Celebrity Culture & The Myth Of Fertility

It seems like the media constantly bombards us with information about celebrities who have successful pregnancies.  Jessica Simpson gets pregnant again when her first is only several months old. Angelina Jolie goes from having two gorgeous adopted children to a brood of six, including three that are biologically hers. Now we're hearing about a number of actresses who are over 40 and pregnant: Rachel Zoe at 42 and Gwen Stefani at 43, to name two. And, seemingly achieving the impossible, Halle Berry at 46 (and emphasizing that the pregnancy occurred "naturally," no less).

It's no secret that the average maternal age at childbirth in the U.S. has been increasing and that there are record numbers of women in their 40s who are having their first children. Assisted reproductive technology (ART), such as intrauterine insemination (IUI) and in vitro fertilization (IVF), is one reason why this trend is possible. I often hear women in their mid-to-late thirties, with no current plans to expand their family, say, "Oh, I'll just seek fertility treatment when I'm ready. After all, if Rachel Zoe, Gwen Stefani, and Halle Berry can do it, why can't the rest of us?"

It is not impossible for the rest of us to get pregnant past 40 — we hear stories all the time of people who know people who conceived naturally after making it "over the hill" — but it is definitely less likely than it seems at first glance. Even when using an ART like IVF, the chances of becoming pregnant and having a live birth decrease rapidly after 40, and there has been no documented case of a woman becoming pregnant with her own eggs after age 45.

Let me repeat that last part: her own eggs. This is the key. When a woman undergoes IVF, she can either use her own eggs, or she can use donor eggs. Donor eggs typically come from young, healthy, well-adjusted women who are paid a large sum of money to donate their eggs. This increases the likelihood that the offspring will have good genes. But, the catch is that a woman carrying a fetus with a donor egg will not be biologically related to her child. This is the crux of the problem with which so many women struggle. How do I explain this to my child? How do I explain this to others? Will others judge me for my choice? Does using donor eggs mean something bad about me?

To my knowledge, no celebrity has admitted to using donor eggs. Some speak publicly about the use of donor eggs in general (Marcia Cross, for one, who gave birth to twins just shy of her 45th birthday) or the use of surrogates (for example, Sarah Jessica Parker, who used a surrogate to have twins when she was 43), but they stop short of saying that they used donor eggs themselves. Kelly Preston gave birth at age 48, and although experts suggest that it is a virtual certainty that she used a donor egg, she has remained silent about the possibility.

On one hand, the fact that celebrities would be hesitant to admit to using a donor egg is understandable. After all, fertility is an immensely private subject, and celebrities are humans, too. They could be experiencing the same sort of stigma that the average person who faces the choice of using donor eggs experiences. Who would want millions — possibly billions — of people discussing the intimate details of their reproductive lives?  And, given the attention they would receive, would a donor somehow try to determine whether the child is actually hers and try to enter into the child's life in order to steal her 15 minutes of fame? Celebrities have every right to maintain their privacy.

On the other hand, I believe that because celebrities are not more forthcoming about the use of donor eggs, the rest of us have unrealistic expectations for our own fertility. Consider some of these sentiments expressed by anonymous women who posted on babycenter.com:

"I wish to God that for once these women would proudly admit to using donor eggs so that the rest of us don't feel like lesser women for not being able to use our own eggs at 40!"

"My pet peeve, is that all of these celebs that can afford countless IVF's and Donor Egg cycles, while saying "whoops, it was an accidental surprise!" message, give women a false sense of security that we can easily reproduce into our forties … Too many women that can't afford these procedures are going to have a cruel wake up call in their future."

When a well-known individual does open up about her use of donor eggs, it will be a breakthrough that will serve as a role model for many, many women. However, it is not celebrities' responsibility, per se, to set the record straight about donor eggs. It is important for the rest of us to do some research and have accurate knowledge pertaining to our own fertility. For example, know the rates of natural conception, conception using IUI, and conception using IVF (with your own eggs) on the basis of your age. You can get ballpark rates just by reading articles from reputable sources on the Internet, and fertility doctors can give you data on the success rates from their own practices.

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It is possible that after doing this research, you will become fearful of not being able to succeed and discouraged about the possibility of having the family that you've dreamed of having. If you are doing research on the Internet, you will likely stumble upon many forums for women who are struggling with infertility and pregnancy loss. These stories can be scary and heart-wrenching. They can lead you down a road paralyzed by the "what ifs." What if I can't get pregnant? What if I never have children?

The thing about childbearing in general is that it's uncertain. There's no getting around it, and most people hate uncertainty. All too often, when people are faced with uncertainty, they go to the negative  in their minds and conclude that uncertainty is bad. However, in just as many instances, uncertainty leads to something good. When we worry about the worst-case scenario occurring, it's almost as if we take as fact that it will happen, and it seems excruciating.  Here are some suggestions to accept and even embrace uncertainty about childbearing:

1. Adopt a mindful approach to living your life. Mindfulness is defined as being in the present moment (rather than focusing on the past or the future) in an intentional and non-judgmental manner. It facilitates a sense of acceptance over what life is, and letting go of the struggle of what life is not. Mindfulness is being integrated into many facets of modern medicine and psychotherapy, and there are many books and courses that can help you develop skill in leading a mindful, present-focused life. Try starting with one by a mindfulness master, Jon Kabat-Zinn.

2. Get some exposure to uncertainty. For example, eat at a restaurant for which you haven't read a review. Take a new route home from work. Although uncertainty is much different in these exercises than it is when it comes to fertility, they will help you to build up your "uncertainty tolerance muscle."

3. Make sure you are living an active, engaged, fulfilling life according to your values. I look at our self-concept as a pie chart, with each piece of the pie being a valued role that we fulfill. If your pie chart is consumed by our desire to become a parent, and you experience obstacles to childbearing, then you are vulnerable to feeling empty and hopeless. However, if becoming a parent is one of many pieces of the pie chart, then while it would certainly be disappointing to struggle with infertility, it would not be as devastating. The other pieces of the pie, whether they are close relationships, work, or outside-of-work passions, can carry you through. I currently have a client who is struggling with the perception that she is the only one of her friends and co-workers who is not pregnant or who does not have a child. She has worked to identify valued roles and activities that would contribute toward living (excuse the language) a "kick ass" life.  You can figure out how to live your own kick ass life.

These and other suggestions are compiled in a book I recently completed entitled Coping with Infertility, Miscarriage, and Neonatal Loss: Finding Perspective and Creating Meaning, which will be release by APA Books in February 2014.

The bottom line is that your life will probably not be identical to the celebrities portrayed in the media.  But, when you have accurate expectations regarding your fertility and live your life, in its totality, according to your values, you can bet that it will be rich and fulfilling, such that you handle the highs as well as any curve balls with grace, dignity, and acceptance.