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In one sense, the confusion is understandable: it is only in the past 10 years that doctors themselves have discovered the limitations. "I remember being told by a number of doctors, 'Oh, you have plenty of time,' even when I was 38," says Claudia Morehead, 47, a California insurance lawyer who is finally pregnant, using donor eggs. Even among fertility specialists, "it was shocking to us that IVF didn't work so well after age 42," admits Dr. Sarah Berga, a reproductive endocrinologist at the University of Pittsburgh School of Medicine. "The early '90s, to my mind, was all about how shocked we were that we couldn't get past this barrier." But even as doctors began to try to get the word out, they ran into resistance of all kinds.
One is simply how information is shared. Childlessness is a private sorrow; the miracle baby is an inevitable headline. "When you see these media stories hyping women in their late 40s having babies, it's with donor eggs," insists Stanford's Adamson, "but that is conveniently left out of the stories." The more aggressive infertility clinics have a financial incentive to hype the good news and bury the facts: a 45-year-old woman who has gone through seven cycles of IVF can easily spend $100,000 on treatment. But even at the best fertility clinics in the country, her chance of taking a baby home is in the single digits.
In hopes of raising women's awareness, ASRM launched a modest $60,000 ad campaign last fall, with posters and brochures warning that factors like smoking, weight problems and sexually transmitted infections can all harm fertility. But the furor came with the fourth warning, a picture of a baby bottle shaped like an hourglass: "Advancing age decreases your ability to have children." The physicians viewed this as a public service, given the evidence of widespread confusion about the facts, but the group has come under fire for scaring women with an oversimplified message on a complex subject.
"The implication is, 'I have to hurry up and have kids now or give up on ever having them,'" says Kim Gandy, president of the National Organization for Women. "And that is not true for the vast majority of women." Gandy, 48, had her first child at 39. "It was a choice on my part, but in most ways it really wasn't. It's not like you can create out of whole cloth a partner you want to have a family with and the economic and emotional circumstances that allow you to be a good parent. So to put pressure on young women to hurry up and have kids when they don't have those other factors in place really does a disservice to them and to their kids."
To emphasize a woman's age above all other factors can be just one more piece of misleading information, Gandy suggests. "There are two people involved [in babymaking], and yet we're putting all the responsibility on women and implying that women are being selfish if they don't choose to have children early." She shares the concern that women will hear the research and see the ads and end up feeling it is so hard to strike a balance that it's futile to even try. "There is an antifeminist agenda that says we should go back to the 1950s," says Caryl Rivers, a journalism professor at Boston University. "The subliminal message is, 'Don't get too educated; don't get too successful or too ambitious.'"