Sixty years ago in Bermuda it wasn’t unusual for a girl to be married and expecting her first child by the age of 17. Nowadays the average age of a woman having a baby is 29 (in England and Australia), and the number of women having babies after age 35 is at a record high.Dr Matan Yemini, co-director of the Diamond Institute for Infertility which frequently provides Bermudian patients with treatments such as in vitro fertilisation thinks this is one of the reasons so many couples come through their doors seeking assistance with fertility.Dr Yemini, a reproductive endocrinologist, will be in Bermuda in August and will give a lecture for Paperwhites Fertility Support Group.He said until the Diamond Institute became connected to Bermuda, most Bermudians sought treatment for fertility issues overseas.“When we learned that the Island was looking for someone to take care of the infertility of people, we met with the medical board and some obstetricians and gynaecologists in Bermuda and talked about a plan,” said Dr Yemini. The Diamond Institute helped Dr Dale Wilmot offer more advanced fertility care in Bermuda than was being offered at that time. “He can do more potent fertility drug treatment,” said Dr Yemini. “Only when the patients need more advanced treatment such as in vitro fertilisation, or embryo donation do they need to come abroad. They can do the preparation through Dr Wilmot and their obstetrician/gynaecologist depending on what type of operation they need.” Under this plan, the patient usually only needed to travel to New Jersey for the last few days of the treatment, stay for a few days in New Jersey, and then return home for monitoring.In 2010, the Diamond Institute provided in vitro fertilisation treatment for 13 Bermudians. Of those 13, seven patients have delivered their babies, and one is still pregnant. There was one miscarriage, and one patient who is still in treatment.“I don’t think there is more infertility in Bermuda than in New Jersey,” said Dr Yemini. “But there are things that effect our ability to take care of ourselves. We are seeing more patients who are advanced in age, coming for care. When you try to figure out how it is happening, it is a combination of things. I believe that most of the patients are working two jobs. I believe it is the cost of life, and building their homes and all those little things. It brings them to delay their care.”Unfortunately, advanced fertility treatment can be costly as many insurance companies will not pay for treatment. Dr Yemini said this was a “touchy” area.“Last year, we saw fewer patients from Bermuda than what we used to see,” he said. “The overall economy might be effecting people. The average age of patients we see is close to 38 or so. The older you are, the more likely you are to have fertility problems.”He said the first issue with advanced age in pregnancy is the quality of a woman’s eggs. Quality decreases with age. The second factor is the health of a woman’s reproductive organs. Diseases such as endometriosis might damage ovaries and pelvic organs. Fibroids can also affect fertility, among other things.Dr Yemini said the rule of thumb is that a couple trying to have a baby under 35-years-old should try for a year before seeking treatment. Couples 35-years-old and older should seek assistance after six months. A couple over 40 should seek assistance as soon as they think about trying.“If you take 100 couples age 32 who try for a year, 85 will probably get pregnant,” said Dr Yemini. “The other 15 will have infertility. If you take 100 couples age 42, in a year maybe ten will get pregnant. At age 43 they might need egg donation. He said 40-year-olds should seek assistance right away because they simply don’t have the luxury to try for long periods of time.“It is not that you need in vitro fertilisation right away, but you need testing to make sure everything is okay. Because you don’t have the luxury to wait until age 41. You don’t want to wait.”Infertility issues, aren’t all on the woman’s side. Around 35 to 40 percent of the time it is an ovulation problem, but 40 to 45 percent of the time, the problem rests with the man’s sperm. Endometriosis and tubal problems also make up a large percent of the causes, but unfortunately five percent of all infertility goes unexplained.“Even for those five percent you can treat them,” said Dr Yemini. “Even if you don’t find a reason there is still treatment.”Dr Yemini said many of the couples he sees are worn down from trying.“Everyone can have a baby,” he said. “It is not a question of can we treat the patient, but how long can they take treatment. It is very emotional, and some couples take it harder.”He said the biggest fear of many patients before coming to the Diamond Institute is that they will be told, ‘you will never have a baby’.“That is not true anymore,” he said. “We can do all different types of treatment such as in vitro fertilisation. Some people need someone else to carry their baby, because there is something wrong with the uterus. Some people need sperm donation, egg donation or genetic testing. Sometimes it is so difficult, and I have nothing but respect for the patient who can keep doing it because you need a lot of courage.”Dr Yemini said one of the most rewarding times of year at the Diamond Institute is in May when they hold their annual Mother’s Day party. All their clients who have had babies are invited to attend the party.“That fills us with emotion,” said Dr Yemini. “In May there was over 200 babies in one room. You and the staff and the nurses that work with us, that is alot of good emotion and good positive energy to keep doing that. It is really rewarding.”The Diamond Institute has been operating for 43 years, and staff are now seeing some of their babies, now grown up, coming in for fertility treatment themselves. “We call them ‘Diamond’s Babies’,” said Dr Yemini.Dr Yemini is originally from Israel. He has three children, and five grandchildren.“I was blessed,” he said. “I didn’t need to go through infertility treatments. I can only appreciate over many years how difficult it is for our patients. You never see the patients cry because of the physical pain during treatment, but you see a lot of patients crying from the heart. I always say you have to be very cautious taking care of them. We know how to fix a broken ovary or uterus, but we don’t know how to fix a broken heart. We have to be very careful not to break their hearts. If your patients lose hope then they stop treatment, then a few years later they come back and it is more difficult.”Dr Yemini will be speaking on August 2 about the various fertility treatments available. This is an opportunity for anyone wanting to speak directly to a specialist to do so and find out about options and how it all happens from Bermuda. The talk is from 6pm to 7.30pm at Spirit House at 65 Middle Road, Devonshire. More details on www.paperwhitesbermuda.com.