Photo by Steven St. JohnTribune

Tribune

Ross Reichard holds his twin newborn Vreni while working on his laptop computer at home. Although Reichard, 36, and his wife, Kaari, 39, are doctors, they said they were surprised at how low their odds of having children had dropped by the time they were ready.

Photo by Steven St. JohnTribune

Tribune

Ross and Kaari Reichard get ready to take a walk to a nearby park with their twin daughters Caroline and Vreni. The Reichards are among a growing number of couples who have had children with the help of fertility treatment. "The best thing in the world is that I have two healthy kids," Kaari Reichard said.

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The adjustment to parenthood seems effortless when you see Ross Reichard's two 6-week-old daughters sleeping in his lap, occasionally peppering the air with tiny baby snores.

But the path to pregnancy for Ross, 36, and his wife, Kaari Reichard, 39, was anything but effortless.

Though both are doctors at the University of New Mexico - she's a cancer pathologist and he's a forensic pathologist - they said they were surprised at how low their odds of having children had dropped by the time they were ready.

At 38, Kaari's chance of naturally conceiving was only about 4 percent. And with the help of a fertility specialist, that only grew to about 20 percent, the pair said.

"It was disheartening - the chances even with in-vitro fertilization," Ross Reichard said. "You tend to think if you want kids you can have them."

The Reichards are far from alone. Business is growing fast at Albuquerque's fertility clinics - especially as older would-be parents learn of their odds.

Chances of fertility drop off rapidly for women in their late 30s and early 40s. By 46, the chance of conceiving naturally is just about zero.

Those odds are a common shocker for hopeful couples like the Reichards who come into the office of Paul Magarelli, a fertility doctor at UNM.

"We're physically geared to reduce fertility starting at age 26," Magarelli said. "And in the past, that was OK because we didn't live that long. But we're young at 40 now. A 40-year-old has 46 years ahead of them."

The Reichards came to Magarelli's office after trying on their own for a year - and got pregnant after their first try with in-vitro fertilization, a method in which an egg is fertilized in a lab and then implanted in the woman.

The Reichards were lucky. It's not uncommon for it to require several tries before a baby takes. And at $9,000 to $14,000 per try, it can take quite a financial toll.

There's also an extensive physical regimen for each try - including operations, acupuncture, exercise, vitamins, drugs and staying away from hot tubs, alcohol and tobacco.

"If I had to, I'd do it again," Kaari Reichard said. "I don't want to, but I would."

Older men also have to take vitamins, exercise and avoid unhealthy activity as part of the process.

A man's fertility rate also drops in his 40s, but not as significantly as the woman's.

Still, none of that has stopped couples from flowing into Magarelli's office in Albuquerque and his main office and lab in Colorado Springs, he said.

After three years, Magarelli's Albuquerque practice has grown to about 90 patients in 2007 - and he's expecting that number to double to 180 in 2008.

"It's pretty much doubled each year since the first year," Magarelli said.

The Center for Reproductive Medicine of New Mexico, which has the state's only fertility lab, has seen a similar increase, said Lee Caperton, one of its two doctors.

"We do have a large portion of people who postpone seeking care until they're over 40," Caperton said.

For the Reichards, waiting until their late 30s to have twins Vreni and Caroline has been a good thing. They're more stable financially, and they're emotionally ready for the responsibility of parenthood, they said.

"I definitely have more patience than I would have had 10 years ago," Kaari Reichard said. "You're more established, more set up in your life."

The technology to help older couples has improved quite a bit since the 1980s, when the Center for Reproductive Medicine was founded, Caperton said.

"The nature of the medicines we use and the types of stimulations we do have changed," Caperton said. "The way we transfer embryos has been refined; the quality of our lab equipment is much better. It really has dramatically improved the chances of pregnancy."

The first in-vitro baby was born in the 1970s. Back then, chances of conception weren't as good - even with fertility drugs and lab techniques - and so a trend started where doctors would fertilize multiple eggs, Magarelli said.

"That's good news and bad news," Magarelli said. "The bad news is they all take. The good news is they got a baby."

The technique led to a growing number of multiple births, which is not usually the ideal result, Magarelli said.

Since then, the technology has vastly improved, he said. There's still a higher chance of getting twins than in natural conception, but the rate of triplets, quintuplets and other multiples has gone way down, he said.

"In 1978 we were putting in 10 embryos," Magarelli said. "In 2007 we use a lot less. One or two if the patient is in her 20s, three or four if they're from age 38-40. And four to six if they're over 40."

In the 20s, a larger percentage of a woman's eggs are healthy. In her 40s, 90 percent or more are unhealthy, Magarelli said.

But a newer technology can get around that. It's the ability to freeze eggs or embryos while women are in their 20s and save them until people are financially and emotionally more prepared to have children.

"That technology has advanced rapidly over the last decade or so," Caperton said. "The idea is an intriguing one. A lot of women have looked at egg-freezing as an option to preserve fertility."

The most important thing is probably just to be aware of fertility odds at a younger age - so people have a plan for what to do if they want to start a family, Magarelli said.

After the process, the Reichards are telling all their friends what they've learned, in hopes they'll be better informed about the odds, they said.

"The best thing in the world is that I have two healthy kids," Kaari Reichard said, smiling at her two sleeping daughters.