Motherhood and the ticking clock

A few days ago, during the Rome meeting of the  European Society of Human Reproduction and Embryology, a group of Iranian researchers leaded by Professor Ramezani Tehrani said that in a short time we will be able to predict when a woman will hit menopause many years before it actually happens.

 

This will be possible thanks to a test that will measure levels of  anti-Mullerian hormone (AMH) which is the hormone that controls  the development of follicles in the ovaries. Still some research and experiments need to be done, in order to predict more accurately the actual beginning of the menopause, because at the moment it is unclear if same levels of AMH in women from different ethnicities will bring to the same result. Moreover, at the moment the predictions are just close but not perfectly accurate.

Leaving aside  the  technical issues that we can reasonably expect to be solved soon, the news made me think about some social and moral issues involved.   The plausible implication of this test is that women will be able to plan ahead their future, deciding for instance to start pregnancies in their late twenties instead than in the late thirties or deciding to freeze eggs or embryos.

The point is that menopause is just the final step of a process (the decrease of fertility) that starts pretty early in a woman’s life. Already after the age of 28 the chances to get pregnant start to diminish and from a purely biological perspective the best time to have a child is about the age of 20.    Sure we have in vitro fertilizations and therapies for infertility, but the truth is that our bodies can better face a pregnancy up to the age of 35-40, after that point involuntary miscarriages are more common as well as the chance to find out that the foetus is affected by a genetic disease.

So what should we do about it? There is a gap of about 15 years between the optimum biological time to have a baby and the moment a woman feels ready to have a child (at least in Europe and in North America, the situation is different in other areas of the world). On the other hand women rarely have the real opportunity  to become mothers before they are in their late thirties or later. Even if someone knows that her menopause will start soon, but she is not in the right (economical or familiar) situation to plan a pregnancy, the  fact itself  to be aware that time is running out is not going to help.

There are both  a medical (or technological)  and a social solutions to the problem.

The medical solution is obviously to find new ways to extend women’ fertility, or to develop better and cheaper ways to freeze eggs, or to improve techniques of artificial fertilization so that they can be successful also for elder women.

But we maybe want to offer women also a different kind of option, that is to give women the real chance to procreate when they are young. At the moment a woman in her twenties can hardly both success in her career and  have a baby, because taking care of a child implies (at least) that one has  less flexibility, less energy and less time.

Maybe many women want to procreate when they are young and do not want to wait for the moment their career is at the top because perhaps at that point they will have less energies and less desire to adapt their lives to parenthood challenges. So I think it would be good to offer not just better technological options that will allow women to procreate later, but also to provide social and economical assistance for the ones who do not want to wait or who cannot wait (because their menopause is predicted to occur very early). For instance we can encourage men to take a parental leave, or we could offer better  and free kindergarten services for infants, or we can re-think offices space in a way that mothers can bring their children with them, or just make it easier to work from home (this of course couldn’t be possible for any kind of job, but for quite a few). I believe many solutions can be offered in order to support young women who want to become mothers, and unless some scientific evidences at some point will prove that becoming parents later in life is a better option both for parents and children, I am inclined to think that society should support women who want late pregnancies as much as the ones who opt for an earlier motherhood.

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