The Myth of Over 35

The Myth of Over 35

Dear Readers, I wrote this piece some time back and then sat on it because I didn’t really want to have a bunch of arguments about fertility issues.  For whatever reason, people just DESPISE older women having babies, and will get really bent out of shape over it, choosing to argue by dredging up old studies that have been completely debunked while ignoring all other studies and all anecdotal evidence (there’s nothing wrong with anecdotes, peeps, the word “anecdote” simply means a case study that was never published). This leaves me to expend massive amounts of time looking up studies to prove what I say is true, studies which are then typically ignored because people just despise older women having babies and will stop at nothing to try to prevent it.  Not only is this BORING and a pointless waste of my precious time trying to convince the unconvinceable, it also bears a stunning resemblance to what I do all day at my job as a fertility counselor, and since I write for fun, that’s an unpleasant experience for me.  

Additionally, and more importantly, the message I impart in this essay is hurtful to some women who have experienced premature ovarian failure, who wanted to conceive at older ages (and in some cases, even at younger ages) and couldn’t.  And hurting anyone’s feelings is never my intent.  It is entirely true that because odds of conception do wane with time, some women cannot get pregnant easily or at all over 35, 37, 40, and me sharing the reality that most women CAN is in no way meant to invalidate these experiences in any way.  I am simply trying to impart biological reality to women who have been terrified by liars and charlatans into imagining that all their eggs poof into dust on their 35th birthday, because for the majority of women, that simply isn’t the case.  This myth has caused misery and stress to SO MANY WOMEN and it is past time that someone begins to push back on it.  

I heard about a bit of a brouhaha on Twitter a few months back involving Stefan Molyneux, who’s some kind of terrible MRA pundit-y person.  He posted this little factoid:

This is the kind of thing I find outrageous because I run a fertility website and it’s blatantly, pathologically untrue.  And it’s the worst kind of untrue – just true enough to trick people into believing it.

On the surface of it, it is true.  Technically It’s from a study called Human Ovarian Reserve from Conception to Menopause

And here’s one of the scary, scary graphics from that study.

But if you go to the article and read the fine print, you’ll see that the “0” is actually 18-22 weeks before birth and the steepest part of the curve when egg reserve drops the fastest is between conception and age 20 (very few legitimate people are calling for women to have babies when they’re less than 20 years old, not even Stefan Molyneux, and to my knowledge no one is calling for babies in the womb to get pregnant, not even the Quiverfull Movement).

The reason why 90% of a woman’s eggs are “dead” by the time they’re 30 is because 50% of them are dead by the time she is BORN.  That’s right – the age at which a female human being has the most eggs she ever will is at 20 weeks’ gestation – somewhere between 7-10 million eggs, for most of us.  Then, for reasons we do not understand, while that little baby girl is still growing in her mother’s womb, half of those eggs die.  And they don’t stop dying, either.  They keep right on dying – a process called “atresia” – until puberty begins, at which point girls have about 300,000 eggs left.  And those eggs continue to age and die throughout our entire lives.  But despite all this, it is still more than enough as women will only ever ovulate about 300-500 of those eggs.

If that sounds unbelievable, let’s quickly do the math: Let’s assume you get your period at the age of 12, and have menopause at the age of 50.  That’s 38 years of ovulating, 12 months in a year, 456 eggs released.  And most of us skip out on at least some of those months due to irregular cycles, pregnancy, and breastfeeding, so we don’t even need that many.

So for Molyneux to claim “90% of all your eggs are dead by the age of 30” may be technically accurate, but it’s realistically bullshit.  It’s a math trick framed in frightening language.  If you start off with a very high number of something, and explode 90% of them, but only need a few, you still have plenty left.  Women only ovulate 300-500 eggs over their entire lives and most couples only want 1-3 children.  Although it’s true that we lose eggs very quickly before birth and up to puberty, and continue losing them across our whole lives, at age 30 the vast majority of women have plenty of eggs left to have 1-3 children!  Even the vast majority of women over 35 have plenty.  You only need ONE EGG to conceive, you don’t need to have millions of them waiting in the wings (which is fortunate since not even 20 year olds have millions of eggs!)  Most women can get pregnant at the dreaded 35 without difficulty, and many of us, myself included, conceived without trouble even over 40.  By the time you’re 43, 44, 45, the picture is less rosy, of course, (although still not insurmountable for some) – but that doesn’t mean that 30 year olds need to be in a panic over their dying eggs.

