Science is changing pregnancy for women over 40. But many doctors remain cautious about the prospects of childbirth in middle age.

By: Elizabeth Segran

In 2015, Cynthia Griner delivered a baby girl at the age of 48. Griner already had four sons, but in her early forties, she felt an overwhelming desire to try one last time to have a daughter. These days, Griner’s Instagram feed is splashed with pictures of her and her toddler wearing cute “mommy and me” outfits. To any woman nearing 50 still hoping to have a child, Griner’s story seems like a dream come true.

But what is less obvious from the pictures is that it took four years–and lots of money on infertility treatments–for Griner to have the family she had always wanted. After going through a battery of tests and hormonal treatments, Griner learned that she did not have any viable eggs left. In consultation with a fertility specialist based in Jupiter, Florida, Griner decided she would be willing to conceive with the help of an egg donor. “This whole process put stress on my body, my marriage, my family,” Griner says. “But it was all worth it, because our family is now complete.”

Griner is fully aware that her baby is the product of many scientific interventions. But the bottom line is that it is currently impossible for women to have a baby with their own eggs when they are nearing menopause and their supply of healthy eggs has dwindled. “This is a universal reality,” says Dr. David Seifer, a fertility specialist at Yale Medicine. “Every woman on the planet has the challenge of the DNA within their eggs degrading over time, a process that accelerates from the time they are in their mid-30s to menopause. Historically, it has been impossible to reverse.”

That might be about to change. There are several experimental techniques on the horizon designed to help prolong the viability of a woman’s eggs. One cutting-edge treatment involves rejuvenating a post-menopausal woman’s ovaries and uterus using the healing properties of blood, while another involves transferring the mitochondria or cytoplasm of a younger woman’s eggs into those of an older woman. Science may be catching up to society’s desire to prolong fertility.

The State of Fertility

An increasing number of women are spending their twenties throwing themselves into their education and career, which means they are starting families older than generations past. American women with a college degree or higher now have their first child at an average age of 30.3. In big, expensive cities, women are increasingly pushing motherhood until even later: In New York and San Francisco, the average age is 31 and 32, respectively.

However, it’s still not very common for women to have babies with their own eggs in their late 40s unless they froze their eggs when they were younger. Since egg freezing was classified as an experimental procedure until 2012, most women who are currently in their 40s never had the opportunity to do it. (An estimated 20,000 American women have now had their eggs frozen, but an estimated 85% or more have not had them thawed to have a baby.)

The average woman experiences menopause at the age of 51. This is the moment when her body stops releasing eggs and, by extension, she stops having periods. Between five to 10 years before that, women go through a transitional phase called peri-menopause, when they have irregular periods because their reproductive hormones begin to decline. “There is no way to delay menopause,” says Dr. Melynda Barnes, the clinical director of Rory, a startup devoted to helping women deal with menopause. “A woman is born with the number of eggs she’s going to have throughout her life. The best that doctors can do is optimize your fertility potential when you’re peri-menopausal.”

If Griner’s story of delivering a healthy baby at the age of 48 sounds familiar, it’s because it’s a story that we hear frequently in the tabloids. Over the past few years, magazine covers have been splashed with the images of celebrities having babies on the later side of 40, normalizing this reality. Two years ago, Janet Jackson had a daughter at the age of 50. In 2014, Laura Linney had a son at the age of 49. In 2013, Halle Berry had a son at the age of 46. In some cases, these pregnancies are totally unassisted. Kelly Preston, John Travolta’s wife, for instance, had an unplanned pregnancy at the age of 48 in 2010. But often, readers don’t know what these women and their families went through to have babies.

Over the past few decades, Seifer has seen an uptick in the number of patients in their forties visiting him because they want to have a baby. In some cases, he has found that these stories of late-in-life pregnancy give women false hope that they can easily have a child close to 50. “It builds an urban myth, because these magazines don’t often give the full story,” he says. “These celebrities may have had miscarriages, cycles of IVF with their own eggs, then decided to do an egg donation before it worked out.”

It’s also true that many fertility clinics market happy, healthy families to women of all ages, making it seem like it is far easier to have a baby than it often is. The global market for in-vitro fertilization (IVF) is growing quickly, and is expected to expand at a rate of 10.2% by 2026 to reach $36.2 billion. On average, it costs $50,000 to conceive a child through IVF.

All of this is aggravated by the fact that it occasionally has been controversial for the medical establishment to discuss age-related infertility. In 2oo1, the American Society of Reproductive Medicine launched a campaign to educate women about the potential problems they may run into if they delayed pregnancy until their 40s. But it famously pulled the campaign due to intense backlash from people who felt like this was encouraging women to have children before they were ready, or to prioritize having children over their career. And there is plenty of medical evidence that older sperm can also lead to infertility or birth defects, and this male age-related infertility is even more rarely discussed.

