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Preserving Fertility

From the WebMD Archives

Sept. 13, 2001 -- When actress Jane Seymour gave birth to twins five years ago at age 45, the news shocked many, but these days it seems there is an endless parade of fortysomething celebrities having babies. Actress Susan Sarandon had her third child at 45; actress Mimi Rogers, also 45, is expecting; and playwright Wendy Wasserstein, author of The Heidi Chronicles, became a first-time mother at 48.

Forty-eight? Is there something going on here? Do famous women have slower biological clocks than other women? Fertility experts say these high-profile new moms give women the false idea that midlife pregnancies are no big deal when, in fact, only about 2% of babies in the U.S. are born to mothers over the age of 40.

"Everyone is entitled to their privacy, but I would love to get my hands on some of those [celebrity] medical records," says fertility specialist Michael Soules, MD. "It is not very likely that celebrity status slows the aging of the ovaries, so I suspect some of these women are using assisted reproduction techniques and not disclosing that." Soules is president of the American Society for Reproductive Medicine.

Many older celebrity moms, including Seymour and Wasserstein, have acknowledged undergoing fertility treatments, but such treatments offer notoriously poor chances for success in women over 40. Success rates are so poor that infertility clinics often refuse to perform in vitro fertilization on women older than 41 or 42.

The only currently available treatment that offers a good chance of success to women approaching pre-menopause and beyond is implantation of donor eggs or embryos from a younger woman. Up until a few years ago, most donor eggs came from other infertility patients, relatives, or friends. But these days the egg trade is becoming big business, with clinics routinely seeking donors through ads in college newspapers.

Success rates for women receiving donor eggs are reported to be as high as 50% per cycle in some programs -- even in women past their mid-40s. The procedure's success in older women became evident to the world in 1997, when a 63-year-old grandmother in Southern California gave birth to a baby conceived with a donor egg.

But can technology do anything to help a woman in her peak productive years preserve her fertility? Researchers have been working for two decades to perfect a method of freezing eggs for later use but have had little success, says reproductive endocrinologist David Adamson, MD. The problem -- freezing affects the chromosomes of the eggs.

"The probability of success with frozen eggs is so low that it is not considered clinically applicable technology at this time," he says. "I think we may see some improvement in success at some point, but even women who are now in their early 20s cannot count on this technology being available for them. Science may not solve this problem for a long time."

Researchers are also looking at freezing ovaries to prevent aging. Though the process is still experimental, women can now have an ovary surgically removed, sliced, and frozen, with the hope that it will one day be reimplanted and begin producing eggs. The procedure has been used with some success in sheep, but to date, no ovary slices have been reimplanted in humans.

While a "cure" for age-related infertility may not be imminent, medical science may be closer to pinpointing the age when a woman's fertility will begin to decline, using information in her genes.

Researchers in the Netherlands recently reported that the age at which a woman reaches menopause is largely genetically determined. Identifying the genes responsible for menopause should also help identify the ages at which a woman becomes subfertile and infertile.

"I do see a day when women in their 20s will be able to put their fertility on hold, but we are definitely not there yet," Adamson says. "We just haven't had any big breakthroughs, and we are back today trying the things we tried 15 years ago."

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