This is the best time in the world to be a woman! Not only do women have many more professional opportunities than they had in the past, they also have a number of inherent biological advantages as compared to men, which allow them to shine. Not only is their emotional quotient much better, they are also better at multitasking, as a result of which they will often do better than their male colleagues if they are allowed to do so. Thanks to the new laws which promote gender equality (for example, those against sexual harassment), it is quite likely that women will continue to do increasingly well as time goes by.
However, while the opportunities for women to crack the glass ceiling are going to progressively improve, the fact still remains that they pay a price for this. Just as they have certain biological advantages, they also have certain biological disadvantages, one of which is their biological clock. While women would love to become the CEO and have babies as well, with the way modern society is set up, it has become extremely difficult for them to do so.
This is why most smart, ambitious women find themselves on the horns of a dilemma: Should they have a baby? or should they pursue a career? Which is more important and which do they sacrifice? And how do they make this decision? There is so much conflicting information — whether it's from the media, from doctors, friends, older colleagues, mentors, and mothers and mothers-in-law!
The other big problem is that because these women are so successful and bright, they often find it very difficult to find a husband who can match up to their expectations, as a result of which most of them are not very keen on getting married just in order to have a baby. They often delay getting married because they just cannot find Mr Right. Consequently, by the time they're about 35, they find that they are in a crisis situation, and that while their career is progressing well, their biological alarm clock is going off! If they want to have a baby, they better do it now, or they may have to sacrifice their biological desire for a baby. This is the kind of decision which causes a lot of heartburn, and their biggest worry is that they may regret the decision they make today, when they're 40 and it's much too late to do anything about it.
Because you are born with all the eggs you will ever have, your ovarian reserve drops as you grow older. If you are over 30 and want to defer child-bearing, you should get your ovarian function tested, so you can make better-informed decisions. It's not just your calendar age which matters — it's the age of your eggs. Interestingly, this does not correlate with your general physical health, and even very fit women may have poor ovarian reserve. Many women get lulled into a false sense of security, just because their menstrual cycles are regular. However, this provides no useful information about egg quality, so don't get fooled.
The good news is that it's easy to check your ovarian reserve with the help of a simple blood test called AMH, or anti-Mullerian hormone. This is now easily available, and can be used to track your ovarian function. The tragedy is that most women (and even most doctors) are unaware about how valuable this test is, which is why they don't bother to do it — an error which they may regret later on!
It's a good idea to test your AMH level every year — perhaps on your birthday, once you cross 30, so you can track this important fertility marker. The good news is that it provides actionable information, and you can use the results to plan your future.
If you find you have poor ovarian reserve, you now have an additional option, which was not available to your mother. You can freeze your eggs using the advanced technique of vitrification, so that you can keep your reproductive options open for the future.
By storing your frozen eggs when you are 30, you are buying time. Even if you do not find the right partner, or if you decide that you do want to have a baby until you are 40, you are no longer forced to use your aged 40-year-old poor quality eggs, but can use the high quality young eggs you froze when they were 30 years old!
While this is an expensive option, this has no medical risk, if done in a good clinic, and the procedure takes only about 14 days. The technological option of egg freezing allows you to literally freeze time when you freeze your eggs.
Today, the success rates achieved via vitrification are in line with fresh IVF cycles in which fresh eggs are used. Many large global corporations including Facebook and Google, are now giving their female employees the option to freeze their eggs. This is a great way for them to retain talent and it acts as an incentive for women to further their career without worrying about the possibility of them having to remain childless in the future.
Egg freezing gives women the choice to have a baby when they want to — versus when it’s biologically possible for them to. It helps them plan their present and their future, so they can make a more thoughtful decision of when to have a baby, instead of rushing into a marriage when they are younger, only because they want to have a family. In effect, it’s an insurance policy for having a future family.
In the 1950s, contraception allowed women to plan their families, so they could decide how many babies to have and when to have them. Now, reproductive technology empowers them even further, so they can make the right life decisions for themselves. Biology is no longer destiny, and women can compete with men on equal terms, without having to worry about their biological clocks!
Dr Aniruddha Malpani is a leading IVF specialist