising the fertility of their daughters.
"Europe's population is shrinking and this will be a major problem for society as we are not replacing ourselves and we need to replace the population if we want to have someone to mind us in our dotage," he says.
Walsh says the Irish are the oldest mothers in Europe having their first babies. Huge numbers of Irish women are now having babies in their 30s . "As far as IVF is concerned, in the 35-39 category you can help around 50 per cent of patients. Whereas for the over-40s, most [IVF treatments] are not successful."
"In France there are financial incentives for women to have children early. It is estimated that Scotland is facing a population drop from five to four million as half of all Scottish women don't have children by choice," he says.
The population in the US is rising but only because of young immigrants coming into the country, he says. "Really women should be encouraged to have children in their 20s. We should all be helping to support young women in society."
The cost of three cycles of IVF is about €15,000. It is tax deductible and about one in four will have a baby from the process. It is estimated that about one million babies have been born from IVF worldwide.
In Denmark, IVF accounts for about 6 per cent of births. In Ireland about 3 per cent are IVF deliveries, according to Walsh. "While IVF is part of the solution, it would be much simpler for women to have children when they are younger."
Dr Martine Millett Johnston of the Kilkenny Clinic in Co Kilkenny says she is seeing older women coming for advice and infertility treatment. She believes women are deferring having babies to develop their careers as they struggle to buy a house, pay the mortgage and become secure.
"There is often a genetic background to the problems they face as the eggs are older," she says.
If their own mothers were nearer to menopause she believes the problem is even more difficult. "We would advise all couples not to defer getting pregnant especially for a first pregnancy. First-time mothers now are often closer to 40 and usually over 35."
There are other medical problems associated with pregnancy as women get older, such as high blood pressure and more likelihood of Caesarean sections, she believes.
"Lifestyle changes too have an impact and mothers will not be as fit as when they were younger. First- time births are more likely to have problems so if you put that together with the older motherhood, the difficulties increase," she says.
IVF can be costly - emotionally, physically and mentally, according to Millett Johnston.
"People forget the sexual problems associated with infertility treatment. The whole procedure is physically taxing, and spontaneous sex becomes non-existent. Having a baby becomes the only reason for sex."
Dr Mary Wingfield of the Merrion Fertility Clinic says that while the findings of Nagy's study are interesting, it was quite a small study and the women surveyed were quite young - in the 25-31 age group. "About one in six couples have fertility problems and about 40-50 per cent of them will opt for IVF treatment," says Wingfield.
It is really important to focus on women's age, she says and argues that we should be trying to encourage women to have babies in their 20s.
"I see women at about 26 or 27 years of age and I advise them to start thinking about having a family and they can be quite surprised," she says.
Changes in society mean that women are not always in relationships until they are in their 30s and she says once they go over 35, their chances start dropping dramatically.
"The average age of women attending here is 37. We need to change society and working life for women. Work will always be there and it is such a short few years to have children."
She says it is heartbreaking to see women trying in their 40s when the chances are so low.
"Miscarriages are higher and chromosomal problems are more common. Then you have to look at donor eggs. All of this could be avoided if we encouraged and facilitated women having babies earlier."
Did you have your first child late in life or are you contemplating it, or do you think many people are forced to postpone pregnancy for other reasons? Readers can email their views to healthsupplement@irish-times.ie. A selection of responses will be carried in a future edition of the HealthSupplement