In short, there is not much an older woman can do to have a baby with her own eggs if she hasn’t already frozen them because the DNA in her eggs has degraded. In practice, defects in older eggs makes it harder to get pregnant, and it also makes miscarriage more likely. Data shows that older women are also more likely than younger women to have babies with chromosomal abnormalities, including Down’s syndrome. Many women are led to believe that they’ll be fertile and able to have a low-risk pregnancy until they’re well into middle age.

The New Science

Scientists are actively searching for a way to rejuvenate a woman’s eggs while preserving the DNA. There have been several efforts to do this around the world.

One controversial new approach is called mitochondrial replacement therapy (MRT), which has been discussed for several decades. It was reportedly used in Mexico and the Ukraine to lead to several successful births.

The approach involves taking a donor’s eggs, removing the nucleus, and replacing it with the patient’s DNA. This effectively improves the quality of an older woman’s eggs, making it more likely for her to conceive. “This preserves the same DNA in the older woman’s eggs, but supports it with energy from the younger woman’s,” explains Seifer.

Last summer, Doctors at the Institute of Life in Athens used this approach on a 32-year-old woman who had four unsuccessful cycles of IVF. Using MRT, she reportedly conceived a baby boy. Now Greece is about to launch a pilot study that will enroll 25 women who have failed to conceive using conventional methods.

In the United States, the U.S. Food and Drug Administration (FDA) has not looked favorably on the treatment. In the late 1990s, several clinics in the United States attempted MRT. It reportedly led to 30 births. The FDA, however, was concerned about the legal and regulatory challenges that this would raise because the ensuing baby would effectively have the DNA of three different people: the mother, father, and the egg donor. Moreover, it is unclear what possible health impacts could occur down the line to babies born this way. For now, any MRT treatments in the U.S. have been banned.

Dr. Kostantinos Sfakianoudisa, a doctor at the Genesis Clinic in Athens, is also working on a new technique that could rejuvenate the uterus and ovaries of women who have had reproductive system disorders, or whose reproductive organs have deteriorated with age. The approach involves drawing a patient’s blood, then isolating the plasma, which is rich in platelets that are capable of healing organs in the body. This approach is currently being used to heal sports injuries. Sfakianoudisa’s innovation has been to inject this plasma into a woman’s uterus and ovaries.

The approach is still exploratory, but initial results have drawn a great deal of interest. In January 2019, Sfakianoudisa published an article in the Journal of Clinical Medicine in which he presented the case of a woman who was diagnosed with premature menopause at the age of 35, and had not had a period since she was 33. At the age of 40, Sfakianoudisa injected the platelet-rich plasma into her ovarian tissue and began in-vitro fertilization. The woman became pregnant, but miscarried during her first trimester.

“The efficiency and safety of this treatment with regard to the reproductive system merits further investigation,” writes Sfakianoudisa and his coauthors in the article. But the study does offer a glimpse into the cutting-edge work being done in the field of fertility medicine. In this case, Sfakianoudisa managed to reverse menopause and restore menstruation, something that had been previously thought impossible. It raises the possibility that other post-menopausal women may be able to conceive in the future.

For Seifer, who sees patients every day, there’s still a gulf between these exploratory fertility treatments and the reality for women in their 40s and 50s who want to have a baby. “For now, these treatments are experimental,” he says. “There’s a fine line between being encouraging and giving false hope.”

That said, recent medical developments along with further scientific advances could mean that more women would be able to have babies in their late 40s in the years to come. It didn’t take long, for instance, for egg freezing to move from being a radical new treatment to being widely embraced. Many tech companies like Facebook and Google even help women pay for the treatment. As a result, the number of women freezing their eggs in their late twenties and early thirties has been growing exponentially since 2015, and the vast majority of them still have not thawed their eggs. If these women try to conceive naturally in their mid-forties–like Cynthia Griner did–and are unsuccessful, they will be able to turn to their own eggs. “These women will essentially be their own egg donors,” says Dr. Jenna McCarthy, Griner’s fertility doctor.

By Dr. Juergen Eisermann

Spring has arrived, along with National Infertility Awareness Week, and everyone is in spring cleaning mode. This is also a great time to look to your own body to clean out some cobwebs.

Let me share a story with you that illustrates one of the most common situations in my professional life.

I am sitting in my office across from a couple who wish to have a second child but are struggling to get pregnant. This is a frequent scenario and makes you wonder: What could possibly be the problem if just a few years earlier they were able to conceive without help?

