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Tick Tock

Confronting the biological clock

Over a century ago, my great-great-grandmother Theckla Servatius did a rare and amazing thing. She gave birth to my great-grandfather at age 46. Had she not had her little "accident," I and about 200 of my closest relatives wouldn't be here today.

A lot has changed since then, and some things haven't changed at all. Rather than spending their 20s and 30s cranking out a baby every year or so like Theckla did, Gen X working women are focusing on their careers, nitpicking the men they date to find the perfect guy, and putting off having a baby into the far, far future. The only problem with this is what hasn't changed -- our biological clocks.

If they talked to each other about such things back then, Theckla's delivery of a healthy baby boy at age 46 would have caused something of a stir among doctors. It would still have the same effect today. Despite all the scientific advances of the last few decades, the odds of giving birth to a child that is biologically yours at 46 are somewhere in the range of being bitten by a shark or struck by lightning. Problem is, many women in their mid-30s are so blissfully unaware of their biological limits that they're counting on fertility treatment miracles that don't yet exist and assuming they'll start trying to get pregnant at 40 or 41.

These women often leave the office of a gynecologist/obstetrician friend of mine in tears. A couple of times a week, she has to deliver the heartbreaking news. It's become one of the toughest parts of her job.

Even with fertility treatments, the odds of the women carrying a pregnancy to term and giving birth to a healthy baby are slim after the age of 40. It's one of the main reasons that just two percent of babies born in the US are born to women over 40. Sure, everyone knows, or has heard of, someone who gave birth after 40. But they're the exceptions rather than the rule.

At first, many of these women don't believe her, she says. Every other week, it seems, there's an announcement in the news of another Hollywood celebrity giving birth at 45. If North Carolina Senator John Edwards' wife did it at 50, why can't I, they ask?

My friend says the media is partly to blame for the confusion. What these news stories don't tell you is that in almost every case, the babies these women are giving birth to aren't biologically theirs. Because most women have run out of healthy eggs by their early 40s, they must use donor eggs. And the cost of achieving and maintaining a pregnancy in your mid-40s? Let's just say that aside from Hollywood stars and senators' wives, most of us couldn't afford to pay that bill. And this doesn't even take into account how much more strenuous a pregnancy is as you get older.

While this isn't the type of message you'll usually read in this space, I decided to write this column after a conversation I had at a party last weekend with three women, all 35, all smart, attractive, successful and unmarried, who were floored to learn that they probably had about five years left to give birth if they were serious about ever having kids. Their shock was palpable.

Don't get me wrong. I'm not suggesting that women should choose family over career or that they should find fulfillment in pregnancy or anything like that. Far from it. I'm simply trying to pass on the facts to women who, five years from now, may end up fleeing my friend's medical office in tears. I'm talking to those women now in their mid-30s who by their mid-40s may wonder what value there really was in the years they spent slaving away in a cubicle in some climate-controlled office and whether what they traded those years for was really worth it. And, as much as I hate to put this in print, I'm also talking to men who want to have kids that are biologically theirs, since men tend to give even less thought to a woman's age or the potential of her fertility when they marry. If the woman you love is in her late 30s, now is the time to research the physical and financial costs of fertility treatments and discuss your options with a doctor.

The fact of the matter is that for at least another decade, maybe two, biology will remain the number one enemy of the ambitious career woman. Men can freeze their sperm, but women's eggs still can't be frozen with much success. Freezing embryos for later use is an expensive but viable option. So, for some who can handle it, is single motherhood. But short of hoping for luck with fertility treatments in your late 30s and early 40s, counting on scientific breakthroughs or planning to adopt, today's career women have tough life choices to make. The time to decide what's really important to you is now, before time runs out.

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