This week for me has been all about Fertility Education. I could write an essay about it but I’ll try and keep this as brief as possible because I’ve got a book to write and a festival to promote (talking of which have you bought your tickets yet? They’re going like fresh eggs if you’ll pardon the pun and read on…).
On Friday I attended a major summit on Fertility Education at the Royal College of Obstetricians and Gynaecologists (RCOG). Professor Adam Balen, Chair of the British Fertility Society, opened the event with a brilliant presentation stating the facts. In just one generation the number of women coming to the end of their fertile lives without children has doubled and the number of children born from fertility treatment is growing. And one of the key reasons for these two things is that women are increasingly leaving it to the latter part of their fertility life cycle to conceive and because of the decline in the number and quality of a woman’s eggs as she gets older it means that many are struggling to have a baby (some with success, some with failure) and some women are not even getting the chance to struggle at all. What’s more the results of a survey, just completed, amongst 1000 young people throughout the UK showed that there is still an inaccurate understanding of fertility aging and what’s fascinating is that although most young people questioned said they wanted their first child in their late twenties this is clearly not what’s being borne out in reality because societal circumstances such as completing education, building careers, meeting the right partner and getting your first home are not enabling the conditions for this to happen. There were a host of interesting speakers at the event including Alex Jones from the BBC’s One Show who is making a groundbreaking documentary on fertility. She said she was shocked by the lack of understanding about fertility aging amongst her peers and later that evening her comments went straight to the top of the Daily Mail sidebar of shame.
I’ll come back to the conference but things actually started for me on this subject the day before when I was invited on the Victoria Derbyshire show on BBC2 to talk about my views. I appeared with, amongst others, Professor Geeta Nargund (who is currently leading a fertility education pilot in London schools) and actress Tina Malone (of Brookside and Shameless). The thing that really shocked me is that of the five women featured, Geeta and I were the only ones that strongly felt that better fertility education for school-age children is needed. In fact Tina’s opening statement was that she felt it was ethically and morally wrong!
The next day at the RCOG, Tina would have been in the minority. Most of the audience was already converted. Doctors, scientists, charity leaders, educators and young people themselves were all advocating for the importance of better sex and relationship education in schools. One of my favourite speakers of the day was Professor Soren Ziebe from Denmark . He opened his session by asking how many of the audience were parents. The vast majority put their hand up. He then asked them to keep their hand down unless they disagreed with the statement ‘that having children had been the most important thing that had happened in their lives’. This time nobody put their hand up. Everybody kept it down. My heart-rushed. Of course it did. But this blog isn’t about that, it’s about fertility education.
Essentially Professor Ziebe’s thesis was that given the audience’s answer, we owe it to young people today to educate them better about fertility aging because if we don’t we might be denying them the chance to become parents. In Denmark they have started to do this by a major intervention programme including a high profile advertising campaign asking women: ‘Have you counted your eggs today?’ as well as a prime time TV show called ‘Fuck for Denmark’. He said it’s got people mad but they have got the message.
So in the Q & A session at the end of the day, I decided to ask a direct question. I said: given everything we’d heard about fertility aging did the panel feel we should be encouraging women to have children in their mid twenties at the biologically optimum time?’ I specifically asked them to answer in one word and everybody said ‘no’. I’ll say it again to make sure you read that. Every single person on that panel said ‘no’ (NB. it didn’t include the Professor from Denmark).
Now, as one of the panelists said later, it was an unfair question because we shouldn’t encourage anyone to do anything, we should just give them the information and let them decide for themselves. And of course that’s right but the thing is every doctor in that room knows that leaving parenthood later is one of the key reasons why the fertility industry is booming. And every doctor in that room knows that IVF doesn’t always work in fact roughly two thirds of all cycles fail. And every doctor in that room will tell you that if you want the least risk of facing fertility issues of any kind you should start trying to conceive in your mid twenties.
The problem is we women have fought so long for equality. Like all those women in Denmark, we don’t want anyone telling us what to do with our eggs. And yet, let me remind you, that every single person in that room who was a parent said that having children was the most important thing that had ever happened in their lives. So I now feel that it’s my turn to answer the question and I hope you’ll forgive me for taking the liberty of using three words not one. And they are: ‘No but Yes’.
Because of course, like the panel, I believe in education and choice (I said exactly that on the Victoria Derbyshire show) but the truth is if women want the best chance of having their own biological children with the least risk of the heartbreak and cost of struggling to conceive and going through fertility treatment which may or may not work then surely the answer has to be ‘Yes’. And I know that brings issues of women’s equality in education and in the workplace and in the home. I also know the struggle that women have gone through to achieve everything we have so far. But sooner or later we’re going to have to tackle this issue as well. Sorry sisters, but we are.
Hi Jessica I just watched the Victoria Derbyshire show. My main feeling was why did they not turn off Tina’s mic sooner! For an actress who claims to be educated she was showing an extreme lack of it. Educating 15 year olds or older about fertility issues is not going to push them into wild sex to have a family before they are out of there teens, that is what sex education is for, something Tina obviously lacked in her teens.
I felt that Victoria’s early questions to the expert Professor Geeta Nargund were aggressive and didn’t encourage an informative start to the debate, rather a defensive one. Also some of the comments from viewers were so far off the mark it was painful to watch.
