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Many women in their forties are realising their dreams of motherhood.
Clutching her exposed belly, where a small tattoo hints at her racy, child-free past, the expectant fortysomething mother lies on the doctor's couch, frown lines forming. ''Is the baby OK?'' Suddenly the room goes quiet as Professor Kypros Nicolaides, a legendary figure in the world of prenatal surgery, whirls through the door in a fireball of Greek Cypriot charisma. ''Heart, bladder, spleen, all perfect,'' he says, as he performs an ultrasound scan. ''Now stop behaving like someone in a Greek tragedy. Next question!''
According to Professor Nicolaides, the number of women having children late in life isn't just rising, it's an ''epidemic''. Today, in his private Harley Street clinic, many of his patients are in their late thirties and early forties. ''In 1970, five per cent of pregnant women were over 35, but in most European countries the figure is now 20 to 25 per cent,'' he says.
Nicolaides, who holds two professorships and runs a medical foundation that researches foetal health, believes that scientific advances will allow more and more women to have children late in life. ''The process of taking women in their thirties and storing their eggs for when they get older will get easier and become more popular,'' he says.
Such heartening news will, of course, offer little consolation to the thousands of fortysomething women who face the agony and heartbreak of discovering they may have left it too late. Some plough their savings into IVF (privately it costs about £3,000 per cycle), others resort to alternative therapies such as acupuncture.
France's First Lady, Carla Bruni, is said to be desperate to have a child with Nicolas Sarkozy. At 41 (the French President is 54), there's no telling if she'll manage it and the couple are reportedly considering adoption.
Nobody is saying it's easy. The miscarriage rate is higher in older women, as is the risk of having a disabled child. And however healthy and fit a woman may feel at 40, the cruel biological truth is that the quality of her eggs declines significantly in her late thirties, and even faster in her early forties. Added to that, men of 35 and older are 50 per cent less likely to conceive a baby with a similarly fertile female partner than men who are younger than 35, according to fertility guru Zita West.
Yet despite these overwhelmingly dismal statistics, a startling number of older women do realise their dreams of motherhood, many of them with no medical intervention at all. And this paradox isn't just a Hollywood phenomenon (see page 2), partly fuelled by energetic cycles of IVF. According to "Mothers 35 Plus", a UK website devoted to late motherhood, the number of women giving birth over the age of 40 has doubled in 10 years.
Professor Nicolaides, whose own grandmother had a child at 53, takes a refreshingly positive – if unconventional – view. ''The risks of late motherhood are completely exaggerated,'' he says, sweeping me into his handsome, wood-panelled office, where spotlit shelves are lined with his collection of ancient Greek pottery. ''There's an increased risk of Down's syndrome but the vast majority of women have normal babies at 40 and completely normal pregnancies.''
He attributes the late motherhood trend to women going ''into the professions'' and becoming intolerant and short-fused. ''You become stroppy like me!'' he says, eyes twinkling merrily (Nicolaides is divorced with two children). ''You develop your own routines and you don't tolerate fools!"
For those older women even-tempered enough to pursue both work and motherhood, the challenge is not necessarily carrying their pregnancy to full term, or even the birth itself, it's getting pregnant in the first place. Many never make it to Professor Nicolaides's clinic.
Instead, they visit Zita West, who runs a private fertility clinic that combines Western medicine with complementary therapies. ''I'm seen as a last-chance saloon,'' she says. ''Most of these women have been told there's no hope. They arrive at my clinic in floods of tears.''
West, a warm-hearted mother of two who trained as a midwife and acupuncturist, believes that the negative voices of authority can become dangerously self-fulfilling. ''Although I have a medical background, I feel the news that's delivered to women is quite brutal,'' she says. ''Having a baby is a deep burning desire for many women. And if you're told that your ovaries are withered and geriatric, it has a huge impact. Yet women age biologically at different rates. Some women over 40 may have the ovarian age of women of 35 and a 35-year-old may be more fertile than a woman 10 years younger.''
West, who has helped clients as old as 44 conceive naturally, believes that the approach to fertility is often over medicalised and fails to examine the whole picture, whether it's emotional health, diet, stress levels or exercise. ''Having sex naturally works better than IVF for women in their forties,'' she says. ''And I'm a great believer in the body/mind connection. Wherever you put your energy, things start to happen.''
