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The two most common ways to aid conception in older women are ovulation induction, in which hormone injections promote the production of eggs, and in-vitro fertilization (IVF), in which eggs are extracted from the body, inseminated with the sperm and used to create embryos that later are implanted in the patient.
Although IVF has been around since 1978, its effectiveness has improved rapidly as its use has expanded across the country. As of 2011, about 12 percent of women of childbearing age in the United States had used a fertility service, according to the Centers for Disease Control.
Beyond the challenges of conception, late pregnancy carries additional risks. Decreased quality of eggs in women older than 40 can increase the risk of miscarriage and the likelihood of chromosomal abnormalities such as Down syndrome.
One solution is using donor eggs, a procedure commonly recommended for women in their 40s struggling to become pregnant. This approach presents problems for observant Jews concerned that the child may be regarded as a mamzer, an “illegitimate” child subject to severe ritual restrictions under Jewish law.
“To overcome that, most of the current rabbis feel that if you’re going to do egg donation, use an unmarried Jewish girl, and that voids the concern about the boy being a mamzer,” Grunfeld said.
For women who want to use their own eggs, growing numbers are turning to vitrification, a technology that allows women to freeze their eggs while they are still viable and implant them later in life. Gila Leiter, an associate professor of obstetrics at Mount Sinai Hospital, told JTA that freezing eggs for later use has become more common among patients in their late 30s as the process has improved radically in the last few years.
“For women in their 30s, vitrification really takes the pressure off,” Leiter said. “Many women have come to me and expressed relief, saying that they are able to approach dating without the same fear of the ticking clock.”
Concerns about increased risk for genetic abnormalities also are addressed through new technologies that screen embryos prior to implantation. Ressler told JTA that the risks of miscarriage are greatly reduced by subjecting embryos to a biopsy before they are transferred to the uterus.