“Now we’re seeing women and men equally likely to get advanced degrees and equally likely to be working in careers where having kids early becomes very challenging,” says Dr. Owen Davis, an OB-GYN, fertility specialist, and president of the American Society for Reproductive Medicine (ASRM). “People’s mentality about how they want to marry and settle down have changed too.”
Women are now waiting longer to marry and settle down than let’s say our moms or abuelas did, and there are a number of reasons why, according to Dr. Spencer Richlin, a surgical director and partner in reproductive endocrinology at Reproductive Medicine Associates of Connecticut (RMACT).
“Some of them haven’t met the right partner, some of them have demanding careers or are still in school, or just really aren’t at a place in their life where they’re ready to start family building."
For Sujeiry Gonzalez, a 38-year-old Dominican woman and New York City–based writer, putting kids on hold had more to do with not meeting the right partner than even her career.
“My career has always been important, but I wouldn’t say I put motherhood on hold for my career,” says Gonzalez who is expecting to give birth to her first child any day now. “I just hadn’t met anyone before my current fiancé who I actually could see myself having a family with and I didn’t want to settle.”
Raising a child is hard, time-consuming work, and women are really starting to recognize that. In fact, according to Jason Fields of the Census Bureau, women were more likely to have married in 1970 by the time they were 24 years old. There’s definitely a freedom today in knowing we don’t have to be married with a kid by 30.
But with that said, cultural pressures still exist especially in the Latino community. For Cindy Rodriguez, a 33-year-old Peruvian journalist from New Jersey, the pressure is always on.
“My parents, family members, and even strangers are always asking me, ‘Why haven’t you had kids yet?’ They are constantly reminding me that I am no 'spring chicken.’”
“I had an aunt who used to always tell me I was going to end up a jamona because she was seeing me getting older, still not married, and still with no kids,” says Gonzalez. “Being raised in a traditional Dominican family, I didn’t really have it that bad, though. The pressure came mainly from my tia and my older sister, but it was still there.”
But here’s the problem with holding off on having kids for too long: it poses a risk on a woman’s fertility because, according to Dr. Davis, it does decline with increasing age, especially for women approaching their mid to late 30s.
“Number one is loss of eggs. When a woman is a fetus inside her mom, by 20 weeks she has about six million eggs and by the time she has her first menstrual period she might be down to 200,000 to 300,000 eggs. The vast majority of eggs are lost even before the woman has her first menstrual period.”
Davis explains how a woman continues to lose up to 1000 eggs a month throughout her lifetime. Not only does the woman lose eggs but as she ages, her eggs age as well.
“When you hold off on having kids for too long, there’s the risk that one’s eggs eventually won’t perform as well. As you get older the eggs aren’t as good as they used to be,” says Dr. Richlin.
Fortunately, there are ways young women can be proactive about their fertility, starting with fertility tests. There are two tests available that can help test the number and quality of a woman’s eggs. There’s the Follicle-Stimulating Hormone (FSH) test and there’s the Anti-Mullerian Hormone (AMH) test, both which are conducted by withdrawing blood. The FSH test measures the level of follicle-stimulating hormone in the woman’s blood. This test has to be done at a specific time in the cycle, usually around day one, two, three, or four, and you also can’t be on birth control to take it.
Davis emphasizes that the problem with FSH test is that it fluctuates from month to month and even day to day, leading to results that can be misleading. He recommends women get the AMH test, which measures the anti-mullerian protein hormone in the blood anytime in the menstrual cycle. This test doesn’t fluctuate as much throughout the month and tends to give more accurate results. Both the FSH and AMH can be conducted by an OB-GYN or fertility specialist.
But the tests are only the first step. Dr. Davis also suggests that women have an ultrasound performed to check for any major abnormalities in the uterus such as large fibroids or endometriosis. Things get tricky after that. He explains that one of the most effective ways of preserving fertility is by the process of egg freezing, an option a lot of women are considering these days, but it’s not as simple as it sounds.
“Egg freezing is a technique that works pretty well but a lot goes into it. It’s an invasive process, there are hormonal shots, followed by the actual egg retrieval, and even insurance companies that cover IVF infertility might not cover egg freezing.”
Davis claims that an egg-freezing cycle can easily cost anywhere between $10,000 to $15,000, not counting the average fee for the actual storing of the eggs, which can cost anywhere from $1,000 to $2,000. Also, for a woman who has less eggs or less quality eggs, she might have to have this done two to three times in order to freeze a descent amount of eggs. This is money that the average woman in her mid to late 30s might not have. You also don’t want to start freezing your eggs too young, because the chances of you actually using them later are less likely.
“The ideal age of freezing eggs should be around between the ages of 30 and 35,“ says Dr. Davis. “This is probably the best time in terms of the likelihood for success and a reasonable likelihood that you’d use those eggs.”
Egg-freezing might sound like a good option, but it’s not a simple one. The process is complicated and the costs alone are enough to turn some women off of it.
"Because I’m already 33, it’s something that's been on my mind lately.” says Rodriguez. She has already booked an appointment with her doctor to have her hormones checked, but is hesitant about getting her eggs frozen. “Now that I know that it costs that much money and is that invasive, I’m on the fence.”
The most important thing to keep in mind for women who do want to have kids in the future is that we do get less fertile with age. Yes, you can put kids on hold, and yes, you can focus on your career first, but consider your options. No one wants to believe that they could ever be infertile, but the reality is it could happen to any one of us.