We are living in a transformative time for women.
From politics and business to medicine and engineering, women are building exciting careers, leading change and redefining what life can be.
In this exciting era for ambitious and successful women, the path to motherhood often happens in the dark: the anxious waiting for results, the heartbreak from pregnancy loss and at times intense fear from all the uncertainty.
This can lead to a sense of frustration over something many assume ‘should be so natural’.
It’s a heaviness new mother Von Glass knows well.
“Society puts pressure on women to do it and have it all, like we’re supposed to be able to produce children, but have a career and have a life and be like this whole person,” she tells Women’s Agenda.
“You can’t be that whole woman if you’ve left it too late or haven’t preventatively supported yourself in the process to know whether or not you can even have a child.
“You have control of most elements of your life and then when it comes to fertility, you kind of don’t”.
Von’s first child was conceived naturally.
“He was a beautiful surprise,” she says.
“But then when I had him, my OB came into my room in the hospital and said to me that if I had any intentions of having more children, I should seek fertility guidance because there’s a lot of stuff going on in there and he was surprised that I was actually able to conceive.”
At the time, Von and her partner were grateful to be on this journey as parents and didn’t really know if they wanted to grow their family.
As time went on, they realised they did want a second child.
But this time round, it wasn’t as easy.
“I’m 38 years of age and the beautiful term of geriatric pregnancy is very predominant on the top of your mind,” she says.
“You’ve achieved all these great successes, found the right partner, secured a great career.
“You have everything that you need in life, which puts you in a position to be an amazing parent – but then you can’t be a parent if your fertility is not there.”
Von is among a growing number of women having children later in life.
For many, it’s an intentional and responsible choice: having children when they’re ready, financially set up and in a place where they are able to lean in and provide.
The latest ABS data shows the median age of a mother is now 32.1 years and 33.9 for fathers.
These figures have been rising steadily for decades.
Fertility challenges are also very common with leading fertility clinic Genea noting that it affects around one in six Australian couples.
After several devastating miscarriages, Von did some research and discovered specialist Dr I-Ferne Tan.
“Having met with a lot of fertility doctors, I found her personality really worked with me,” Von says.
“She was honest and upfront, warm and lovely; someone who was able to communicate with me without medical terminology but was able to give me the insights as to what I needed to know but also do it in a nice, compassionate, empathetic way without kind of scaring me.”
Dr Tan was able to investigate and identify what may have been causing the miscarriages, which then allowed them to develop a treatment plan.
With Dr Tan’s assistance, Von and her husband were finally able to conceive.
They welcomed their son a little while after Von spoke with Women’s Agenda.
Looking back, Von wishes she had taken steps to get an understanding of her fertility health early on even when she wasn’t sure about having children.
She hopes her story will encourage other ambitious women to make note of this.
“The biggest piece of advice I’d ever give as a woman – and I’m a career woman as well so I’ve focused on my career for a lot of my life and I’ve made sure that I’ve tried to make the right decisions on my relationship – is understand your fertility before it’s too late,” she says.
“I kind of wish that in my mid-20s or late 20s, I had gone and had those conversations with a fertility doctor to discuss my security plan.
“And what that would mean is like freezing eggs or understanding where my fertility is at even though I’m not trying so that if I did get to the point where I’m at now when I was actively trying to have a child and it was something that I really wanted, I wasn’t having to go through the medical dilemmas I had.
“I had the backup plan.”
Three things fertility specialists want you to know
Genea fertility specialist Dr I-Ferne Tan has spent years working with women and couples to navigate a wide range of challenges with conception and pregnancy.
Dr Tan would like to see more people get an assessment of their fertility health long before they ever start trying for children.
Understanding fertility early on
Being proactive with fertility can help identify issues early on and it can mean putting in a healthcare plan to mitigate problems that may come up when trying to conceive later.
“I talk a lot about choices,” Dr Tan says.
“Some of these choices are taken off the table if you come to me at 45 and say I want to freeze my eggs.
“I would then be encouraging you not to do that because that kind of choice to freeze your eggs is not a great option anymore.
“As you get older, you’re more likely to have health problems, whether that’s endometriosis, adenomyosis, fibroids, polyps, hormone problems like thyroid issues, immune problems”.
Speaking to a fertility specialist early on can also help with expectations and planning for children later in life.
“It’s this idea of planning for the future,” says Dr Tan.
“It’s not ‘I’ve got one problem, I’m going to fix this one problem’. You need to look at it in the bigger context of what does this mean in terms of your other health problems or in terms of your future fertility planning.
“Everything you do today can affect the eggs that you ovulate in the future.”
Men’s fertility declines with age too
Women in relationships may take on the burden and responsibility when issues with fertility surface.
But Dr Tan says men are 50 per cent of the picture.
“It’s not about shifting blame or anything like that, it’s just about including men in that conversation,” she says.
“Men’s sperm quality does decline with age as well.”
Dr Tan says many patients come in assuming the fertility problem is linked to the woman but the man’s health and fertility may also be contributing.
“So you’ve got declining egg quality, declining sperm quality, declining egg numbers,” she says.
Lifestyles choices like vaping, drinking alcohol and food consumption can all have an impact.
Working with a fertility doctor can help shed light on where an individual or couple is at and what steps they can take to improve their chances of a successful pregnancy.
Egg freezing is not a silver bullet
Advancements in egg freezing have opened up exciting new options for people planning for children later in life.
But it’s not a ‘silver bullet’ solution that can fix everything.
Dr Tan says people mistakenly view egg freezing as an ‘insurance policy’.
“It’s really easy for me to go ‘no worries, we’ll freeze your eggs and you can come back whenever you want’ but I always tell them that 15-25 per cent of women are not going to have anything to use, there’s no embryo to transfer at the end of this,” she says.
This is why it’s critical to get a full understanding of your fertility health and work with a trusted specialist to know what the best options are.
Egg freezing becomes less viable as egg quality and count decline which generally happens with age.
Dr Tan says women often take an AMH test and think they have plenty of time because their egg reserve is high but not only can this drop quickly, the actual quality of eggs also influences whether or not someone can conceive.
“Quality is so much more important than quantity when it comes to eggs,” says Dr Tan.
“The whole idea of ‘let’s defer my egg freezing until my AMH has dropped to a particular level is a terrible plan’ – We can’t predict that trajectory of decline.”
Ultimately, Dr Tan says the best way to know what treatment strategy is right for you is to find a trusted specialist and get a holistic understanding of where your fertility is at.
“As you get older, you need more cycles of IVF just to get to that one baby,” she says.
“IVF is really powerful technology, it’s amazing. But even with IVF, the success rates are much lower with older women because we can’t undo a lot of these factors that are contributing to infertility.
“Not yet anyway. I think we’re still working on that one.”