As a woman ages, her fertility—the chance she will get pregnant—is reduced. Henry Mayo is honored to be the top choice for maternity services by physicians and parents of the Santa Clarita Valley.
In this segment, Dr Navid "Navi" Navizadeh discusses advanced maternal age and fertility, and the choices a women may make in her younger years that might increase her ability to have children at a later age.
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Advanced Maternal Age and Fertility
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Learn more about Navid “Navi” Navizadeh, MD
Navid “Navi” Navizadeh, MD
Navid “Navi” Navizadeh, MD., is an OB-GYN and a member of the medical staff at Henry Mayo Newhall Hospital.Learn more about Navid “Navi” Navizadeh, MD
Transcription:
Melanie Cole (Host): Delaying pregnancy is a common choice for women in today’s society. The number of women in their late 30's and 40's attempting pregnancy and having babies has increased in recent years. As a woman ages, her fertility and the chance that she will get pregnant is reduced. My guest today is Dr. Navid "Navi" Navizadeh. He's a chairman of the Department of Obstetrician and Gynecology and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show Dr. Navi. What do you see happening with women and delaying childbirth until their 30's and beyond? What are some of those factors that you're seeing women doing to delay their pregnancies?
Dr. Navid “Navi” Navizadeh (Guest): Well, Melanie, thank you so much for having me. Let me start with saying that we're seeing more and more moms delaying their childbearing until they are older. This is more likely because of the career choices they're making and because they are more involved with their careers, and they are getting married later. The primary issue that we face with moms that have babies at later age are the risk of genetic diseases or chromosomal abnormalities to the baby. As mom gets older, the quality of their eggs diminishes, and therefore, there is that increase with Down Syndrome as they get older. Also, the risk of chronic diseases such as hypertension, diabetes, thyroid issues increases for age. So, when they choose to have babies at a later age, they also have to deal with these chronic diseases that they haven't had in their younger age.
Melanie: Do you think that information that they're hearing in the media about assisted reproductive technologies may be giving women, Dr. Navi, a sense of security that childbearing can be delayed? Do you think that this is contributing as well?
Dr. Navizadeh: I think the better way of thinking is giving them a false education. As females get older, the quality of the eggs, as I said, diminishes. It gets sometimes harder for them to get pregnant, and I think the media does not a good job of really conveying that. You know, people start maybe trying to get pregnant after age 35, 36, 37 sometimes, and they may not even know that they may have infertility issues that hasn't been worked up, and by the time that those issues are worked up, they're even older.
Melanie: So what would you like women in their 20's -- let's start with women in their 20's at the peak of childbearing years when their eggs are at their strongest, and women are in good shape, but maybe they haven't settled in on a career found somebody to marry. What would you say to the women in their 20's about delaying childbirth and maybe some treatment options -- things that they might consider if they are someone who thinks about delaying until their 30's or beyond?
Dr. Navizadeh: Well, you know, we cannot choose the life; life events choose the life for us. You know, so, in their 20's, people don't know what's going to happen; who they're going to meet. Who they're going to marry; who they're going to have families with. I think a better way of looking at this is that if they get into their 30's -- at least 30's to mid-30's -- and let's say they haven't met the right person or they don’t have any children, and they want to have that option -- one option that they have, and they should think about is to be able to preserve their eggs. The most common way of doing that is to freeze their eggs. I don’t necessarily recommend that to be done in early or mid-20's because that's just too early, and you just don't know what's going to happen in your life in the next few years, but as you get into your 30's – in early 30's to mid-30's, and again, it's just so dependent on the person and the life and, you know, what the expectation is and what their plans are in life, but that's the time that they should really think about this and think about in the sense -- I may have to keep the options open for myself and maybe I should freeze some of my eggs just in case I decide to get pregnant later in life -- in my late 30's or early 40's, and that would be probably the best time, and now if somebody in their 20's, they know for sure that they're not going to be planning to have any kids until late in their 30's or early 40's, which, you now, that's way too long to predict, but if they do, then aloes that's a good time to try to freeze their eggs.
Melanie: What's involved in egg freezing, Dr. Navi?
