Coping with Mid-Life Infertility: An Interview with Expert Ann Douglas By Marilyn C. Hilton   ".. there are some challenges involved in embarking on motherhood later in life."

Ann Douglas is the author of numerous books on pregnancy and parenting, including The Mother of All Pregnancy Books; The Mother of All Baby Books; The Unofficial Guide to Having a Baby; and Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss. Readers appreciate Ann¹s approachable style, her in-depth knowledge on her subjects, and her credibility: Ann courageously tackles topics that she has experienced.

Recently, I interviewed Ann on a topic that is increasingly becoming a daunting reality for baby-boomer women (and men): midlife infertility. Ann¹s responses provide down-to-earth information and hope for those who are dealing with this situation.

MH: Ann, you've written several articles and books on the topics of pregnancy, parenting and childcare. You speak on these topics and manage several related websites. What led you to focus on these particular areas?

AD: Before I had children, I knew I wanted to be a writer, but I wasn't sure what I wanted to write about. But from the moment I started trying to conceive, I suddenly had a thousand things to write about: What it was like to have difficulty getting pregnant when everyone around me seemed to be getting pregnant with no difficulty at all -- and how totally over-the-moon I was with joy when the pregnancy test finally came back positive. Since that time, I've written about some of the other highs and lows of parenthood, sometimes tackling tough topics like miscarriage, stillbirth, children's mental health issues, and other issues we've grappled with in our own family.

MH: Because our readers are considered to be "midlife," what, if anything, has changed in the medical community's attitude toward middle-aged parents? For example, is a woman of thirty-five still considered to be "high risk" when it comes to pregnancy, or has this changed with the increasing number of older women having babies?

AD: You won't be classified as "high risk" unless there's a specific medical reason for giving you that designation, regardless of your age. But you will be offered certain tests -- like chorionic villus sampling or amniocentesis -- that might not automatically be offered to a younger mother. Your doctor or midwife is also likely to advise you that your odds of experiencing a miscarriage increase with age -- something that can likely be explained by the fact that your eggs are aging along with the rest of you. And, should you miscarry, it will likely take you longer to conceive again than it would a younger woman because your fertility tends to decline as you age. So there are some challenges involved in embarking on motherhood later in life.

MH: Compared to a woman in her early twenties, how much does a woman's " advanced" age affect her ability to conceive and give birth to a healthy child?

AD: The main factors that can cause an older mother grief are the deteriorating quality of her eggs and the fact that she may not be ovulating as regularly as she did when she was younger. The net result is fewer "grade A" eggs.

MH: What are some of the most common problems that a midlife woman might encounter when trying to conceive and carrying a baby?

AD: If ovulation isn't occurring in every cycle, a woman isn't going to have as many opportunities to conceive each year as she did when she was younger. And if some of the eggs that are released during the cycles in which she does ovulate are of inferior quality, even if she does manage to become pregnant, she faces an increased risk of miscarriage.

MH: How much does the father¹s age affect a couple's ability to conceive, and in what ways?

AD: While we tend to fixate on the fact that a woman's fertility deteriorates as she ages, we often lose sight of the fact that a man's fertility is in decline, too. Like it or not, even the male reproductive
system has a "best before" date. While we all take note when celebrity fathers manage to conceive children well into their seventies and eighties, these highly fertile older men tend to be the exception rather than the rule.

MH: Other than age, what other factors might affect an older woman¹s ability to conceive? What steps or preventive measures could a couple take to increase their chances of conceiving and carrying a healthy baby?

AD: Lifestyle issues can come into play as well. If a woman and her partner are both at the peak of their career, they may find it hard to devote a lot of time to baby-making -- for example, squeezing in the necessary time for fertility treatments.

MH: How soon after trying (and being unsuccessful) should a midlife couple seek professional help for infertility? When my husband and I were trying for our second and third, we didn¹t wait the usual six to twelve months because I was worried that we were wasting valuable time when we could be giving the process a boost instead.

AD: It's very important to seek medical treatment sooner rather than later if you're over thirty-five and you haven't conceived after six months of trying. (If you're monitoring your fertility signals and you're aware of a possible problem even sooner than that, you may even want to set up an appointment to see your doctor before you reach the six-month mark.) The biological clock waits for no woman, so it's important to be prepared to swing into action mode sooner rather than later.

MH: What kinds of medical tests can be done to treat infertility? What kinds of treatment options might be presented to a couple? And have you seen any major changes or breakthroughs in infertility options in the past two to three years?

AD: There are all kinds of amazing methods of treating infertility today -- methods that put parenthood within the reach of numerous couples who had no hope of conceiving just a few short years ago. These methods involve treating a problem in the female partner, the male partner, or a combined problem involving both partners. They may involve hormonal therapy, surgery, or high-tech treatment methods such as assisted reproductive technologies such as in-vitro fertilization.

MH: One aspect of infertility that¹s not talked about much is the emotional impact on a couple. Can you talk briefly here about how infertility affects women and men emotionally? Do men and women react differently? In what ways could partners help each other during this time?

AD: It's not unusual for infertility to cause a major strain on a marriage, particularly if one partner is determined to keep trying to conceive no matter what and the other is ready to step off the infertility treatment merry-go-round. That's why it's important to have a frank conversation with your partner about how many cycles of treatment you're willing to commit to and what types of treatments are (and aren't) acceptable to you before you embark on a course of infertility treatment. It's one thing to risk losing your dream of having a child; you don't want to risk losing your relationship with your partner, too.

And, yes, men and women tend to react differently to this issue. Typically, having a baby is more important to the female partner than to the male partner -- but not always. Sometimes I hear from men who are totally heartbroken by the fertility problems that they and their partners are experiencing.

MH: Ann, thank you for sharing your time and wisdom!

You can read copies of her articles and tip sheets by visiting her website at http://www.having-a-baby.com .

For the latest on new developments on the infertility treatments and research front, see:
http://www.intelihealth.com....