IVF as a “lifestyle choice”?

TV presenter Kirstie Allsopp has made headlines again with her views on women and fertility – this time claiming that women shouldn’t see IVF as a “lifestyle choice”. Last time she spoke out about age and fertility, I agreed with her – but this time I’m not sure I do.

I honestly don’t think people do see IVF as a “lifestyle choice” – no one wants to go through IVF, no one “chooses” it. I think perhaps sometimes people assume it can help if they’ve left it later to try to have children – and that can be terribly sad if it’s only then that they discover how low IVF success rates drop once you are into your forties.

She also talks about women having to “run the risk” of pumping drugs into their bodies during IVF. Again, although no one would choose to stimulate their ovaries in this way and ovarian hyperstimulation is a potentially dangerous side-effect if not managed properly, I don’t think it’s very helpful to talk about it as running a risk.  To read many newspapers today, you would believe that anyone who has had IVF is likely to develop all kinds of ghastly long-term conditions as a result of the drugs, when in fact there is no evidence of this kind of health risk.

I’m glad she’s speaking out about this and I think she’s right to encourage women to have children sooner rather than leaving it later if that’s a possibility – but I’m not sure talking about IVF as being risky, or as a lifestyle choice, is terribly helpful.

The WoW debate

For those who weren’t able to be there, Saturday’s discussion on Fertility Myths at the Women of the World festival at the Southbank Centre for International Women’s Day proved to be a fascinating debate.  I was chairing a panel with obstetrician Dr Susan Bewley who is known for her concerns about women leaving it later to conceive, Zita West who runs a very popular and successful fertility clinic in Central London, Jody Day founder of Gateway Women which supports those who are childless by circumstance and Jessica Hepburn who wrote a powerful memoir about her experiences of fertility treatment.

Each of the speakers began by giving their own brief introduction, and we then launched into a discussion about fertility myths. The key theme which we returned to time and time again during the discussion was age, and how so many women are still under the misapprehension that IVF offers a solution to age-related infertility. Susan Bewley spelled out some key facts about women’s fertility which many of the audience weren’t aware of – the alarming increase in the miscarriage rate once women are in their forties, and the fact that we stop being fertile up to ten years before the menopause itself.  She explained that although the age at which women’s periods start has got younger as we are stronger and healthier, the average age at menopause has remained firmly stuck at 51.

There were some really interesting questions and comments from the audience, and a lively discussion about why women were leaving it later to have children and how to address this.  As a generation encouraged to delay motherhood, to work hard and have careers, many women who are now in their late 30s and early 40s are finding that following a male career pattern of establishing your position before thinking about starting a family doesn’t fit with a female reproductive pattern – but how we begin to change this is a real challenge.  Why do so many women find it hard to meet the right partner to have children with? Do we think too much about potential obstacles before we have children? Are men enjoying the chance to delay fatherhood at the expense of women’s fertility? Is teenage pregnancy really such a bad thing? Are we guilty of glorifying motherhood?

Thanks to the brilliant panel and the audience too.  In conclusion, it’s clear we can’t change the female biological clock, and perhaps we need to start thinking about how we change society and our own attitudes – your thoughts or suggestions are welcome!

Fertility MOT testing

One of the subjects which came up during the recent debate about whether women are leaving it too late to try to start families was the idea of fertility MOT testing – for anyone who isn’t familiar with it, this usually involves a series of tests for women which look at the ovarian reserve in order to predict whether a woman’s fertility is already in decline.

Of course, it can give some very useful information about your hormones and your ovarian reserve, but there does seem to be some misunderstanding about the limits of this kind of testing. It’s important to remember if you’re opting for a fertility MOT that it’s only giving part of the picture. Most of these tests focus on hormones, but you can have perfectly good hormone levels and be unable to get pregnant naturally if you have blocked fallopian tubes.

You’d also need your partner to have tests too, as male fertility problems are just as common as female ones. And even if you had every test under the sun, nothing can guarantee that you won’t have a problem further down the line.  Many couples with fertility problems go through test after test, and yet experts can never find a reason why they aren’t getting pregnant. Estimates vary as to how many couples are left with no cause for their fertility problems, but unexplained infertility is generally thought to affect between 10 and 25% of those who are having difficulty.

So, fertility MOT tests are fine if you want to find out more about your ovarian reserve, they can indicate that you may have a problem but what they really can’t do is guarantee that you are not going to have difficulty getting pregnant further down the line.