When does your biological fertility clock start ticking?

More and more of us are putting off having kids to focus on our careers, so much so that we now delay having a baby for longer than women in any other country. And with celebrities like Nicole Kidman and Mariah Carey giving birth for the first time in their forties, it’s easy to imagine that we have all the time in the world. But when does the female biological clock actually start to tick? We’ve spoken to top fertility experts to give you the lowdown. British women are becoming mums for the first time later and later, and the birth of the royal baby earlier this month highlighted this trend. While Kate Middleton, at 31, was in no way old, she was still over a decade older than Princess Diana was when she gave birth to Prince William. Things have changed a lot in a generation and the number of first-time UK mothers in their 40s has risen by 15% in the last five years. But at what age do we actually need to start worrying about having kids from a biological perspective? While lots of women are able to conceive later on, could some of us be at risk of missing our chance to become a mother if we wait for too long? 35 could be key ‘There is no “magic number” at which female fertility declines but we know that eggs deteriorate with age,’ says Infertility Network UK’s deputy chief executive Susan Seenan. ‘The speed of that deterioration will vary but rises more steeply after the age of about 35. The more “fertility aware” you are the better, so you can make an informed decision and be aware that it might take you longer to conceive,’ she adds. The NHS agrees that 35 is a key age when it comes to female fertility. Women are most fertile in their early 20s and their fertility declines with age. From the age of 35, this fall becomes steeper. ‘Women in the 19-26 age group have double the chance of conceiving each menstrual cycle compared with 35-39-year olds,’ explains Fertility UK fertility nurse specialist Jane Knight. Women over 35 are also less likely to become pregnant from fertility treatments like IVF, and are more likely to suffer from miscarriages. So does this mean that we all need to get pregnant by 35 or risk never being able to have kids? Not necessarily. You may want to start worrying when you reach 37, though. ‘Egg quality diminishes significantly from about 37,’ explains Jane. Ask your mum Your personal danger age could also be down to genetics. Fertility expert Zita West suggests looking at your mum. ‘One important question to ask is at what age your mother had the menopause as this may be the same for you,’ she says. ‘The decline occurs when the quality of the eggs is diminished with age, and this is usually in the late thirties to early forties.’ But just because you’re still having periods, it doesn’t mean that you’ll get pregnant easily. ‘Nature plays a cruel trick in that women tend to go on having periods long after they have ceased to ovulate,’ says Jane. ‘The ovulation mechanism becomes faulty and the egg quality is very poor long before a woman reaches her menopause, and a woman may no longer be fertile for up to ten years before she has her last period. The average age for menopause is about 51, but many women will have a much earlier menopause.’ So does that mean that, for the average woman, 41 could be the pivotal age? Read more...

Do patients have the right to an anonymous donor?

Given that the Progress Educational Trust (PET) has just completed a project on gamete donation I was more than intrigued about this debate, which took place at the European Society for Human Reproduction and Embryology's annual meeting in London. Despite the slightly odd framing of the question I was looking forward to a really good discussion and getting a wider perspective on gamete donation. One speaker was from Denmark, where donor anonymity is still the norm, and the other from Sweden, where identity release donation was introduced in 1985. Associate Professor Lone Schmidt, arguing for the motion that parents do have the right to an anonymous donor, started by quoting a seven-year-old donor-conceived child: 'I don't care how you made me just as long as you made me'. Schmidt, from the University of Copenhagen, said that longitudinal cohort studies have shown that gamete donor families, including those who have used anonymous donation, have functioned well. It is generally accepted that non-disclosure by the parents about donor conception and the child subsequently discovering by accident that they are donor-conceived can be damaging. So, she continued, using the treatment method that suits the parents best will increase the probability that the parents tell the child how it came into the world. Open identity donation was introduced in Sweden in 1985 but research has shown that only 11 percent of children had been informed that they were donor-conceived. Schmidt postulated that mandatory open identity leads to a disclosure paradox where parents are more reluctant to be open with their children about their conception. Finally she argued that there is no reason to believe knowledge of genetic origin is a fundamental prerequisite for psychological well-being, identity and social relations. Dr Claes Gottlieb, a physician from the Sophiahemmet IVF unit in Stockholm, argued against the motion. He started by saying that although his opponent had been rather balanced in her arguments, he was not going to be so measured. He argued that the title of the debate was wrong and that it should be 'Do children conceived through gamete donation not have the right to an identifiable donor?' He argued that it was the child's interests and rights that should come first and that children have the right to know their genetic origins. He pre-empted a counter argument that children who are conceived naturally don't always know their genetic parentage by saying the 'State can't go in to the bedroom', but where outside help is needed to conceive a child the State has a role. In countries where there is still donor anonymity the demand for identity release donors is increasing, he said. As evidence he referred to one clinic in the USA where 80 percent of patients chose an open donor. Why is identifying information important? Because of the desire to know one's roots, curiosity, for medical problems such as needing a bone marrow transplant and the need to understand the donor's motives. In a Swedish study of parents of donor conceived parents of children aged one to four years, 78 percent of parents planned to tell and 16 percent had started to tell. 'If you were a donor conceived child', he asked, 'wouldn't you want identifying information?' Read more... Article: by Sarah Norcross appeared in Bionews 715 29th July 2013

