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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Do you think it's the place of a GP to warn you of decreasing fertility over 35 when giving you a prescription for contraceptive?

110 replies

TheCountessOlenska · 14/05/2012 20:50

I am not sure what I think!

On the one hand - your GP knows nothing of your life and choices, so it's not really their business.

On the other hand - I guess they don't want to see you come back wanting IVF in a few years and feel that they didn't warn you? (or maybe it could be a concern about the drain on NHS funds!)

This actually happened to someone I know and she's only 30! She was Shock

OP posts:
SeaHouses · 14/05/2012 22:47

Moomins, why did the registrar say that to you?

BartletForAmerica · 14/05/2012 23:07

And someone else might be annoyed that they weren't offered a sterilisation at the same time as their ELCS and that they had to go through another operation...

PestoPenguin · 14/05/2012 23:13

I think this is a great idea! It's surprising how many people don't realise, and sadly only find out too late.

Moominsarescary · 14/05/2012 23:21

seahouses no idea, I'd never met him before. Maybe because we were having our 4th. He wasn't very happy with the age gap either. Ds3 was only 8 weeks old when I became pg again, but I had spoken with my consultant about it and he was fine

butthatsnotfair · 15/05/2012 00:04

My consultant at hospital (who was a man incidentally) told me to have all my babies before I was 35. I was 29 and I'd just had a big gynae op. I took his advice and had DD at 31. And I'm so glad I did as we're now suffering from secondary infertility - but at least we have DD.

I think I'll always be grateful to him for that advice.

Moominsarescary · 15/05/2012 00:15

Yes bartlet but he had my medical history in front of him, so knew I'd had problems with mc, so to bring it up at 12 weeks was insensitive. I lost the baby at 20 weeks.

ChasedByBees · 15/05/2012 00:19

There are some infertility treatments which under NHS rules have age limits on them - I think 35 in some (most?) areas.

To use this, you would need to have been TTC for at least a year before seeking help and then there's the waiting list. I think 30 is probably the right time to get that advice if you want to have maximum chance of having a child.

Thumbwitch · 15/05/2012 00:23

My GP told me the same thing when I was after the progesterone-only OCP at 36, iirc. I was a bit shocked at the time but I think he was right to have mentioned it, especially as so many women go on to have babies later now; it's a good thing to point out that fertility can go into a fairly steep decline after the age of 35 so that women do realise it and not just assume they'll be ok to have a baby at 40, because "so many women do".

I was lucky - I did fall pg at 39, and have again at 44 - but I acknowledge that I am lucky and it's not that easy or common to manage it.

Moomins - sorry to hear about your experience. Sometimes docs are utterly insensitive - like the GP I saw 2w after my 1st MC who told me that as I already had a child and was 42 I should probably just accept that and stop trying to get pg again. Bloody bastard.

samandi · 15/05/2012 09:34

Um, I guess a quick comment wouldn't hurt. I find it difficult to believe that some women are so stupid they don't realise fertility decreases once in their 30's - and especially past mid 30's - though.

Levantine · 15/05/2012 09:40

I got pg first go at 34 and then took two years to concieve dc2 - finally got pg at 38.

I had assumed that because I had got pregnant easily the first time I would be fine again.

So even though I knew fertility decreases post 35 I didn't really get it iywsim

Shagmundfreud · 15/05/2012 09:46

I only knew about the RATE at which fertility declines with age because I made a point of reading up on it when I was 30. And I only did this to get ammunition to persuade DH to have a baby sooner rather than later. DH really didn't have a clue. Many men don't.

So I think it's good for GP's to touch on the issue of age related infertility. A lot of people think they know about it but actually don't have a very good understanding of what it might mean for them.

girlgonemild · 15/05/2012 09:56

I think 30 is a good age to say. Much like anything else it's better to have fair warning than to be told at 35 that from now on your fertility will only be going downhill.

I think as mums/people trying to have babies we are slightly skewed in how much we know about fertility and pregnancy. I don't think a lot of my friends who aren't thinking about babies right now really have a clue despite being otherwise well educated and it would be good if someone like a Dr did give them that information whilst they still have time to do something about it.

noyouhavehadawee · 15/05/2012 09:59

i asked the doctor to refer me for sterilisation (i am 35) and he said there was no point because i would be barron soon Shock, i was agast.

SuchProspects · 15/05/2012 10:00

So long as it's done in a factual way rather than a judgemental or normative "you must get on with having children" way, then I think it is important for GPs to bring this up with women. They ought to bring up the dangers of age related fertility with men more too - their fertility and the quality of their sperm does deteriorate as they get older, there isn't quite the same cut off as with women, but it's still a significant decline. In couples with fertility challenges, the man is as likely to be the one with the issue as the woman. Men don't go to the GP for any contraceptive advice much though, so it is harder for GPs to broach.

Heleninahandcart · 15/05/2012 10:08

Absolutely reasonable, especially if a woman wants more than one child.

