4.) KP:  I imagine that here in the bay area, where there’s so much diversity, that you work with couples from various cultural backgrounds.  How does culture impact this whole process when it comes to dealing with infertility?

Diane: I see people from various cultural backgrounds. I don’t want to stereotype anyone, but there are certain cultures that value having children at a young age, often delaying education.  They typically don’t have problems with infertility.  Then there are cultures that delay having children in order to achieve a higher degree of education and career and financial success. Delays in starting a family can also be due to trying to find the right partner.  This can sometimes take quite a long time.  And then, by the time they feel “ready” to start a family, they may be in their late 30’s or early 40’s and then there are difficulties.   Another thing I see are people who have had a divorce and are on the second marriage.  They finally figured out the partner situation and are ready to have a child but they are often older which is problematic.

The mental health community is trying to influence the medical community, specifically, Ob/Gyn’s, to educate women about the realities of their fertility.  The fact is that after 35 years of age, fertility takes a significant drop. Many women don’t know that. Unfortunately, the media has really done a disservice to women because there are movie stars all over magazines that are 45+ years old having babies.  What they don’t reveal is that they are using an egg donor and they’re not being open about that, so it’s sending women the wrong message.   Women are influenced by this and mistakenly think they can wait until they’re 42 or 44, to easily get pregnant.  Again, fertility dips after 35, and after 40 it takes a very big dip.

KP:  I’m glad you brought up the piece about the significantly diminished childbearing after 35.  That’s important information to highlight.  It seems that, generally speaking, in the dominant culture of white middle class America, there is this you-can-have-it-all-ethos, where people end up delaying the family building part.  And, the media bias certainly doesn’t help matters, as you said.  Of course, there’s nothing wrong with people trying to build families later in life, but like you said, it’s important for all to be aware of the childbearing odds as one ages.

Next: In addition to general fertility counseling, you are also known as a specialist in “third party reproduction” — can you talk about that?