40s are the new 20s

Fabulous & Fertile

 40s are the new 20s

Gone are the days of thinking that life ends at 40.  - We have all heard the expression that 40’s are the new 20’s, but there may be something to this entire theory.  For so long, women have had a difficult time with approaching 40.  Now there seems to be a revolution happening as 40 –year- old women are embracing their ageand younger women are looking forward to reaching the milestone--- coming into the full understanding of their value and capable abilities, living life without apologies, without societal stigma’s and doing everything that makes them happy without approval from anyone. 

Today’s celebrity moms are defying the clock both in their fab wrinkle-free faces... and their biological clocks If there is any indication that 40 is the new 20, look at Halle Berry ( mother at 42 and 47), Madonna (42), Jennifer Lopez( twins at 39) , Salma Hayek (41) Uma Thurman (41); Mariaj Carey and Jane Seymour had twins at 52 and 45! Closer home  pop-singer-actress Raageswari Loomba( 40) delivered a baby girl at 40 ! 

 Joining this amazing list is Miss World (1997)Diana Hayden ,42 , who gave birth to beautiful baby Arya early January this year. Diana  married Collin Dick from Las Vegas, in  2013.^[Collin has been working in Mumbai for an international NGO The curious part? The child was born from an egg that Hayden had frozen eight years ago. The actress-model and her doctors-- Dr. Nandita Palshetkar and Dr. Hrishikesh Pai  talk about the latest egg freezing technology and why it is  important for today’s ambitious women to think about it.

When did you first hear about the technique and why did you decide to opt for it?

Being a voracious reader, I happened to come across some material about egg freezing ten years back. It was mainly being used in the US and Australia in cases of cancer, as a way to allow the patient to have a child once they had overcome the disease. The more I read about it, the more I liked the idea of freezing my eggs as that would give me the option to wait for Mr. Right to come in to my life and for me to decide when I wanted to have a child, instead of time or my biological clock dictating the terms of my life.

I had no idea the technique was being pioneered in India by Dr. Nandita Palshetkar and Dr. Hrishikesh Pai until a common friend who I had told about this, introduced me to Dr. Palshetkar. After meetings and all of my questions being answered, I was sure this was definitely what I wanted to do.

Had you decided you would have a late marriage?

Funnily, everyone in my family always thought I would be married with children by the time I was twenty because I love children. I just never met the man I felt I’d like to spend the rest  of my life with, and there was no way I was going to  get married to anyone but Mr. Right.

You started freezing your eggs almost 10 years back? What exactly did you undergo?

 In spite of my maternal instincts, and being a self confessed die-hard romantic, I wasn’t ready for my choices to be dictated to me which is why I loved the idea of egg freezing. It gave me the freedom of choice. I only confided in my close friends about my plans back then. They thought I was completely insane to consider something so outlandish. There was also a sense of fear on their part; fear of an uncommon medical procedure. Introduced to Dr. Palshetkar by a friend, I could not  see why I should not  opt for the procedure to allow me the freedom to choose when I became a mother, age no bar.

Finally fully satisfied, 8 years back when I was 34 years old, I decided to freeze my eggs.

Did you have a smooth pregnancy? Were there many dos and donts?

My pregnancy was pretty smooth. The biggest issue I had was severe acidity as it has  been an issue with me for years. I had no more Do’s and Don’t’s than any other pregnant woman.

Did you need to prepare yourself mentally to be a mother at 42?

I think if you need to prepare yourself for motherhood it would be more when you are  a very young mother than  an older one. Saying that, from the time I was very young I have always wanted, and looked forward, to being a mother.

Would you say it’s safe to plan later motherhood?

A woman is always better off  having her first child before she turns 30, mainly for medical reasons, but I would never advise any woman to get married and have children because they feel the pressure of age or their biological clock ticking.

Now that you are a mother of a beautiful baby girl, what are the major challenges you  face on a day-to-day basis?

Six  weeks into motherhood of my beautiful bundle of joy, and my biggest challenges are: is she feeding enough and is she pooping properly! I had always heard of what a joy becoming a mother was, but I had never expected it to be such a beautiful, wholesome experience where you fall in love with your child every day, a few times a day. I feel truly blessed to be so lucky to have Arya.

Dr.  Nandita Palshetkar & Dr. Hrishikesh Pai

Do you believe that the 40s are now the 20s with more and more women planning late motherhood?

 Women are delaying motherhood but they still face the constraint of their   biological clocks. Although egg freezing has provided various options to a woman to preserve her fertility, before she starts a family when she is ready, the success of egg freezing also depends on the age at which a woman freezes her egg. Women who are 40 and over, are less likely to benefit from egg freezing. So we recommend that they should freeze their egg at an early age. 

When was the egg freezing first introduced in India?

We have started technique of vitrification in 2006. To our knowledge, we were the first to start vitrification in India.

What exactly is the process of vitrification? Is it safe for eggs to be preserved over long periods?

Egg contains a high amount of water. When it is frozen, the ice crystals that form can destroy the integrity of the cell. To prevent this, the egg must be dehydrated prior to freezing. This is done using substances known as Cryoprotectants.

Vitrification is the newer method of oocyte freezing which utilizes very high concentrations of cryoprotectants that solidify without forming ice crystals. It has revolutionized our ability to thaw successfully frozen eggs as rapid cooling rates spare the egg from forming ice crystals within, and as a result, they are less likely to damage upon thawing. Many studies also say that it is a safe technique.

 What is the normal shelf life of frozen eggs?

Eggs are frozen in the same manner as embryos, utilizing a freezing temperature of  -196 degree Celsius. Based on scientific evidence as well as our experience, pregnancies have been achieved successfully with embryos frozen for 5 to 10 years. It is expected with the egg freezing also that, long term storage will not result in any decrease in quality. Our patient, Diana, conceived with eggs frozen 8 yrs ago.

What are the precautions a mother needs to take?

A woman should check her ovarian reserve before going for egg freezing. She should be counseled regarding the success rate as well as risk related to procedure.

As such egg freezing is not related to any risks or side effects. Rarely use of injectable drugs to induce ovulation, can cause ovarian hyperstimulation syndrome, in which your ovaries become swollen and painful soon after ovulation or egg retrieval.

 What are the advantages and disadvantages of opting for this technique?

·        Egg freezing gives opportunity to a woman to preserve her fertility in order to increase her chances of being able to start a family when she is ready.

·        Avoids loss of surplus oocytes in countries, where embryo freezing is not permitted.

·        This is like an insurance policy for a woman, as she can use the eggs later on when wants to conceive.

Disadvantages:

·        Success rates of frozen eggs are now better than previously; still freezing of eggs is not a guarantee for success.

·        Other issue related with oocyte freezing is that patient will need Intracytoplasmic injection of sperms (ICSI) as only procedure for fertilization with frozen oocytes due to hardened egg shell (zona pellucida) in the process of freezing.

How cost effective is the procedure?

The cost of oocyte cryopreservation is similar to the cost of an IVF cycle, and intracytoplasmic sperm injection (ICSI) is required to fertilize the thawed oocytes.

It can be said to be  a cost effective procedure as it provides a chance to maintain the reproductive potential for women wishing to delay their reproductive choices. In addition it avoids the cost of oocyte donation, which is the most common option  left if they plan for IVF later, especially after the age of 40.

Is egg freezing now becoming more acceptable or are there misconceptions?

Egg-freezing is the latest development in the field of assisted reproduction, which gives women an opportunity to slow down their biological clock by freezing their eggs. Considering its advantages American Society of Reproductive Medicine removed the "experimental" label from the technique in 2012 and it has since been included in mainstream fertility practice.