http://blogs.prideangel.com/post/2013/07/55-million-reasons-to-be-thankful-for-IVF-treatment.aspx

The world’s first test-tube baby has paid tribute to the fertility pioneers who gave her and millions of others life as she celebrates her 35th birthday. Louise Brown was born at Oldham General Hospital on July 25, 1978, after her parents Lesley and John became the first parents to successfully undergo in vitro fertilisation (IVF). Her birth attracted controversy, with religious leaders expressing concern over the use of artificial intervention and some raising fears that science was creating “Frankenbabies” who could experience medical difficulties later in life. There are now thought to be more than 5.5 million IVF babies worldwide and, as she prepared to celebrate her birthday with a private family meal, Mrs Brown said she hoped the public could now see the benefits of the breakthrough. “When I was born they all said it shouldn’t be done and that it was messing with God and nature but it worked and obviously it was meant to be,” she added. “It’s helped millions all around the world and if it can help improve success rates, obviously it’s a good thing. “I’ve now had my own son without IVF and lots of people I know or have heard of have gone on to have children naturally. “That shows that it is just the beginning of life that’s a little bit different, the rest is just the same.” Mrs Brown, whose younger sister Natalie was also the product of IVF, now lives near Bristol. She is married and has a six-year-old son, Cameron. She recently unveiled a plaque to honour IVF pioneers gynaecologist Patrick Steptoe and reproductive biologist Robert Edwards at Bourn Hall, the clinic they founded in Cambridge and where the techniques and drugs now used worldwide were first developed. Their research led to the successful fertilisation of a human egg outside the body and the transfer of the resulting embryo to the womb. Sir Robert, who was awarded a Nobel Prize in 2010, died aged 87 in April this year. Steptoe died in 1988 and did not receive the prize as it is not awarded posthumously. Article: 25th July 2013 www.cambridge-news.co.uk

