Guest post: "Young adults need to understand the facts about fertility"
Educating teenagers about the impacts of age and lifestyle choices on fertility could help to tackle misconceptions, says Dr Geeta Nargund
Medical director of Create Fertility
Posted on: Thu 14-Apr-16 10:13:01
(99 comments )
Conversations about fertility usually take place when there's a problem. They focus on treatment, rather than prevention. But with one in seven couples having difficulty conceiving, effective education could help to stop those numbers from rising.
As we live longer, have children later, and often build our careers before settling down - we're facing a fertility time-bomb in Britain. Having children in our late 30s and 40s is not always straightforward, and both age and lifestyle choices can have an incredible impact on our ability to conceive. Yet, even though we are aware of this, the widespread disconnect between social and biological reality means that the extent of such impacts isn't always known.
So how do we tackle the misconceptions around fertility? For me the solution is clear, and that is encouraging the next generation to be as informed and educated as possible on this subject.
I know this is both a sensitive and emotive issue, and I am aware of the argument that most young people are already aware of their biological clock, and that adding to this pressure is damaging. Yet it is my opinion that such a view is short-sighted. By providing reliable medical facts we are looking to remove fear and anxiety, rather than create it. It is a simple fact that we cannot turn back the biological clock once it is too late, and we should be giving young people the information they need to make informed decisions about their lifestyle and future.
There isn't enough awareness about the impact low or high body weight, smoking, alcohol, drugs, STIs and thyroid problems can have on fertility. Effective education could help.
We need to be informing teenagers and young men and women of the possible effects of their lifestyle choices. There isn't enough awareness about the impact low or high body weight, smoking, alcohol, drugs, STIs and thyroid problems can have on fertility.
We have already been successful in reducing teenage pregnancy through Sex and Relationship Education (SRE). Contraception and conception are two sides of the same coin. Last year I wrote a letter to Nicky Morgan MP, calling for the government to include fertility education as part of SRE in the secondary school curriculum. I am working with South London Schools to develop a pilot scheme in which secondary school children are provided with clear information as part of SRE on both the male and female fertility timeline and the effects of lifestyle.
At the most basic level, young men and women need to understand the fundamental facts about their fertility. A harsh biological reality is that female fertility declines much faster than that of men, decreasing significantly from the age of 35. Women are born with a finite number of eggs, and the decline in fertility comes from a reduction in the number and quality of eggs as women age. This decline can be measured by testing to indicate how many active egg sacs a woman still has. Sperm quantity and quality also decline with age - but at a much more gradual rate.
When it comes to reproductive ageing, nature has created a 'gender inequality'. Family history of early menopause also plays a part, and I encourage young women to speak to their mothers and female relatives openly. Education is crucial to ensuring that women who wish to have children don't miss out on the chance of motherhood due to misinformation.
Without effective education, the number of people facing fertility problems is only set to rise. But by passing on accurate and responsible information we can empower informed adult decisions. We need to shift the fertility paradigm from treatment to prevention - education can help us do this.
By Dr Geeta Nargund
This is all well and good but I don't know one woman who had children in their late 30's or 40's from choice.
I genuinely believe the concept of women delaying families for a career is a complete myth. In my opinion, and I realise at this point it's only backed up by anecdotal evidence, it's because they haven't met the right person or been in a stable relationship ...and that hasn't been through choice either.
We need to do more research on the actual reason that children are being delayed in certain demographics. I don't believe this proposal in any way addresses the actual root causes of the issue.
Couldn't agree more with stumblymonkey. I don't know anyone who has delayed having a family as lifestyle choice. I had DS at 37, because I didn't meet DH until I was 34. I would gladly have had my first child earlier, it just wasn't feasible unless I wanted to be a single mum.
I think you're actually going to do more harm than good with that approach.
I am a 30 year old woman, have been married for almost 4 years and been ttc for 3. I was 27 when I started trying because I didn't feel ready before then.
I am an educated person, with a nice job and a supportive husband, but the pressure to have children 'at the right time' doesn't help anyone - if I had a child at 22 I would have been considered too young. Now at 30 people are concerned I am too old.
Educating people about fertility is fine - but start with GPs first. They are worse than useless when it comes to this.
Surely, making everyone worry about potential fertility issues is going to do a few things - increase demand on the NHS to test for problems, encourage people to try before they're ready / not with a suitable person just in case there is a problem, or make people with fertility problems feel more stigmatised than we already do. Your own post talks about lifestyle choices effecting fertility - which can be translated as my trouble conceiving is my own fault because I'm a little overweight and I waited too long.
