Conceiving and raising one child is demanding enough – yet historical

reports suggest that one woman bore 69. Are they true? And will
modern medicine push the limit even further?

I
If British tabloids had existed in the 18th Century, they would have gone utterly barmy
over the family of Russian peasant Feodor Vassilyev.

Why? His first wife – whose name is lost to history – holds the widely cited world record
for bearing the most children. According to a local monastery's report to the government
in Moscow, between 1725 and 1765 Mrs Vassilyev popped out 16 pairs of twins, seven
sets of triplets and four sets of quadruplets, over 27 separate labours. The grand total:
69 children.

You can only imagine how a present-day newspaper editor would react to such
fecundity, especially given the tabloid clamour in recent years over octuplet
mother Nadya "Octomom" Suleman, who has 14 children, or the Radford family in
Britain, which has 16 kids – and a TV show.

So, is it even possible to birth 60+ children? "It sounds fantastical. I mean, 69 kids?
C'mon!" says James Segars, director of the Division of Reproductive Science and
Women’s Health Research at Johns Hopkins University.
A woman could, in theory, become the mother to more children
than we ever thought possible
I decided to dig a bit deeper into this astonishing – and seemingly dubious – claim, by
consulting reproduction experts. My hope was to discover the fundamental limits to how
many children a woman could ever naturally have. But along the way, I also discovered
that if you take modern science into account, a woman could, in theory, become the
mother to more children than we ever thought possible.
In the UK, only around 1.5% of pregnancies lead to twins, and as for triplets, it's a
vanishingly small three ten-thousandths of a percent (Credit: Getty Images)
First, let’s consider the mathematics of the Vassilyev report. Would she have had
enough time for 27 pregnancies in the 40 year-span that is claimed? Initially, the answer
appears to be yes, especially if you take into account the fact that triplets and
quadruplets are usually birthed after shorter-than-average terms.
Mrs Vassilyev would have been pregnant for 18 years in total
Some rough calculations: 16 twins times 37 weeks; seven triplets times 32 weeks; four
quadruplets times 30 weeks. Add it up, and Mrs Vassilyev would have been pregnant
for 18 years of the 40 years – half of the time, or two-decades-worth of craving pickles
and ice cream.

But whether that would be possible in reality is another matter.

For starters, could she have been fertile enough over such a long time period? Women
typically go through menarche at around age 15, when their ovaries begin releasing
usually a single egg every 28 days. This ovulation continues until the egg supply,
insofar as we know, is exhausted at menopause, the typical onset of which is 51 years
of age.

Most women don't get pregnant past their mid-forties, so would there be enough time to
have 69 children? (Credit: Getty Images)
Well before menopause, though, women's fertility plummets. "The percentage chance of
having a baby per cycle when a woman is 45 [years old] is about 1% per month," says
Valerie Baker, an associate professor of obstetrics and gynaecology at the Stanford
School of Medicine.

As women get older, egg quantity and quality diminish. Halfway through fetal
development, unborn females have as many as seven million immature egg cells, but
they are born with closer to only one million eggs. Only a few hundred thousand eggs
then persist into adulthood. And of these legions, technically known as follicles,
something like 400 ever mature and eventually ovulate, assuming a 30-year span of
potential childbearing.

The last of these eggs, ovulated late in a woman's fertility window, have far higher
chances of accruing damage and mutations, such as chromosomal abnormalities. Many
pregnancies with these atypical eggs self-terminate.

"Most women don't get pregnant past 44, 42 [years of age]," says Segars. "But you'll
occasionally hear of people pregnant in their late 40s."

Females are born with close to only one million eggs, and the number rapidly dwindles
(Credit: Getty Images)
The ability to become pregnant goes down with each pregnancy,
as successive labours take their toll
What’s more, the ability to become pregnant goes down with each pregnancy, as
successive labours take their toll out on a woman's reproductive anatomy. And if Mrs
Vassilyev were breastfeeding, as might be expected for a peasant who could not afford
to keep wet nurses about, her body would not ovulate. This built-in, biological method of
birth control would lengthen the odds even further for her getting pregnant as often as
she apparently must have for 69 crumbsnatchers.

Feodor and his wife, therefore, would have had to be extremely lucky (or, arguably,
unlucky) to have kept hitting the mark into her 50s.

Surviving labour

The hurdles for ushering 69 children into the world hardly stop there, however. The
winding down of a woman's "biological clock" makes a lot of sense from an evolutionary
perspective, for carrying and delivering a child is an incredibly difficult task made harder
with age.

"Nature would want to make limits," says Baker. "Pregnancy is the most physically
rigorous thing a woman's body ever goes through."

