Does fertility treatment have any side effects?

With fertility treatment becoming cheaper and more popular, couples are choosing IVF without thinking too much about it.  After all, many people already know someone who got a child through artificial insemination and of course so many celebrities undergo in vitro fertilization that it makes as much news as their being arrested for DUI. 

Since the fertility experts make tons of money in these procedures, their goal is to maximize number of pregnancies, even if they eventually end in miscarriages or deformed babies are born (for these they always blame the parents).  Of course they also don't care what happens after a child is born.

Now experts are learning that kids born through IVF are more likely to have diseases like high blood pressure, diabetes and certain cancers.  The reason is that when conception takes outside the body, the cells are exposed to way more oxygen than what they get inside the womb.  This changes how many and which genes are turned on.

What if I cannot give child to my younger husband?

Betty writes, "I am a 39-year-old woman. I have been divorced for a little over a year, and I have a son who just graduated from high school and has left home to join the military. I have also returned to school to get my college degree. I am typically attracted to men my age or older, but find myself attracted to a 27-year-old man. I met him at school. I feel interest/attraction there, on both our parts, but I can't help but worry about the "children" issue. This is something I feel women must think about at my age who are dating younger men who haven't yet had children. I'm not against having more children, but let's be honest... my "clock is ticking." Assuming we even begin dating, do relationships like this ever really work? What if I can't have more children? I just worry about falling for someone who is younger, only to have him leave me for someone closer to his own age."

I think the issue that you are worried about is a bit premature. Based on what other couples in similar situation have told me is no different than what happens to couples in general of same age group. Some men do not want children, some women cannot have children, some couples adopt, or use procedures like IUI, IVF, and donor eggs if they really want to become parents. As you can see, there is a whole range of options depending on what a couple actually wants. As the relationship evolves, most couples figure out a way to address this issue and generally love trumps all, unless it is a couple (Mark and Vanessa Loring played by Jason Bateman and Jennifer Garner) like in Juno.

Yes, relationships like this are increasingly common and they work as well, with or without children. Men who are dating a woman whose biological clock is ticking understand that their options are limited; otherwise, they don't date women in their 40s.

I tell women not to lose sleep over the possibility of these men leaving for a younger woman because even if you marry an older man, he could do the same.

Lesbians right to artificial insemination

Remember those homophobes who run a clinic by the name of North Coast Women's Medical Group in Vista, CA? Arguing that Jesus Christ hates lesbians, they turned away Guadalupe Benitez and her partner Joanne Clark when they were denied ART.

It turns out that Jesus sent them an email clarifying that he loves gays and lesbians as much as he loves everyone else, including homophobes. The doctors then decided to settle the case rather than lose in a court for discrimination.

Michelle Stafford parent through surrogate mother

As I have written before, by the time a woman is 40, her fertility has dropped to a point that it is highly unlikely that she can deliver a living, healthy, normal baby. Yes, some women do that but the number is in very low single digits. Others can try techniques like IUI or IVF but they are not much help. A smarter thing to do is to what Celine Dion did who froze her embryos a long time ago and then became pregnant with it.

If you have failed with these attempts (and burned thousands of dollars in case your insurance does not cover these procedures) then your next option is to use donor eggs, in which case, the real mother is someone else but a woman can still feel connected to the baby since she will be carrying it. These procedures are prohibitively expensive in most of the Western world but in countries like Czech Republic or Ukraine, poor and desperate women will sell their eggs for a very low price. The probability improves but if this does not work, another option is to use a surrogate mother, a procedure used by Ricky Martin, Sarah Jessica Parker, Marissa Jaret Winokur, and Clay Aiken. In other words, hire a woman to carry a man's child using the surrogate's or donor's eggs. This procedure can cost tens of thousands of dollars and surrogate moms are not lining up for the job.

We can now add another name to the list of women who are becoming "moms" with the help of surrogates: Michelle Stafford, who at 43, tried all of the above, but failed. Interestingly, in her case, since she is single mom by choice, both the sperm and egg are from donors and she will simply be raising the child. This option is akin to paying someone for adopting their baby.

My wife wants to have a child before she gets too old

Mark, a man in his 20s is in a serious relationship to a 46-year old woman. He writes, "I know it's difficult for a woman in her 40's to have kids and believe me I don't even know if I want any. I guess that she's worried that I might want to be a father some day and that I might leave her for a more younger fertile woman. I keep reassuring her that that's never going to happen but she tells me that she wants to have a baby with me more then anything (some day) and she's worried that soon she won't be able to. The donor egg option is definitely worth considering. I know the relationship is still new (we have been dating only a few months) and to be honest I don't know if I want to be a father. That's something I'm still mulling over but I do plan to ask her to marry me within the next couple of months. I already told her 19-year old daughter and she was surprised and happy. She still tells me that she won't refer to me as dad."

