Sunday, April 21, 2013

Halle Berry's pregnancy: The real deal on fertility in your 40s

Bombshell Halle Berry dropped a bombshell of her own recently. The 46-year-old actress, the first African American to win a Best Actress Academy Award (for Monster's Ball in 2002), announced she was pregnant.

Berry, who has said she has type 1 diabetes, has a daughter, Nahla, 5, from a previous relationship. She is expecting her second child with fiancée Olivier Martinez, who is 47.

"I feel fantastic," the former Bond girl told CNN. "This has been the biggest surprise of my life, to tell you the truth. Thought I was kind of past the point where this could be a reality for me."

Berry's happy news has been a surprise to some infertility experts, as well. It's caused one to issue this caution to the woman on the street: "We don't want the 38-year-old woman deferring childbearing to take this as proof that they can easily conceive naturally in years to come," said Dr. Joshua U. Klein, medical director of Reproductive Medicine Associates of New York-Brooklyn.

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"When you hear of people in the public arena who are pregnant in their 40s, the obvious suspicion is that they've availed themselves of fertility treatment, but aren't being transparent about it," Klein said. "I'm not saying that's what Halle Berry did, but the odds are against her having conceived naturally at her age."

There are numerous misconceptions about conceiving after 40; here's the truth:

What are my odds of getting pregnant at 46 naturally?

Not good, said Klein. "Natural pregnancies—when a woman is trying to get pregnant with her own egg—do occur in women in their mid 40s, but it would be nearly miraculous," he said. Even in women using the assistance of IVF (in vitro fertilization), there has never been a clearly documented case of a baby being born from an IVF pregnancy in a woman older than age 45 using her own eggs. Klein estimated that the chance of having a baby at age 46 without intervention is probably about 0.01 percent or less.

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What's the difference between fertility in my 30s and fertility in my 40s?

The big difference: a woman's eggs. Egg quantity and quality starts a precipitous decline in a woman's mid 30s. By your mid-40s, IVF with your own eggs is unlikely to be successful. In fact, the CDC calculates that only 4 percent of women 43 and up will go on to deliver a baby via IVF with their own eggs (after one try), Klein said.

That's at age 43, Klein pointed out. "When we're talking about declining egg quality, the difference between 43 and 46 is vast."

If I wanted to be successful like Halle Berry, what hikes my odds?

Get fertility help right away, Klein said. "The recommendation for 40 and older is don't wait to try naturally for several months, get help now. That's reflective of the fact that your odds of natural pregnancy are so low and your odds of have trouble getting pregnant are so high; around 65 percent to 75 percent."

IVF with donor eggs, which is what Klein suspects many celebrities do, is a routine treatment that has enormous success rates. "We have great success with this. In fact, using younger donor eggs relieves most of the age limitation," he said. "Whether you're 35 up to 50, the odds of success are the same, about 65 percent to 70 percent."

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How does Halle Berry's diabetes or her boyfriend's age play into her pregnancy story?

If Berry is controlling her diabetes, which it appears she is, she shouldn't have any issues with a healthy pregnancy, experts say.

As for Berry's fiancé? At 47, his sperm is likely to be as perky as ever, said Klein. (Although some research suggests that older fathers may increase the risk of certain health conditions in offspring.)

"Unlike women's eggs, which don't regenerate, sperm does—every three months right up until old age," he said. "At 47, there should be no meaningful decline in sperm count or fertility potential."