Your child may be at risk for certain anomalies
Once again, the older an egg, the more likely it is to have chromosomal issues, which can increase your child’s risk for certain birth defects. For women who get pregnant at 25, the risk for Down syndrome, the most common chromosomal condition, is about one in 1,250; at age 40, that risk jumps to about one in 100.
Of course, noninvasive blood tests for chromosomal issues like Down syndrome allow you to get information about your child’s genetic makeup as early as 10 weeks.
There is also some, if limited, evidence that older fathers may pose certain risks to their offspring. A review published in 2019, for instance, found that babies born to fathers 45 or older were at higher risk for certain complications like low birth weight, a low Apgar score (a quick test to gauge a baby’s well-being one to five minutes after birth) and premature birth. They also seemed to be more likely to develop autism, schizophrenia and obsessive-compulsive disorder than the children of men who were younger. It is important to note, however, that all such studies were observational, so more research is needed.
The bottom line
What, then, to make of all of this? The most optimistic clinician I spoke to was Dr. James Grifo, M.D., Ph.D., program director at the NYU Langone Fertility Center. He pointed out that while “pregnancy is one of the riskiest states that most women experience in their lives,” the odds of a calamitous event are still low. “The average age of my patient is 39, and obstetrically, they do quite well,” he said. “Age is not a reason not to try if you want a baby.”
Over and over, I found myself having two conversations with experts: One about what they knew from their patients or their research, and another about the choices they made about when to have children on their own.
Dr. Brinton, for instance, who had a daughter when she was 42, said that her biggest issues were “societal” rather than medical. “I was always the older mother,” she said. “When I would go to school, I would be asked if I was her grandmother. When it comes from a child, it’s a stab in the heart.”
Dr. van Dis, who had twins at 39, said she wished she had children when she was younger, but not because of the health risks. She put off having children earlier because of her medical career and her then-husband’s ambivalence toward starting a family — and now she is divorced. “I would have told my younger self that it’s better to be a single mom than to partner with someone who is not committed to you, just because you think you won’t be able to have a family if you don’t have a partner,” she said.