The Hard Truth About Fertility and Aging

By Melanie Landay MD

So you’re not ready. Maybe you’re in school, developing your career, waiting for financial stability or simply haven’t met the right person yet. Whatever the reason, the time just isn’t right to have children and start a family. It’s understandable—having kids is a big deal, and you need to be in the right time and place. But, in the back of your mind you know the longer you wait to conceive, the harder it might be. And that perfect time may never come.

Today, women have more choices than ever before. Once-experimental techniques like oocyte cryopreservation (aka egg freezing) are now widely performed and help some women by allowing them to save their eggs for future use. Embryo freezing is another, even more reliable option for some. But neither comes with a money-back guarantee. And every woman’s options are limited by what we might call her personal fertility profile(and that of her partner, if she has one).  Too many women make life-altering decisions about how and when to address their fertility questions without this key information.

If you’re like so many of my patients, you have done extensive research and soul-searching. You’ve read everything online, talked with friends and family and perhaps even consulted your general OB-Gyn. You know the basics: you are born with all the eggs you are ever going to have and these eggs decline in quality and quantity over time.  You’re half hoping you have all the time in the world to make your reproductive choices and half terrified it’s now or never.   But most women don’t know where their personal biology fits within the general statistics. And unless you are trying (and succeeding or failing) to get pregnant, or you have the advice of a trained fertility specialist, you can’t know.

This is where people get stuck, and it’s exactly why Maria came to see me. 

Maria is incredibly successful, smart, and busy. She has an amazing career that’s a top priority for her right now. She definitely wants to have children, but she’s not ready to put things on hold to have a baby—and she isn’t sure when she will be. But because she and Keven took charge and learned about their fertility profile, they discovered they have challenges that would likely make it difficult to conceive even now without assistance.  They know that egg freezing is an option. But given their strong commitment to each other and to being parents together, embryo freezing is a better option and will give them the best chances for conceiving in the future if they are unable to do so naturally.

There are no right or wrong decisions in this area. But I believe that women should arm themselves with more than just statistics and anecdotes when making what could be one of the most important decisions of their lives.  They need personal information, knowledge, and reasonable expectations. Ultimately, Maria and Keven will have to make a choice that’s right for them, balancing all the complex factors of their lives.  Knowing their fertility issues doesn’t make this decision easy, but it does make it an active choice rather than a passive roll of the dice.

And this leads me to the single most important piece of advice I can offer women struggling with these same decisions about whether to postpone motherhood, and if so, how: Do exactly what Maria did. Find a qualified fertility specialist who can help you learn everything you can about your current fertility status.  If you do, you can make informed decisions about your future with minimal guesswork and maximal power.

Find a specialist you trust and can relate to, and find out about your fertility profile today.


Melanie Landay, MD practices fertility medicine at the Valley Center for Reproductive Health in Sherman Oaks, CA.


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