Your Top 4 Options for Having Kids After Age 45
If you’re like me, meaning the algorithm knows you're a Cameron Diaz fan, then you’ve seen the story about Cameron Diaz welcoming a baby at age 51. I am a huge Cameron Diaz fan! If there was a romantic comedy with her in it, I would watch it in movie theaters - no waiting for the movie to be out on TV or DVD. From The Other Woman, to There’s Something About Mary, In Her Shoes, the list goes on. And even though my favorite genre is - you guessed it - rom coms, Cameron Diaz was a good reason for me to venture out of my comfort zone with blockbusters such as Gangs of New York and My Sister's Keeper.
Anyways, I digress! Needless to say, I was so happy when I saw this story and it made me think of the amazing options we have today to allow us to continue to have children into our late 40s and 50s. A feat that would have been near impossible a few decades ago.
If you’re looking for an honest and straightforward roadmap of the most viable options to having kids in your late 40s and 50s, you have come to the right place. I will not include any supplements or lifestyle factors on this list, because while they are important for optimizing fertility, the truth is that by age 45, they are no longer able to make a difference due to the significant damage that the natural and normal aging process has dealt to our eggs.
Here are my top four tips for having kids after age 45 (they also increase your odds after age 40…)
Freeze your eggs
If I had to choose my favorite IVF advancement of the last 20 years, I would say it is the widespread availability of egg freezing to allow women preserve their fertility following the optimization of the vitrification process by which eggs are frozen today.
Egg freezing is a two week or less process. It involves daily medications, administered via injections (very small needles, I promise). These medications make your ovaries grow and mature eggs that would otherwise be discarded by your body at the end of the month. These eggs are then removed from the ovary through an egg retrieval - a 20 min ultrasound guided procedure usually performed under anesthesia with a needle as skinny as the ones used for blood draws.
Why is egg freezing so revolutionary? Egg freezing is revolutionary because, as we age, both the number of eggs and the quality of our eggs decrease. Decreasing egg quality means decreased potential of an egg to become a baby.
This decrease in egg quality with age is so dramatic that while 10 eggs frozen at age 30 have a 7 in 10 chance of becoming one baby, by age 40 it is down to a 3 in 10 and by age 44 it’s 0.5 in 10.
Additionally, while it is pretty common to freeze 10 eggs from one retrieval at age 30, by age 40 it is common to need 2-3 retrievals to get to 10 frozen eggs.
While egg freezing is not a guarantee, it is an excellent option to keep the childbearing window open for longer. It is normal to be hesitant to begin the egg freezing process. However, it is also worth mentioning that most women report a sense of relief after the process, often saying that they feeling less pressure to settle for a less than ideal spouse in order to start a family and have children.
Freeze your embryos
From the perspective of the person going through the process, egg freezing is exactly the same as egg freezing i.e “a two week or less process. It involves daily medications, administered via injections (very small needles, I promise). These medications make your ovaries grow and mature eggs that would otherwise be discarded by the end of the month. These eggs are then removed from the ovary through an egg retrieval - a 20 min ultrasound guided procedure usually performed under anesthesia with a needle as skinny as the ones used for blood draws.”
The only difference is that following the egg retrieval, the eggs are fertilized with sperm. The fertilized eggs, known as embryos, are then kept in the lab for 5-7 days in the incubator, a very controlled environment. Any embryos that reach their developmental milestones at the end of that 5-7 day process are frozen.
On average, if you have 10 mature eggs retrieved, expect 7-8 to become embryos and 2-4 to make it to the point where they can be frozen.
You also have the option of doing a biopsy on the embryos before freezing them to test for certain abnormalities in the embryo. This process is known as pre-implantation genetic testing or PGT.
This ability to know exactly how many embryos are present in a particular cohort of eggs and to also perform testing for the number of chromosomes is one of the key benefits of embryos freezing over egg freezing. However, it also means committing to a sperm source, and since one of the main benefits of egg freezing is not having to commit to a sperm source it is often a mute point.
In my books if you’re not ready to commit, egg freezing is almost always the right path to take.
IVF with donated eggs or embryos.
IVF with donated eggs is an excellent option if you find yourself in your 40s or early 50s, with a very low egg count and/or low egg quality with a desire to grow your family.
When going through IVF with donated eggs, an egg donor goes through a process similar to egg freezing described above i.e “a two week or less process. It involves daily medications, administered via injections (very small needles, I promise). These medications make your ovaries grow and mature eggs that would otherwise be discarded by the end of the month. These eggs are then removed from the ovary through an egg retrieval - a 20 min ultrasound guided procedure usually performed under anesthesia with a needle as skinny as the ones used for blood draws.”
These eggs are then fertilized with your partner’s sperm or sperm of your choosing. Embryos are then created as described in the embryo freezing section above.
One of these frozen embryos is then transferred into your uterus and you go on to carry the pregnancy.
In the case of embryo donation, these are embryos that were already created through IVF by another couple. These embryos are usually donated by couples that have completed their family building process.
In most cases, egg donors and embryo donors remain anonymous, however there are some options open egg and embryo donations in which the donor and the recipient have a relationship.
On average, egg donation tends to be more expensive than embryo donation. Some options to decrease the cost include:
Sharing the donated eggs with the donor, where a percentage of the eggs go to the recipient and a percentage is frozen for the donor for future use. Cofertility is an amazing company that offers this, but there are other options.
Using a fixed number of frozen eggs which are a fraction instead of having an egg donor
4. Adoption
Adoption is another option for growing your family in your 40s and 50s. While it does not include fertility treatment there are other processes involved. While this is outside of my bailiwick as a fertility doctor, here are some resources to help you explore if adoption is right for you.
https://www.adoptionadvocates.net/resources/adoptive-parent-resources/
What other questions do you have about having kids in your 40s and 50s or fertility in general. Did anything about this surprise you?