The Myth of the Biological Clock?

Last year an article came out supposedly debunking the idea that it is more difficult to conceive after 35.  Women around the world cheered, and jubilant articles were written, applauding how science could finally free women from the pressure to start their families before they were ready and the guilt they might feel if they didn’t. Let’s celebrate ladies: the notion that our bodies are too old to reproduce is just another way the patriarchy has been trying to keep us down and out of the workplace.

Now, the articles and critiques are reappearing upon the publication of Tanya Selvaratnam’s book The Big Lie: Motherhood, Feminism and the Reality of the Biological Clock, which addresses the conflicting information women receive about the reality of their bodies and reproductive capabilities and the media focus on the many celebrities over 35 or even 40 having children seemingly effortlessly.  This morning I read an article in Salon by Mary Elizabeth Williams that criticized Selvaratnam for blaming feminism for never tackling the issue of fertility. My first issue with Williams’ piece was that I didn’t think her examples of previously-written articles did much to debunk Selvaratnam’s thesis. Secondly, this quote:

Can we stop setting up the straw man, as Selvaratnam does, that “Biology does not bend to feminist ideals”? Because I’ve got to tell you, I know a lot of people who’ve been to hell and back trying to become parents but I don’t know a single one who put off motherhood because she was a self-centered pawn of feminism.

Here’s the problem. I don’t think any of the journalists who write pieces like this have ever been to a fertility clinic. I have the dubious honor of having been to three different clinics on our 4-year journey to parenthood and I can assure you that at ages 28-31 (hardly a spring chicken), I was often one of the youngest patients in the waiting room. I joined fertility message boards and read blogs from other going through infertility and again, there is a decent number of women who were over 35 trying to conceive.

It’s kind of funny because when I was in the trenches and would read articles escoriating “those women” in fertility clinics for putting their jobs first and bringing their conception problems on themselves, I wanted to scream that not all women having trouble conceiving were older (age was one of the few things Jimmy and I had going for us). But that was the perception: trouble conceiving = advanced age = selfish bitch who put her career ahead of family.

So my question for Williams and others is just who are those women over 35 in fertility clinics? Why are they there? Was it because they just didn’t meet the right person until later in life? Maybe. But the bottom line is that for many women, they are in the clinic over age 35 because they put off having a baby for whatever reason. Maybe it was their career. Maybe it was because there were other issues. Maybe it was because they wanted to travel, see the world, whatever. It doesn’t really matter WHY; what matters is the fact that they delayed childbearing and then found themselves in a fertility clinic because they were having problems conceiving.

Now it appears the tables have turned and women supposedly have more time to conceive and woe anyone who dares to question that “fact.” Because science.  This change is troubling because, well, SCIENCE.  The fact is that while humans have made incredible gains in longevity, basic biology hasn’t changed. Maybe in a few thousand or hundreds of thousands of years, our reproductive organs will catch up to the fact that we can live longer lives, but the reality is that fertility declines with age, especially for women. And if you do conceive, you have a higher chance of miscarriage or having a child with a disability. I’m not going to cite the facts; you can read many of them here. Yes, yes. I know. We all know women who have conceived on their first month trying at age 40 and gone on to have a healthy baby. And of course, celebrities and their apparently amazing fertility after 40. Those are the outliers. Those are the examples that tempt us to believe we have more time than we do.

Selvaratnam is correct in that frank discussions about fertility are a feminist issue. We cannot change biology and the basic fact that the human body is best suited to reproduce in its 20s when we are busy building careers. Yes, I know that SUCKS, but feminism cannot change that and needs to acknowledge that. You know what feminism could change? Policies that make it career vs family. Policies that make it easier to delay childbearing because it hurts your career and earning potential to have a child. We’ve read the articles that tell us women who have children are often mommy-tracked and lose earning potential. That’s what we need to change. That it’s not career OR family but career AND family. The ability to downshift for a few years when children are young. Affordable, quality daycare. Supportive workplaces and flexible schedules.

At the very least, feminism could lead discussions about basic fertility. Why aren’t we taught more about our bodies beyond ovaries, eggs, fertilization and menstruation in school? Every one should be required to read Taking Charge of Your Fertility. I was amazed by what I learned about what my body could do and tell me (mine wasn’t working so well at the time, so it was mostly theory but still) and shocked that at almost 30, I knew none of that information. Put off having children if you want, but at least make that decision knowing the facts about female biology.