Most women are aware fertility decreases after 35 but not how dramatically this decrease accelerates towards 40. It is not just about getting pregnant, miscarriage rates only increase slowly but genetic defects and complications at delivery also increase considerably between 35 an 40.

I had a wake up call from a Consultant at 34. Despite thinking I knew all the facts (I didn't) it still shocked me and I'm grateful that I then was able to have DC.

Treats · 15/05/2012 10:16

Funnily enough I was thinking about this only this morning. I wish I had had my first baby sooner and if a GP (as opposed to a friend or relative or someone else that I'd have suspected of having an agenda) had said this to me at 30 - or even earlier - I think it would have made a difference.

I had DD at 32, and DS at 34 and had planned for that to be it. However, we lost DS at 6 hours old, so I'm now trying again at age 35 and am spooking myself with the fact that age is increasingly against me. I'm just enormously relieved that we do at least have DD and that I'm not trying now for my first child.

I don't think you do REALLY know about the impact of age on fertility until you seriously start to think about ttc. Most people think about trying to fit children into their career or after other things they want to do, and they don't really think about the physical impact of waiting.

The other reason people delay is because of foot-dragging by the man involved who doesn't want to abandon his bachelor lifestyle. I think if women were to reflect more deeply on the consequences of waiting, it would help them make up their minds to ship out of a flagging relationship more quickly (too many sad stories of women being dumped by their boyfriends in their mid 30s and realising that time is running out to find another man to have children with). Alternatively, if he is worth hanging around for, then confronting him with some empirical evidence of the consequences of waiting might encourage him to get a move on.

The message I always had as a young woman was that I should have a good career and enjoy myself before settling down to have babies. I think the advice I will give to my DD will be a bit more nuanced - live your own life as much as you can but don't leave babies too late. I wonder if that's just me (and a product of my own experience) or whether we'll see a generational shift in attitudes.

MrsTittleMouse · 15/05/2012 10:28

As long as it's done in a sensitive way, I'd have no problem with it. My fertility specialist told me that although 35 and 40 are nice round numbers, he can see a definite decline in fertility at 33 and the steep drop starts happening at 38. When you factor in the time to find out that there is a problem (usually a year) and then the time that it takes to get an appointment with a specialist, the time it takes to get a load of tests done, then you need to go back and get a diagnosis (perhaps) and then you have to decide on treatment, then actually get the treatment, it can take a significant chunk of your potentially fertile years that are left. And that's when you have the money for private treatment, I've not figured in the NHS waiting lists!

As an aside, I had the opposite with the first GP that I saw - I mentioned that things weren't happening for us, and that I was worried about my age, and he told me that his wife had just given birth to their 6th child and she was much older than me. Hmm Useful that, especially as we were diagnosed the year after with a 0% chance of conceiving naturally. :( We often wonder how he deals with patients with other conditions "You're losing the vision in your left eye?", "Why, I have perfect eyesight!".

TheBigJessie · 15/05/2012 10:31

Well, nearly ten years ago, I knew a 45 year old who was rather displeased to go through an "early menopause at 45" (her words), as she'd always vaguely planned to have a baby then.

She is still, to this day, convinced that 45 is very early, and that most women are capable of having babies at 45, and just don't want another one!

Ignorance about all aspects of fertility is rife. I mean, many men and women think that vasectomies are 100% reversible and that young married men should have them, even if the couple want children in a few years' time. Shock If people have to have it explicitly explained that Dave up the road's operation was successful does not prove all operations will be successful, then understanding of female fertility will be even lower.

MrsTittleMouse · 15/05/2012 10:33

I completely agree with Treats, by the way, about the role of men in this problem. And a lot of women who are paying attention to the biological facts about fertility are seen as nagging or trying to entrap a man who isn't ready to give up his free and easy lifestyle.

bruxeur · 15/05/2012 10:43

Not being completely aware of the (fairly complex) details of declining fertility isn't stupidity, as some charmer said upthread, it's ignorance. And that is pretty rife in the general population

Added to the positive recall bias inherent regarding successful pregnancy later in life - people will happily broadcast their successes but don't often chat about their persistent inability to conceive - and it's not surprising that there's a skew on perception.

PostBellumBugsy · 15/05/2012 10:56

I think it should be pointed out, in the same way that the risks of taking the pill are pointed out. It is simply a medical fact - it isn't a judgement on the individual.

AnaisB · 15/05/2012 11:11

If it's done sensitively I don't have a problem with it.

Are men told about the increased risks of fathering children when they're older though - this seems to be less well known about.

bruxeur · 15/05/2012 11:16

I'm not sure you've got that quite right.

thebody · 15/05/2012 11:18

It's far worse when they ask you your alcohol intake and u blush And lie with 14 units.

Ephiny · 15/05/2012 11:28

I think it's fine for them to mention it, as long as it's not done in a 'preachy' way and they respect the woman's decision (either to wait, or to not have children at all if that's what she chooses).

Yes most of us here already know the facts about fertility and age, but it's generally better for doctors to be explicit about such things than assume everyone knows.