Eggs are bizarre things.  Most of them are truly born to die – in our mother’s womb, when we’re little girls, when we’re surly teenagers, and then every month we ovulate until menopause.  We actually develop 15-30 eggs in each ovary every month and only release the best one or two.  Additionally, 1000 eggs per month die without being developed.   These eggs are not “wasted”.  They are clearly serving some purpose that science does not yet understand, and rather than viewing them as precious resources that are being squandered by our stupid bodies doing stupid things stupidly, view them as an important and fully necessary part of the reproductive process instead.  For some reason we do not understand, we NEED those eggs.

We NEED those eggs to form and then die when we’re in our mother’s wombs.  We NEED those 1000 eggs to die each month.  We NEED those 15-30 eggs to start to develop and then stop along the way leaving only the best one to be released to greet their hordes of admiring spermy fans.  Because if we didn’t need them for something, those eggs wouldn’t exist, and our bodies would have some other method of ovulating (many animals do).  Those eggs are serving some purpose and it’s silly to act as if they were precious potential babies poofing into dust.

I mean, seriously – men make as many as 500 million sperm in one ejaculate, but only about 200 of those make it to the egg.  Do we look at those extra sperm as wasted, as a biological mistake, of course not, because historically most doctors have been men and men tend to see things their bodies do as right, and the things women’s bodies do as wrong.  Through most of human history we were in a kind of Medical Dark Age where women’s bodies (which are freaking insanely cool – it’s AMAZING how it all works, and if you have a female body, give it a hug! your body deserves it!) have been made out to be deeply flawed and in need of men to fix them, either by having sex with them or treating them medically.  The notion that women’s bodies are these ticking time bombs constantly about to explode in everyone’s faces while men’s bodies function the way bodies are supposed ta be is misogyny at its most insidious.

When some began to push back on Stefan’s ridiculous math, he changed tactics, but continued to mislead.

First of all, you can see how neatly he changes tactics within this tweet – he started off talking about women age 30, and then switches to 40-45 when called out on it.  I somehow managed to get into a Twitter spat with some other MRA wack job again recently over the same study, and he pulled the exact same trick – started off tweeting about how 30 year olds are “90% infertile” and then switched over to talking about 45 year olds immediately.  But this doesn’t pass the smell test – after all, all of us know lots of 30 year olds who get pregnant easily, and even plenty of 35-40 year olds, thus we all know instinctively that saying “90% of all eggs you ever have are dead” does NOT translate to “90% infertility rate” regardless of how someone tries to twist a study.  At age 37 you still have about 25,000 eggs left on average and that’s plenty to conceive with for at least a few years.

Telling 30 year olds they’re 90% infertile by using data regarding 45 year olds is a massive “how to lie with stats” switcheroo, isn’t it?  But beyond that particular act of sophistry, the rate of miscarriage across the ENTIRE population is believed to be 30% if you include chemical pregnancies (pregnancies that end very soon after a positive pregnancy test).  The rate of pregnancies that end after being medically confirmed by a doctor (including recurrent miscarriages) is 17-20-28% FOR EVERYONE regardless of age (the range of numbers is depending on the stats you use…different studies have found different rates because they were done in different sample groups).  So going from 17/20/28% to 34% is really not the huge jump that people might assume that it is.  And at least some of that risk can be mitigated by taking folate supplements, avoiding smoking, coffee, alcohol, and medication (including herbal supplements YE GODS ladies please enough with the herbal supplements, they are HARMFUL TO YOU no matter what your “naturopath” says), and following a lower carb, but NOT very low carb diet when trying to conceive.