It is a common concern among most older women even when they are married to a man their age and they have reasons to fear it -- so many men do leave them for younger women. The concern is amplified when they are married to a much younger man.

The way the donor eggs work is that you will have to find a younger woman who is willing to donate her eggs. Yes, the child will not be genetically your wife's but she will carry the baby like any other woman and be able to breastfeed her like any regular mom. Not everyone is comfortable with the idea, though (you may not always know the genetic history of the donor and if you decide it to keep it a secret, the nosy people will comment that the child has no resemblance to the mother) and finding a donor plus having the medical procedures done can cost as much $30,000 in the US.

Birth abnormalities due to fertility treatment

I have previously answered the question if fertility treatments work.

I think that there is some more information that should make you rethink assisted reproductive techniques (ART). A study by Jennita Reefhuis shows that kids born through IUI and IVF are 2-4 times more likely to have birth defects like heart problems, cleft lip, cleft palate and abnormalities in the esophagus or rectum.

Obviously there are several caveats but the major takeaway from this is to let Nature do its magic, try not to have a baby during advanced maternal age, and there are plenty of kids waiting to be adopted.

Single moms by choice

When Ricky Martin fathered twins with the help of a surrogate, we were all surprised by his decision. It turns out that very few men try to take on the role of a single dad. On the other hand, it is a growing trend among women who are rapidly adopting what is know as "single motherhood by choice."

Why single moms?

As women have become more economically independent, they have realized that they do not need men to either support themselves or to become moms. In any case, with 50% divorce rate, the faith in the institution of marriage is already at an all time low among the educated women. With so many single parents out there, women are already seeing that not only it is more likely, it is also possible.

Another major reason for the trend is that many career-minded women put dating and marriage on hold while they build their careers. As they reach their late 30s, they realize that it is increasingly harder to find a man. Since compromising who they want to marry is not on their priority list, they simply do not want to miss their biological clocks and go ahead with pregnancy while still pursuing their dream man.

Another major change is the availability of IUI and IVF to lesbians and single women. While it was somewhat difficult to do so in the past, many single women can now easily find a sperm donor and fertility clinic to help them in the process.

Naomi Campbell pregnancy

One of the biggest challenges that college-educated, ambitious women face is that they have to balance work and life and have to make choices that can come to haunt them later. While the best time to get married (the right age to get married, according to several studies, is late 20s) and have children is in your late twenties to early thirties, career-minded women do not have that freedom.

And with all the commitment phobia among men, long-term relationships and marriages ending up in divorce 50% of the time, is not rare to see a woman end up close to 40 with no child.

And we all know that pregnancy after 40 is nearly impossible without IUI or IVF or some other kind of fertility treatment, and even if that happens, there are higher possibilities of genetic disorders.

Supermodel Naomi Campbell is one such woman who is now 38 and realizes that she does not have children. It turns out that while she was not actively trying to get pregnant, though, the Russian billionaire Vladislav Doronin will definitely prove to be a rich father the way Salma Hayek landed a rich father Francois-Henri Pinault for her daughter. What she learned recently that she was technically infertile until a surgery corrected it. Now she is saying that she is ready to start a family.

The message here is that if you are not getting pregnant after trying for 12 months, it is time to seek fertility treatment.

How did Sarah Palin get pregnant?

While it is great news that Alaska Governor Sarah Palin got pregnant at the age of 44 (when it is nearly impossible for a woman to get pregnant) and had a child (Trig) but the bad news is that the child suffers from Down's Syndrome (it is widely known that children of parents of advanced age suffer from a variety of diseases if there is no miscarriage).

So how did she become pregnant?

It was a mistake. Many women stop their birth control around this age (Palin has some pretty extremist beliefs and it is not clear if she believes in birth control) and are often surprised that they become pregnant. Most women will lose the baby in a miscarriage.

Planned pregnancy. Many couples do not realize the risks that they are taking when they try to become pregnant in their 40s. Considering how clueless this woman is (her own daughter is a teenage mom and her speeches and statements make it obvious that she is simple an airhead; there was a widespread rumor that Trig was actually her grandchild that she adopted by faking a pregnancy so that she could shield her daughter but after her daughter was visibly pregnant that rumor died), it would not be a surprise that she genuinely believes that she could have yet another child at the ripe age of 44 (like Michelle Duggar).

Possible use of artificial reproductive therapy (ART). Palin already had four children, and though she had expressed a desire for a lot of children, there is no information available if that was the case.