一位四十来岁的母亲充满期待地躺在医生的检查椅上，她皱着眉头，手放在裸露的腹部上，那里有一处小小的纹身，暗示出她从没生育过孩子。“孩子好吗？”突然，房间里静了下来，基普罗斯.尼克莱德斯教授大步流星走进门来。他是世界产前外科界传奇式的人物，是希腊塞浦路斯族中的英雄。“心脏、膀胱、脾脏，一切完美。”他边操作着超声波扫描议边说。“好了，不要像演希腊悲剧那样悲悲切切了。问下一个问题。”
据尼克莱德斯教授说，大龄生育妇女不只是数量上升的问题，而是成了一种“传染病”。今天，在他哈雷街的私人诊所里，许多病人接近或超过了四十岁。他说，“1970年，5%的怀孕妇女超过35岁，但是在大多数欧洲国家里，现在这个数字是20-25%。”
尼克莱德斯已经取得了两种教授资格，他管理着一个专门研究胎儿健康的医学基金会。他认为科学进步会允许越来越多的妇女可以在较晚的人生阶段生育孩子。他说，“从三十多岁的妇女身上取得卵子并储存起来到她们年龄更大时使用，这种医学处理过程将会更加容易，也会更加流行。”
如此的消息令人鼓舞，给成千上万四十岁左右的妇女带来了不小的安慰，她们原以为自己生育已经太晚而苦恼心碎。她们中有人用积蓄去投入“体外授精”的疗法，（私人医生做体外授精，整个过程花费3000英镑）还有人采用了如针灸等的不同的疗法。
据传，法国第一夫人卡拉.布鲁尼非常想为尼古拉.萨科齐生一个孩子。她已经41岁了，（法国总统54岁）不知道她是否能做得到，据报导总统夫妇考虑领养一个孩子。
没有人说这是一件容易的事情，大龄妇女的流产率很高，生残障孩子的风险也比较大。妇女到了40岁，无论自己感觉多么健康，也无法改变残酷的生理学事实：在接近四十岁时，妇女卵子的质量明显下降；过了四十岁，卵子质量下降更快。此外，据生育专家兹塔.惠斯特称，35岁以上的男人与35岁以下的年轻男人相比，使妇女受孕的可能性也下降了一半。
尽管统计数字令人沮丧，有数量惊人的大龄妇女实现了做母亲的梦想，其中许多人根本无需医学的介入。这种看似矛盾的境况并非好莱坞现象，部分是由于体外授精富有生命力的周期造成的。据一家英国大龄生育网站“35岁以上的母亲”估计，在10年里40岁以上生育妇女的数量翻了一翻。
尼克莱德斯教授本人的祖母在53岁时生了一个孩子，他对大龄生育持正面的新观点，假如算不上离经叛道的话。他把我推进他那漂亮的，用木制护壁板装饰的办公室，用射灯照亮的书架上陈列着古希腊的诗集。他告诉我说，“大龄生育的风险完全被夸大了。虽然婴儿患唐氏综合症的风险会增加，但是大多数40岁的妇女能正常生育孩子，会有完全正常的孕期。”
他把妇女大龄生育的潮流归咎于女性从事职业，她们的个性变得易怒和不太宽容。他愉快地眨着眼睛说，“你有了自己的日常事务，容不下蠢人。”（尼克莱德斯已经离婚，有两个孩子。）
对那些心性平和，既想要工作又想当母亲的大龄妇女，对她们的挑战就不一定是足月的孕期，甚至不是生产本身，而首先是怀孕。在尼克莱德斯教授的诊所里，有许多人压根就没有怀上孕。
于是那些妇女转到兹塔.惠斯特的诊所求医。她有一家结合西医和其它辅助疗法的私人生育诊所。她说，“她们把我这儿看作是最后的希望。许多妇女被告知没有可能了，她们来到我这儿时眼泪汪汪。”
惠斯特是一位热心肠的两个孩子的母亲，她接受过助产士和针灸师的培训。她相信当局对于大龄生育发出的负面声音是颇具危险性的自说自话。她说，“虽然我有医学背景，我认为传递给妇女的信息相对当残忍。对许多女人来说，生育孩子是内心深处炽热的欲望。假如你告诉我卵巢已经萎缩衰老，对我会是一种巨大的冲击。女人的生理年龄各不相同，有些四十多岁的女人卵巢相当于35岁，一个35岁的女人有时比年轻10岁的女人更能生育。”
惠斯特曾经帮助年龄大至44岁的客户自然怀孕，她相信生育的途径经常在医学之外，无论是情感，健康，饮食，紧张程度或体育锻炼的因素，难以全部描述出来。她说，“对四十多岁的女人来说，自然的性交要好过体外授精。我是灵肉一致的信奉者，你只要投入精力，事情就会有开始。”