Dr. Navizadeh: Very good question. First, they have to see their OB/GYN doctor, and they have to get a complete checkup with a pap smear and a complete examination and make sure they're in good health, and then they will be referred to a reproductive infertility specialist. They're going to get screened by them as well, and they are going to go through a process called ovulation induction process where they get medications to help them to ovulate more, and the idea is for them to produce more eggs in one cycle. After going through that process – through that cycle -- before they ovulate, they go through a procedure where the eggs get withdrawn and get aspirated, and the eggs get frozen. So, through this process they could have anywhere between a few eggs up to 10 eggs withdrawn and frozen and depending on the quality of the eggs and depending on what the needs are, this process can be repeated.
Melanie: So, besides egg freezing, Dr. Navi, what do you tell women when they might say to you, "Oh, I'm delaying having a child"? What are some other bits of good advice that you tell women as they're thinking about these things and looking into other treatment options that may be available -- should they delay childbirth?
Dr. Navizadeh: Well, the first thing and most important thing is to stay healthy – you know, persons staying, you know, be in good health, good weight, a good diet, you know, keep fit, and also I always say, you know, don't fall into false sense of security trap that you could be in your late 30's, early 40's and can try to get pregnant and that you're going to get pregnant easily. That may never happen. It's not as easy as we can think. You may end up having to do a fertility workup, or you may have to do insemination or IVF, even, to get pregnant. If you have the choice, the ability, if the life events allow you to have a baby through that, you should try that, but if you can't, just be prepared that you may end up sometimes using other methods -- other assisted reproductive means such as insemination or IVF to get pregnant when you're older.
Melanie: And so for women that are older, just give us a list of some of the treatment options that they can look to if their fertility is limited -- egg donation, or you know, using a gestational character just list out a few that you tell women are out there.
Dr. Navizadeh: So, it depends on the age of the patient and depends on quality of their own eggs. If they have good quality eggs, and they're young enough, they could try on their own for six months and if they don't get pregnant then they can take treatment from a reproductive specialist. Depending on the quality of the eggs, they could start with insemination procedure where they can have the sperm or semen inseminated, or they could have in vitro fertilization where we go through the process of ovulation induction just like the egg freezing process we mentioned, and then they have the egg withdrawn or aspirated with an assistive reproductive technique, the sperm gets introduced to the egg and those mate and then implanted into the uterus -- that's IVF. Sometimes patients are later age, their ovary quality is not very good; it's just not going to work. The ovaries don't make any eggs or the quality of the eggs that the ovaries make are just too poor for them to be able to get pregnant even through IVF -- there's just not enough good quality of eggs even with IVF. Those patients have the option of A. first, adoption B. an egg donation where they basically purchase somebody else's egg that gets fertilized with their partner's sperm, and then it's transferred to the uterus, and they carry the pregnancy, so that's for patients who can't use their own eggs, and they have to use, specifically, somebody else's egg, and the last option, which is a very new option is called embryo adoption. There are now, through the process of IVF, people who have extra embryos – embryos that they're not using -- the couple has gone through the IVF process and have seven embryos; they use two and have the baby and they have five other embryos that they're not using anymore. They're not trying to have any more kids. Those embryos could be donated to research, would be destroyed or now they could be donated or be, you know, the couples could adopt those embryos for themselves, so that's embryo adoption. It's relatively a new thing, and, you know, that's the last thing, again, and so, one other thing, surrogacy, which I didn't even talk about.
Some couples could also use a surrogate to carry the pregnancy for them, and that's not so much also the age issue, but that if their own uterus is not really capable of carrying the pregnancy for them or for whatever reason they had to have their uterus removed, and they cannot carry the pregnancy and then they have to use a surrogate.
Melanie: Dr. Navi, as we finish up here, how long should a woman in her 30's, or if she's 35 years old or older, wait before seeing a doctor to discuss fertility treatments and have an evaluation?
Dr. Navizadeh: Well, any woman should be having annual exams. They do not have to have a pap smear every time, every year, you could have the Pap smear maybe every two to three years, but they have to be seeing the doctor every year. As part of that conversation with their OB/GYN doctor or their women's health care provider, should be about fertility, so they -- every year they have an opportunity to discuss this with their physician, and they have to bring it up and discuss it and that should guide them and have them decide what to do.
Melanie: Thank you so much, Dr. Navi, for being with us today. If you would just wrap it up for us and give us your best advice for women in their 20's, 30's and beyond, that are considering childbirth that may not have had children in their 20's, what would you like them to know?
Dr. Navizadeh: To try sooner than later. If they have the opportunity, if they have the means, as I said, if their life allows them to, and as you know, you know, there are many different events in life is all about control. If they can, try to do it sooner – the sooner, the better, and if they can, and they know that it's not going to be possible, then they should think about possibly freezing their eggs and keeping that option available for themselves for later years.
