Like most mothers, Judy Bershak is a proud and effusive parent who will tell you not only how remarkable her 5-year-old daughter is - how Sarah knew her full address including her ZIP code at the age of 2, how she tap dances and plays piano - but also how sweet-tempered she is and how beautiful.
"We got the Gerber baby," she says.
What makes Bershak decidedly different from most mothers with a 5-year-old is that Bershak is 55. She gave birth to her daughter at age 50, after she had gone through menopause.
She did it with the help of an assisted reproductive technology called egg donation, using an egg from a younger woman. In Bershak's case, the donor was a 25-year-old art student who was paid $2,500.
Occasionally, someone assumes Bershak is the grandmother, but she says that doesn't bother her. "I am old enough to be her grandmother," she says spiritedly.
But in 2002 in the United States, she is also young enough to be a first-time mother. And the number of women like her is growing.
The number of births to women aged 45-54 rose to 4,565 in 2000, the last year for which figures are available. Though a small percentage of all births, this is the highest number recorded for that age group in more than three decades, according to the Centers for Disease Control and Prevention, and that's due at least in part to fertility-enhancing therapies.
The percentage of women having children after age 44 was higher in 1960 than it is now, because more women then continued to have children until they hit menopause. Lacking convenient, reliable contraceptives, they lacked today's choices about when to have children. The birth control pill became widely available in the early 1960s.
Why are women today choosing to have a child later in life?
Judy Bershak says she simply hadn't met anyone she wanted to marry until she turned 44. But because of her age, she and her husband, David Cook, couldn't conceive.
Initially, the couple turned to adoption, but were defrauded of $10,000. "It was a horrendous year and a half out of our lives," Bershak says.
A neighbor told them about egg donation.
"Last chance," says Bershak, a Los Angeles school teacher. She and her husband requested that the donor have light eyes, as they do, and be of medium height. They were able to examine a 27-page dossier on the eventual donor's background, from schooling to religion to medical history.
Sarah has been a joy, and Bershak says her own age has not been any more of an issue in keeping up with her child than it is for any other mother.
She continues early-morning workouts that she began 20 years ago,and gets help from her husband, who is 35. He once led a "Mommy and Me" class, singing and playing in the swimming pool.
Sarah has brought her parents closer to their own families, and Bershak wishes her daughter could also meet the egg donor - though that's impossible because, as in most cases, the records are sealed.
"I think any connection my daughter can have to family and people and blood or any other kind of connection is good," Bershak says.
Helane Rosenberg, another egg recipient, is perfectly happy not to have the donor's identity known though, like Bershak, she is open with her children about the fact that there was a donor.
Rosenberg, an education professor at Rutgers University, is in her early 50s. She and her husband Yacov Epstein, 60, live in Highland Park, N.J., and have 8 1/2 -year-old twins, Nathaniel and Allegra.
Rosenberg and Epstein, a psychologist, counsel couples with fertility problems. The subject comes up in the family, and the children know, for example, that women who get pregnant with donor eggs often have multiple births. Forty-percent, in fact.
Rosenberg says when she and her daughter were in a Manhattan park, they noticed an older woman with young twins. That lady, her daughter guessed, must have had an egg donor. "My little girl figured it out," Rosenberg says.
As with Bershak, regular exercise keeps Rosenberg's energy level high. "I get up at 5 and do the treadmill from 5:30 to 6 or so."
But unlike Bershak, Rosenberg is aware of looking older. Her son, she jokes, "always picks the kid to be best friends with who has the youngest mother in his class."
Because she looks older, younger mothers sometimes ask her for advice.
"People see me as wiser," she says. "And I'm surprised. My kids are exactly the same age, and I don't know any more than they do."
Both she and Bershak have considered cosmetic surgery. But Rosenberg says, "It's more than just the surgery. It's thinking young. With kids it's really important to be 'with it' as a mother when you're not 28. It's important ... to know what's going on in the world."
Why did Rosenberg put off having children? She, too, didn't meet Mr. Right until her mid-40s. But there was another reason: She grew up in the generation that was told women could "have it all" - delaying a family until they had established a career.
