"At a time when Apple and Facebook are picking up $20,000 tabs for employees to freeze their eggs as well as offering other generous high-tech fertility benefits, it's clear that professional women have more and more options with assisted reproduction technology. Many of them will need it: At least one in eight couples overall suffer from infertility, and much of that is due to delayed childbearing. Even as the U.S. birth rate is at an all-time low, multiple births have skyrocketed from fertility drugs and in vitro fertilization treatments involving multiple embryos. In 1980, there were 70,000 twins born in the U.S.; in 2012, there were 131,269, along with 4,598 triplets and 276 quadruplets.
Credit goes to the 450 high-tech fertility clinics in the U.S., 75 of them in California....
...Even so, media coverage of glowing older celebu-moms — from Halle Berry, who just had her second child at age 47, to Laura Linney, who gave birth to her first child in 2014 at 49 — can mislead. "My concern is when celebrities in their mid- to late-40s announce they're pregnant," says Guy Ringler of California Fertility Partners, one of Southern California's most in-demand clinics. "It gives many people false hope that you can get pregnant at any age. It's not realistic."
L.A. women in particular have misguided expectations, adds Ringler: "Many of our patients eat well, exercise, are very health-conscious." Then they realize physical health and appearance largely are irrelevant to the viability of their eggs. ... "They've done studies that found going through infertility is equivalent in stress to cancer or HIV."
...IVF is a more complicated process in which sperm and harvested eggs are joined in a petri dish to become 100-cell blastocysts. The best one or two embryos are implanted; the rest are frozen for later use. A round of IVF costs from $15,000 to $18,000; most women in their late 30s or 40s require more than one round.
...Genetically testing the embryos, known as preimplantation genetic diagnosis, or PGD, is one way to stack the odds in favor of a pregnancy. Nearly every embryo that Steinberg transfers has been tested to confirm that it has the correct number of chromosomes; other tests confirm the lack of certain inheritable-disease genes such as BRCA, the breast cancer gene that Angelina Jolie carries. Steinberg says PGD reduces miscarriages: "What that's done is eliminate Down syndrome. We can't guarantee a perfect baby, but we can guarantee that anything you're concerned about isn't there." (Including the wrong eye color: In 2009, after admonishment from the Vatican and the medical community, Steinberg stopped allowing parents to choose their babies' blues — the most popular color — but quietly started up again with 15 infants last year: "There's a huge interest. Even when we retracted, the emails just kept coming in.")
Despite genetic testing, IVF still has significant limitations. "A woman in her 40s has a less than 5 percent pregnancy rate per treatment cycle," say Ringler, while a woman in her early 30s has up to a 70 percent rate. One proven way to conquer fertility decline from aging eggs is using a donor egg. (A woman's eggs start to decline in fertility in the late 20s. "At 40, most women drop off the cliff," says Steinberg.) "For a woman in her mid-40s who uses a donor egg, her pregnancy rate jumps up to 75 percent per treatment cycle," says Ringler, who thinks donor eggs are the best option for "all women 44 and older, an age when 95 percent of eggs are chromosomally abnormal." Adds Steinberg, "Nature won't let abnormal embryos make babies."
...Most donor eggs come from women in their 20s, paid $5,000 to $10,000 to undergo egg retrieval. "Bloating was the biggest downside," says an egg donor named Sara, who first donated eggs in 2007 when she was a 22-year-old acting student. (Sperm donors are paid $75 to $150 a go for a vial of sperm that might sell for $700 or more.)...
Disclosure is one of the stickiest issues with egg-donor use, which one L.A. mom, who suffered three miscarriages on the way to a biological son at 42, calls the "last bastion of shame" in fertility medicine. It's common for couples to seek out a donor who resembles them to "pass" — letting family, friends and the kids themselves believe they are the genetic parents. Several Westside fertility doctors say that about half their patients plan to keep their offspring's origins under wraps; Steinberg estimates 70 percent of his patients do.
...Oddly perhaps, hiring a stranger to carry a child for you has become less taboo than buying an egg. Nicole Kidman used a surrogate for her youngest child, born when she was 43. Sarah Jessica Parker used a surrogate to carry her twin daughters, who went home to a 44-year-old mom. Both actresses were effusive in their thanks to their carriers but avoid discussing the genesis of the eggs.