Monday 22 April 2019

We warn teens about getting pregnant - but what about fertility problems later on?

We have been very effective at teaching teenagers how not to get pregnant. Now, we need to start teaching them about fertility as well, so they can get pregnant when they choose to
We have been very effective at teaching teenagers how not to get pregnant. Now, we need to start teaching them about fertility as well, so they can get pregnant when they choose to
Sinead Moriarty

Sinead Moriarty

Women need to conceive before they are 30 or they may be too late and end up childless.

So says Greeta Nargund, Senior Consultant Gynaecologist and lead Consultant for Reproductive Medicine services at St George's Hospital, London.

She believes we are facing a 'fertility timebomb' as the average age a woman gives birth is rising.

But in Ireland we are in serious trouble as the age of motherhood rises every year. The average age Irish women have their first baby is now 30.3.

A recent EU study showed that Irish mothers are the oldest in Europe and there are more first-time mothers aged 40, or over, here than in any other EU country.

Many women believe that scientific breakthroughs have bought them far more time than is the case. You hear about all these new fertility drugs and presume one of them will work for you.

Women of 42 or 43 believe that with IVF they can easily have a baby, whereas really success rates are very low for women using their own eggs at that age.

Most late pregnancies will result in a healthy baby, adverse pregnancy outcomes also rise with age. Women over 40 are considered to be at a higher risk of complications.

In Ireland we now have the highest infertility rate in Europe which is extremely worrying. We need to address the issue and educate our young people so they don't leave it too late to have a family.

The World Health Organisation defined infertility as "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse".

Dr David Walsh, Medical Director of Sims Fertility Clinic, said World Health Organisation statistics for Ireland show that one in five people now have fertility issues.

"In fact, we have the highest infertility rate in Europe, largely due to pregnancy being delayed until relatively late in life."

As someone who struggled with fertility, I know too well the pitfalls of leaving it too late. I eventually had my first child aged 34.

But I was one of the lucky ones, many are not so lucky and end up heartbroken and childless, not to mention broke from endless rounds of failed IVF.

The average cost of a round of IVF is €5,000, rising to €10,000 with donor eggs. The average number of treatments per couple is four and most fertility treatments are not covered by private health insurance.

Every fertility clinic you go to will tell you about their success rates, however the average success rates for IVF are on the low side: 30pc for women under 35; 24pc for women aged 35 to 37 and it drops off a cliff for women over 40, with only 3pc of women aged 43 to 44 having success with IVF.

But the true cost of infertility cannot just be measured in financial terms. There is the additional emotional, physical and social pain to deal with. Finding yourself unable to conceive is a rollercoaster. Couples have to deal with stress, blame and trying to cope with the intense, deeply primitive 'survival of the species' drive to have a baby.

Women may also feel judged for leaving it too late and are devastated when told their egg supply is not good enough or too old.

So why are women leaving it so late to have babies? Many reasons are cited. Women feel they have to wait until their career is well-established before trying to start a family. Couples want to be set up financially before they bring a baby into their lives.

Women are studying for longer, travelling more, climbing up career ladders, enjoying life and generally putting off settling down.

Irish women are now waiting longer than any other nationality in Europe to have their first child.

Declan Keane, a senior clinical embryologist and founder of ReproMed Ireland fertility clinics, says that modern life and cultural changes 'work against the natural biological clock'.

The curse of busy-ness and the drive to have a successful career and be financially secure is causing many couples to put having babies on the long finger.

I did it myself. I waited until I felt 'ready'. And I was almost too late. Professor Nargund noted, "I have witnessed all too often the shock and agony on the faces of women who realise they have left it too late to start a family.

"For so many, this news comes as a genuine surprise and the sense of devastation and regret can be overwhelming."

We clearly need to educate our young people on the pitfalls of leaving it too late.

So how can we educate our daughters, and sons, so that they don't make the same mistakes?

Professor Nargund believes that children should be given 'age appropriate' information from primary school to university to highlight the importance of having children when they are at an optimum age.

"Information is power and the best way to empower people to take control of their fertility is through education."

It is certainly true that most of our young people are ill informed about the impact of age on fertility.

We should separate reproduction education from sex health education in school as they are two distinct things. Young people need to be taught that fertility diminishes as you get older, for both men and women.

We have been very effective at teaching teenagers how not to get pregnant. Now, we need to start teaching them about fertility as well, so they can get pregnant when they choose to.

At least then if our children decide to leave having babies until later in life, they will know that there are serious risks involved and they can make an informed decision on whether to risk waiting.

Irish Independent

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