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How is it like to be a parent for the first time after age 40 using in vitro fertilization?

The age at which women are having their first child has steadily risen over the last several decades. The medical consequences of ‘delayed childbearing’ have been extensively studied and include infertility, poor birth outcomes and potential developmental problems in offspring. In the February 2012 issue of the journal “Human Reproduction”, K. Mac Dougall and colleagues from the University of California, San Francisco have presented a very informative paper highlighting the experiences of this group. Here is a summary.

They interviewed 46 couples and 15 individual women who had their first child after age 40 using IVF. The median age at the birth of their first child was 42 years for women and 43 years for men. The majority of participants were Caucasian, employed, married, had a post-graduate education, identified as a member of a religious group and reported median family incomes of $150 000–$199 000. Approximately 75% used their own gametes for conception via IVF, 15% used donor sperm and 10% used donor eggs or both to conceive one or more children. The results were interesting.

Advantages of parenting later in life

Emotional preparedness

The majority of the participants were “ready” to be parents. As one man summarized: “I know that I'm way more self-aware than I was 20 years ago. I feel like I'm in a better position to communicate better with my child and help them more in life and I understand how to be a supportive, encouraging parent”.

Career associated advantages

Having an established career with financial security or the flexibility to reduce their working hours, work at home or schedule their work days to better suit their personal and family needs was cited by over one-third of men and nearly half of women. Those in established careers appreciated that they no longer had to ‘prove themselves’ at their jobs by working extra hours or engaging in lengthy travel. One woman reflected on the greater latitude and opportunities she experienced by having children later in life: ‘If I had gotten pregnant when I was 26, I would have been in business school. The trajectory of what windows would have been open to me would have changed. That's no longer true. I have a reputation. I have a history. I have a little bit of political capital to spend. So, if I need to take three months off and have a kid, I can do it’. A common theme among them was the increased time available for parenting compared with their experience with the children they had in their earlier relationships. They reported feeling more involved in daily parenting tasks and enjoying being more active in parenting than they had in the past. They attributed this change largely to decreased time and/or energy that they had previously devoted to career building and income generation.

Committed co-parenting relationships

An advantage of later childbearing was the establishment of stable and committed relationships with partners. These were perceived to be beneficial for both men and women, and contributed to a positive family environment for children. Almost all participants characterized their partners or spouses as being involved and sharing parenting tasks. Many men and women were surprised to be having so much fun parenting and felt that having children later in life was keeping them young.

As one woman summarized: ‘Except for the actually getting pregnant part, for me, it's mostly been just a lot of advantages’.

Disadvantages of parenting later in life

The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling ‘lucky’ to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents.

Lack of physical energy

Over a third of women and a quarter of men cited the lack of physical energy they experienced as later-life parents. Noting the substantial demands of raising children, participants reported feeling depleted and they imagined having more vigor for parenting if they were younger. A mother mused: ‘I wish I was 10 years younger, then I wouldn't be so pooped out by the end of the day. I'd have more energy to keep up with my daughter, but I'm tired’. Some were concerned about maintaining physical strength as their children age: ‘I think we'll still be able to go out and do outdoor activities with him when he's a young man or a growing teen. I want to be in somewhat good shape’. However, in contrast to this desire, many parents noted that their personal fitness efforts had diminished due to parenting demands.

Less time with children

Another disadvantage cited by almost a third of women and a fifth of men was the calculation that participants would have less of their total lifetime to spend with their children. While feeling positive about their own projected health and life spans, they simultaneously reflected on having children later with a sense of loss. As this father said: ‘By the time they graduate from high school, I'll be in my seventies…I will probably be pretty long lived because our family has a good history of it, but I won't see a lot of their adult life’. Some expressed concerns that they would not live long enough to see their grandchildren.

Smaller family size

A related consequence of later-life parenting was that women had fewer children than they wished for, with two-thirds of participating families having only one child. This was because they were at an age where IVF success rates are low. Men generally did not report dissatisfaction with family size.

Anticipating age stigma

Almost a fifth of men but fewer women expressed concerns about future stigma for themselves and their children due to age. Women in particular remarked that they ‘look young’ and stay active so people cannot tell their chronological age from their appearance. Nonetheless, they did anticipate that as their children get older their age as parents would become more visible and their children would be stigmatized as a result. This woman imagined: ‘I think now maybe people don't think, ‘That's an older parent.’ The older we get, and then he will be in high school, it will be more apparent.’ A theme cited by women and especially men was anticipation of being over 60 when their children graduated from high school, which for many was emblematic of the wider generation gap as older parents. For example, as this man predicted: ‘When my son is graduating from high school I'm going to be about 60 years old, and that's probably a lot older than the other dads … I'm going to be getting near a period of time where I'm wanting to retire and he's just going to college. So it just concerns me that I don't want to be old when he's still that young’.

When asked about the optimal age for parenting, the majority of the participants wished that they were 5 – 10 years younger. Conversely, having children near retirement age was considered irresponsible, as this man explained: ‘If you're going to be dead whenever your kid is out of high school, that's probably too late. It's not a biological thing; I don't think it's great for the kid to have so much of their life without that parent’. ‘If it weren't for the "inconvenient biology", I really think 35 to 45 is a great time to have kids. That may not be true for everybody’. Female Participant.

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Dr. Vishvanath Karande

Dr. Vishvanath Karande

Dr. Karande is Board Certified in the specialty of Obstetrics and Gynecology as well as the subspecialty of Reproductive Endocrinology and Infertility. He is a Fellow of the American College of Obstetricians and Gynecologists and Member of the American Society for Reproductive Medicine.

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