"No one ever talked about a decline in fertility except for menopause, which seemed to be happening well into one's 50s. If someone had informed me, I might have reconsidered things. I would have thought more consciously about whether a man might be husband material, not just date material."
Around age 35, a woman's fertility rate drops and continues declining, then drops even more at 40, studies have shown.
Dr. Richard Paulson believes that ignorance about fertility and age continues to be a problem. Paulson is the head of the infertility program at the University of Southern California medical school and the co-author with Judith Sachs of "Rewinding Your Biological Clock."
Paulson, a pioneer in helping older women get pregnant with egg donation, explains the procedure: Eggs are retrieved from a younger woman and combined with sperm in a glass dish (in vitro literally means in glass), then the resulting embryos are transferred into the older woman's uterus. Often, more than one embryo is transferred in case they don't all successfully implant.
Egg donation has been around since 1983 for younger women; Paulson and his team first reported their success with women over 40 in 1990, and in 1993 for women over 50. For Paulson, the cutoff age is 55 because his clinic has had limited experience with women between 50 and 55.
Younger women should know the facts about age and reproduction, he says. "In fact, age is a problem. I still see it nowadays," Paulson says, "when someone comes into my clinic and she's 45 years old and she says, 'I'm ready to have a baby.' They don't realize that even if they're having regular periods, at their age their eggs frequently have chromosomal abnormalities."
Kris Bevilacqua is a psychologist in Brooklyn, N.Y., who counsels women with fertility problems. Bevilacqua, 51, also became an older mother with the help of egg donation. She and her partner, Andy Novick, 49, have 4 1/2 -year-old twins, Kyra and Seth.
Some of Bevilacqua's clients have pointed to celebrities giving birth in their 40s and 50s. Though few acknowledge it, she says, "I'm going to put money on it that it's a donor egg" in many cases.
As a physician's assistant, Carol Rhyner, 51, was quite familiar with the ticking of her biological clock. She and her husband, Ira Drescher, 45, now have two children, Sam, 5 1/2 . and Daryn, 3, both conceived with donated eggs.
Do they worry about juggling retirement and college funds? Not really, Rhyner says. "Both my husband and I had been saving toward our retirements for many years before the children were born."
Some see downsides to egg donation for older women.
The point of view of the child is not considered enough, says Harvard law professor Elizabeth Bartholet.
The inability of the child to find his or her "genetic forebears" is a problem, she says.
Those who believe that "birth heritage is completely unimportant" are mistaken, says Bartholet, author of "Family Bonds: Adoption, Infertility and the New World of Child Production," a book about her own journey with infertility and how she ultimately opted for adoption.
"I think we should require not just record-keeping, but require that at least upon adulthood kids born with the help of donated eggs have access to the information. Just as increasingly, I think, people are coming to recognize that that would be a good idea for adult adoptees."
Bartholet has called for a national commission on these and other modern reproductive technology issues.
One issue is what critics call "the selling" of eggs, sperm and embryos. Defenders say egg donors are not paid fees for tissue or organs but are compensated for their trouble, which can include weeks of injections, blood tests and ultrasounds.
But there are a lot of determined couples who don't want any restrictions.
Demand is high for donor eggs, and some wait up to a year to receive them. Hoping to increase the donor egg pool, many clinics in New York City and New Jersey have recently raised the fee they pay donors from $5,000 to $7,000.
The donor fee is only part of the cost for recipients - which can reach $26,000 in New York, including doctor fees for the donor.
Some older couples have taken second mortgages on their homes or liquidated retirement funds to meet the cost.
These people are motivated, informed, and they've made a considered decision that they're going to have a child, he says. In addition to self-selection, there's medical selection. In his program, the candidates are put through psychological as well as physical screening.
"If anything," Paulson says, "the older couples have an easier time, many of them have waited so long to have this, and the child is such a blessing."
Helane Rosenberg vigorously agrees.
"I always wanted to have children," she says. As if on cue, her daughter appears and climbs up on her lap.
On the Web:
The American Infertility Association Web site: http://www.americaninfertility.org
Resolve: The National Infertility Association Web site: http://www.resolve.org
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