It is NOT sexist to warn women about diminishing fertility

I am re-printing a post from Kate Brian’s excellent blog, Fertility Matters,

More from me later this week.

How late is too late?
by fertilitymatters
The Telegraph returns to the subject of later motherhood this week, following on from the suggestion by the British Pregnancy Advisory Service that an increase in abortions amongst women of 35 and above was due to “scaremongering” about the biological clock which was leading women to assume that they couldn’t possibly be fertile in their late thirties and forties. The article cited the cases of women who’d happily and easily had children in their forties, and suggested that reduced fertility might have more to do with how healthy you are than your age. It even concluded with the point that there might be a “sexist agenda” in telling women that they needed to have children earlier.

You don’t have to have spent much time working in the world of infertility to know that this is one side of a very complex picture. Yes, of course there are plenty of women who can get pregnant very easily in their late thirties and early forties- but there are also many others who can’t and who feel angry that they were not made aware of the limited options that fertility treatment could provide. I talk to so many women who wish they’d started trying for children earlier and who are passionate about the need to educate women about the biological clock.

I’m aware, of course, that this is just one other side of the complex picture, but we do need to get the balance right – we don’t want to scare women unnecessarily, but unfortunately there are many women going to fertility clinics for the first time in their forties only to discover that despite feeling young and being healthy, their ovaries are no longer in top shape for conception.

I don’t want women to start trying to have children earlier because I have a sexist agenda – I want them to be aware that if they leave it until later, fertility treatment can’t wave a magic wand. Being fit and healthy is not going to stop the biological clock, the fact that you are still having periods in your forties doesn’t mean that you are still fertile and female fertility declines far more rapidly than male fertility. It’s unfair, it’s annoying, it’s frustrating – but talking about this isn’t being sexist, it’s just being honest.

fertilitymatters | May 20, 2014 at 5:10 pm | Tags: age and IVF,


About oliviasview

Co-founder and now Practice Consultant at Donor Conception Network. Mother to two donor conceived adults and a son conceived without help in my first marriage.
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12 Responses to It is NOT sexist to warn women about diminishing fertility

  1. marilynn says:

    I applaud you for being blunt about this because what you say is true. It is not sexist to lay out the biological facts of the matter. I know how helpless and angry a person can feel when they are being told something along the lines that they could have had a bio child had they started earlier. I’ve been told it myself. I scraped in under the wire at the very last nanosecond with the very experimental and not entirely supported methods of a brilliant doctor who had me shot up with blood thinners every few hours – in my stomach no less.

    But really I was 31 when Samuel was born and died and I had just turned 33 when Ruby was born and that is a supper common age for women to begin trying to get pregnant – right at the end of their time being fertile. Getting pregnant in your 30’s is a bit of a long shot really and that’s when us modern women get married these days, not in our teens when our bodies were flawless and built for reproductive awesomeness. We are at our most fertile at a time when society says we are too young to be involved in serious relationships; worry about school, college, seeing the world – then find a nice guy get married settle down and have kids. I’d venture to say most women can’t cram their awesome fertility into that timeline. It sucks it really does that men can wait all that time and still be potent for the most part. But there is nobody to take our greviances up with. Nobody to write a strongly worded letter to. No manager we can call upon when we don’t like the service we receive.

    If my kid get’s pregnant unmarried and too young to raise a kid – I’m very pro choice but I’d let her know she could finish school and we would work together as a family to help her raise her child while she finished school and got her bearings about her – so that she’d be making her decision with that knowledge fully in hand. I believe in the right of women to choose whether or not to continue a pregnancy. I also would like to meet my grandchildren and have some fun with them before I die and it won’t matter to me in terms of love if she had them with a husband or with some boy she did not know very well – they’d still be my grandkids and I would happily help her with them whether ‘legitimate’ or not.

    I don’t know the answer to the problem. We should encourage girls to get an education and make the most of their lives and careers no different than boys. But maybe we need to offer our girls and boys a little extra in the area of family support and comittment if they are faced with the option of having a child young. Not tell them it will ruin their life. Not tell them they’d be throwing their lives away if they try to have and raise the unexpected kid. Just say it was an adult action that requires adult decision making and if they go though with having the kid that we parents will help them finish up their childhoods and get stable so they can be great parents. There is never a bad time for a new life to begin. It’s the only way I can see to support their efforts educationally and career wise while simultaneously reinforcing the biological reality of things.

