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.''

一位四十來歲的母親充滿期待地躺在醫生的檢查椅上，她皺著眉頭，手放在裸露的腹部上，那里有一處小小的紋身，暗示出她從沒生育過孩子。“孩子好嗎？”突然，房間里靜了下來，基普羅斯.尼克萊德斯教授大步流星走進門來。他是世界產前外科界傳奇式的人物，是希臘塞浦路斯族中的英雄。“心臟、膀胱、脾臟，一切完美。”他邊操作著超聲波掃描議邊說。“好了，不要像演希臘悲劇那樣悲悲切切了。問下一個問題。”

據尼克萊德斯教授說，大齡生育婦女不只是數量上升的問題，而是成了一種“傳染病”。今天，在他哈雷街的私人診所里，許多病人接近或超過了四十歲。他說，“1970年，5%的懷孕婦女超過35歲，但是在大多數歐洲國家里，現在這個數字是20-25%。”

尼克萊德斯已經取得了兩種教授資格，他管理著一個專門研究胎兒健康的醫學基金會。他認為科學進步會允許越來越多的婦女可以在較晚的人生階段生育孩子。他說，“從三十多歲的婦女身上取得卵子并儲存起來到她們年齡更大時使用，這種醫學處理過程將會更加容易，也會更加流行。”

如此的消息令人鼓舞，給成千上萬四十歲左右的婦女帶來了不小的安慰，她們原以為自己生育已經太晚而苦惱心碎。她們中有人用積蓄去投入“體外授精”的療法，（私人醫生做體外授精，整個過程花費3000英鎊）還有人采用了如針灸等的不同的療法。

據傳，法國第一夫人卡拉.布魯尼非常想為尼古拉.薩科齊生一個孩子。她已經41歲了，（法國總統54歲）不知道她是否能做得到，據報導總統夫婦考慮領養一個孩子。

沒有人說這是一件容易的事情，大齡婦女的流產率很高，生殘障孩子的風險也比較大。婦女到了40歲，無論自己感覺多么健康，也無法改變殘酷的生理學事實：在接近四十歲時，婦女卵子的質量明顯下降；過了四十歲，卵子質量下降更快。此外，據生育專家茲塔.惠斯特稱，35歲以上的男人與35歲以下的年輕男人相比，使婦女受孕的可能性也下降了一半。

盡管統計數字令人沮喪，有數量驚人的大齡婦女實現了做母親的夢想，其中許多人根本無需醫學的介入。這種看似矛盾的境況并非好萊塢現象，部分是由于體外授精富有生命力的周期造成的。據一家英國大齡生育網站“35歲以上的母親”估計，在10年里40歲以上生育婦女的數量翻了一翻。

尼克萊德斯教授本人的祖母在53歲時生了一個孩子，他對大齡生育持正面的新觀點，假如算不上離經叛道的話。他把我推進他那漂亮的，用木制護壁板裝飾的辦公室，用射燈照亮的書架上陳列著古希臘的詩集。他告訴我說，“大齡生育的風險完全被夸大了。雖然嬰兒患唐氏綜合癥的風險會增加，但是大多數40歲的婦女能正常生育孩子，會有完全正常的孕期。”

他把婦女大齡生育的潮流歸咎于女性從事職業，她們的個性變得易怒和不太寬容。他愉快地眨著眼睛說，“你有了自己的日常事務，容不下蠢人。”（尼克萊德斯已經離婚，有兩個孩子。）

對那些心性平和，既想要工作又想當母親的大齡婦女，對她們的挑戰就不一定是足月的孕期，甚至不是生產本身，而首先是懷孕。在尼克萊德斯教授的診所里，有許多人壓根就沒有懷上孕。

于是那些婦女轉到茲塔.惠斯特的診所求醫。她有一家結合西醫和其它輔助療法的私人生育診所。她說，“她們把我這兒看作是最后的希望。許多婦女被告知沒有可能了，她們來到我這兒時眼淚汪汪。”

惠斯特是一位熱心腸的兩個孩子的母親，她接受過助產士和針灸師的培訓。她相信當局對于大齡生育發出的負面聲音是頗具危險性的自說自話。她說，“雖然我有醫學背景，我認為傳遞給婦女的信息相對當殘忍。對許多女人來說，生育孩子是內心深處熾熱的欲望。假如你告訴我卵巢已經萎縮衰老，對我會是一種巨大的沖擊。女人的生理年齡各不相同，有些四十多歲的女人卵巢相當于35歲，一個35歲的女人有時比年輕10歲的女人更能生育。”

惠斯特曾經幫助年齡大至44歲的客戶自然懷孕，她相信生育的途徑經常在醫學之外，無論是情感，健康，飲食，緊張程度或體育鍛煉的因素，難以全部描述出來。她說，“對四十多歲的女人來說，自然的性交要好過體外授精。我是靈肉一致的信奉者，你只要投入精力，事情就會有開始。”