If you're like many women today planning to start or add to your family later in life, you'll be happy to learn that there are many choices for you to consider.

When Jenn Hewlitt, 45, of Hartford, Conn., successfully conceived twins two years ago, her dreams came true after agonizing years of waiting.

Medical advances, such as in-vitro fertilization (IVF), now make it possible for women to decide to enjoy career stability first and start a family later.

Eggs Age Along with You It's important to be aware of the risks involved in delaying motherhood. A woman's fertility peaks around age 28 and then drops every year after.  "Many women at age 36, 37, or 38 think they have plenty of time. They don't," says Robert Straub, M.D., a reproductive endocrinologist with Reproductive Biology Associates in Atlanta, Ga. But this isn't necessarily true for every woman, as the incidence  of midlife pregnancy when you haven't planned is very high.

But even with the help of state-of-the-art reproductive technology, many women who struggle to conceive face the reality that they can't get pregnant with their own eggs. You have fewer eggs as you get older, but your ovaries shed the healthiest eggs when you're young and the more defective, less viable eggs as you age. Because of this, the success rate of IVF is only 10 percent for a 43-year-old woman, says Peyman Saadat, M.D., medical director and founder of the Pacific Reproductive Center in Beverly Hills, Calif. By 45, that rate drops to between zero and 1 percent if you require the IVF route.

But, if you beat the odds and conceive with your own eggs, you risk miscarrying or giving birth to a child with Down syndrome or another chromosomal abnormality because of the poor quality eggs. At age 35, roughly 33 percent of a woman's eggs are abnormal. By age 40, that percentage jumps to 50 percent. By age 44, it's at 90 percent. For those women who need assistance to conceive, IVF provides the opportunity to have a biologically related child, but only if you are younger than age 44, says Saadat.

In its simplest form, IVF involves using drugs to stimulate the ovaries to produce more than one egg. These eggs are then surgically removed ("retrieved") and mixed with sperm in a laboratory.

The resulting embryos are either implanted into a woman's uterus or frozen for later attempts. 

Using Donor Eggs In IVF with donor eggs, the fertility center screens the donor to ensure she's a good candidate, both physically and emotionally. Information such as eye color, skin tone, and ethnic and educational background can be used to try to match a donor's background to the recipient's.

If you are attempting pregnancy with an egg donor, once you choose your donor, the center mixes 10 to 15 of the donor's eggs with your partner's sperm, while you take hormones to stimulate your uterine lining to secrete the nutrients needed for an embryo to grow. By the seventh week of pregnancy, the placenta (the specialized organ that nourishes the fetus) makes its own hormones, and you no longer need additional hormones.

For those women requiring IVF, success rates with donor eggs vary from 50 percent to 70 percent regardless of age. But few centers offer the procedure to women older than 50, citing ethical reasons. Women who have a baby at age 50-plus will be caring for teenagers in their late 60s. Furthermore, little is known about the effects of pregnancy on women who are more than 50 years old, or the effects of age on the uterus as the place to nurture a baby.

Understand the Risks Getting pregnant is just part of the story, however. The longer you wait, the more dangerous it can be-for mother and baby.

Older moms are at increased risk of developing pregnancy-induced diabetes and high blood pressure, as well as preeclampsia, a dangerous condition that can result in liver and kidney damage, and, in rare cases, death of the mother and/or baby.

Also, older women are taking on parenthood when their peers are considering early retirement. With achy joints and aging bodies, they assume a role that requires many sleepless nights and lots of heavy lifting. Instead of having an extended family that can offer help, older moms often find themselves caring not only for their children, but for aging parents, too.

What older parents lack in energy and strength, however, they often make up for in patience and dedication. "It's so intentional at this age," says Nancy London, manager of www.mothersoverforty.com and author of Hot Flashes, Warm Bottles: First-Time Mothers Over Forty. "It's not like you are 20 years old and thinking, 'Oops, I got pregnant.' You usually have put some effort, and often your life savings, into it."

When IVF Isn't an Option If you've had a hysterectomy or have medical problems, such as high blood pressure, diabetes, or heart disease, IVF may not be a possibility. One option to have a genetically related child if you are unable to get pregnant is surrogacy; where couples use their own sperm and eggs (in some cases donor eggs) to create embryos that are implanted into a younger woman's uterus. This surrogate carries the baby to term and then turns it over to the couple to raise. As you might imagine, surrogacy raises numerous sticky issues, and it is recommended that you meet with a reproductive rights attorney before moving forward.

If IVF has been ineffective, is too expensive, or not appealing for other reasons, you could consider adoption. Bear in mind, though, that some U.S. agencies set an age limit of 40 for adoptive parents. If you're over 40, you may be able to adopt a child from another country. China, for example, offers adoption only to parents over 30 and sets no maximum age.

No matter your age and no matter how you become a mother, one fact is almost certain: You'll love your child as your own, even if you are not genetically related. 

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