Late ar­rival

Due to break­throughs in re­pro­duc­tive medicine, more and more Ir­ish women are hav­ing ba­bies in their 50s, writes Sharon Ní Chonchúir

Irish Examiner - Feelgood - - Cover Story -

SU­SAN never imag­ined she’d be a first­time mum aged 50. “I thought I’d be pre­par­ing for re­tire­ment, not chang­ing nap­pies and deal­ing with night feeds,” laughs the now 53-year-old from Co Meath.

She is one of an in­creas­ing num­ber of women hav­ing ba­bies in their sixth decade. In 2007, only four women in Ire­land had ba­bies in their 50s but by 2015 — the year Su­san’s daugh­ter Ni­amh was born – that fig­ure had risen to 16. A fur­ther 17 ba­bies were born to women in their 50s in Ire­land last year.

Th­ese fig­ures are small but they are grow­ing, thanks to break­throughs in re­pro­duc­tive medicine.

In Ire­land, women are in­creas­ingly spend­ing their 20s fo­cussing on ed­u­ca­tion and their 30s build­ing ca­reers and search­ing for suit­able part­ners. In­evitably, some face fer­til­ity is­sues when the time is fi­nally right for ba­bies.

Us­ing donor eggs is one of the rev­o­lu­tion­ary new treat­ments that can solve this prob­lem. It now looks as if there may be even more ad­vanced treat­ments on the hori­zon fol­low­ing the re­cent suc­cess of Bri­tish sci­en­tists in grow­ing hu­man eggs in a lab­o­ra­tory for the first time.

Donor eggs are what al­lowed Su­san to fi­nally be­come a mother.

“I al­ways thought I’d have ba­bies in my 20s,” she says. “But sev­eral re­la­tion­ships didn’t work out which meant I was 35 and run­ning my own busi­ness by the time I met Paul.”

They were mar­ried within two years and im­me­di­ately tried for chil­dren. How­ever, 18 months and one miscarriage later, they found them­selves un­der­go­ing fer­til­ity tests.

“We dis­cov­ered a prob­lem with Paul’s sperm that made it dif­fi­cult for us to con­ceive and more likely to mis­carry,” says Su­san.

The clinic sug­gested us­ing donor sperm. “But Paul couldn’t han­dle the idea,” says Su­san. “The dis­ap­point­ment and heartache of it all even­tu­ally drove us apart.”

In her 40s by then, she gave up hope of hav­ing chil­dren.

“I thought I was past it but then I met Mar­tin,” she says. “I was 46 and he al­ready had two chil­dren of his own but when I told him how much I had wanted a child, he thought there might still be a chance. When­ever there was a story in the news about older celebri­ties hav­ing ba­bies, he’d tell me to go for it.”

Those celebri­ties in­clude Janet Jack­son who had her first baby aged 50 last year and 54-year-old Brigitte Nielsen gave birth to her fifth child, a girl, in May.

Such sto­ries don’t nec­es­sar­ily give the full pic­ture, says Dr John Water­stone of the Water­stone Fer­til­ity Clinic.

It’s un­likely that celebri­ties aged over 50 have used their own eggs, he says. “A donor egg was prob­a­bly used but that will never be made pub­lic.”

Egg do­na­tion dra­mat­i­cally in­creases an older woman’s chances of con­ceiv­ing.

“Aged 35, one round of IVF is likely to re­sult in a baby,” says Dr Water­stone. “Aged 40, the chances are 25%. At 42, it’s 5% and af­ter 45, it’s van­ish­ingly small. With donor eggs, you can con­ceive at any age. That’s why you some­times hear of women hav­ing ba­bies aged 65 or 70.”

Dr John Kennedy, med­i­cal di­rec­tor of fer­til­ity spe­cial­ists SIMS Clinic, says that about 1,000 ba­bies are born as a re­sult of donor egg treat­ment in Ire­land an­nu­ally. “In our clinic alone, we carry out about 300 new egg do­na­tion cy­cles and up to 40 women aged 47 seek our help with con­ceiv­ing ev­ery year,” he says.

Cur­rently, there is no le­gal limit to the age at which women can avail of fer­til­ity treat­ment in Ire­land. At the Water­stone Clinic, they treat women up to the age of 51.

The SIMS Clinic has a sim­i­lar age limit.

“Our self-im­posed limit is 50 for a first treat­ment,” says Dr Kennedy. “We chose the age of 50 be­cause it’s the aver­age age of menopause but noth­ing is writ­ten in stone.”

Su­san was ner­vous when she and Mar­tin made an ap­point­ment at a fer­til­ity clinic. “I was 49 and thought they’d laugh when they heard my age,” she says. “But they’d ac­tu­ally helped women like me be­fore and it wasn’t long be­fore we were dis­cussing us­ing Mar­tin’s sperm and a donor egg to con­ceive a baby.”

The cou­ple re­ceived coun­selling to en­sure they were com­fort­able with the idea of be­com­ing par­ents in this way.

“It re­ally helped,” says Su­san. “We talked about the pros and cons and our coun­sel­lor even made us con­sider what we would say to our child in the fu­ture about how they were con­ceived.”

Mar­ian Ó Tuama is a psy­chother­a­pist at the Water­stone Clinic, where the pol­icy is that peo­ple us­ing donor eggs, sperm or em­bryos must have coun­selling as part of their treat­ment. The other clin­ics fea­tured in this piece have the same pol­icy.

“We ex­plore the im­pli­ca­tions of their de­ci­sion,” she says. “I ask them how and what they will tell their child and other peo­ple. We dis­cuss what it will be like if the child doesn’t re­sem­ble them. We also talk about the chal­lenges of the treat­ment and how they will cope in the event of it not work­ing and what sort of par­ents they would like to be if it does.”