    • oliviasview says:

      It gives me great pleasure to agree with you for once Marilynn, although I think you are drawing the line for fertility even lower than most would say is reasonable. Up to around 35 for most women is OK (although there will be those for whom this is too late). I conceived our three children at 23, 35 and 38 and our grand-daughter was conceived by IVF when her mum was 38 (but with 37 year old eggs!). I know lots of women for whom second half of thirties pregnancies were pretty easily achieved, but very few who conceived after 40.

      • marilynn says:

        You may know better than I do since my understanding comes from family stories and such but does conception make a woman more fertile in the future. I was told, and it held true for me, that women are very fertile after having a miscarriage. My great grandmother in Norway I’m told had 18 or 20 children. Granted she had like a bucket load of twins in there. She had her last child in her mid 40’s (so the story goes) but started having kids in her teens. Should women be more confident about getting pregnant in their 30’s or 40’s if they’ve already had a few kids? Less confident if they’ve had none?

  2. gsmwc02 says:

    I think a common myth with infertility today is that it’s caused by couples waiting too long. The reality is there are many women and men who started trying in their 20’s who are dealing with infertility. Yes, men and women have biological clocks and yes, fertility decreases in our mid to late 30’s. However, environmental factors are a bigger issue in causing infertility today.

    • oliviasview says:

      Can you give us some evidence for that assertion Greg?

    • Liz says:

      The medical information about infertility is important to share. However, some people use these cautionary tales in a sexist way. (Read the comments on any story about infertility, and you’ll see some people stating things about “selfish career women.”)

      In regards to infertility, I think there is simultaneously too much blame/sexism/unhelpful judgements, AND a lack of medical information. The blame game needs to stop, and more accurate information needs to be disseminated.

      It’s too simple to state that infertility ends at the age of 35. Too many women will notice that their friends are getting pregnant past that age, and they will ignore that message.

      The reality is more complicated. Age accumulates risk. Fibroids for women and varicocele for men. Egg quality drops quickly between the ages of 38-42. In particular between 40-42. But overall, infertility is caused by other factors. There are women who present with ovarian reserve problems in their 20s. There are women with severe endometriosis in their 20s and 30s. There are implantation and genetic/chromosomal problems at all ages.

      Years ago I heard a fertility specialist on TV suggest that a couple start trying by 32 if they wished to have a child, because they would have time to get treatment if there were problems. That seems prudent. That would be helpful information to share with the public.

      If infertility is not diagnosed until 35-40, the couple is in a race with time to get into treatment. Many have to quickly save thousands of dollars for treatment, and they have no time to waste. As treatment continues, the chances of conception go down, because the couple is aging.

      That said, I personally know of two people this year — first time pregnancies — who are 45 and, shockingly, 46, who became pregnant by accident. They were shocked, as they should be, because it’s not statistically likely. One had suffered from infertility for years, undergone IVF, and divorced as a result of the stress. So, it’s also prudent for doctors to advise the continued use of birth control unless one is hoping for a surprise baby.

  3. tomama2014 says:

    I completely agree that women are dealt a bad hand when they are told they can postpone having children well into their late 30s or early 40s. Celebrity culture doesn’t help with a disproportionate number of woman past 45 getting pregnant all the time, with no concurrent mention of the method of conception, which may have included a gamete donor or two.

    It’s not sexist to properly educate women about the inevitable reality of declining fertility. It’s, in my opinion, responsible. But it will be hard to get these safe through. Women are bombarded now by so many competing messages…get a higher education, excel at work, find a loving partner, keep a perfect home, make sure you learn to cook, etc, etc. It would take most women at least a decade longer than my parents generation to get a handle on these competing priorities and then settle down. So maybe that is where the sexism lies…expectations of women have been upped and upped over time. If there is even the possibility of delaying baby making, some women will take that gamble.

    Getting pregnant after 35 is when things start to get iffy…really the stats show that it’s after 38 that the fertility rates drop off signifanctly. Then again, as was pointed out above, infertility can and does struck at any age. I started tryinfb when I was 28. Five years, literally hundreds of needle sticks and 7 miscarriages later I learned it wouldn’t have mattered when I started. I got dealt a bad fertility hand.