Based on the medical information I reviewed, the woman’s reproductive system is in good shape. She has regular ovulation, open fallopian tubes and a healthy uterus.

However, her husband’s sperm count is subpar, and he reports having lots of stress at work. He’s doing a lot of traveling and has gained 25 pounds since they had their two-year-old daughter. He also loves fast food, soda and doesn’t exercise.

The wife is also more than 20 pounds overweight and notes that sexual activity has diminished quite a bit, often missing intercourse around ovulation.

To create optimal conditions for conception, it’s essential they try to get in shape. At our office we have trained lifestyle consultants who specialize in creating personalized plans to help people accomplish this goal.

Here are a few of their tips to boost your natural fertility simply by helping your metabolism get rid of built-up metabolic waste products called free radicals and oxidative stress:

• Double up your walking, take the stairs, get out of breath twice a day
• Clean out your system by cutting your meal sizes and lower how many
  times you eat per day
• Check your Vitamin D level, confirm that your blood pressure and
  fasting blood sugars are normal
• Stop microwaving foods in plastic, Styrofoam or paper cups and cut out
  the sodas
• Double up on salads, fruits and veggies, instead of meat and
  potatoes/rice/pasta

The funny thing is that we all know what to do and how to live healthy, but we have such a hard time ditching our old habits.

It’s been my observation over the years, that concerns about future fertility seem to be the last thing on the minds of millennials. Mostly, they worry about how to prevent unwanted pregnancy and there is obviously nothing wrong with that. But when the subject of starting their families in their late 30s or early 40s comes up, there is this sense of, “I can do it just like all those celebrities who you read about having twins in their thirties do it.”

Little do they know about all the emotional and financial hardship associated with often frustrating fertility treatments, after the eggs have aged, and the sperm production is not what it used to be.

Fortunately, there is quite a bit everybody can do to optimize their chances of conceiving in the future.

Sadly, there is nobody more motivated to try whatever aggressive, unproven, experimental and even costly treatment, than infertile patients. Interestingly, they are more eager to follow recommendations pertaining to their general health, lifestyle and eating habits than the average infertile patient that has yet to be exposed to all the conventional medications.

Still, too many of these patients with all their prior treatment failures fall into the trap of more must be better. In reality, adhering to healthy habits may make more of a difference for them than any medication regimen.

Sometimes a coach or trainer works, and even just joining a group of likeminded friends or family can do the trick. Sticking with the program, monitoring your success and sharing your results with everybody around you can also be so rewarding.

If one analyzes carefully how the most successful IVF programs in the U.S. prepare their patients, it becomes very clear that nutritional counseling plays a big role. Attention to metabolic parameters such as inflammatory indicators, lack of Vitamin D, or an underperforming thyroid gland, can tip the scale towards better success without breaking the bank or requiring unrealistic
sacrifice.

In fact, with the proper guidance, a well-designed plan can be a lot of fun to implement. Many of my patients have gotten pregnant in the process and are living proof of the amazing benefits a lifestyle adjustment can provide. So, good luck and have a great and fruitful springtime.

Click here to view original article.

By Carolyn Steber

If you’ve ever wondered if certain lifestyle choices can impact fertility, the answer is a resounding yes. It may not be the only factor involved, but “when it comes to lifestyle and boosting your fertility, there are both things to do and things not to do,” Marta Montenegro, a Florida-based fertility lifestyles specialist at IVFMD, tells Bustle. “There are, for example, at least five areas to consider when it comes to lifestyle,” including what you eat, how you handle stress, and how much you exercise.

“There are good things you can do for your reproductive system and the hormones that make it work properly, and also bad things,” Montenegro says. “And we are learning more and more about what these are with each new study. It’s important to note that many of these factors not only affect your fertility, but will have repercussions for your pregnancy as well.”

In other words, these habits, as well as those of your partner, can play an even bigger role than you think. “A healthy pregnancy begins with healthy parents,” Dr. Rink Murray, reproductive endocrinologist specialist, OB/GYN and co-founder of Tennessee Reproductive Medicine, tells Bustle. “Prioritizing health can help maximize the chances of getting pregnant and of having a healthy pregnancy.” Here are a few lifestyle habits that can make you more fertile, according to experts.

1. Getting Enough Omega-3

Getting enough omega-3 fatty acid through your diet is good for your reproductive system. “So if you’ve been eating non-animal sources of protein like walnuts, lentils, beans, chickpeas, sesame, flax, and pumpkin seeds, as well as grains quinoa and farro, you are already on the right track to maintaining your fertility,” Montenegro says.

