1. Health
Rachel Gurevich

Older Parenthood Has Its Risks — But So Does Parenthood

By December 13, 2012

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There's lots of buzz around an article at The New Republic, "How Older Parenthood Will Upend American Society." Older parenthood has consequences, and delaying childbearing doesn't always work out as it should. The increased risk of birth defects and other diseases is not a new idea. That said, this article comes off as alarmist and gets a few things really wrong.

Right away, the article seems to try to intimidate the reader. While talking of her personal experience, the article reads, "If Clomid didn't work, we'd move into alphabet-soup mode: IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection), GIFT (gamete intrafallopian transfer), even ZIFT (zygote intrafallopian transfer)."

After reading that, I was tilting my head and saying, "Huh?" Because I can't imagine many (or any) fertility doctors listing GIFT or ZIFT as treatment possibilities, especially since they are rarely used (accounting for less than 1-2% of all ART procedures). GIFT is mainly used for Catholics who oppose IVF.

So my next thought was, why list all those acronyms? In my opinion, to freak people out. To get them to think, "Woa, I thought I knew about IVF, but what are all these other letters?" That paragraph -- plus the apparent guilt the author seems to have (wondering if her older motherhood is to blame for her child's sensory integration issues) -- led me to take the rest of the piece with several grains of salt.

Next in the article, the author says a study found birth defects were higher in those who conceived with ART. She claims the study "rang alarm bells" regarding the safety of ART. But I did a quick read of the abstract of that study, and it also reads that, "The increased risk of birth defects associated with IVF was no longer significant after adjustment for parental factors." So a history of infertility, and perhaps older parenthood, led to the increase, but not ART. Reading the article alone would leave you with a different impression.

So should older parents not try to have a baby because of these risks? We've known for awhile that age increases birth defects, as can a history of infertility. But there are a number of diseases and risk factors for birth defects and genetically linked diseases. Many studies have found that depression, anxiety, and even eating disorders may have a genetic link - should people with a history of these problems stop having children? Autism runs in families. Schizophrenia runs in families. Should these people not have kids?

Shulevitz also mentions an increased risk of birth defects with clomid, but the study she references to back up this statement didn't have a big enough sample size to back up the conclusion. (It's not even mentioned in the abstract.) Other studies on clomid have not found this increased risk.

One last bit that really got to me was the reference to egg freezing, where the author writes, "Would-be mothers have been freezing their eggs since the mid-'80s." Hold on a moment. Egg freezing may have been around since the 1980s, but was far from successful or mainstream as is implied here. In fact, egg freezing using vitrification (a rather new technology that was not around in the 80's) only lost its experimental label a few months ago, and is still primarily used for cancer patients, not so much for delayed childbearing.

The article then goes onto to talk about sperm banking and the high cost, at a big $850 for the procedure. But there's no mention of the way-higher-cost of egg freezing, which can run up to $10,000, not including the later IVF needed to conceive with the banked eggs, and not to mention the risks to the woman's health. (Risks, that yes, every woman has when using IVF. Sperm banking, alternatively, doesn't have any medical risks.)

I'm not poo-pooing everything the article states, and there are important points made. The concerns around ICSI treatment do need to be taken seriously, and the treatment should be used carefully. Older women and men do have a higher risk of passing on genetic problems to their kids (but so do other parents with other risk factors).

The bottom line: much of the article is conjecture, and a few things down right inaccurate. Unfortunate, really, since the topic is an important one to discuss.

What are your thoughts? Feel free to leave a comment below, I'd love to hear from you!

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December 18, 2012 at 8:33 pm
(1) HW says:

I am so glad to read this. I am 41and my husband and I are just starting fertility treatments. I read the article you are referring to last week and it nearly brought me to tears and has now scared me about potentially having a child with birth defects or some kind of learning or behavior challenges.

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