Choosing to delay Cancer treatment to preserve Fertility

When Amy Miller was diagnosed with bowel cancer in March 2008, aged 32, her first thought was how she was going to beat the disease. "I was saying to my doctors, 'Oh my God, oh my God, start doing something now.'" But her doctors suggested delaying treatment for up to 20 days. The tumour was about 10cm in diameter at this point and lay close to her reproductive organs. Dr Miller, who has a PhD in Medieval art history, said: "It might not be right for everyone but in my case it wasn't an aggressive form of cancer and I was told that a delay of 20 days wouldn't make any difference to the effectiveness of my treatment - whereas without the delay I would never be able to have my own children. 'Difficult conversation' "Sometimes we can get so preoccupied by death that we forget to see the patient as a person who has a future ahead of them too." Dr Miller and her then-partner, now husband, Justin Ward, were referred for fertility counselling immediately after she was diagnosed. "Obviously I wasn't desperate to have children, otherwise I would have had them by then," she said. "I was 32 at the time and I was still studying for my PHD and my husband was still studying too. We hadn't really thought about having kids, but being faced with the possibility of not being able to have them, that was very different." Cancer should not define people, Dr Miller said Cancer treatment often destroys women's eggs and leaves the patient infertile, but with early intervention eggs can be harvested and fertilised and the embryos then frozen and stored until the couple wish to use them. The Teenage Cancer Trust said more care needed to be given to young women requiring cancer treatment that could damage their chances of having children. However, Dr Allan Pacey from the University of Sheffield said fertility preservation was often not a realistic option if cancer treatment needed to start immediately. Responding to a study by the cancer trust, Dr Dan Yeomanson, a consultant paediatric oncologist for Sheffield Children's NHS Foundation Trust, said there was still a need to discuss fertility issues with young patients - especially females - before treatment began, even if there were no options available for fertility preservation. Dr Miller said: "All of a sudden we had to have this really difficult conversation. We were still getting our heads around the cancer and didn't know if I was going to survive and they were asking us if we wanted to have children together. "That's a big decision for a couple to make. "They take you down the adoption route essentially and talk through what would happen to the embryos if you break up, or in the event of one or both of you dying. "But I'm so glad they did." 'Patient empowerment' Dr Miller, who is from Kenilworth in Warwickshire, said she was thrown headlong into the medical system from the instant she was diagnosed. "It's serious, it's immediate and it's complicated. They make appointments for you and you go. The staff are brilliant but it is a very dehumanising experience. "Going for fertility counselling was really comforting - just having someone listen to you that's not concerned about the cancer as such, who asks about how you are feeling, is so welcome and refreshing. "When you're dealing with cancer you don't know whether you have any future. Going through fertility treatment and creating viable embryos felt good because I knew if something happened to me, at least Justin and my family would have something of me that would survive into the future. "I think it is so important to get counselling and have the discussions early on about the impact on your reproductive system, not only if you want to have children. It's understandable that oncologists want to focus on treating the cancer, but the cancer should not become the person. "Making decisions about your own reproductive system is important to retaining a sense of wholeness and empowers you as a patient." Dr Miller has now been clear of cancer for four years, having undergone surgery and radiation therapy - but she has no immediate plans to start a family. She told the BBC she and her husband felt under no pressure. "One good thing to come out of all this is that I don't feel guilty now [about] having children later in life because my eggs have been frozen as my 32-year-old self. As we would have to go down the surrogacy route too, there is no risk to the baby from delaying this." Article: 21st July 2013 www.bbc.co.uk

Kate gives birth to Royal baby boy born 22nd July 2013

The Duchess of Cambridge has given birth to a baby boy, Kensington Palace has announced. The baby was delivered at 16:24 BST at St Mary's Hospital in Paddington, west London, weighing 8lb 6oz. The Duke of Cambridge said in a statement the couple "could not be happier". He and the duchess will remain in the hospital overnight. The news has been displayed on an easel in the forecourt of Buckingham Palace in line with tradition. A bulletin - signed by the Queen's gynaecologist Marcus Setchell, who led the medical team that delivered the baby - was taken by a royal aide from St Mary's to the palace under police escort. The document said: "Her Royal Highness, the Duchess of Cambridge was safely delivered of a son at 4.24pm today. "Her Royal Highness and her child are both doing well." When the news was announced, a large cheer went up from well-wishers and journalists outside the hospital while a large crowd greeted the posting of the bulletin outside Buckingham Palace. The Kensington Palace press release said the Duke of Cambridge was present for the birth of his son, who will be known as the Prince of Cambridge and who is third in line to the throne. "The Queen, The Duke of Edinburgh, The Prince of Wales, The Duchess of Cornwall, Prince Harry and members of both families have been informed and are delighted with the news," it said. A Kensington Palace spokesman said the names of the baby - who was delivered in the private Lindo Wing of St Mary's - would be announced in due course. The Prince of Wales, in a separate statement, said he and the Duchess of Cornwall were "overjoyed at the arrival of my first grandchild. "It is an incredibly special moment for William and Catherine and we are so thrilled for them on the birth of their baby boy," he added. "Grandparenthood is a unique moment in anyone's life, as countless kind people have told me in recent months, so I am enormously proud and happy to be a grandfather for the first time and we are eagerly looking forward to seeing the baby in the near future." BBC royal correspondent Peter Hunt said the duke and duchess spent time bonding with their son before they told the family their news. Royal doctor Mr Setchell described the new arrival as "wonderful baby, beautiful baby", our correspondent added. Prime Minister David Cameron, speaking outside Downing Street, hailed the "wonderful news". "It is an important moment in the life of our nation but I suppose, above all, it's a wonderful moment for a warm and loving couple who've got a brand new baby boy," he added. He said the Royal Family could "know that a proud nation is celebrating with a very proud and happy couple tonight". Scottish First Minister Alex Salmond said: "I am sure that people across Scotland will be absolutely thrilled to hear the news of the birth of a baby boy to the Royal couple and will want to join me in wishing the proud parents many congratulations." And Welsh First Minister Carwyn Jones congratulated the couple "on behalf of the people of Wales" as "they enter their journey into parenthood". The Archbishop of Canterbury, meanwhile, said he was "delighted to congratulate the Duke and Duchess of Cambridge on the arrival of their baby boy". "Along with millions here and around the world, I share in their joy at this special time," he added. "May God bless this family with love, health and happiness in their shared life ahead." Catherine and Prince William had arrived at the hospital at 06:00 BST ahead of a Kensington Palace announcement that she was in the early stages of labour. The world's media had been camped outside St Mary's for days in anticipation of the birth. Article: 22nd July 2013 www.bbc.co.uk