2. Eating A Nutritious Diet

Your iron levels also play an important role in fertility. If you have beeneating iron-rich foods like spinach and lentils, Montenegro says you are also being good to your reproductive system. But that’s not the only nutrient you’ll want to think about. Eating a healthy diet overall is important, too, as it ensures you get other vital nutrients, like folic acid and vitamin B12, which studies have shown have positive effects on fertility.

3. Avoiding Excess Caffeine

While the occasional cup of coffee tends to be fine, drinking too much caffeine can be detrimental, when it comes to fertility. “It’s important to remember that this includes caffeine from any number of […] sources, such as soft drinks, tea, and chocolate,” Montenegro says. Caffeine can do a number on your reproductive system, which is why limiting your intake may be key.

4. Getting Plenty Of Sleep

Getting enough sleep can improve your overall health, while also potentially making you more fertile. “Good sleep is more important to fertility than many know,” Montenegro says. “This is not just about quantity of sleep, but also about quality.”

If you have a solid sleep schedule, and wake feeling refreshed, that’s a good sign. “Women who are fully rested are allowing for their reproductive hormones to function properly in keeping with the biological rhythms of the body’s natural 24-hour cycle,” Montenegro says. “Disrupt your sleep, and you disrupt this delicate hormonal balance and rhythm with negative results for your fertility.”

5. Doing Lighter Workouts

“If you’ve been doing a little exercise and physical activity, that’s good for fertility, too,” Montenegro says. “But you don’t want to overdo it. Those who have been doing low to moderate exercise have the right habits for boosted fertility. If you do too much exercise, too intensely, and too frequently you start to do more harm than good to your fertility.” While short bursts of activity may boost your fertility, for some people, doing more intense exercises can make it difficult to conceive.

6. Using Natural Cleaning Products

“Endocrine disruptors are substances that mimic hormones and alter the normal physiology of our hormones,” double board-certified physician Dr. Rocio Salas-Whalen, MD, tells Bustle. “We see decline in fertility when there are endocrine disruptors present. Endocrine disruptors are found in plastics, pesticides, cleaning products, and in some processed food.” So if you’re using these things regularly, it may negatively impact your fertility.

Instead, it can help to eat and drink out of glassware, use natural cleaning products, buy organic foods whenever possible, and choose grass-fed dairy products, Dr. Salas-Whalen says. “It may sound banal but endocrine disruptors are real and truly affect the way our hormones work, specifically infertility.”

7. Finding Ways To Relieve Stress

While stress can’t always be avoided, if you regularly find ways to deal with it in a healthy way, it may have a positive effect on your fertility. “If you’ve been doing yoga or mindfulness exercises you are doing a big favor to your fertility,” Montenegro says. “That’s because chronic exposure to cortisol, the stress hormone, down-regulates ovulation.”

8. Avoiding Smoking

“Women who smoke or [having smoking partners] have lower monthly pregnancy rates,” Dr. Murray says. Which is why so many reproductive specialists advise women to either quit smoking, or avoid secondhand smoke.

“For women, smoking is known to have a negative impact on estrogen levels and can impair ovulation,” Dr. Murray says. “There has been a link found that chemicals in cigarette smoke can speed up the loss rate of eggs.”

9. Getting Enough Vitamin D

“Vitamin D is needed to help the body create sex hormones, which in turn affects ovulation and hormonal balance,” natural fertility specialist Hethir Rodriguez, tells Bustle. And this vitamin can be important during pregnancy, too.

“Vitamin D also supports healthy bone development in the fetus during pregnancy,” Rodriguez says. “This is [a vitamin] many people are taking regularly that is healthy and necessary during pregnancy as well.” Of course, fertility is a complex thing, and it’s not always easy to predict what will have a positive or negative effect on it. If you’re struggling to get pregnant, it might be necessary to speak with an expert, to help uncover other underlying issues. Lifestyle can play a big role in keeping you healthy, but it definitely isn’t the only thing to consider.

By Kristine Fellizar

Getting pregnant doesn’t come easily for everyone. But, according to research, there are some things that may increase someone’s chances of conceiving, and you may not be aware of them.

“There are a few general things women can do to increase one’s chances at getting pregnant,” Connie Alford, M.D., a Naples-based fertility specialist at Florida’s IVFMD, tells Bustle.” For instance, maintaining a healthy lifestyle, eating right, limiting caffeine, taking prenatal vitamins with DHA, and having sex frequently around the time of ovulation can really help. “Sperm can live for a few days in the female reproductive tract, so having intercourse early and often can definitely improve your chances,” Dr. Alford says. Nowadays, there are so many different apps out there that you can use to help track your cycle so you can maximize your chances, if you are looking to get pregnant.