But…wait! What about those treatments in the fertility clinic? They allow women to have babies. It’s cool. I can just saunter into a clinic and have IVF whenever. Maybe even get twins! Fertility treatments let us overcome age and are actually a source of empowerment! Oh dear. Bless your heart. Reproductive technology is awesome, and I salute science for helping me to overcome my fertility issues to have my son. But folks, it is not a panacea. Clomid != baby. IUI !=baby. IVF !=baby. What assisted reproduction does is give you a chance, increase your odds.  The stats surrounding success rates for these treatments are fairly dismal. You may have a 0% or 10% chance on your own; IVF may increase it to 30%.  Yes, those are improved odds but not necessarily ones I’d take to Vegas. If I saw we had a 30% chance of it raining, I’d assume that rain was unlikely.

Age rears its ugly head in fertility treatments too. Over a certain age, you may not produce many eggs and the ones you do may not fertilize or develop.  The doctor may tell you your best bet is to use the eggs from – wait for it – a donor who is 10-15 years younger than you are. The only reproductive organ age doesn’t impact as much or can be overcome more easily is the uterus, which is why you read about 60 year old women carrying their own grandchildren. Part of the problem is that beyond concluding that eggs are old and of diminished quality, doctors really don’t know much more about egg quality and why some IVFs work and some don’t. What they do know is that their success rates decrease dramatically for women using their own eggs over 35. Frankly, successful conception is a crap-shoot for everyone, regardless of age.

Speaking of empowerment, there is little empowering about fertility treatments. I did 6 clomid cycles, one injectable IUI cycle, 2 fresh IVS, and 1 FET. I’ve also had a HSG, 2 laps, and a lot of pain. I have one child. I can think of little that is empowering about the following:

  • Feeling rage, hot flashes and irrational while taking Clomid.
  • Having a doctor tell you that maybe the excruciating pain you feel that makes you seriously contemplate a DIY oophorectomy is normal for you
  • Bleeding daily for months
  • Finally being in a position to afford children only to have to pay exorbitant sums to attempt to have a child (outcome not guaranteed)
  • Feeling depressed and unable to focus at work because you are focused on how you feel less of a woman; you are supposed to be able to do everything – why can’t you have a baby? And why isn’t your career enough for you?
  • Hating your body because it failed you so spectacularly (hardly body acceptance)
  • Accepting that your only path to a biological child is for another woman to carry your child (are you Mom Enough? Apparently not)
  • Looking like a heroin addict thanks to daily blood draws at the clinic
  • Two weeks of painful shots of progesterone-in-oil (PIO) in the butt
  • Becoming comfortable dropping trou and extremely familiar with the “dildo cam”
  • Lack of focus at work because you are in and out for doctor’s appointments and waiting on the daily call on your hormone levels; sobbing uncontrollably when the levels don’t cooperate
  • Having little control over your reproductive outcomes; that control resides in the RE, usually a man, which isn’t necessarily bad, but it does reinforce a power differential
  • Having your clinic break up with you because you are a hopeless case and they don’t want you to ruin their stats.

Those are just a few I can think of based on my own experiences. Others have more examples I’m sure.

The point of this post is not to blame or shame. Do what you want, wait as long as you want, but do so armed with information. Understand that every decision has consequences. Understand that it sucks for women because our biology pits us against other goals we have that don’t involve children.  And it isn’t talked about. Not as much as it should be.  Ann-Marie Slaughter alluded briefly to the fact that she waited until her mid-to-late 30s to have her children and did experience trouble conceiving, but that tidbit was lost in the brouhaha about how she dared to tell women they couldn’t have it all and that they needed to think carefully about their choices.

So maybe feminism didn’t lie overtly to you about putting off having babies, but at the very least, it was a lie of omission. We can do better than that for each other.

 

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15 comments

  1. I so so agree about the Taking Charge of Your Fertility. Life. Changing. Why don’t they tell us this stuff in health classes? I was 29 when I read it and had NO FREAKIN’ CLUE that cervical mucous had a purpose, let alone its change/consistency indicated what my body was doing. 29. I should know my body by then! Unfortunately, no one ever reads it.

  2. I read Taking Charge of Your Fertility at 31 and also had NO IDEA about any of it, but of course, I’d had the impression that I knew everything I needed to know already. I saw Salon’s article yesterday too and was similarly left with a bad taste in my mouth. I completely agree with you that feminism did lead to a lie of omission, because the stereotype of a feminist is someone who doesn’t get married young, who doesn’t have children young, and who is driven career-wise. I’m not saying better conversation about biology would have changed my decisions, but the problems I encountered in family-building wouldn’t have been such a shock. I would have been better equipped to advocate for myself too. Great post!

