When Judith Bershak told her mother she was pregnant, the octogenarian grandmother-to-be thought the announcement was a joke - for two reasons. First of all, Bershak was 50 years old. And second, she had already gone through menopause.
"There I was, telling her I'm expecting my first baby at an age when a lot of other women are becoming grandmothers," says Bershak, a Los Angeles schoolteacher. "She just didn't believe me. But when she finally took it in, she thought it was wonderful."
With the birth of her daughter, Sarah, eight months ago, Bershak joined an elite group of late-life, high-profile moms. The group includes 63-year-old Californian Arceli Keh, the world's oldest first-time mother; Italy's Rosanna Della Corte, 62; and TV actress Adrienne Barbeau, 51, who recently gave birth to twin boys.
Despite all the headlines, only 100 or so pregnancies worldwide have been reported in women over 50. But with recent advances in reproductive technology, pregnancies in women 40 and older continue to increase.
"Women over 40 are a sizable number of the patients we see," says Dr. John Nulsen, director of the Center for Advanced Reproductive Services at the University of Connecticut Health Center in Farmington. "In many cases, couples establishing careers have put off having children and the longer they put it off, the more difficult it is to conceive. So they turn to reproductive technology."
Fertility is affected by aging, Nulsen says. Women over 40 have only about a 28 percent chance of conceiving within a year, while fertility at 50 or older is essentially zero. But with the help of in-vitro fertilization, using donor eggs from younger women, those numbers increase by 20 percent to 40 percent for women 40 and older. (For in-vitro fertilization, eggs are removed from the ovary and combined in a tube or dish with the male's sperm. Fertilized eggs are then placed in the woman's uterus.)
Bershak's experience is a prime example. Married at 44, she tried to conceive naturally until going through menopause at age 46. Afterward, she and her husband tried to adopt, but were unsuccessful.
"Then we learned about an in-vitro clinic that had a donor egg program and went for a consultation," Bershak says. "They put me though every test in the book to be sure I was healthy. On the first attempt, I got pregnant."
Pregnancy can put strenuous physical demands on older women. The best candidates for successful late-life pregnancies, says Dr. John Rodis, an associate professor of obstetrics and gynecology at UConn Health Center who specializes in high-risk pregnancies, are nonsmokers in good health with no significant medical conditions.
"As women age, there is an increased risk of pregnancy-related complications such as gestational diabetes and high blood pressure," Rodis says. "But many of these conditions are diagnosable and manageable. With careful monitoring, older women can have successful outcomes."
Post-menopausal moms have sparked a dialogue on the moral and ethical questions of late-life pregnancies. Legislators, medical ethicists and public health experts continue to debate limiting the use of such reproductive technologies. In France, in-vitro fertilization is available only to pre-menopausal women and other countries are considering the same restrictions. Nulsen says ageism and sexism are fueling the debate.
"There are definitely different attitudes toward men and women when it comes to becoming a parent," he says. "Nobody reacts much when older men become fathers. Now that the technology exists that allows women in their 40s, 50s and beyond to become pregnant, people are forced to re-examine their biases."
To her critics, Bershak cites follow-up studies that show the majority of patients over 47 are raising their babies in stable, healthy families, and that older parents are often more committed, focused and prepared than younger parents.
"Today, people are living longer and healthier lives. Age is simply no longer the issue it once was," she says. "What's really important is that these are incredibly wanted and loved babies."