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    Planning a Family

    Family Planning

    Waiting Too Long? continued...

    "Ultimately, age matters," says Ruth Fretts, MD, obstetrician/gynecologist at Harvard Medical School and Brigham and Women's Hospital in Boston. "Women tend to not want to hear this. But the large, well-designed studies show that women who delay significantly are going to have an increased risk of infertility. Biology is sexist," adds Fretts. "Biology just doesn't care."

    At New York University Medical Center, obstetrician/gynecologist Steven Goldstein, MD, says career women often come into his office at age 38 or 39, perhaps having just gotten married, and announce that they plan to wait a couple more years before having a baby. "I find myself gulping," he says. "Particularly in women over age 40, physicians are nervous as hell that these women are flirting with disaster by having waited. They may not get pregnant when they want to, not because they aren't ovulating, but because the quality of their eggs has diminished."

    So how long is too long to wait? "Unfortunately, there's no test doctors can conduct that will tell you, 'You have two years,' or 'You have four years,'" says Goldstein.

    According to Fretts, women who delay childbearing often have "more education, good jobs, and perhaps more money -- so they're socially advantaged but biologically disadvantaged. The optimal time to have children is really in the 20s."

    Gayle Peterson, PhD, MSSW, a family therapist in Berkeley, Calif., says that the challenge of balancing work with the desire for parenthood is becoming very intense for many women. On the one hand, as their biological clock ticks, they understand the need to start their family, she says. "But lately the work environment has moved toward demanding more overtime, especially in certain professions, and it's almost impossible for these women to find balance."

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