Ricky Martin father through surrogate mother

On the heels of the development that lesbians are entitled to have IUI and IVF, comes yet another development: single men can become fathers through surrogate mothers.

One of the high profile example of surrogacy is that of Marissa Jaret Winokur who could not have her own children due to a medical condition.

Now Ricky Martin has become a father of twin boys by using a surrogate mom. He is not married and is not even dating a girl and there has been speculation for years that he is gay and would eventually come out. However, due to high rate of homophobia among Hispanics, he has chosen to remain in the closet.

It is great news for anyone who now wants to be a parent.

IUI, IVF for lesbians

The sad reality is that despite all the small advances made by gays and lesbians, they are openly discriminated in all walks of life. Homophobia is actually on the rise, largely driven by Republican politics and hatred created by many Christian groups.

The case of Guadalupe "Lupita" Benítez highlights how the name of Jesus Christ can be used by so-called Christians to find an excuse to discriminate. That is exactly what these so-called doctors Christine Brody and Douglas Fenton were doing. They belong to the same category of Christians who supposedly value life but strongly support death penalty. Similarly, they want to protect the institution of marriage but are fighting strongly against gay marriage laws.

The decision by California Supreme Court means that hopefully doctors will stop telling you why you cannot be a mom and do what their job is, that is, to dispense medicine. I wouldn't be surprised if something did not go right because the pharmacists already have the right to deny you your legally prescribed medication because their so-called God tells them not to.

While the last thing on a couple's mind when they are trying to become parents (particularly after 40 when each day matters) is a lawsuit but if you have to do it, it is worth it. Lupita's fight paid off. She is now a happy mom.

Do fertility treatments work?

When a woman is unable to get pregnant particularly after she is 40, it is natural for the couple to get desperate. That is when the greedy fertility treatment industry starts to exploit them. While many such couples may be able to pay for the outrageously expensive assisted reproductive therapy (ART) with the help of their insurance company (it is mandated by law in those cases), others will have to come up with tens of thousands of dollars on their own, often through financing with high interest rates.

Most people borrow this money and can get stuck in a cycle of debt for decades or even declare bankruptcy, often without becoming parents.

The so-called fertility doctors (and a whole industry that now includes acupuncturists, yoga teachers, natural medicine doctors, personal consultants, etc.) are in great position to exploit the desperate people. If the couple gets even technically pregnant, they take all the credit, and keep pushing them to try again (often more money, though, to trap them they will give some discounts not available to first-time patients).

And if you do not get pregnant, then they put all the blame on you. "You are too old, your eggs are no good, your husband has low sperm count, your husband has low sperm motility, etc.," they say.

Well, if you are one of those people that are desperate to have your own child but are unable to get pregnant, here is a piece of news that may save you tens of thousands of dollars.

According to research published in the British Medical Journal, use of drugs like Clomid and artificial insemination is no more useful than trying to get pregnant naturally. These fertility drugs also have serious side effects, chances of multiple babies is high (it may appear like great news to have more than one baby when you struggled to have just one, but these pregnancies are complicated with risk of death for both the babies and mother and higher possibility of development complications in children) and long-term effects on a woman's body, particularly menopause, are not yet known.

I can understand why it is tempting to undergo treatment. You feel that you are doing something and trying really hard, but trust me, the best way to try really hard is to hole up with your spouse in your bedroom.

So are IUI and IVF worthwhile?

No. They only make sense when natural pregnancy is impossible, for example, when using donor eggs or sperms or using a surrogate mother or when the fallopian tubes are blocked.

Men infertility

Until now it was believed that if a woman over 40 was trying to pregnant and she was not having success it was because her eggs were just too old. Unless a man had a low sperm count, the thinking was that the man had nothing to do with infertility.

Not any more. A new study suggests that if a couple is unable to conceive it is because the man is over 35. The probability of a pregnancy drops further if he is past 40.

Such advanced age couples (the medical term for couples who are too old for having healthy babies), even if they get pregnant, are more likely to suffer from miscarriages or have babies born with genetic disorders. (Related: How to get pregnant after 40)

So what are the options for these mature couples?

In the past, it was recommended that a woman choose donor eggs and a whole fertility treatment industry evolved in countries like the Czech Republic. Now it seems that unless you are a mature woman married to a younger man, donor eggs may not be the best idea for an IVF.

The best alternative would be to adopt a child or get a surrogate mother using both donated sperm and egg, if necessary. The world is already populated and unless you are an Albert Einstein or Virgin Mary or Mozart or Picasso there really is no need for you to reproduce.