  4. This is certainly my story. The reason I used a donor was because I thought I had all the time in the world but found out I didn’t. I was in my early 30’s when I started trying but was successful at 35 and 37. I’m not ashamed to admit that I wish I hadn’t fallen for the nonsense and not only started much earlier but actively looked for a partner.

    Sure there are women that have children at 40+ but is that desirable? I’m not speaking of those that tried for years and weren’t successful until 40+ but why would anyone want to wait that long? You’re still young and full of fun in your 40’s so why be tied down to young child rearing if you don’t have to? Yes, I know that’s not PC but it’s how I feel. Let’s not mention the health and developmental risks.

    People can claim all they wish that we have plenty of time but the reproductive system doesn’t lie. It’s in the best interest of men and women to start sooner rather than later. While I won’t be teaching my daughters that having children defines them, I will teach them that IF it’s something they want, don’t wait too long. I’d support them if they found husbands and started families right after college.

  5. Tracey Siansbury says:

    Excellent sharing Olivia and an excellent blog post from Kate, the realities of fertility should be taught in school; where there are no fertility problems irregular cycles can occur after the end of fertility…I certainly wasn’t aware of that. Sadly part of my role working as a counsellor is working with young donors or women wishing to egg share who come in to donate and find out they have fertility problems, you can look amazing on the outside – but sadly it often has no correlation with how things are inside.

  6. Silver says:

    It is not hard, published evidence but I started trying to conceive when I was under 35 and DID conceive but then miscarried. I have friends I met through miscarriage and infertility groups who were in their 20s and unable to conceive because of medical conditions like Polycystic Ovarian Syndrome and Endometriosis. I also have friends who, like me, were recurrent miscarriers and were encouraged to continue trying to conceive on their own or with IVF because their ability to conceive was conflated with an ability to carry a pregnancy to term. I get very angry when I read about the idea of “selfish career women” who don’t start trying for a baby till it’s too late, when most of the fellow strugglers I met through my journey to become a parent were either a sensible age when they started but had faulty eggs from the get-go (like me) or had other medical problems – or would have loved to have tried but did not meet the right person till they were a bit older. I think most women know full well that their fertility diminishes with age, but wanting a baby and knowing we are the right age to have one does not mean we should grab the first partner that goes past or attempt to become a single parent or ignore our financial/work situation – children deserve stable lives. We are also not best served by the medical system, which encourages you to try for up to two years unsuccessfully on your own or wait for three miscarriages in a row before the most basic tests. Then, if you get into the system, you might wait up to three years for an NHS IVF cycle – or, like me, age out and have no free cycles. I’d like the same system that wags its finger at us about waiting too long to act quicker when young (or youngish) women go to them with fertility issues – if there *are* medical issues going on, waiting is not going to help.

    • marilynn says:

      I think you make many good points. It also sounds as if we have had some similar physical difficulties with pregnancy. I started having cysts in my late teens. I started getting pregnant and having miscarriages in my late teens as well. Yes they were accidental or negligent pregnancies on my part but I was miscarrying none the less. I got married at 29 and started trying for a baby shortly after and had many miscarriages. I carried my son to term but he died after he was born. Not until then did a doctor say to me hey, maybe something’s wrong with you. I was 31 when my son was born/died and just 33 when my daughter was born and it was not an easy pregnancy at all. She almost died and I guess so did I.
      I really was not ready for the responsibilities of motherhood prior to my 30’s it was not on my radar because of the way life is in the city where it takes people longer to grow up and be responsible. We extend our childhood and play years longer. Its just a harsh reality that by the time I felt old enough and grown up enough to take responsibility for another person that I was at the tail end of the years when women can get pregnant. The years when, if you are healthy, its a snap to get pregnant are not years where people are married with houses and stable lives anymore.
      I don’t know the answer. I don’t think it is sexist to tell men and women that if they want to have their own kids be aware that it might not happen if they wait too long. Does that mean go for mister right now? No. Does it mean get married if you don’t want to or feel like crap if you can’t find the right person? No. I think the best I can say is that the decision to terminate a pregnancy that was accidental (and I’m totally pro-choice by the way) should be carefully considered if circumstances in your life are not terrible, even if your not head over heels in love. Like if your 28 and single with a job then maybe just don’t assume that other opportunities will come up. Is that sexist? Prudent? I’m not real comfortable with it yet but it seems a message should be put out there. And doctors should have told me sooner something was wrong. You are spot on there.

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