TODAY   |  June 05, 2013

Doctors caution patients on fertility and age

Women have long been concerned about their biological clock, but now more doctors are opening discussions with patients about when to start a family. NBC’s Mara Schiavocampo reports and Dr. Evelyn Minaya, a board-certified OB-GYN, discusses the complex topic.

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>>> more doctors are raising the issue of when to start a family with some of their older female patients. nbc's mara schiavocampo has more on the story.

>> good morning, savannah. thanks to advances in fertility and gains in the workplace, many women are having children later in life but some doctors worry they may be wait too long late and are making a point to talk to their patients, not just about general health but also fertility . callie irwin loves being a mom. but this all happened sooner than she planned. the 37-year-old wanted to put off parenting until a fateful visit with her obgyn who advised her not to delay starting a family.

>> he gave me a real kick in the pants. i think i was a little bit shocked. i'm always kind of surprised by my age. in my mind i'm still kind of 22.

>> reporter: call it a new version of the talk, more and more doctors initiating conversations about fertility with their 30-something patients. it's not without good reason. growing number of women , about 20% wait until after 35 to have their first child.

>> i mention that there may not be a perfect time to get pregnant, and that sometimes it's better to pursue things earlier than waiting until later when miscarriage and infertility may be an issue.

>> reporter: a controversial first response ad campaign in the uk also focuses on fertility . preview in "the telegraph" features a much older woman heavily pregnant. the message, don't wait too long. concerns about fertility aren't new.

>> my biological is ticking like this!

>> i'm pregnant. i never met the right guy and i thought if i waited any longer i might miss my chance.

>> reporter: doctors worry advances in fertility and images of pregnant 40-something celebrities like halle berry and kelly preston may be sending some women the wrong message.

>> you want to truly assess what you want to do as far as getting pregnant. 40 is not the new 30 when it comes to a woman's reproduction.

>> now doctors aren't just having these conversations with women in relationship. many are also discussing fertility options with single women in their 30s as well, which increasingly includes freezing their eggs. savannah?

>> mara , thank you. this topic caught our eye in the " wall street journal " over the weekend. here is dr. evelyn maniah, board certified ob/gyn. good morning.

>> good morning.

>> this is a hot potato of a topic. do you think that women need to hear this talk? in other words do you think they're laboring under the misimpression that they'll remain fertile in perpetuity?

>> you mean to tell me i'm not 26? you got to be kidding me, yes. i think it's a sensitive topic and i this i that most of us don't think that in general we're very healthy people, why can't our eggs then function. so if you're 35 but feel like you're 26, running marathons, doing your 5ks, why not but unfortunately your biological clock is ticking and your eggs are 35 years old.

>> mara mentioned it but do you think now we see older moms, celebrities, look so young and beautiful having babies well into their 40s is giving a false expectation?

>> i think that's the whole thing. it's the expectation of things, and that's what our role is as physicians to give you realistic expectations, and with all due respect to those women , they don't tell you that some of them are not even their eggs, so if you see a woman in their 40s, the likelihood that it's her own egg, it's a little diminished.

>> we'll give you the scoop then here. at what point does fertility drop off? what is the substance of the talk you are giving to women in their 30s?

>> it depends on your lifestyle. already at 30 it starts to drop off. about 20% of women have a problem getting pregnant but that means then 80% of them can get pregnant on their own. at 35, you add miscarriages, you add infertility, even more infertility issues because of the age but it's not only that. it's also your time, your lifestyle. do you have time? are you jetting off somewhere and your husband is somewhere else ? so that has a lot to do with it as well.

>> genes and stress also a factor into whether you're fertile at any age.

>> absolutely. absolutely and also what you do for a living and especially stress.

>> i have to ask you, this has got to be a fairly sensitive topic as you mention. i know a lot of women in their late 30s or early 40s who would love to have a baby, they have not met the right person and a conversation like this with their doctor would probably put them over the edge . what do you say about that?

>> first of all you should have a relationship with your doctor that shouldn't put you over the edge . i think honesty is the best policy and again realistic expectations. i encourage my patients especially exactly that scenario, 35, 37, single still, why don't you freeze your eggs, if you are financially sound to do it or you could be a single mom as well, as long as you have support.

>> is that effective? there was a time when it was unclear whether or not freezing your eggs was a good idea.

>> right.

>> whether you get your money's worth because it is expensive.

>> it is expensive and insurance does not cover it. so yes, but now that we have really advanced technology , it's definitely an option.