Here are the facts: Female fertility in fact begins to decline from late twenties/early thirties (not thirty-five), with the rate of decline increasing at age 35, another drop at age 37, and pregnancy chances significantly reduced after age 40. IVF success rates similarly drop after age 35. This varies amongst women - in some cases it could be sooner, in others later, but the one common theme is that most have absolutely no idea how fertile they are. Men also are a far larger part of the equation than people realize – a third of cases relate to solely male fertility issues.
So what's the biggest surprise? It is the amount of misinformation that exists in society. How often men and women really know very little about their own fertility.
This is reinforced by a University of British Columbia study reported last year in the Journal of the American Society of Reproductive Medicine, which highlighted that while women were aware that fertility declined with age, they were not aware of the extent to which it declined concluding that this lack of education was leading to an increase in the number of unintentionally childless women. Yet fertility seems to be something which even well-informed people are reluctant to discuss for fear of offending. The question is why? Why does this misinformation exist?
Mis-education and misinformation to a large extent comes from the media. They are focused on sensationalist headlines, such as ‘Woman of 50 gives birth to twins’ or ‘celebrity X becomes mother at 45’. They fail to report medical facts accurately, or without spin. They should report the statistical likelihood of such a pregnancy happening with one’s own eggs, to give a real sense of the (low) probability of it happening or if donor eggs were used. They misleadingly give the impression that IVF cures all infertility issues.
Women who have suffered or are suffering from fertility issues can add to the lack of information by not sharing the knowledge they obtained with others. Many suffer embarrassment or shame to admit a problem. Some do not wish to receive negative feedback. Others develop ‘rose-tinted spectacles’ after a successful birth, forgetting their troubles. I was amazed at how many women suddenly shared their stories, but only after you started to tell yours. It is only through sharing honest accounts that we get the correct information and start to really ‘get it’.
People may expect their families to ask about plans for children and talk about such issues. This is not always the case, particularly in this modern world where often parents are scared or do not want to be ‘too involved’ in children’s lives. Today many take the approach with their adult children of, ‘I don’t interfere’. Parents may not share relevant medical information relating to their own fertility. Some feel that they don’t have to, once children are adults. Yet ironically as children they were probably too young to appreciate the information’s relevance.
Assumptions that people make about working women can be very alarming. If they see her working with dedication to her job, they assume she is a career-girl not interested in children, even if she has not been asked or said anything along those lines. Assumptions are something people do often, to somehow ‘classify’ things in their heads, even if without the facts. It’s easier than asking questions.
Men also suffer from this misinformation. Because of it, they can equally delay starting or feel that a woman who talks about starting a family sooner is being ‘paranoid’ or ‘unnecessarily panicky’. Men should understand about their own fertility, and that of women, and vice versa. After all, it is a fifty/fifty equation, isn’t it?
With all these factors bouncing around, what can we do to grapple the issue by the horns and improve awareness?
Education can improve at various levels. Start at school with sex education classes extended beyond prevention of teenage pregnancy, to include knowledge of the changes in fertility with age. Improve the education of GPs - surprisingly, these can sometimes lack understanding on the extent that fertility declines with age. GPs should be required to have fertility conversations with women at contraception checks to ensure they’re properly informed. The same should be done at gynecological checks. Regular fertility checks should be promoted.
Employers should be encouraged to be supportive of women in their more fertile years, so that they feel they can return to work without risk. This needs positive affirmation from employers beyond relying on legislation. It would be good to see employers embrace fertility awareness days in their organizations.
We can encourage people to speak more openly about fertility to foster improved education and awareness and remove the stigma of discussing. In the States, Giuliana Rancic and her husband are pioneers with their openness on their troubles to conceive whilst in the celebrity spotlight. After speaking to some of those who said ‘you have plenty of time’ previously, I was surprised at how receptive and onboard they were to change how they spoke going forward. And even if they aren’t immediately receptive, at least the seed for thought is planted. So we can do it, starting with our everyday exchanges.
Information needs to be relayed in an intelligent fashion. Intelligent people need to be spoken to intelligently. Statements such as ‘You don’t want to leave it too late’, leave only an impression of feeling nagged. People are much more likely to listen if you speak to them with clear facts. For example, that it could take 5 or 6 months to get pregnant for a woman age 30, compared to nearly 2 years closer to age 40. That chromosomal defects increase in your thirties. That miscarriage risks increase with age, being about 1 in 5 at age 35. That IVF success rates similarly decline after age 35.
