Optimal Age for Starting a Family: Fertility & Health Concerns

Question
My fiance and I plan on getting married July 2, 2005.  We have been together for 3 years.  He is 27, and I am 22.  He wants to have children right away, and I want to wait for a while.  He says he's getting older and wants to be able to be active with our children once they get older.  Not only that, but we are both worried about the fertility factor and to what age is safe to have a healthy baby (i.e. downs' syndrome).  I would appreciate any insight you may offer in this matter.  
Thank You,
Linda

Answer
You can conceive safely until you reach menopause (around age 50). After the age of 35 it becomes more difficult to  conceive. However, if you have regular periods, there is no problem. Up to the age of 30, the risk of chromosomal abnormalities (like Down's syndrome) is 1 in 2700. At the age of 35, the risk of Down's syndrome is 1 in 350. Since the risk for Down's syndrome at that age is 1:350 and the risk of miscarriage from amniocentesis at that age is 1:400, we recommend amniocentesis because the risk of the disease is greater than the risk of Down's syndrome. At the age of 40,  the risk is 1:100, and as you get  older after  40, the risk increases logarithmically.  I would not worry. I have had many patients who were in their 40s having their first baby. Don't worry. I would recommend that you conceive when you are financially ready, and ready emotionally. Good Luck.