Rates of Down Syndrome do rise with age as well but again, Molyneux goes directly from arguing about 30 year olds to much older women. 

Even accepting these stats at face value, they mean 999 out of 1000 women at age 30 will not have a baby with Down Syndrome.  399 will not at age 35.  99 will not at age 40.  And very few women have babies at 49!  The guy is using numbers that while gleaned from legitimate sources, he frames in a manipulative, smoke-and-mirrors way to scare 30 year old women – who have in most cases a solid decade of fertility ahead of them with risks only slightly higher than they did in their 20’s.

Brief aside, I feel the need to point out here that most women at the ages of 45+ DON’T WANT TO have children.  I think these scumsucking MRA play upon the natural desire of women in their 30’s to have children to trick people into subconsciously envisioning this barren future in which women sit around with a raging case of the sadz because they can no longer bring life into the world.  It isn’t like that.  It’s been shown in studies that women are HAPPIER after menopause.   Your life doesn’t revolve around your period or lack thereof!  Think about it – those years between 25-50 you had time to do all these things you like to do, well, the years between 50-75 last just as long only you have even more time to do them in!  Just because you have different priorities rather than being pregnant and whatever mischief your toddler is getting into and going to shitty school programs, that does not mean you are unhappy, depressed, longing for youth/death, or any such thing.  (I kinda wonder if this is men projecting their OWN fears about old age onto women…hmmm…)  When you get here, you’ll know, but in the meantime, take it from an old chick, 50 is fabulous.

This is what 50 looks like:

No dried up old crones here.  Still happy, still healthy, still energetic, still surrounded by friends and family, still brimming over with purpose in my life, still looking forward to the next 25 years and all the crazy shit I’m gonna pack into it. 

And another brief aside, why do we act like Down Syndrome is the worst thing that ever happened, anyway?  Ya ever met anyone with Down Syndrome?  They’re fucking AMAZING and if the worst thing a person ever experience in their lives is getting to know and love a person with Down Syndrome, that is a blessing, not a curse.  QUIT ACTING LIKE DISABILITIES ARE PRISON SENTENCES.  They aren’t.  People live with disabilities and loved ones with disabilities every day, and the fact that so many conservative men particularly (because this is a conservative feminist blog, y’all, in case you forgot) have fallen under the spell of MRA and buy into the notion that women over the age of 35 must not be allowed to breed under any circumstances because they have a higher chance of a baby with Down Syndrome flies in the face of what being PRO-LIFE even means.

You may wonder why this matters, I mean, srlsly, why do I even care, whatever, forget it Jake, it’s Molyneuxtown.  But it matters because a lot of women are TERRIFIED at 30, at 35, at 38 – that they’re infertile or will be any minute.  Women are in a panic and going to see specialists and taking countless herbs (which in many, many cases DIMINISH your odds of conception, make your cycle highly irregular, and can even cause miscarriage) and dangerously high doses of vitamins/fish oil/aspirin (high doses of blood thinners can also cause miscarriage, and may even KILL YOU) and having Mayan Fertility Massages (yes, that’s an actual thing) out of this totally misguided fear that their eggs are all poofing into dust when they aren’t – or they are, but it’s by design.  Women are making insane life-altering decisions like marrying irredeemable douchenozzles at freakishly young ages and passing up on career opportunities because of this misinformation.  Women who DO NOT NEED IVF are mortgaging their homes and charging up credit cards pursuing IVF after only a couple of months of trying – taking the doctor’s time and energy away from actually infertile women who DO need IVF to conceive.  Women are spending their entire pregnancy stressed thinking they’re “high risk” (stress – not good for pregnancies!) when they’re only 30 years old.

IT IS ALL BULLSHIT.

