True Love May Last Forever, But Fertility Does Not

british royalsWhen it comes to fertility, we frequently find that our patients take their lead from celebrities. Too often, this has a negative impact on our patients. We see Hollywood starlets, senators’ wives, and TV personalities having children in their mid- to late 40s or even early 50s, and we are left with the impression that fertility lasts longer than it actually does. Sadly, as we have said before, many of these pregnancies are achieved through egg donation (using a younger woman’s egg to get pregnant), but the general public is not really aware of this.

Lately, we’ve had a new couple to watch, a couple to remind us about the choices that face all of us who are lucky to find our true love. The couple is Prince William and his bride, Kate Middleton. The choice is: when to start a family.

I came across a nice little article by Dr. Manny Alvarez, who had some advice for this couple. And by extension, it applies to many couples.

Dr. Alvarez correctly points out that Kate’s fertility will be on the decline from this point on. He advises her to try to conceive soon, rather than wait. Of course, from a medical perspective, he’s correct.

“But life is about balance and, for many of us, the trick is to know what decisions to make to maximize our chances of future happiness.”
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Most of us dream about finding true love. We dream of all that comes with it. We will be secure. We will be complete. We will have children and we will watch them grow. We will be happy.

But most newly married couples do not want to have children right away. They want to have time on their own to consolidate their married life together, to grow accustomed to the changes this brings. Adding a child immediately into the mix can place a couple under financial strain, time constraints and emotional fatigue that can interfere with the initial bonding between the couple.

In the case of Prince William and Kate Middleton, I’m not sure we could concoct a more storybook modern-day romance. Kate, the commoner (a term we don’t use in the U.S.), marries a prince and becomes a princess. The presumption is that she will also become a mother and chances are good that she will reach this goal without assistance from me or any other infertility specialist.

I hope they do have a storybook life.

But if I were in Kate and William’s shoes, would I follow Dr. Alvarez’s advice and try to have children right away?

That would depend on my goals, I guess. I frequently ask patients to project themselves into their early to mid-40s and picture themselves childless. From that vantage point I ask them to look back on their lives and reflect, to the best of their ability, what choices do they wish they had made when they were younger.

If the life they spent growing together fuels their happiness, perhaps that is more important. If not having children is a devastating thought, perhaps they should begin just as soon as they are ready.

Either way, this decision is to be considered carefully. Think about the pitfalls of each choice, about each direction. Think about how you will deal with those pitfalls ahead of time. Talk about them as a couple. Have a plan for what you will do if things don’t work out as planned. Agree with each other about how you will treat the other person if things don’t work out as planned. Agree to remain flexible as, sometimes, we can all change our minds.

As for Will and Kate? It’s the same as I have for any couple. I wish them a storybook ending no matter whether it was the ending they planned, or not.