I'm pregnant with our first child at 28. My husband and I have been together for over a decade but had to wait a long time to start a family as we both went to university and then struggled to find careers, then save up for a house, then save to get married and then save more money in order to be a little more prepared to deal with the cost of a child. Feasibly, we could have started a family around 23/24 but with the pressure of finances, we had to make decisions based on what would be best for us in the long run.
I personally think fertility should be discussed much more openly as the myth that unprotected sex= baby can be very disheartening for couples trying to conceive. I honestly believed that we would get pregnant straight away as neither of us were aware of any issues or factors that would affect our fertility. It only took us a few months but there are so many women on MN trying for over a year and feeling really despondent about the whole thing; blaming themselves and driving themselves insane. The tough reality is that many couples take months, if not years to conceive for no apparent reason, and I think that needs to discussed much more openly to prepare both women and men for any difficulties they face conceiving. If anything, it would help to reduce the amount of couples feeling like they are failing or broken.
I think just generally educating people about fertility is a good idea. I work with teenagers and I can guarantee that most girls have no idea about how their own bodies work, let alone information about their fertility.
I think educating teenagers on fertility issues is a good thing. I find clear information makes me feel more in control and less anxious. It doesn't mean 15 year old have to create a life plan there and then.
The current economical set-up does not support couples having children in their 20s. Even couples in their 30s and 40s struggle to afford a family. Social media and online dating has widened possibilities to meet new people and makes commitment harder.
Its a hard one made worse by social conditions (i.e. careers, finding the right person, stigma attached to young parents, financials like house prices). Id agree that more education is needed re fertility. Notwithstanding the reasons behind trying (or not) for a baby, it is important for women to know that essentially, unlike men, there is a time limit. And iVA etc. isnt a magic want
was shocked recently at reading the high unsuccesful rate. Should we be educating men too? Does it even apply to men as when they are 40/50 they then have the choice of being in a relationship with a much younger 'fertile' woman.
Educate away - however, nothing would have prepared me for the pain of infertility or miscarriages. No one thinks it will happen to them and very few would start trying when they weren't ready just in case.
As previous posters have said, very few people delay for the hell of it. The economy doesn't make it easy for people to have homes, let alone families...
I have a question for these doctors, and anyone really who keeps coming out with this stuff. Do you want us have kids with the first vaguely suitable man who comes along in our twenties? Do you really think that bringing a child into an potentially unstable and untested relationship which would otherwise have run its course is preferable to waiting a few years, and hoping you actually meet the right person to have kids with, to bring them up in a stable happy and loving relationship? Because that's the reality, that's the message you are sending out here - don't think about the consequences just get knocked up because it'll be easy and you could wait for ever for the right time and it will not happen!
And if you think for one second that we are deluded about our fertility declining you could not be further from the truth - that insidious message is already well and truly out there, and under our skin and caused me a near constant low level depression and anxiety that I may never have my own child because I was leaving it too late, and each new month there was no potential partner on the horizon, and the dashed hopes when each relationship which didn't work out was my future family disappearing from grasp. Is this something I needed to learn in school? Of course not. There are far better much useful things they you need to teach school kids and this is not one of them. No women who is about to turn 30 and wants kids doesn't already know this.
Well, anyway I'm in the happy position now of being 36, in a relationship with a wonderful man and 14 weeks pregnant. We met when I was 34 and started TTC after 18 months "due to my age". It took us a year. We didn't even waste time to get married first.
I wouldn't/couldn't have done anything different. If I followed your advice I'd be bringing up a child a single parent and probably longing for a sibling but no chance of that due to single parenthood and finances. Oh and I'd have an arsehole ex to deal with on a regular basis who I had known in my heart of hearts during the relationship wasn't suitable the husband/father partner for me, but I ignored this and took your advice!
Mumsnet please can you stop posting things like this, it's patronising and damaging, please have some respect for the intelligence of your users and especially those on the conception and infertily threads, not one of whom could have been saved their position because of a couple of sessions at school.
How the hell are we supposed to encourage young women to have babies young when there's little to no state-funded childcare, UK men do far less than their fair share of parenting/housework, and far fewer fathers take the salary/career hit than mothers do?
I'd rather my lovely daughters spent their 20s child-free, thanks.
Sorry for typos, had to get that out!