At the tender age of 30, let alone 35, a fairly huge chunk of women have been brainwashed into worrying themselves into a state of panic thinking they won’t be able to have kids or more kids because some click-seeking pundit on the Internet posting a misleading study.  Women, and not a few of them, either, are existing in a perpetual state of existential terror thinking they have to fall pregnant in a month because they’re 32 and they JUST KNOW they’re like totally infertile or whatever if it takes them three months instead (this is totally normal!!).  Lest you think I exaggerate, I have to talk people down off this fertility ledge every darn day because of misinformation like what Molyneux is peddling.  Literally just yesterday I had a 28 year old worried that she “wasn’t as young as she used to be.”

It’s ridiculous.  Completely and totally ridiculous.  But is there any truth to what he’s saying?  We wouldn’t be doing our jobs here if we didn’t look at how this all REALLY works. So look we shall.

We’ve all heard that fertility drops suddenly, precipitously, dramatically, drastically, shockingly, like a stone, insert your over-the-top frightening adverb of choice here, once a woman hits 35.  I regularly, REGULARLY have people who come to me and think there is some magical event that happens on their 35th birthday, like a switch gets flipped, a bomb goes off, and good eggs suddenly turn bad.  This is NOT SO. 

There is, absolutely, a gradual decline in overall fertility and egg quality that starts off…you guessed it – back when a woman is in her mother’s womb, and continues over the course of an entire life.  But declining fertility is like walking down a hill – as we age, we start walking a little faster over time and the hill gets a little steeper.  Our eggs do decline gradually in quality as we age.  But there is no appreciable difference between a woman’s eggs a month before her 35th birthday, and a month after, or 2 months after, or even a year after.  35 is simply the age where across the entire population, this decline in fertility becomes statistically observable, and rising rates of negative events such as miscarriage, chromosomal abnormalities, and high risk pregnancy also begin to become statistically observable.  

Despite this, a woman over 40 has about a 5-7% chance of conceiving in any given month.  But considering that 30 year olds only have a 20% chance of conceiving in any given month, this is not as huge a drop as you might think.  And this is BY MONTH and NOT overall (huge misconception!)  These statistics do not mean that only 5% of women over 40 will ever get pregnant, but that in every month that passes, 40-plus year olds who are trying, 5-7% of them get pregnant.  (this number is higher for the average 40 year old than the average 45 year old, of course, because they’ve walked further down a steeper hill.) Keep trying, and if you’re still fertile, even though you’re not as fertile as you were at the age of 22, you can expect that 5-7% chance every month.  

That sounds scary low, but consider this – even younger women only have a 20-30% chance of conceiving every month!  It takes fully fertile couples an average of 3-6 months to fall pregnant.  According to the NHS, women 19-26 92% will get pregnant in a year and 98% after 2 years.  Women 25-39 82% will conceive after 1 year, and 90% after 2 years (hey, wow, that 90% includes even those women over the dreaded age of 35!!)  If you use timed intercourse (being sure to have sex in the fertile window, which lasts 2-4 days for most couples) the average couple can boost their chances of conception per month from 10-15% to 14-23% depending on their age. 

Even at 40, your chance of conceiving within a year is 40-50%, much higher than the gloom-and-doomers would have you believe.  And it may be even better than that for many women.  A peculiarity of medical studies is that when you’re studying a group of people who does something that is inherently not random (such as, women age 40 getting pregnant, which has historically not been terribly common) it skews the results.  Until very, very recently, relatively few women got pregnant over 35, let alone 40.  Because women tended to marry young and have children right away, most women had already completed their families by 30, let alone 40.  They were no longer trying, so we cannot know how easily (or not) they might have conceived. The vast majority of women who were trying at age 40 (again, until quite recently) were women who for SOME REASON had not had children by then.  Such reasons include fertility issues and overall poor health both of which lower chances of conceiving considerably.

That’s right, all those scary numbers you’ve read about were based NOT on a random sample, but on women who were basically handpicked to be more likely to have fertility issues to begin with.

