Last December Nicole Kidman and Keith Urban surprised fans when they announced the birth of their daughter Faith, their child born via a gestational carrier. Kidman has since spoken openly about her ups and downs with fertility, most recently on last Sunday's Australian "60 Minutes."
Kidman's willingness to discuss her fertility woes is a refreshing change from all the secrecy that typically surrounds late blooming celebu-moms. Kelly Preston, John Travolta's wife, was 48 when she gave birth to their son Benjamin this January. She's kept completely mum about the baby's conception.
Back in 2009, Sarah Jessica Parker, then 43, was a little more forthcoming when announcing she and husband Matthew Broderick used a surrogate to carry their twin girls though she pointedly avoided answering questions about egg and sperm donors. Even the late Elizabeth Edwards, usually known for her refreshing candor, refused to talk about how she was able to conceive, carry and deliver two children when she was approaching the age of 50.
The truth that rarely comes across as we view pictures of 40- and even 50-something famous moms holding up their babies in People Magazine, is that most women over 40 will struggle to conceive, especially if they want a biological child.
"Everyone thinks that they can get pregnant forever," Dr. Laura Corio, a top Manhattan ob/gyn, said. "Patients will often complain that so and so had a baby and never seemed to have any issues. They often can't believe it when I explain to them that we have no idea what so and so went through to get pregnant and it probably wasn't as simple as they've led everyone to believe."
The oldest woman in Corio's practice to conceive with no help at all from modern science was 46. "And we're talking one event like this in 30 years of practice," she said.
So while it's not exactly the stuff of Ripley's Believe It or Not, many in the medical community still consider it outside the norm for a 40-plus woman to conceive naturally. Dr. Kari Sproul, a Santa Monica, Calif., infertility specialist, said that for each year after age 30, fertility drops precipitously. By age 45 or so, the majority of women are quite infertile. The chance of getting pregnant without assisted reproductive technology after age 40 is only about 10 percent. During any given month, the chances of a woman over the age of 45 getting pregnant under her own steam and with her own eggs is less than 1 percent.
Sproul stressed that it isn't a matter of simply trying harder either. Women are born with all the eggs they'll ever have; by puberty only about 300,000 remain and of these only 300 or so will mature and be released through ovulation.
"Even the healthiest woman's reproductive capabilities become less and less efficient as she ages so that by the time she hits menopause she only has about a thousand eggs left and most of them aren't viable."
Older women willing to use assistance to have a child who shares their DNA, don't fare much better. A large fertility study performed at Cornell University showed that 4.4 percent of women over the age of 44 were able to get pregnant by in vitro fertilization (IVF) using their own eggs; just 2 percent carried to term. A few women over the age of 46 were able to get pregnant with their biological eggs but miscarried. By 48, none were able to conceive using their own eggs.
Donor eggs are usually the route older mom-wannabes must take, adoption notwithstanding. This is true whether they carry the child themselves or use a surrogate. "I tell my patients over the age of 45 we can try it with their eggs but donor eggs are more likely to be successful," Sproul said. "About 55 percent of donor egg transfers result in live births."
Yet as Suzanne Schlosberg, a writer who decided to go the egg donor route to have her twin boys pointed out, there still seems to be some stigma attached to using a donor.
"The only celebrity I can think of who has ever revealed using someone else's eggs is Elton John, and that one was obvious. For some reason having a child with someone else's genetic material is still viewed as second rate," Schlosberg said. This is probably how Kidman conceived though she pointedly never mentions it. It's doubtful she froze her own eggs since methods are still cutting edge; many doctors who do these procedures have yet to defrost any.
Schlosberg noted that actress Marcia Cross, who had twins at the age of 44, is the only celebrity she can think of who has discussed donor eggs publically. "But even then she only says it's common knowledge how difficult it is for women in their forties to get pregnant with their own eggs. She always stops short of admitting to using them herself," Schlosberg pointed out.
In the interest of full disclosure, I should mention that I had my daughter when I was two months shy of my 45th birthday. For me, pregnancy came out of the blue. It was something of a surprise and there was no helping hand from science.
I honestly had no idea it was such a big deal to have a baby by natural means at my age until someone accused me of lying about it. This woman is so convinced there is no way I could have gotten pregnant without assistance that to this day she is still sure I'm withholding information. Another friend in the midst of her own fertility drama once reamed me out for getting pregnant so easily. She finds it frustrating that a baby just seemed to fall out of the sky for me, especially because it wasn't something I was focused on or even thinking about. After being enlightened about the statistics, I can honestly understand their disbelief and frustration.
I can also understand why Kidman and others who openly discuss their infertility issues are doing a real service. Not that celebrities owe us any information about the particulars of how they procreate. But the ones who stay silent give women the impression that fertility is an everlasting, renewable commodity and that it's never too late to start a family -- although biologically speaking, it sometimes is.