Like Eleanor says, you'd have to be living in a cave to have resisted the tide of headlines screaming WOMEN! HAVE BABIES WHILE YOU'RE YOUNG AND TOOTHSOME! DO NOT BECOME A DESSICATED CRONE SIGHING OVER PRAMS WHILE LAMENTING YOUR FERTILE YEARS SACRIFICED SELFISHLY TO YOUR MAN-IMITATING CAREERS!
And fwiw I'd have loved to have babies at 28 but my bloke buggered off. I'd have loved to have them at 34 but my bloke buggered off. It took me to 37 to find a bloke who wouldn't bugger off.
I'm not sure adding a lecture about female fertility to the already overstuffed and meddlesome national curriculum would make much difference, well-meaning though it might be. People delay having children because they haven't met the right person, don't feel they can afford a baby or for other reasons don't feel they are in a good position to raise a child. These are rational economic decisions people take. The only exceptions to this are women for whom state-funded childbearing, with or without a partner, is itself a rational career choice.
The ideal solution for women from a fertility perspective would be to have babies in our early twenties, THEN go to university and start careers. But in our age of extended adolescence fewer and fewer men are keen to start families before they are well into their thirties. So if you were to have a situation where women were looking to pair up and start families around 20 and the only men willing to participate are 35 or 40 years old you are building a pretty unappealing power differential in your average marriage and family.
So failing a situation where it's normal for women to marry men 15 or 20 years older and delay studying and starting careers until they have had children, women will carry on having to make difficult decisions that balance the need for a stable home, some kind of study and working life and a trustworthy partner. So I'm afraid I think adding a lecture on fertility to the very long list of things schools now seem to be expected to convey to young people is a bit of a waste of time.
(At which point I got pregnant instantly, btw. Without ahem ever trying.)
hello everyone meet ME (as many people were saying you hadn't met anyone like me before)
married at 23, didn't want kids, got hit by hormones at 30, had kids mid-late 30s
one little point
Women are born with a finite number of eggs
yes they are but it is a rather damn large finite number
To be more precise, a woman is born with about one to two million immature eggs, or follicles, in her ovaries.
At puberty, only about 300,000- more than enough for a lifetime of fertility remain.
Even though the post says young people, it is invariably always the girls that get told this, because of their 'finite number of eggs,' or their biological clock. What about telling boys about their increased likelihood of gathering a child with autism the older they get, or that it's not guaranteed that they are going to hit 50 and meet a 20 year old willing to procreate with them?
Even allowing for that, most teenagers will not think it applies to them bas 30 is almost grandmother like to them. The more important point is that telling girls (again, because it will be girls) that their education and career is all very well, but what if you can't have babies? when they are about to do GCSE and A levels that will determine their future is highly undesirable.
I didn't start trying until I was 34. I didn't want children before then, so I suppose it was by choice. Thing is, though, I didn't WANT children before then. What should I have done, gotten pregnant in the hope that when they turned up I'd like them?
I'm glad your post talked about both sexes, but don't think provision of evidence and scientists' views on fertility to people is the main issue, in comparison with (for example) labour markets, housing costs and "gender politics".
IME men are already very well aware that they have more time in their "biological clock" than women of similar age and often act accordingly.
Eleanor - yes! Absolutely. We're buggered either way - if we have kids before we've found the right man or before we can afford it, we're irresponsible. If we wait, we're irresponsible.
My mum and dad had me when they were 25. It seems ridiculously young to me now, but they had no debts apart from their mortgage, were both in professional careers, and they were married. I had my first baby at 29 - and really any earlier would have been a massive mistake.
I got married at 22, but we didn't start ttc until I was 35 (and got pregnant within 4 months)....all by choice...
We went down the route of both of us getting decent jobs, a nice house in a nice area etc before deciding to ttc. In fact, we honestly didn't even discuss having children for over 10 years - it wasn't something we wanted to do at that point!
No amount of education about fertility would have made me want to get pregnant in my 20s living in a London flatshare with barely two pennies to my name! Oh and no actual boyfriend!
No amount of education about fertility would have made me want to get pregnant in my 20s living in a London flatshare with barely two pennies to my name! Oh and no actual boyfriend.
manatee has hit the nail on the head exactly.
SRE and PSCHE are not compulsory despite many MPs calling for them to be compulsory. As all schools are going to be made to be academies who don't have to follow the national curriculum there is no point contacting Nicky Morgan.