The truth is, we honestly do not know what a woman’s real chances of conception at 40 are.   We do know that by the time a woman is my age, 50, she is at a pretty high risk of infertility/miscarriage/chromosomal abnormalities/pregnancy complications were she to get pregnant, if she could, which I probably couldn’t, thank heavens, because I already have so many children I have to lay them down to sleep in laundry baskets and the bathtub.  But this decline in fertility/rise in risks is MINOR especially at first.  A woman who is 39 is at a much lower risk than a 49 year old, and a woman who is only 35 is significantly lower still.  And if you’re 30?  Fugetaboutit, girl, you’ve got time!  Your eggs poofing into dust is not something you need to be worrying about. 

Tell Stefan to eff off and you do you.  

Again, this is across the entire population.  A good many problems that affect fertility or raise chances of miscarriage and pregnancy complications, are treatable, controllable, or avoidable.  A good part of the reason why pregnancy risks (aside from egg quality issues) go up as women age is because more people in that cohort have those problems.  High blood pressure, diabetes, thyroid disease, autoimmune disorders and many other ailments become more widespread as a population ages and all of them can cause reduced fertility, greater rates of miscarriage, and for a pregnancy to be higher risk.  But if you don’t have these problems – or if you do, and you’re being medically treated for them – and are in otherwise good health, the odds are excellent your pregnancy will go just fine for both mother and baby, even IF you do suffer a complication.  

People are bad at analyzing risk.  It’s just a fact.  So people who are less bad at it like, oh, I don’t know, DOCTORS, who go to school a really super long time to learn…something, right?…ought to be far better at breaking this information down for people.  Doctors and other medical professionals have GOT to do better at communicating the reality of risk becasue otherwise Stefan Molyneux is going to do it instead.  The vast majority of people over 30 are able to get pregnant just fine.  Most people 35 plus, even up till 40, and maybe a little beyond, are able to get pregnant just fine.  It may take a bit longer and older moms may have slightly more miscarriages and slightly higher risk of complications than the population as a whole, but if they’re in good health and living a reasonably healthy lifestyle they can have healthy pregnancies with healthy babies.

Why is it that we’re not told these things?  Because we are NOT being told these things.*

I was amazed to learn most of the numbers that al legedly “prove” that women have trouble conceiving over 35 came primariy from birth records compiled in the 1600s through the early 1800s.  That’s right, those oft-quoted statistics come from a time before prenatal vitamins, before antibiotics, from a time and a place where diseases that left both men (during the past, in many cases if a couple did not have children it was assumed to be the woman, but we now know it’s just as likely to be male factor infertility) and women infertile such as syphilis, mumps, and rickets, were endemic.  More recent data paints a much happier picture of the ability of 35-40 year olds (let alone 30-35 year olds!) to conceive.  

I think the most likely explanation for this phenomenon is that the medico-industrial complex doesn’t want to admit they were wrong.  They’ve spent the past several decades declaring loudly and constantly that you’re risking your own life and your baby’s life if you get pregnant over 35 IF you can even conceive at all, and for them to turn around and say “welp, as it turns out we were using data FROM THE 1600s-1700s TO PROVE THAT and oopsie it appears we were just a tad bit wrong” I’m sure would be pretty embarrassing.  So they aren’t saying that. 

For the less cynical in the audience, even if it’s just the idea that OBGYN’s and pediatricians don’t want to deal with any elevated risk factor since it’s stressful for them and makes more work – hey, I understand how that could be.  I can understand that.  You’ve seen some horror stories, you may be overly proactive in warning people from taking even remote risks.  But if you’re a skeptic like myself, you may even stop to wonder “hmm, fertility doctors are actually profiting on promoting this myth, scaring every woman who got two negative pregnancy tests in a row into thinking they’re infertile and need IVF to the tune of $30k” and it seems a little more sinister.  I’m not saying it’s true, but I’m just saying it occurs to me it could be true – and I’ve seen enough clients go to visit a reproductive endocrinologist and come out convinced they need IVF, only to conceive naturally on their own with ease, to find it plausible.