The burden of labour is what really begins to undermine the credibility of Vassilyev's 69
children claim – especially considering the setting of hundreds of years ago, out in the
Russian countryside.
Multiple twins or triplets could in principle allow for high numbers of children, but the
health risks are great (Credit: SPL)
In developed nations, modern obstetric care, such as medically necessary caesarean
sections, has slashed maternal mortality rates. In the UK, just eight women per 100,000
live births die due to pregnancy-related issues while pregnant or within six weeks of
ending a pregnancy, according to the most recent statistics from the World Bank.
Meanwhile, in one of the poorest countries on the planet, Sierra Leone, the rate is 1,100
maternal deaths per 100,000 live births.

Assuming Mrs Vassilyev survived 27 labours is accordingly dubious. "In the past, every
pregnancy was a risk to the mother's life," says Segars. Notably, the risks for serious,
deadly complications, such as hemorrhaging, skyrocket with multiple births such as
quads. 

"Every pregnancy back then was a complication, even a singleton," says Tilly.
An awful lot of nippers

Mrs Vassilyev's multiple conceptions of twins, triplets and quadruplets further strains
credibility. Fetal twins and their more numerous permutations come about in one of two
ways: either multiple ovulated eggs are successfully fertilised by sperm – so-called
fraternal twins – or a single fertilised egg divides into two or more viable embryos,
leading to identical twins with the same genetic code.
A propensity to have twins runs in families, so could Mrs
Vassilyev have been extreme example?
Overall, these events are very rare. In the UK in 2012, for instance, the chances of
birthing twins stood at just 1.5% of pregnancies; triplets, a vanishingly small three ten-
thousandths of a percent, and quadruplets or more, just three instances out of 778,805
maternities, according to statistics compiled by the Multiple Births Foundation. 

True, a propensity to have twins does run in families, so Feodor's wife could arguably
have been just an extreme example. But overall, the odds for Mrs Vassilyev to have
somehow conceived and then survived the cranking out of 16 twins alone – let alone the
quads – seem astronomical. "Even just the 16 sets of twins? I'd be shocked," says
Jonathan Tilly of Northeastern University, who is investigating oocyte stem cells for their
use in infertility and women's health (which we'll hear more about later on).
Modern fertilisation techniques mean births of countless children could, in theory, be
possible (Credit: SPL)
Yet another red flag in the Vassilyev tale: supposedly 67 of those 69 children survived
infancy. Infant mortality was high in the 18th Century for full-term singletons, and
dismally more so for higher-order births, who are almost always born pre-term and less
healthy. "Even if you had four sets of quads today, I'm not sure they'd all survive," says
Segars.

Finally, there’s one question that beggars belief: what woman would want to do this?
"Just think of the stress!" says Baker.

Segars agrees. The last reason he doubts the Vassilyev claim? "Sanity! I couldn't
imagine living in that house."
If it were true after all, however, the daunting childcare duties could be part of the
reason why after decades of marriage, the Vassilyev couple split up. Old man Feodor
took a second wife, who allegedly had "only" 18 children. Talk about tabloid fodder.

Brave new world

So what is the actual limit? Answering that question today is complicated because the
"natural" limits to offspring from an individual woman no longer strictly apply.

For starters, assisted reproductive technologies (ART) developed in the late 1970s has
led to a spike in twins, triplets and so on. (“Octomom” Suleman, for instance, used
ART.) The fact that surrogate mothers can now carry the biological fetuses of other
people also potentially increases the maximum number of children possible within one
family.

One researcher believes that it might one day be possible to switch on a woman's
ability to produce vastly more eggs (Credit: SPL)
The fact that surrogate mothers can now carry the biological
fetuses of other people potentially increases the maximum number
of children possible within one family
But perhaps most intriguingly, research findings in the last few years hint that the outer
limits of female reproduction could be much greater than we can imagine. Recent
studies suggest woman's ovaries contain "oocyte stem cells" that, if properly stimulated,
might allow her to produce eggs in almost unlimited number.

Tilly and colleagues have documented these cells in creatures ranging from flies to
monkeys and, in 2012, humans, too. While oocyte stem cells do not produce eggs in
humans, they do in other creatures. Female flies make fresh eggs routinely this way.

While many doctors in his field harbour doubts, Tilly believes the mechanism in
women could, in principle, be switched on, helping women whose existing egg supply is
in dire straits or prematurely exhausted from cancer treatment, for instance.
In theory, women could be more like men – with the capability of
mothering hundreds if not thousands of children
If that hypothetical procedure does turn out to be possible, consider this extreme
scenario: fertility drugs could be used to induce ovarian hyperstimulation, wherein
multiple follicles mature and ovulate at once. These bunches of eggs could then be
surgically removed and fertilised in vitro, outside the body, for subsequent surgical
placement into the uterus of an army of surrogate mothers, who would carry the foetus
(or foetuses) to term. Each one could potentially have twins – or more.

From a reproductive perspective, then, women could therefore be more like men – with
the capability of mothering hundreds if not thousands of children, leaving Mrs Vassilyev
in the dust.

Tilly makes clear that his research is not in any way intended to open the doors to
women having thousands of children. The idea is to aid the fertility of those who are
struggling. Still, he's hopeful it might level the playing field when it comes to fertility
across the genders.