I saw an interesting piece on BBCHealth Doctor's Diary today. Dr. Reggie Sangha related a story of a relatively young patient, in her mid to late twenties, who came in to ask about a referral for fertility tests. She had only been trying to conceive for four months. Dr. Sangha took a reasonable approach, in my opinion, of reassuring her patient that it was still early days and that she should continue trying to conceive naturally for up to one year. Dr. Sangha also pointed out that there is a "heightened public awareness" of the fertility problems that affect older women, over the age of 35, and that our "fast-paced society" is creating higher expectations and demand from younger women.
As always, there are two sides to each coin, and this issue is no different. I believe that it is a question of how well-informed a woman is about fertility in general and how in tune she is with her own reproductive health. I agree with Dr. Sangha that the media's focus on the topic of infertility is probably causing some undue concern for women who will actually have no problem conceiving naturally. However, the anxiety is to be expected, considering how little we knew until recently and that, now that infertility is no longer a stigma, we hear about more and more women giving birth via assisted conception.
The main culprit in probably the fact that women have been marrying at an older age for the past two decades, thus beginning their journeys to motherhood at just about the same time that their fertility begins to decline seriously. This group, now in their late 30's, 40's and early 50's, were not educated early enough about the biological factors that would make a difference to their dreams, hopes and plans of becoming mothers someday. No one in this group will have discovered in the playground, in "The Talk" with Mum or in a school Health & Sexuality Class that women are born with all the eggs we will ever have and that they diminish both in quantity and quality as we age. When we were being educated about how to protect ourselves from unwanted pregnancy, we weren't given the flip side: the obstacles to a healthy pregnancy. Having achieved that awareness by now, and too late for some, it is being trumpeted to the general public, with bells and whistles attached so no one can ignore it.
As far as I am concerned, awareness of reproductive health and fertility facts should be heightened. While this may lead to overly high expectations in some, it would still assist many women to make informed decisions about when to trade career or carefree social lives for motherhood. If it is widely known that smoking, binge drinking, sexually transmited diseases, obesity and stress are all linked to infertility, perhaps women will make better choices for their lifestyles. Positive measures, such as tracking the pattern of menstrual periods, can give their doctor information about how they ovulate. By the time women reach the age of 35, their window of opportunity begins to close and by 40 it may be nearly shut. No time should be wasted in asking their doctor to refer them for tests then; 4 - 6 months of unsuccessful attempts to become pregnant are probably sufficient to raise the alarm.
The point is, forewarned is forearmed. If there are new statistics, new medications or new procedures ready to be released, bring them on. The number of younger women who could get unduly worried will also be better educated as a result. Those that aren't, can find reassurance from doctors like Reggie Sangha or relaxation through a yoga class. It's a matter of the greater good, really.
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