Then there are the com­mon wor­ries shared by older par­ents. Will they be the old­est par­ents at the school gate? Will they find it dif­fi­cult to keep up with the phys­i­cal de­mands of a small child?

“I find it best to ac­knowl­edge the re­al­ity of all that,” says Ó Tuama. “But I also ask them to imag­ine sce­nar­ios where age is a ben­e­fit. They might have less en­ergy to run af­ter a child but more time and at­ten­tion to give if they are more es­tab­lished in their ca­reers or more fi­nan­cially se­cure.”

This is true for Su­san. “I have three women work­ing for me in my busi­ness and I’ve only gone into to work for a cou­ple of hours a day two days a week since Ni­amh was born,” she says.

“Mar­tin has eased back a bit too and doesn’t go in un­til later in the morn­ings. We have play­time af­ter break­fast ev­ery day. I don’t know many par­ents who have time for that.”

An­other worry for older moth­ers is the med­i­cal im­pli­ca­tions of car­ry­ing a child in their 50s. Dr Ahmed Omar, clin­i­cal di­rec­tor of Bea­con Care Fer­til­ity, ad­mits there are in­creased risks.

“Older moth­ers are more likely to mis­carry and to suf­fer with high blood pres­sure, pre-eclamp­sia and di­a­betes dur­ing preg­nancy,” he says. “Their ba­bies are also at higher risk of pre-term birth.”

How­ever, as long as they are closely mon­i­tored, th­ese risks can be min­imised. “If women are healthy and us­ing donor eggs, then their preg­nan­cies are mostly un­com­pli­cated,” says Dr Water­stone. “I’ve treated hun­dreds of women in their late 40s and older with no prob­lems.”

Su­san had no par­tic­u­lar is­sues. “I had lots of scans and check-ups and was seen more reg­u­larly than a younger woman but ev­ery­thing went well,” she says.

That’s not to say that there weren’t awk­ward mo­ments. “I was by far the old­est woman at the an­te­na­tal classes and I’m of­ten mis­taken for Ni­amh’s granny at the play­ground,” she says.

“I just laugh as I don’t want Ni­amh feel­ing em­bar­rassed about it as she grows up.”

She thinks a lot about Ni­amh’s fu­ture. “I worry I won’t be there when she needs me so I pay close at­ten­tion to my health,” she says. “I ex­er­cise and eat well and go to the doc­tor reg­u­larly. I make sure Mar­tin does too.”

She is also pre­par­ing to tell Ni­amh about how she

was con­ceived. “We’ve al­ready read books where chil­dren are adopted or have un­usual fam­ily set­ups such as two mums or two dads.

“We’ve de­cided that as soon as she starts ask­ing where ba­bies come from, that’s when we’ll tell her. Wait­ing un­til she’s older could be a mis­take.”

Su­san oc­ca­sion­ally finds her­self think­ing about her egg donor. “I don’t know much about her ex­cept that she’s from the Ukraine, has blonde hair and blue eyes and has three chil­dren of her own but there are times when I see a look across Ni­amh’s face, a look that’s noth­ing like Mar­tin, who she re­sem­bles a lot, and I won­der if that’s her bi­o­log­i­cal mother.”

De­spite the fact that she and Ni­amh are not ge­net­i­cally re­lated, Su­san has never felt like she wasn’t her real mother.

“We had to try hard to con­ceive her and I had to take hor­mones and other medicines,” she says. “Then she grew in­side me and I brought her into the world. I have looked af­ter her ev­ery day since. I don’t think it could be pos­si­ble for us to be closer.”

Med­i­cal ex­perts be­lieve there will be more moth­ers like Su­san. “The num­ber of older women hav­ing ba­bies has been steadily ris­ing for three decades,” says Dr Omar.

“As we live in a health­ier so­ci­ety with more and more women choos­ing to de­lay try­ing for a baby, this trend is only go­ing to rise.”

Sci­ence now al­lows us to push our re­pro­duc­tive years for­ward by decades but what will be the ef­fect on so­ci­ety if women have ba­bies into their 50s, 60s and even 70s?

The 2017 As­sisted Hu­man Re­pro­duc­tion Bill, which is still in draft stages, has tried to leg­is­late for this.

The draft leg­is­la­tion does not sat­isfy Dr Water­stone. “The cut-off age for women seek­ing fer­til­ity treat­ment has been set at 47 and makes no dis­tinc­tion be­tween women us­ing their own eggs and donor eggs,” he says. “What we would like to see is a younger cut-off for IVF with a woman’s own eggs but a higher one for those us­ing donors.”

Dr Kennedy agrees. “In the UK, the cut-off is 50, which is what it is in most Ir­ish clin­ics at the mo­ment,” he says. “If we bring it down to 47, we’ll be re­mov­ing choice and op­por­tu­nity from too many women. As doc­tors, we’ll be fight­ing tooth and nail to op­pose this change in the law.” He thinks a broader con­ver­sa­tion is re­quired.

“Men can fa­ther chil­dren no mat­ter what their age and sci­ence is now mak­ing this pos­si­ble for women,” he says.

“It’s easy to have a knee­jerk re­ac­tion and say it shouldn’t be al­lowed. But peo­ple who al­ready have chil­dren or don’t want them don’t know what it’s like to be sub-fer­tile or in­fer­tile. Who are they to de­cide for oth­ers?”

As for Su­san, she’s still amazed she fi­nally be­came a mother. “I never imag­ined I’d wait 50 years be­fore I got to hold my baby in my arms,” she says. “Ni­amh came to us so late in life but I’m so grate­ful that we got to have her at all.”

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