My heartfelt congratulations. The dilemma looms of when to announce a pregnancy to family, friends and employers. Early disclosure in the past may have triggered painful situations if a miscarriage occurred. Pregnancy after infertility may be further complicated by preexisting conditions related to the infertility diagnosis or related to the process of conception. These include multiple pregnancies, third-party reproduction, older parents and secondary infertility. For the older first-time mother, pregnancy may represent a last chance to have a child and fulfill a dream. Risks to the mother’s health may be minimized or heightened. Parents may wonder if they are too old or question whether they have the energy to keep up with the demands of young children. In addition to medical risks, social complications may result as remarriage, stepchildren or adult children from previous marriages are considered. On the other hand, women may feel secure in their careers and have the time and wisdom to share with a child who is the primary focus.