With more and more couples finding it harder and harder to conceive, what obstacles will our children face when they want to start their own families? Here, Professor Dr Geeta Nargund, Medical Director at CREATE Fertility shares her views and expert advice….
As an IVF clinician, every day I meet with women and couples facing the agony of infertility, many of whom are shocked to be there. As we now live longer and are encouraged to concentrate on building our careers before settling down, many think having children in our late thirties and forties is straightforward. However the harsh reality is that both age and lifestyle choices can have an incredible impact on our ability to conceive.
In the UK about 1 in 6 couples currently have trouble conceiving, yet fertility issues are all too readily swept under the carpet – a cultural attitude that further entrenches the problem. Last month I wrote a letter to Nicky Morgan MP, calling for the new Government to add fertility as part of sex and relationship education to the secondary school curriculum. By starting these conversations early, we encourage the next generation of women to grow up informed and in control of their future fertility.
In looking to tackle infertility, for me the solution is clear, and that is encouraging women and men to be as informed and educated as possible about their fertility. With NHS provision for IVF still very much a postcode lottery, and with long waiting times for funded cycles, being in the know about your fertility is key.
What steps can we all take to protect our future fertility?
At the most basic level we all need a thorough understanding of the fertility fundamentals. One of the key facts many women are unaware of is the decline of female fertility from the age of 35. While many camps still find this an uncomfortable fact, multiple studies have repeatedly shown the steep decline in egg-count as women reach their mid to late thirties. Of course, in some women this fall in egg reserve will be less steep than others, which is why we hear anecdotal stories of successful pregnancies from women in their mid-forties. To address this, women can take the step of checking their egg reserve so that they know their fertility status.
The most straightforward tool for assessing whether there are any problems that may need to be addressed or considered is a ‘one-stop’ fertility MOT. In the space of a lunch hour, through a 3D and Doppler scan for women and a detailed sperm test for men followed by consultation, both women and men can obtain a comprehensive insight into their present fertility status, and get an idea of what the future may hold. If there is indeed an issue found with regards to egg reserve or sperm quality, then detecting this early provides ample time for looking into potential solutions or protective measures.
While once seen as an ‘experimental’ process, new egg-freezing techniques such as ‘vitrification’ (also known as ‘fast-freezing’) combined with safe “mild stimulation” process for women have significantly improved egg survival rates when frozen. The rule of thumb with egg-freezing is the earlier the better, as the younger eggs are the healthiest, so again awareness of such treatments earlier in life will significantly improve the potential for success later on.
In looking to proactively help improve our fertility, the effect that certain lifestyle choices is another area where awareness is often lacking. Having an extremely high or low body weight, smoking, drinking excess alcohol, or taking recreational drugs can all very negatively impact on future fertility. However there are simple ways to positively impact fertility, through following a healthy diet and exercise regime, reducing stress, and ensuring normal Vitamin D levels. I would also always advise women to find out more about their own fertility family history, as knowing your mother’s age of menopause can give a broad indication of your own likely fertility window.
The next generation deserves better, but in the meantime we can make a positive impact among ourselves. By passing on up to date, accurate, and unbiased information on lifestyle choices and the technology available, we are empowering all women to make informed decisions and ensure that those who desire children are not faced with the unexpected impact of thousands of pounds worth of IVF, or indeed childlessness. We need to shift the paradigm from treatment to prevention in fertility, and in order to achieve this knowledge is certainly power.