Mythbusters Part 1: The Dusty Old Ovary

I’m going to start a series of posts that I’ll call Mythbusters. The idea is to address certain myths associated with fertility and pregnancy. The purpose of our book is to help take some of the fear our of pregnancy and make it a journey of faith and peace. Misconceptions by friends, family and the media can add to the fear, often unnecessarily.

I recently had a nice patient come in for her pap smear who had the wonderful news that she had just gotten married. She was 26 and her husband was 27. She then proceeded to say something along the lines of “We don’t feel ready to have kids yet, but I’m worried since I’m SO old! Should we go ahead and try?”

Okay, so my first reaction, as an elderly 34 year old, was indignation.

Next I had one of those medical day dreams (like JD does on Scrubs):

I picture a serious scene with dramatic music.
“I need a crash cart STAT! These ovaries are dying!” I say.
“1-2-3….CLEAR!”
I then proceed to use the paddles to coax the dusty shriveled up old ovaries back to life.
” Phew! I saved one last egg in the nick of time.” I say with much bravado
“Thank you doctor! You’re so awesome! “ says patient
“All in a days work ma’am” I say and walk away into the sunset

Then, she clears her throat and I come back to reality. I begin to discuss the facts with the patient. First off you should not have kids until you’re ready. Period. While there is a slight decline in fertility at the age of 27, there is not a sharp decline until age 37.

“Yeah, but everyone says you need to have your kids by 35 because that’s ‘Advanced Maternal Age’” says patient.

How I hate that term. I hate it more since I’m breathing heavily down the neck of 35 as we speak. This term has to do with the risk of Down’s syndrome, which does increase with age. The age of 35 is when the experts originally recommended testing, because the risk of the test (aminocentesis) was less than the risk of the disease. Technology has changed and we don’t base our testing only on these figures, but much to my chagrin the terminology has remained. This has helped perpetuate the dusty old ovary myth.

Here’s the numbers:
At the age of 20 your risk of having a baby with Down’s syndrome is 1 in 2000
At the age of 35 your risk of having a baby with Down’s syndrome is 1 in 250
At the age of 40 your risk of having a baby with Down syndrome is 1 in 69
At the age of 45 your risk of having a baby with Down syndrome is 1 in 19

Let’s look at the numbers another way. What’s your chances of having a baby that DOESN’T have down syndrome:
At the age of 20 its 99.095%
At the age of 35 its 99.6%
At the age of 40 its 98.6%
At the age of 45 its 94.8%

Yeah. I like the second set of numbers better. So yes, in an ideal world, medically we should all have our babies when we’re 20. Socially, however, that’s usually not the best time. This is a personal decision for each couple.

Ok. So watch a good scrubs clip. Now, I’ll try to stay off you-tube,and get back to writing this book!

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