And don’t even get me started on the herb and vitamin peddlers, who have made a cottage industry out of giving women herbs that actually CAUSE fertility problems in the guise of “curing” fertility problems that women don’t even have.  That’s a whole ‘nother article there.  Suffice it to say, if you’re over 35 and want to conceive the very best thing you can do is not take herbs or massive doses of vitamins even if your chiropractor told you they were great and that you had “adrenal fatigue” or “estrogen dominance”   or some other medical-sounding issue that is probably not even real or is a pathologicalization of a normal biological state.  If you’re taking herbs (while wondering what became of your period and why your hair is falling out now) because you read online that “women over 35 are infertile” please toss them in the trash, and if you’re not on them, I beg you to never start.  Herbs cause fertility problems for a great many people who start taking them and if you go to your naturopath with this problem and their solution is “take more herbs” please throw your naturopath into the garbage as well.  

Diet quacks are also partly to blame.  The whole “eat lots of carbs, not much meat, and everything low fat” diet that was recommended by “experts” most of our life is proving to be utterly terrible for egg quality.   The second best thing you can do to help yourself conceive after ditching herbs and those who prescribe them is to eat a lower carb (but not VERY low carb), higher protein diet that has good levels of healthy fat.  Keto diets can also be quite bad for fertility, disrupting the menstrual cycle of many women on it. Your best bet is a Mediterranean-style diet with whole grains, healthy fats, fruit, veg, low or no sugar, and a good amount of protein and healthy fat.  And exercise MODERATELY – not too much, not too little.

Lastly, like I mentioned in the intro, people have SUCH a passion for hating older moms!  It seems almost primordial to me, like it’s tapping into some sort of vestigial animal programming or something.  And who knows, maybe it is.  People have a vested interest in controlling others’ behavior, from an evolutionary perspective.  Historically, it very well may have been the case that the villagers didn’t want to see Abraham’s wife Sarah getting pregnant at a very old age because they might have had to care for the baby when she died.  These kinds of primitive fears hang on in our guts even though we live in the modern world.  We may have anxiety about older parents written into our very DNA – but like Katharine Hepburn said in “The African Queen”, nature is what we were put on earth to rise above.

But did you notice what I noticed about all those people?  All of them are benefiting in some way or another from scaring women into thinking their fertility is tanking at a very young age.  Whether they’re selling IVF, herbs, diet programs, or are just busybodies who like to tell other people to run their lives, none of these people necessarily have women’s best interests at heart when they terrify them with horror stories about dying eggs and pregnancy complications.  I’m not saying they are evil monsters out to get innocent women, of course, but I’m just saying they have their own motives for keeping women insecure about their fertility.

The unfortunate thing about this essay is that I actually share Molyneux’ outrage about some of this stuff.  The fact is, even though it’s not as sudden a drop as people claim, fertility does decline with age and risks do increase.  That’s just reality.  Please don’t take my pushing back on scaremongering as a denial of that reality.  There are women, quite a few of them, who did postpone having children and ended up childless or having fewer children than they desired as a result.  

I can’t disagree with the guy here.  Really can’t.

The women of at least 3 generations – the Boomers, my cohort Generation X, and the Millennials, were indeed sold a pretty massive bill of goods about their ability to get pregnant at older ages (Millennials, it’s not too late!!  Learn from our mistakes!)  We were told that we HAD TO have a solid career and a long term, very stable marriage to a man who was “ready to be a father” before we could even consider having a child.  And that left a whole lot of us looking 45 in the face and realizing we had done everything but that one thing that mattered the most. 

But the answer to this is NOT to turn around and sell women of future generations some OTHER bill of goods that is equally untrue.  Stefan Molyneux should have made his case without resorting to deceptive fearmongering with a healthy dollop of misogyny, and if he had, I would have applauded and agreed. 

*While I was lucky and had a supportive doctor and great medical care for my pregnancies at 37, 39, and 42, the stories I have heard from many of the women on my fertility website are haunting – medical professionals saying absolutely inexcusable things, offering unsolicited life advice, outright lying about a woman’s chance of having a healthy pregnancy, denying women medication that is medically indicated because “you already have enough children”, even pushing people to have highly invasive tests (despite there being better tests available now) like amniocentesis, that in a few cases caused the loss of genetically normal babies. This is not ok.

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