Getting pregnant at 40. In this interview, Dr. Lauren Roth shares important information about fertility and how she ended up in the field of Reproductive Endocrinology and Infertility.
Dr. Roth shares her #1 recommendation for women who are putting babies on the backburner for now… Maybe you are building a business or climbing the corporate ladder. Perhaps you just haven’t found that special someone. Whatever the reason, if you are in your late 30s and know that you want to have children, keep on reading.
Dr. Roth also dishes out her expert opinion on the following:
- Does stress really affect fertility?
- The role weight and lifestyle choices play in getting pregnant.
- The effects of postponing pregnancy for career
- Getting pregnant at 40 – what every woman over age 35 should consider if they want to have children later on
- When you are doing everything right and still not getting pregnant…
- When to see a fertility specialist
- Advice for women considering medical school and an occupation in medicine
Dr. Lauren Roth’s Story
12 years old and on the path to be a Doctor
My interest in medicine started when my father (an anesthesiologist) took me to the operating room as part of a Girl Scout project. In college, I studied Biology and majored in Women’s Studies at the University of Maryland College Park.
Medical rotations to OBGYN
In medical school, I did rotations in all the main medical specialties. Although I had a longstanding interest in women’s health, I kept an open mind. In the end, I chose Obstetrics and Gynecology (OB/GYN) because the field offers a good variety of surgery, medicine, and caring for women. OB/GYN also offers opportunity for advocacy and the ability to take care of women throughout their lives.
Residency and Fellowship here I come
As part of the national match for residency, I matched at University of Colorado, Denver. During my 4 year residency, I was exposed to the full field of Obstetrics and Gynecology as well as the associated subspecialties. The subspecialty of Reproductive Endocrinology and Infertility (REI) was a perfect fit me. It offers a balance of science, surgical procedures, and long-term relationships with patients. Helping patients build their families is an honor.
Once I decided that I wanted to specialize in REI, I once again entered the national match for fellowship and was able to stay at University of Colorado, Denver for the 3 year REI fellowship. I continued as part of the faculty there for 2 years after completing fellowship, caring for patients and teaching residents and fellows.
Shady Grove Fertility
Several years ago, there was an opportunity at Shady Grove Fertility and I jumped at the chance to work for such a well-regarded fertility practice. Shady Grove Fertility is one the largest fertility practices in the United States. Most of my time is spent caring for patients though I am involved in other aspects of our practice including educational outreach for physicians and patients.
Effects of postponing pregnancy for careers
Question: Dr. Roth, many women are waiting longer to have children. They are focusing on their careers and pushing pregnancy later in life. I know many women trying to get pregnant at 40. What are the fertility consequences?
Waiting to have a baby until a woman is more established in her career is an increasing trend. It is also a large majority of patients that we see. The age of first pregnancy is increasing for everyone and certainly for professional women.
Career time verses fertility time
Unfortunately, the prime time for fertility is typically when women are starting out in their careers. Unfortunately, our society is not always supportive of pregnancy and motherhood at the time women are establishing themselves career-wise.
By the time women are more established, they are often older. Age is one of the biggest causes of fertility problems. Our fertility declines with age due to decreasing egg number and decreasing egg quality. Even though society has advanced, the egg and the ovary haven’t caught up.
Getting pregnant at 40 – Advice for women who are planning for children later in life
Question: Dr. Roth, what advice do you have for women who are planning for children later in life?
Freeze your eggs. Egg freezing has become a viable option for women who are planning for children later in life. With egg freezing, you are actually freezing the eggs in time.
Your eggs are the best quality that they are going to be right now. Your egg quantity and quality are going to decline over time. They will be frozen in time for when and if you need to use them. If you can’t get pregnant on your own when you are ready; you will have those frozen eggs as a backup.
Stress and pregnancy
Question: Dr. Roth, does stress decrease your chance of getting pregnant?
I often get asked about stress and fertility. The correlation between stress and fertility is just so difficult to study because something that stresses you out, might not stress me out and vice versa.
Furthermore, even if we can identify the causes of stress, there is not always a clear remedy for stress.