Educating students ‘once they are at University’ would be a waste of time as a very large number of them won’t go to university, so tackling the issues when they are collectively all together at school before leaving age is the obvious solution and can be a very useful time for the 15 plus children to enter into a healthy debate about fertility. I think there was a view that 15 year olds are too immature to be given information about infertility and I don’t think the rest of the panel realise just how mature these children are nor give them credit to be. This information is not going to lead to STD’s. Again that’s what sex education is for and isn’t that taught from age 14?
There are, unfortunately always sweeping generalisations in emotional debates; one of the tweets said “healthy mum’s have healthy babies”, well my wife and I have just found out I have a chromosome disorder in my sperm that has been with me since birth. We’ve been eating organic food for 10 years and don’t smoke so clearly that is not right. “A healthy lifestyle and diet seems a good thing” said another.
Look at half the rock stars children too, Liv Tyler, Georgia Jagger, Kelly Osborne, Peaches Geldof, the list is very long. Now we all know their parent’s lifestyle choices with drugs and diet were questionable and yet the healthy children popped out.
This is too vast a problem to try to define it with comments about diet and lifestyle. I think fertility education in young children is a brilliant idea. The amount of over 30 year old friends I have who I have talked to about my wife and my situation is large and almost all of them were ignorant about many details in fertility, eg women are born with all there eggs. That is a huge thing not to be aware of in people over 30!
This whole debate was too much about why we shouldn’t educate children aged minimum 15. It was scare mongering and frustrating to watch.
This subject should be taken into the curriculum it is so fascinating, not shunned for being something only grown ups can handle and to deny this is simply naive.
Thanks Fergus for your brilliant comment. It’s also great to hear the male perspective because it’s heard even less than women’s on this subject. I 100% agree with you that 15 year olds are ready for this information and school is the place to do it. It’s just patronising to say that they are not able to take it in, in my experience 15 year olds are more switched on than most adults! Jessica x
Hi Jessica, I just read your amazing book and have located your blog which is great. I’m sad for your struggle but thank you for sharing. As a woman who has struggled with fertility since starting to try for a family at the age of 30 this particular subject on aging and fertility education very much resonates with me, and even more so now as I head towards 38. I don’t like the term I’ve been lumped with – “secondary infertility” – as I feel it’s inaccurate, I do after all have a 4 year old son, but there is no doubt I have fertility issues. And now in my mid/late 30’s my age is suddenly the spectre in the room, the primary suspect in my mind and my consultant’ s as far as I can tell, having been trying for baby no.2 since I was 34. I wish wholeheartedly that I had had any idea about female fertility age factor in my twenties so that armed with that knowledge I could have made informed, and possibly different, decisions. I don’t think school is the right place for fertility education, but how about when young women start having smear tests or as part of contraception clinics? There are many opportunities to reach young women and objectively give them the information they need. Looking back I struggle to not regret not trying sooner and the irony that I thought I was doing the right thing to leave trying until we were 30 -thinking that was the optimum time and following the right order of uni, job, house bought, get married then baby – but now in hindsight with 7 years worth of googling, research and fertility experience behind me I realise that at that point I was already over the crest of the fertility hill and beginning the walk down the other side. And that’s sad. I feel like a secret was kept from me so I hope this subject is given the attention it deserves as the next generation heads into its fertile prime. Sorry for the long post but thank you for highlighting this issue.
Thanks for your comment Katherine and thank you also for reading my book and saying such nice things. It always means a lot to hear that people who’ve read it, like it. I think your comments around ‘secondary infertility’ are really interesting. Like you say, you’re not infertile! But it absolutely is a growing issue that people are struggling to conceive their second child because of fertility aging – love your description of being over the hill and walking down the other side because it’s absolutely right! Like you, I really hope that the message gets out. Well, either that or the science needs to improve or people need to be preparing themselves for parenthood in different ways if they’re going to leave it later. It’s a massive issue, and it needs to be discussed! Thanks again for writing, do keep in touch. Jessica x
Really well argued blog Jessica, and congratulations for standing up and being counted.
I agree with you completely, education is important because then women can make their choice. Knowledge is power. There will always be some who for many reasons leave it until they’re older but education will mean that less people, like myself sleepwalk into their mid 30s not realising how much their fertility is dropping.
Thanks Lesley. Knowledge is power absolutely! Jessica x
I knew that it was harder in your 30’s but I had no idea how hard it would be. I agree women should be educated but along with lifestyle and eating habits. This is very important to optimize your chances of conception, regardless of age!
You’re right. They need to understand the whole package! Jessica x
Education is so Key that we are today better informed on the importance of parenthood In the developpment and well being of a child .
We know very well today the impact of environnent ,relationship and mental health of parents on a child.
Éducation on fertility is important indeed for girls and boys but not to make them believe that they have control on the thing they can not despite progress In sciences which convinced many that they could have children whenever they want.
Promoting parenthood as early as possible is putting pressure on women particularily on the most vulnerable with no garantee that they will have children .Doctors know very well that many women have tried to conceive In their early twenties ,kept trying In their thirties and no biological children at the end.
Fertility Education yes to inform and prepare for all perspectives In life not to dictate what one should or should not do. Life ( and biological) circumstances are so divers . It would be important to make understand young people that everybody is worth living and can be happy on this earth with or without children.
You have made some really important points, thank you. I totally agree that happiness is possible with and without children although I do believe that fertility education is the key to choice whilst recognising that choice we make isn’t always possible and happiness sometimes takes a lot of work! Jessica x