I personally think it is amazing how much we talk about our reproductive options these days. We hear about how “free” women’s lives have gotten–we can now marry or not marry; chase a professional goal or stay at home as a “housewife”; have children or not have children; if we want a child, we can now choose when and how…
But when it comes to having children, obviously things are not so simple. While women have more access to professional success than ever before in history, a lot of anxiety seems to accompany our new gains. Everyone knows that successful woman who seems to have everything anyone could possibly want in life–only to be challenged daily by the one thing she doesn’t have: a baby.
The fact is that there are a lot of things one can want in the world, but only 24 hours in a day. Some things are infinite, while some things are finite. Time is finite, so is the number of eggs in a woman’s ovaries. These two pieces of fact send thousands of women in Singapore to the IVF clinics that have sprung up in a number of places on the island.
Assisted reproductive technology (ART) is becoming an increasingly common, go-to option for late-marrying couples. Whether through egg donors, intrauterine inseminations or IVF (In vitro fertilization), more and more options are becoming available for couples to gamble with fate, or biology. It seems that if you cannot decide on your priorities in life, that decision can be postponed. You can first carve out your place professionally and the reserve option of ART is always there, just as long as you have the money for it (currently, one cycle of IVF can cost up to $20, 000 in private clinics, although government subsidies can be applied in some cases).
Yet IVF is far from being a reassuring “reserve option.” As Danielle Moylan describes for the New York Times, although IVF is a very common procedure, it can remain a rather mystifying and deeply frustrating one. The fertility business is booming as birth rates fall in the wealthiest of economies around the world. Unfortunately for its consumers, fertility clinics are mostly unregulated. Moylan opines: “For such a common medical procedure, statistics are hard to find, difficult to understand and flawed, sometimes even excluding women with the poorest prognoses.”
Things are made murkier in the IVF world through the fact that statistics are competing against something much stronger: human hope, the need to leave something of yours, something of you, behind in this world. Despite falling birth rates, that need seems to be a rather resilient one, which explains the boom in the fertility business.
If you are trying to conceive after the age of 35, the statistics can hit you like a tidal wave. This is made no better by the fact that most statistics are tied to some opinion about childbirth. In Singapore, a recent article in Today set out to debunk 5 myths about fertility. Somewhere in there, you encounter this disheartening fact: “Studies have shown that a 30-year-old woman has an estimated 20-to-25-per-cent chance of conceiving naturally with every menstrual cycle.” But in your mid-20s, the chance of conceiving, during the most fertile days of your period, is only about 33%. If I put it this way to you, is there really so much of a difference between 25% and 33%? Yet, when a piece of statistics is presented to you in isolation (“at 30, you only have a 20% chance of getting pregnant”), you might think that the contrast indicates a 100% chance of getting pregnant at 20 (which of course, is not true). And you might think that having only a 20 or 25% chance of getting pregnant, in comparison to 100%, is pretty hopeless.
I am not saying it is not much more difficult to conceive at 35 as compared to 25. Of course it will be harder to conceive when you are older! I am saying however that exactly how much harder it will be to conceive at 35 vs. 25 is hard to tell from the numbers alone. One fact seems to be true: Even if chances are still good that you can conceive after 35, your chances of a miscarriage or of a fetus with birth defects do increase.
The fact is that despite having technology for scanning for the number of follicles left in you, or for counting the number of eggs left, there is a lot left unanswered in birth-centered technology. After all, there is still a miraculous element to birth. Women who are undergoing IVF in their 30s never quite know how much they should allow themselves to hope for that miracle (or how much of it is indeed a miracle). And IVF–from all accounts I’ve read–seems to be a deeply challenging and frustrating experience. The statistics continue to be manipulated in the name of profits for the fertility clinics. Some might advertise a success rate of as high as 40%. The truth hovers around 20-30%. Note moreover that pregnancy rate is not the same thing as live birth rate. An IVF cycle could lead to a pregnancy, but miscarriages also happen. Using donor eggs from a younger woman increases the chance for success in IVF, but most women would baulk at the idea of having someone else’s baby growing in their womb.
So, how much can we really manipulate biology? These days, we seem to have more options than ever before to manipulate biology towards our own needs and preferences. But the frustrations seem as endless as the possibilities. If you are someone trying to conceive, I can only tell you to do your research intelligently in terms of the “numbers” presented to you. Trying to conceive after 35 is far from impossible, but it seems that you will nonetheless need some patience and faith for the journey ahead. And don’t be fooled by the numbers!