It isn’t about creating fear amongst people. There will always be a need for IVF for a variety of reasons. But it is about stopping avoidable instances of infertility; to put more people with infertility in the age bracket (below 35) with the best chance of success in treatments. That has to be a good thing – less financial cost to couples, reducing the turmoil that comes with the uncertainty of fertility treatments, and reducing any health side-effects which may come as a result of fertility drugs.
http://theafa.typepad.com/theafablog/2010/07/infertility-prevention-from-a-personal-perspective.html - see AFA blog posting of the same
So what's the biggest surprise? It is the amount of misinformation that exists in society. How often men and women really know very little about their own fertility.
This is reinforced by a University of British Columbia study reported last year in the Journal of the American Society of Reproductive Medicine, which highlighted that while women were aware that fertility declined with age, they were not aware of the extent to which it declined concluding that this lack of education was leading to an increase in the number of unintentionally childless women. Yet fertility seems to be something which even well-informed people are reluctant to discuss for fear of offending. The question is why? Why does this misinformation exist?
Mis-education and misinformation to a large extent comes from the media. They are focused on sensationalist headlines, such as ‘Woman of 50 gives birth to twins’ or ‘celebrity X becomes mother at 45’. They fail to report medical facts accurately, or without spin. They should report the statistical likelihood of such a pregnancy happening with one’s own eggs, to give a real sense of the (low) probability of it happening or if donor eggs were used. They misleadingly give the impression that IVF cures all infertility issues.
Women who have suffered or are suffering from fertility issues can add to the lack of information by not sharing the knowledge they obtained with others. Many suffer embarrassment or shame to admit a problem. Some do not wish to receive negative feedback. Others develop ‘rose-tinted spectacles’ after a successful birth, forgetting their troubles. I was amazed at how many women suddenly shared their stories, but only after you started to tell yours. It is only through sharing honest accounts that we get the correct information and start to really ‘get it’.
People may expect their families to ask about plans for children and talk about such issues. This is not always the case, particularly in this modern world where often parents are scared or do not want to be ‘too involved’ in children’s lives. Today many take the approach with their adult children of, ‘I don’t interfere’. Parents may not share relevant medical information relating to their own fertility. Some feel that they don’t have to, once children are adults. Yet ironically as children they were probably too young to appreciate the information’s relevance.
Assumptions that people make about working women can be very alarming. If they see her working with dedication to her job, they assume she is a career-girl not interested in children, even if she has not been asked or said anything along those lines. Assumptions are something people do often, to somehow ‘classify’ things in their heads, even if without the facts. It’s easier than asking questions.
Men also suffer from this misinformation. Because of it, they can equally delay starting or feel that a woman who talks about starting a family sooner is being ‘paranoid’ or ‘unnecessarily panicky’. Men should understand about their own fertility, and that of women, and vice versa. After all, it is a fifty/fifty equation, isn’t it?
With all these factors bouncing around, what can we do to grapple the issue by the horns and improve awareness?
Education can improve at various levels. Start at school with sex education classes extended beyond prevention of teenage pregnancy, to include knowledge of the changes in fertility with age. Improve the education of GPs - surprisingly, these can sometimes lack understanding on the extent that fertility declines with age. GPs should be required to have fertility conversations with women at contraception checks to ensure they’re properly informed. The same should be done at gynecological checks. Regular fertility checks should be promoted.
Employers should be encouraged to be supportive of women in their more fertile years, so that they feel they can return to work without risk. This needs positive affirmation from employers beyond relying on legislation. It would be good to see employers embrace fertility awareness days in their organizations.
We can encourage people to speak more openly about fertility to foster improved education and awareness and remove the stigma of discussing. In the States, Giuliana Rancic and her husband are pioneers with their openness on their troubles to conceive whilst in the celebrity spotlight. After speaking to some of those who said ‘you have plenty of time’ previously, I was surprised at how receptive and onboard they were to change how they spoke going forward. And even if they aren’t immediately receptive, at least the seed for thought is planted. So we can do it, starting with our everyday exchanges.
Information needs to be relayed in an intelligent fashion. Intelligent people need to be spoken to intelligently. Statements such as ‘You don’t want to leave it too late’, leave only an impression of feeling nagged. People are much more likely to listen if you speak to them with clear facts. For example, that it could take 5 or 6 months to get pregnant for a woman age 30, compared to nearly 2 years closer to age 40. That chromosomal defects increase in your thirties. That miscarriage risks increase with age, being about 1 in 5 at age 35. That IVF success rates similarly decline after age 35.
It isn’t about creating fear amongst people. There will always be a need for IVF for a variety of reasons. But it is about stopping avoidable instances of infertility; to put more people with infertility in the age bracket (below 35) with the best chance of success in treatments. That has to be a good thing – less financial cost to couples, reducing the turmoil that comes with the uncertainty of fertility treatments, and reducing any health side-effects which may come as a result of fertility drugs.
http://theafa.typepad.com/theafablog/2010/07/infertility-prevention-from-a-personal-perspective.html - see AFA blog posting of the same
No comments:
Post a Comment