Melanie: Thank you so much. You’re listening to It's Your Health Radio with Henry Mayo Newhall Hospital. For more information, you can go to henrymayo.com. That's henrymayo.com. This is Melanie Cole, thanks so much for listening.
Melanie Cole (Host): Delaying pregnancy is a common choice for women in today’s society. The number of women in their late 30's and 40's attempting pregnancy and having babies has increased in recent years. As a woman ages, her fertility and the chance that she will get pregnant is reduced. My guest today is Dr. Navid "Navi" Navizadeh. He's a chairman of the Department of Obstetrician and Gynecology and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show Dr. Navi. What do you see happening with women and delaying childbirth until their 30's and beyond? What are some of those factors that you're seeing women doing to delay their pregnancies?
Dr. Navid “Navi” Navizadeh (Guest): Well, Melanie, thank you so much for having me. Let me start with saying that we're seeing more and more moms delaying their childbearing until they are older. This is more likely because of the career choices they're making and because they are more involved with their careers, and they are getting married later. The primary issue that we face with moms that have babies at later age are the risk of genetic diseases or chromosomal abnormalities to the baby. As mom gets older, the quality of their eggs diminishes, and therefore, there is that increase with Down Syndrome as they get older. Also, the risk of chronic diseases such as hypertension, diabetes, thyroid issues increases for age. So, when they choose to have babies at a later age, they also have to deal with these chronic diseases that they haven't had in their younger age.
Melanie: Do you think that information that they're hearing in the media about assisted reproductive technologies may be giving women, Dr. Navi, a sense of security that childbearing can be delayed? Do you think that this is contributing as well?
Dr. Navizadeh: I think the better way of thinking is giving them a false education. As females get older, the quality of the eggs, as I said, diminishes. It gets sometimes harder for them to get pregnant, and I think the media does not a good job of really conveying that. You know, people start maybe trying to get pregnant after age 35, 36, 37 sometimes, and they may not even know that they may have infertility issues that hasn't been worked up, and by the time that those issues are worked up, they're even older.
Melanie: So what would you like women in their 20's -- let's start with women in their 20's at the peak of childbearing years when their eggs are at their strongest, and women are in good shape, but maybe they haven't settled in on a career found somebody to marry. What would you say to the women in their 20's about delaying childbirth and maybe some treatment options -- things that they might consider if they are someone who thinks about delaying until their 30's or beyond?
Dr. Navizadeh: Well, you know, we cannot choose the life; life events choose the life for us. You know, so, in their 20's, people don't know what's going to happen; who they're going to meet. Who they're going to marry; who they're going to have families with. I think a better way of looking at this is that if they get into their 30's -- at least 30's to mid-30's -- and let's say they haven't met the right person or they don’t have any children, and they want to have that option -- one option that they have, and they should think about is to be able to preserve their eggs. The most common way of doing that is to freeze their eggs. I don’t necessarily recommend that to be done in early or mid-20's because that's just too early, and you just don't know what's going to happen in your life in the next few years, but as you get into your 30's – in early 30's to mid-30's, and again, it's just so dependent on the person and the life and, you know, what the expectation is and what their plans are in life, but that's the time that they should really think about this and think about in the sense -- I may have to keep the options open for myself and maybe I should freeze some of my eggs just in case I decide to get pregnant later in life -- in my late 30's or early 40's, and that would be probably the best time, and now if somebody in their 20's, they know for sure that they're not going to be planning to have any kids until late in their 30's or early 40's, which, you now, that's way too long to predict, but if they do, then aloes that's a good time to try to freeze their eggs.
Melanie: What's involved in egg freezing, Dr. Navi?
Dr. Navizadeh: Very good question. First, they have to see their OB/GYN doctor, and they have to get a complete checkup with a pap smear and a complete examination and make sure they're in good health, and then they will be referred to a reproductive infertility specialist. They're going to get screened by them as well, and they are going to go through a process called ovulation induction process where they get medications to help them to ovulate more, and the idea is for them to produce more eggs in one cycle. After going through that process – through that cycle -- before they ovulate, they go through a procedure where the eggs get withdrawn and get aspirated, and the eggs get frozen. So, through this process they could have anywhere between a few eggs up to 10 eggs withdrawn and frozen and depending on the quality of the eggs and depending on what the needs are, this process can be repeated.
