'Inconvenient biology:' advantages and disadvantages of first-time parenting after age 40 using in vitro fertilization.

Background: As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of 'delayed childbearing' has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore the perceived advantages and disadvantages of postponed conception as well as participants' retrospective opinions on the 'optimal age' for parenting.

Methods: To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46 couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median income was 3-4 times higher than that of the average US family, which may bias their largely positive parenting experiences.

Results: Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-parenting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culminated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling 'lucky' to have children at all. Other disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents.

Conclusions: These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of participants identified the optimal age for first-time parenting as 5-10 years earlier than they had conceived. This age range was imagined to maximize the financial and emotional advantages of later parenting while minimizing the impact of age-related infertility, diminished energy, anticipated health issues and the social stigma of appearing too old to parent.