'Sperm donor the only option for me' says Big Brother contestant

Aisleyne said: ““Sperm donation seems the only logical option. I don’t need a man financially. I can do it myself. I’m 34, my biological clock is ticking and I haven’t got forever.” The party girl says she's had to rethink her priorities since the death of her mother and uncle from cancer last year. She was left devastated when mum Sophia, 54, passed away in February, then three months later in May her uncle Dennis lost his battle with the disease aged 52. Speaking to Now magazine, she said: “I was too busy having fun. I thought I was invincible and had forever. It made me realise how fragile life could be and that I wanted to become a mother. “I want that responsibility of looking after someone completely helpless, to bring them up to be decent and give them the best life I possibly can. I want to live for someone other than just myself.” Since making the Big Brother final in 2006, Aisleyne has kept her love life largely out of the public eye. She briefly dated Mike Tyson in 2009, but despite a rumoured proposal from the former boxer, has yet to find someone to settle down with. She said: “I do think a child needs a dad and that’s a big drawback to doing it on my own. But there are so many single parents or children with a bad father – in this day and age the nuclear family hardly exists. “If I do meet Mr Right he’s going to have to accept me with this child. And anyway, having no stability is more detrimental to a child than having no father at all.” Article: 16th July 2013 www.thesun.co.uk

Exercise during pregnancy reduces risk of a Caesarean birth

Women who exercise during pregnancy are less likely to require a Caesarean birth, say scientists. A brisk walk three times a week halves the risk of having a heavy infant - one of the main causes of the emergency surgery. C-sections have been linked with babies becoming obese in childhood, being more prone to infections and asthma and developing diabetes. A study of 510 sedentary expectant mothers who exercised for less than 20 minutes on only two days of the week or fewer found those given a training programme reduced their chances of giving birth to a baby weighing over 4 kilos by 58 percent. And the number of expected Caesarean deliveries fell by 34 per cent, according to the findings published in the British Journal of Sports Medicine. Both are risk factors for gestational diabetes mellitus - a condition in which previously healthy mothers develop glucose intolerance while they are pregnant. Dr Jonatan Ruiz, of Granada University in Spain, said: 'The findings reinforce the need to encourage more supervised exercise interventions during pregnancy to combat the negative effects of gestational diabetes mellitus.' The intervention group followed 55 minute sessions of aerobic, muscle strength and flexibility exercises on three days a week during the last six months of pregnancy while the others received standard care. Previous studies have shown babies delivered by Caesarean miss out on protective bugs that could help prevent a host of disorders in childhood and later life. C-sections now constitute about 25 per cent of births in England and Wales or over 190,000 a year - more than double the proportion in 1980. It's believed surgical babies may be missing out on physiological changes that happen during labour including exposure to bugs which are necessary for the immune system to mature. Women who are overweight or obese are more likely to end up having surgery when giving birth - and the rise in these deliveries coincides with the obesity epidemic. Obese women are at risk for pregnancy-related complications including hypertension, gestational diabetes and blood clots - all of which can lead to a recommendation for caesarean delivery. Article: 17th July 2013 www.dailymail.co.uk