  3. I have friends in my class who are young and are already stressing out about when they are going to have kids if they want to pursuit whatever medical specialty they want to do. You’re right that society needs to stop making women feel the need to choose between career and family. I’m rare, I did both at the same time, but I am still considered an “older” student and I am still behind the game with where if am in my career… Not because if having kids, but because I changed careers. I don’t know what I would do if I had to choose. However, I know that most people in my stage of the game are extremely envious that I somehow pulled it off…

    1. I know that having kids as a PhD student or medical student is very difficult, and I admire you for being able to do it even if you ended up being that “older” student! But hey, if you can have kids and go to medical school at the same time, I think you can do almost anything!

  4. Gosh, all of the above is so, so true. I just got “lucky” I guess. I never really wanted children until I met my husband, but we didn’t even meet until we were 30, and then didn’t get married until we were 34. Started trying right away, and while we were working on sperm issues, saving for IVF, etc. my egg quality/FSH levels/etc. diminished tremendously from age 35 when I first got tested and 37 when we attempted our first IVF. Three IVF’s later, I got pregnant. Unfortunately our fetus had a genetic abnormality, which ironically usually comes from the sperm and not the egg. Sad to think my last decent egg got mixed up with a bad sperm. I guess it’s good she did it at conception rather than as a teenager? Ha.

    I certainly didn’t put off kids because of a career, I just wasn’t ready. Sometimes I wish I had just gotten knocked up during my wild single days, but then it wouldn’t be as special. I didn’t always have the desire to be a mom – that desire manifested when I was older and in a relationship. I suppose if anything, perhaps feminism stopped many from being pushed into a marriage and kids before they were ready. Does it mean having kids at an early age is better? Not at all. I can’t even regret the time it took for me to “afford” IVF. Bitter and angry, but not really regretful. Sigh.

    1. It’s tough because I know I wouldn’t have been ready or wanted kids at 25. 28? I thought I was ready, but truthfully, IF helped me pursue a graduate degree. Sometimes it comes down to choices; sometimes it comes down to fate/kismet/the universe/the hand you’re dealt.

  5. The issue have with her take on feminism and the blame she placed on it is that, while not perfect, it has help women decide if motherhood is even something she wants or not. And it has help choose a right partner and not just anyone because s/he is there at the time.
    I also married late and had a financial goal before wanted to have a child, I wouldn’t trade my partner or security for anything. Yes, I’m childless now, but I’m at peace with this decision.
    Don’t blame feminism for infertility, but blame the patriarchy, religious groups and the purity/slut BS that is thrown around, I mean, how many grew up with the thought that even looking at a boy would get us pregnant?! And now, people act surprise it doesn’t happen that way.
    I think, there are so many women that hate to be labeled “feminist” because of all the stigma it carries and when things don’t go right, the first thing they blame is feminism. And Selvaratnam isn’t helping either.
    And if I never see the whole “having it all” tripe again, won’t be soon enough.
    Feminism is also what’s behind having a better understanding of our bodies and sexuality; and yes, I agree with everyone here that we need to do a better job collectively on this. Yes, more is good.
    In addition, you can’t just take the increase in number of childfree women alone, per example, and assume all of them wanted to have a child. Because if you think that way, the argument is very flawed.
    In conclusion, I felt that Selvaratnam was all over the place.
    kind of like this rant.

    1. Oh, I definitely agree that the increase in childfree women should not be tied to a thwarted desire to have a child. Just as we are slowly accepting that a woman can stay home OR work, we are slowly accepting that you can have children OR not have children and those are all legitimate choices. Slow-going but improving. I don’t blame feminism for infertility, but I do think there is a squeamishness about talking about the realities of situations that cannot be overcome – like biology – by sheer force of will and policy change. Here’s a radical thought – maybe if more women (and men) understood biology and human reproduction, all this BS stupidity about how BCPs are abortificants and such nonsense could be avoided.

  6. I actually liked large chunks of the Salon piece today and have been turned off by the book most because I don’t believe we were ever lied to. Confused by conflicting messages, maybe. But no one ever told me that I could conceive any time I wanted to and to just wait until it was convenient to me. I was encouraged to start trying to procreate when I was ready to procreate. And I was 27 the first time around in the clinic, and seemed to be around the same age as the fast majority of the waiting room. I didn’t see a lot of older women.

    There are so many places in life where we are lied to; where facts are obscured because money changed hands and we’ve been told by a gov’t agency something is okay for us and then told later that it causes tremendous harm (and sometimes that is because more studies are done that refute the first studies). But this isn’t one of them. And when she claims she was lied to or that we are lied to, I start focusing on that rather than her main argument about what we aren’t taught.

