Fertility Nation? Janet Jackson and the Future of Pregnancy After 45

Janet Jackson and husband Wissam al Mana attend the Giorgio Armani fashion show in 2013. Venturelli/WireImage/Getty Images

Janet Jackson (Miss Jackson, if you're nasty) is no stranger to controversy, but her latest exploit doesn't involve posing topless on the cover of Rolling Stone or another Super Bowl "Nipplegate." Girlfriend is pregnant. For the first time. At 50 years young.

Her camp is staying mum about the conception method, but it's likely that she had some medical assistance. The Southern California Center for Reproductive Medicine doesn't mince words, calling pregnancy over 45 a "very difficult proposition." In fact, women in said age group have a less than 1 percent chance of getting pregnant using their own eggs because these eggs are likely to be genetically abnormal. "Successful pregnancy over 45 is therefore nearly always the result of egg donation," the group states on its website. "Many high profile women who have become pregnant in their 40s especially after the age of 45 did so with the help of donor eggs."

It's also worth noting that sperm viability decreases with age. Motility (how well sperm move toward the egg) and sheer volume tend to drop consistently between the ages of 20 and 80. It can take five times longer to get pregnant by a man over 45, as by a man under 25, according to nonprofit fertility education group Your Fertility. For the record, Jackson's husband, Qatari billionaire Wissam Al Mana, is 41.

So what infertility treatments might they have undergone? That would depend on what the problem is and whether the issue is with the man, woman or both. More complex cases often require assisted reproductive technology (ART), the most common being in vitro fertilization (IVF). This typically involves the retrieval of a woman's egg, followed by fertilization with sperm in a petri dish. Embryos are implanted in the woman three to five days later.

Sometimes the doctor needs to fine-tune this process. She may have to perform assisted hatching (opening the outer covering of the embryo so that it can more easily implant into the uterus) or intracytoplasmic sperm injection (injecting one sperm squarely into a mature egg, usually when there are few "boys" to choose from) to make a viable pregnancy more likely.

What's on the horizon

Science is attempting to take things to a new level by growing entire eggs or sperm, although for the moment that's limited to mice. A group of Japanese researchers reported in 2011 that they'd made embryonic mouse stem cells into primordial germ cells, which were then implanted into testes or ovaries of live mice, becoming sperm or eggs, respectively. This has since been followed up by a Chinese team that reported in 2016 creating mouse sperm using stem cells entirely in a dish, no rodent host necessary, although some scientists doubt if this really happened.

The implications of using stem cells to produce eggs and sperm are mind-blowing, but would-be Janets shouldn't get their hopes up too soon. The human equivalent is likely to be at least a couple of decades down the road. "Mice are far less complicated than human beings," explains reproductive endocrinologist/fertility specialist Dr. Daniel Shapiro. "This study [done by the Chinese team] deals with sperm, which isn't that hard. Eggs are much more difficult to handle."

Shapiro also notes that 20-30 years of longitudinal data will be necessary to prove that the resulting eggs and sperm from stem cells are genetically safe and sound. Until then, "Is it right to create eggs and sperm where you don't know the long-term consequences of the creative processes on the human being that would result?" he asks. "It's going to be practical to do long before it's proven safe. That's the ethical concern."

Other ethical concerns could be using embryos created from stem cell eggs and destroying the unneeded ones, or creating 100 embryos and doing genetic testing on each one. "That's the future I see, people will use [the technology] to make lots of eggs and then test each embryo," says Hank Greely, Stanford University law professor and author of "The End of Sex and the Future of Reproduction."

Greely adds that it's not too far-fetched to assume that eggs and sperm could one day be generated using simple skin cells, which we shed in spades everywhere we go. "You leave cells on every Diet Coke can you throw away. So, the possibility of people becoming unknowing parents becomes bigger," he notes, with the potential for storylines fit for a soap opera. "A whole bunch of odd parental relationships (like a dead person becoming a parent) could be brought into being this way."

Until that day comes, let's all be happy for Janet that she didn't have to resort to stalking someone's soda can to bring her bundle of joy into the world. She might not have taken the traditional path, but when has she ever been predictable, anyway?

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