Melanie: So, besides egg freezing, Dr. Navi, what do you tell women when they might say to you, "Oh, I'm delaying having a child"? What are some other bits of good advice that you tell women as they're thinking about these things and looking into other treatment options that may be available -- should they delay childbirth?
Dr. Navizadeh: Well, the first thing and most important thing is to stay healthy – you know, persons staying, you know, be in good health, good weight, a good diet, you know, keep fit, and also I always say, you know, don't fall into false sense of security trap that you could be in your late 30's, early 40's and can try to get pregnant and that you're going to get pregnant easily. That may never happen. It's not as easy as we can think. You may end up having to do a fertility workup, or you may have to do insemination or IVF, even, to get pregnant. If you have the choice, the ability, if the life events allow you to have a baby through that, you should try that, but if you can't, just be prepared that you may end up sometimes using other methods -- other assisted reproductive means such as insemination or IVF to get pregnant when you're older.
Melanie: And so for women that are older, just give us a list of some of the treatment options that they can look to if their fertility is limited -- egg donation, or you know, using a gestational character just list out a few that you tell women are out there.
Dr. Navizadeh: So, it depends on the age of the patient and depends on quality of their own eggs. If they have good quality eggs, and they're young enough, they could try on their own for six months and if they don't get pregnant then they can take treatment from a reproductive specialist. Depending on the quality of the eggs, they could start with insemination procedure where they can have the sperm or semen inseminated, or they could have in vitro fertilization where we go through the process of ovulation induction just like the egg freezing process we mentioned, and then they have the egg withdrawn or aspirated with an assistive reproductive technique, the sperm gets introduced to the egg and those mate and then implanted into the uterus -- that's IVF. Sometimes patients are later age, their ovary quality is not very good; it's just not going to work. The ovaries don't make any eggs or the quality of the eggs that the ovaries make are just too poor for them to be able to get pregnant even through IVF -- there's just not enough good quality of eggs even with IVF. Those patients have the option of A. first, adoption B. an egg donation where they basically purchase somebody else's egg that gets fertilized with their partner's sperm, and then it's transferred to the uterus, and they carry the pregnancy, so that's for patients who can't use their own eggs, and they have to use, specifically, somebody else's egg, and the last option, which is a very new option is called embryo adoption. There are now, through the process of IVF, people who have extra embryos – embryos that they're not using -- the couple has gone through the IVF process and have seven embryos; they use two and have the baby and they have five other embryos that they're not using anymore. They're not trying to have any more kids. Those embryos could be donated to research, would be destroyed or now they could be donated or be, you know, the couples could adopt those embryos for themselves, so that's embryo adoption. It's relatively a new thing, and, you know, that's the last thing, again, and so, one other thing, surrogacy, which I didn't even talk about.
Some couples could also use a surrogate to carry the pregnancy for them, and that's not so much also the age issue, but that if their own uterus is not really capable of carrying the pregnancy for them or for whatever reason they had to have their uterus removed, and they cannot carry the pregnancy and then they have to use a surrogate.
Melanie: Dr. Navi, as we finish up here, how long should a woman in her 30's, or if she's 35 years old or older, wait before seeing a doctor to discuss fertility treatments and have an evaluation?
Dr. Navizadeh: Well, any woman should be having annual exams. They do not have to have a pap smear every time, every year, you could have the Pap smear maybe every two to three years, but they have to be seeing the doctor every year. As part of that conversation with their OB/GYN doctor or their women's health care provider, should be about fertility, so they -- every year they have an opportunity to discuss this with their physician, and they have to bring it up and discuss it and that should guide them and have them decide what to do.
Melanie: Thank you so much, Dr. Navi, for being with us today. If you would just wrap it up for us and give us your best advice for women in their 20's, 30's and beyond, that are considering childbirth that may not have had children in their 20's, what would you like them to know?
Dr. Navizadeh: To try sooner than later. If they have the opportunity, if they have the means, as I said, if their life allows them to, and as you know, you know, there are many different events in life is all about control. If they can, try to do it sooner – the sooner, the better, and if they can, and they know that it's not going to be possible, then they should think about possibly freezing their eggs and keeping that option available for themselves for later years.
Melanie: Thank you so much. You’re listening to It's Your Health Radio with Henry Mayo Newhall Hospital. For more information, you can go to henrymayo.com. That's henrymayo.com. This is Melanie Cole, thanks so much for listening.