I can’t tell you “don’t be stressed.” That is unreasonable! Stress likely plays a part in fertility, but it’s not the only thing making it harder to get pregnant. It is good for everyone to reduce stress when they can (through healthy diet, exercise, time with friends, good sleep).
Do not put off going to see a fertility specialist because you think “it’s all related to stress.” Often, having an appointment will help decrease anxiety and stress.
Weight and infertility
Question: Dr Roth, does being overweight affect your ability to have a baby?
There are a many different lifestyle factors that can impact fertility. Weight is one of them. When looking at weight and fertility, it is actually the extremes of weight (underweight and overweight) that decrease the chances for pregnancy even with fertility treatments.
Healthy lifestyle
Maintaining a healthy lifestyle is one of the best things you can do for general health and fertility. Healthy lifestyle includes no smoking, minimal to moderate alcohol, no drug use, maintaining a healthy weight, sleeping, and moderate exercise. I am also supportive of acupuncture and other complementary therapies if patients want to try it.
Remember extremes of anything are bad. This includes extreme amounts of exercise. Extreme exercise and rapid weight loss can actually be counterproductive for fertility.
Doing everything right and still not getting pregnant
Question: Dr. Roth, what if I am doing everything right and still not getting pregnant?
This is a concern for many people. Despite a healthy lifestyle and “doing everything right,” they have been unable to conceive. Unfortunately, you just have limited control over fertility.
When to see a fertility specialist
Question: Dr. Roth, when would you encourage a couple who has been trying to have a baby come in and see you?
It depends on the couple and different types of parameters. But, the general advice is:
- Women under 35 years of age – after 1 year of unprotected intercourse and no conception
- Women 35 to 39 – make an appointment after 6 months of unprotected sex and no conception
- Trying to get pregnant at 40 – make an appointment after 3 months of unprotected sex and no conception
- Come sooner if there are other issues that may make getting pregnant more difficult (irregular periods, endometriosis, prior pelvic surgery)
Almost no one comes too early. Most people wait or try to get pregnant on their own for much longer than we would recommend. And I get that going to see a fertility doctor is a very big decision.
It’s personal, it’s intimate, but what’s your bigger goal?
Question: Dr. Roth, why do you think people wait too long to seek fertility help?
Trying to get pregnant is personal and intimate. Of course, you want to get pregnant at home, for free, without anyone else involved! However, it is important to keep the larger goal of having a family in mind.
Couples should know that they aren’t the only ones who are having fertility issues. Infertility is very common, impacting 1 out of 8 couples. Many do not share their struggle but everyone knows someone with infertility.
The hardest part of your job?
Question: Dr. Roth, what is the hardest part of your job?
I give a lot of bad news every single day. Delivering this news is difficult. There are patients who have been trying for years to have a baby and I have to tell them that they just had another miscarriage or that their cycle did not result in a pregnancy.
On the flip side, I get to celebrate with people too when they are successful. The emails of new parents and baby pictures that patients share are amazing. Most people who are pursuing fertility options will have a baby — if they can keep going. It can be a long and difficult process but worthwhile for most.
Advice for women considering medical school
Question: Dr. Roth, what advice do you have for women who are considering medical school?
The best thing to do is get involved in activities associated with medicine and science. In college, seek out local doctors and shadow them. Do research in a field that you are interested in. There are numerous summer research programs for college students. These programs are a great opportunity to explore your potential field and add to your resume.
Becoming a doctor is a very long road and an intense education process. No matter what area of medicine you practice, you will spending a lot of time at work. Before you commit, make sure that you are deeply and truly passionate about your work and the specialty you choose. Talk to doctors and see what their life is like. Ask them: how many hours they work each day and how they balance work and family.
Medicine is a rewarding field and I am honored to be a part of this amazing field. I’m passionate and proud of the work that I do each and every day.
To learn more about Dr. Roth and to “Discover What’s Possible” please visit Dr. Roth’s webpage where you can see her full biography, publications, reviews, schedule an appointment, and much more. Visit Shady Grove Fertility and “BELIEVE IT’S POSSIBLE.”
Also, in case you missed it Rachel Brumberger acupuncturist and co-owner of Third Space Wellness shares her top 5 wellness tips for women on how to be Present Confident and Sexy.
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Hugs and Handshakes,
Lauren Rebbel
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