Although some fertility experts may suggest certain sex positions or lubricants to help up your chances, Dr. Daniel Kort with Neway Fertility tells Bustle, “these haven’t been associated with increased pregnancy rates.”

But there are some surprising research-based things that are linked to an increase in pregnancy. So here are some weird, interesting, and lesser-known things that can increase someone’s chances of getting pregnant, according to research.

1. Eating Seafood

A 2018 study published in The Journal of Clinical Endocrinology and Metabolism found that people who consumed at least two servings of fish per week were 22 percent more likely to have sex. Furthermore, those who continued to each fish regularly for a year had a 92 percent chance of getting pregnant in that first year. According to researchers, the high levels of omega3 fatty acids found in seafood helps to reduce inflammation and increase blood flow, both of which are good for increasing your chances of getting pregnant.

2. Walking Leisurely

If you’re looking to get pregnant, living a healthy lifestyle can definitely help. But if you’re not one to hit the gym regularly, a 2018 study published in the journal Human Reproduction found that walking can be helpful. For some women in the study, walking leisurely or even just strolling for 10 minutes was found to improve their chances of getting pregnant. In general, those who exercised for more than four hours a week had significantly higher chances of getting pregnant than those who barely exercised at all.

3. Sleeping In Complete Darkness

A 2014 study published in the journal Fertility and Sterility found that darkness is important for “optimum” reproductive health in women. According to researchers, melatonin is pretty important for a woman’s fertility because it has antioxidant properties used to protect the eggs. So as Mark P. Trolice, M.D., founder and director of Fertility CARE: The IVF Center, tells Bustle, “Sleeping in total darkness for eight hours can increase the body’s natural melatonin.” Not only will you get a good night’s rest, but it will ensure that your body’s cycle is functioning as it should.

4. Saying Goodbye To Lube

If you’re looking to up your chances of getting pregnant, Dr. Trolice says, “Throw away the [spermicidal lube] because it’s […] toxic to sperm.” In fact, a 2014 study published in the journal Fertility and Sterility found that many personal lubricants out there have been found to reduce the motility of sperm. While there are some lubricants out there specifically made towards helping fertility, researchers from this study suggest staying away from silicon and water-based lubes if you’re trying to conceive.

5. Consuming Royal Jelly

“Believe it or not, there are a lot of weird ways to increase your chances of becoming pregnant,” Hethir Rodriguez, founder and president of NaturalFertilityInfo.com, tells Bustle. “One I highly recommend is eating royal jelly.” Royal jelly is the main food source for bee larva in their first three days of development. It typically contains water, proteins, sugar, fats, vitamins, and amino acids. It’s called “royal jelly” because it’s what queen bees typically eat. “Research finds royal jelly is nutrient rich, revitalizes the adrenal glands, and acts as a gentle phytoestrogen giving fertility a natural boost,” Rodriguez says.

6. Eating Seasonally

In general, eating healthy is a great way to increase your chances of getting pregnant. In fact, studies have found positive links between consuming folic acid, vitamin B12, and omega-3 fatty acids, and fertility. As Dr. Aaron K. Styer, MD of CCRM, tells Bustle, conscious eating is important if you’re looking to conceive. One way to practice this is to choose seasonal foods. “By choosing seasonal foods, you can help your body deal with the demands of the season and keep your body in an all-systems-go posture when you are trying to conceive,” he says. For instance, during winter in New England, the body must deal with the elements of cold and dryness. Eating warm meals and drinking hot beverages, greatly reduces the demands placed on the body to maintain its interior warmth and moisture. “Choosing recipes for casseroles, soups, congees (think Chinese oatmeal) combine the warmth and moisture needed to combat demands of the cold winter months,” he says.

7. Thinking Positively

It may be a challenge, and positive thinking may not guarantee a pregnancy, but it doesn’t hurt. Studies like one from the University of California, Los Angeles have found that practicing mindfulness can have a positive effect on your health. When you’re more aware and living in the now, it can help to manage stress and anxiety. According to Dr. Styer, this is pretty important if
you’re trying to conceive. Each day you have another chance to hit the reset button. “Every day has 1440 minutes of opportunity to either keep on your current path or try something new,” he says. “Most women I see are so focused on what isn’t working, they forget to note what’s going well. Having a positive perception can make a huge difference during this time of your life.” Focusing on “fertility” instead of “infertility” may make all the difference between seeing options or roadblocks.

Unfortunately, conceiving doesn’t have a magic formula, and certain recommendations will not work for everyone. But overall, living a healthy lifestyle is your best bet — these are just a few unusual and lesser known things that might also help.