    I agree with you that more needs to be done about making career/family not an either/or situation. But I have to be frank; in a lot of fields, it isn’t either/or. In a lot of careers, family building is an accepted facet of life and it’s still possible to get ahead and still take care of responsibilities at home. And some fields are way behind the times and don’t allow for that growth if you take the family building route and you’re female. But I think we need to focus our efforts on those careers and not paint the whole culture with one brush.

    1. It sounds like you and I had very different experiences 🙂 I agree with you that “lie” is inaccurate. That’s why I made the point about it being more of a lie of omission. I think what got me was possibly her NYC reaction to the book and its points. You can’t disagree, though, that we receive mixed messages from society about what women should aim for and how fertility is still plausible for everyone at older ages. Sure, we should have the common sense to realize that maybe we’ve been sold a bill of goods by pop culture and shouldn’t base our knowledge of biology on Halle Berry and Mariah Carey. I think that’s where feminism could have stepped in and helped clear up a few things. I do think this current wave of feminism is still reluctant to tackle family issues, and I do think some women – myself included before we had “the Trouble” – thought that fertility clinics would be the answer to any problem we had conceiving. Sooo maybe this wasn’t the most cogently-argued post, but I really, really, really don’t want women to get the idea they can put off having families and always expect it to work out. We have made such strides through Resolve and the blogosphere in helping people understand the causes of IF – including aging – and it would be terrible to see that work undone.

  7. “You know what feminism could change? Policies that make it career vs family. Policies that make it easier to delay childbearing because it hurts your career and earning potential to have a child. We’ve read the articles that tell us women who have children are often mommy-tracked and lose earning potential. That’s what we need to change. That it’s not career OR family but career AND family. The ability to downshift for a few years when children are young. Affordable, quality daycare. Supportive workplaces and flexible schedules.”

    This! THIS!!!

  8. There are too many thoughts swirling around for me to make any kind of coherent statement. But I want to add to the point of education – it’s not just lack of teaching in schools, I think it goes back to doctors not taking seriously that young women can have fertility problems and helping them learn about how their bodies work. (long story ahead sorry) When I was 16 I went to a NP in my mom’s OBGYN office because I had irregular – to nearly non-existent – painful periods. I was put on the pill. When I asked if this would affect my ability to have kids someday I was told I didn’t need to worry about that now. When I was 23 I was diagnosed with PCOS. I asked my GYN if this would affect my ability to have kids someday. I was told not to worry about it, when I was ready I could just take a pill and it would cause me to ovulate and I could get pregnant. After I got married and asked the NP I saw for my annuals when I should go off the pill since I was pretty sure I was going to need “help” getting pregnant I was told “You’ve been on the pill so many years you don’t know what your body does. Go off the pill and try for a year” (Well I do know exactly what my body does thankyouverymuch. One or two super long super painful periods a year). I went to a new OBGYN after 4 months who gave me Provera/Clomid (which I waited another 2 months to take because while there is never a good time that would have been a very bad time) and I didn’t ovulate (I was temping), got a BFN, and no period. I called the doc and told him I didn’t think I ovulated – he saw me, did an internal, refused an ultrasound, said he was pretty sure I did ovulate but would check my estrogen (I think it was) to confirm and appease me. Then he said wait 10 days take another round of Provera/Clomid and THEN SAID Your young (27) just relax it will happen.” I then called the RE who I saw in the middle of that second Clomid cycle which I started before 10 days. I was 5 DPO at that meeting and what the RE said was “I get that this is stressful for you. You are doing the right thing by coming in now. We will get you pregnant.”
    ELEVEN years and multiple doctors for one to take me seriously – and I am fully aware that I am one of the very lucky ones who only took two Clomid cycles and have a second unassisted pregnancy.
    BUT the important point here is that along the way the message I was getting is, “you’re young. you don’t need to worry about your fertility right now.” Which is really the “feminist message” of do whatever you want, live your life and when your ready science can do it. Which is all a bunch of crap.

  9. I also wish that adoption was a bigger part of conversations about fertility and feminism. It’s not to say that adoption is easy or guaranteed. But when biological children are the only option discussed it puts that goal as the only path to motherhood and makes all of those negative things you mention acceptable for that goal. If adoption was a more acceptable path to parenthood, and more people understood their options, I think that many would opt out of any fertility treatment and maybe waiting wouldn’t be so scary. It’s often shocking to me what people will put their bodies and relationships through, never mind how much they will spend, before they even consider adoption. It’s the last choice and that doesn’t make any sense.

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