Monday, March 24, 2014

The older newly married couple and infertility


We are now seeing a different kind of patient in our clinic these days. These are couples who are older and have got married recently , so typically the wife is more than 35 ; the husband is more than 40. They are usually professionals who have had very busy lives and fulfilling careers . They are doing very well for themselves ; and chose not to get married for many years because they couldn't find the right person. Now that they have finally found the right person ( often online , thanks to sites like shaadi.com; or through friends, neighbors, relatives),  when they finally hook up with someone they then need to decide whether they should start a family or not.

This is when they come to grips with the fact that their biological system no longer functions as optimally as it would for a younger woman ; and this can be a bit of a rude wake-up call for lots of these older women. These are typically very successful professionals who are used to doing everything for themselves and succeeding in life . They have high-profile lives and high-profile careers and most of them have been able to climb the rungs of their profession to get to whatever stage they wanted to.

They also automatically ( and naively) assume that once they have found Mister Right , they’ll be able to have a baby when they want to, because they have always been able to get what they want in life , as a result of their hard work and determination.  However, when they find out that their eggs maybe too old for them to be able to get pregnant , this comes as a bit of a rude surprise and shock , because no one ever prepared them for this eventuality.

What can be very disconcerting for some of these women is how strong their craving to have a baby can be – baby lust can be a very powerful force indeed !  These are the kind of women who would have never thought of the possibility of becoming moms or thinking of themselves as taking care of babies or toddlers when they were 30, who now find that at the age of 36 that this has become the major obsession in their life.

These are very interesting patients to work with because they're well read and well informed and have done their homework . They are mature and have seen quite a bit of life , as a result of which they are very capable of making their own decisions for themselves .

Many of these women come with many regrets and a lot of emotional baggage. ( I wish I had decided to have a baby earlier ! I wish I hadn’t put it off for so many years. I wish someone had told me about the biology of ovarian aging !) It’s quite challenging to explain to them that even though IVF technology has advanced significantly , there are still limits as to what we can do when we deal with women with poor ovarian reserve.

Many of them are worried that they are now too old to be good parents and are concerned that they will not have enough energy to be able to bring up a toddler.  I remind them that while their parenting style will be different from a 25 year old mother’s, in some respects it will be much better. They are likely to be much more laid back and mature; and since they have more money, they are in a better position to provide their child with a lot of life’s luxuries. Also, since they are spending so much time, money and energy on getting pregnant, they are likely to do a stellar job with bringing up their baby, who will not lack love and attention.

Fortunately, not all older women will have poor ovarian reserve ; and some of them will very happily get pregnant in the first IVF attempt itself , so that it makes all the efforts we put on their behalf very worthwhile.

Are you an older couple ? Are you worried about your biological clock ticking away ? Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !




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