Courteney Cox 'Revs Up' for Second Baby at 45

OCTOBER 16: Coco Arquette (L) and Courteney Cox (C) sighting on October 16, 2009 in Los Angeles, California.

Courteney Cox has made no secret about her struggles to conceive daughter Coco.

Now, at 45, she says she's "revving up" to have her second.

"We're not trying yet. We're revving up the engines," she told OK magazine. "I'm only ready 'cause time's a-ticking. If I was 34, I'd wait another year, because I like those three-to-four gaps. I want Coco to be helping me with the next one. One child is hard. Two is probably harder."

Cox, who conceived Coco through in vitro fertilization or IVF, when she was 39, will most likely find it more difficult her second go-round.

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"Forty-five is considered the dividing line," Los Angeles fertility specialist Dr. Richard Paulson told ABCNews.com.

Paulson said women 45 and older have a 5 percent chance of getting pregnant without any assistance -- and most likely they will require an egg donor.

Courteney Cox is "revving up" to have a second child.

IVF using donated eggs runs between $20,000 and $25,000, Paulson said. And if a surrogate is required, such as in the case of 44-year-old Sarah Jessica Parker, the cost can easily go up to $100,000, he said.

Forget about health insurance picking up the tab. Many policies won't cover IVF, egg donors or surrogacy.

But the financial costs are less of a concern to the rich and famous, who like Cox and Parker are willing to go to great lengths to have a child in their 40s and beyond.

Sarah Jessica Parker turned to a surrogate to have her twins.

"I don't like to say that these are the lengths that people go to, rather in 2009, it is good to know these options exist," said Paulson, director of the fertility program at the University of Southern California.

Apparently, Cox agrees.

"In vitro is a wonderful thing that people can do in this day and age, and I'm lucky enough to be able to afford it," Cox told Good Housekeeping.

Paulson said women as old as 50 -- and under some "extenuating circumstances," 54 -- should have the right to have children by any means if they are medically healthy.

"Children are orphaned every day in this country, and even younger moms can be run over by a bus," he said. "They can get cancer or another disease.

"I think in this country, the respect for privacy and reproductive freedom is very high," Paulson said. "I am not saying it trumps the rights of the child, but most of us think that a woman should be able to choose whether to carry a pregnancy or not."

More celebrity women are pushing off that decision until after they turn 40. Some, like Holly Hunter, who had twin boys at 47, and Geena Davis, whose twin boys were born when she was 48, refuse to divulge how they conceived their children.

Therapist Patricia Mendel, co-chair of the American Fertility Association, understands celebrities' need for privacy but said it "gives other women the image that they can have a baby at any age."

"The reality is at 47, I don't care how young you look, how much exercise, your eggs are still 47," Mendel said.

That said, Mendel said she believes egg donation is a wonderful option -- for people who have the money.

"I say to people, 'Do you have enough money?' If you don't have money, adopt. There's much more (financial) help for adoption," she said. "Some will still say, 'I'll figure it out, but I have to try this.' There's a way to hedge your bets, where you would have a better outcome."

Other celebrities are more candid about the uphill battle they faced after 40.

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