On egg freezing

There have been a couple of interesting items on egg freezing in the last few days. The first is a piece from the Telegraph, based around a BBC Radio 4 documentary about egg freezing presented by Fi Glover which looks at the reality of egg freezing. It’s definitely worth a read – and a listen – as it looks at why people consider egg freezing and asks whether the promises it offers are a reality.

At the same time, the Guardian’s Mariella Frostrup was answering a dilemma in a letter from someone who felt angry and let down by a friend who had suggested that she shouldn’t bother freezing her eggs at 35 as she was now 40, wanting a baby and had been told she had possibly left it too late. What was most interesting about this was the completely misplaced certainty that she would have been able to have children had she frozen her eggs, when in fact as Fi Glover’s programme and the Telegraph article explain, this may be very far from the case.

There is a huge media interest in egg freezing, and this is an interesting discussion whatever your point of view…

Can people without fertility problems be infertile?

flag_of_who-svgWhen a story about the World Health Organisation apparently deciding to revise their definition of infertility to include single men and women without fertility problems who wanted to become parents, there was an inevitable media flurry of stories about the NHS having to offer them fertility treatment.

The Daily Mail heralded the story with a headline shouting “Single, childless but want a baby? You could be labelled infertile“, while The Telegraph told us that “Single men will get the right to start a family under new definition of infertility” and The Sun went one better with “Gay couples and single men who want kids will be branded ‘INFERTILE’ – to make accessing IVF easier“…

In reality, the chances of this happening in the UK in our current fertility funding climate is very slim. It is already hard for couples with proven fertility problems to access treatment in many parts of the country, let alone those without them. We have seen cuts to fertility services in recent months and fewer and fewer fertility patients are now being offered the treatment that NICE recommends – which is three full cycles of IVF for those who are 39 and under. So the idea that commissioners are going to rush to start offering treatment to single men and women is far from likely…

National Sperm Bank in the news

DownloadedFile-17It was interesting to see the news coverage today following an article in The Guardian yesterday headlined ‘UK sperm bank has just nine registered donors, boss reveals’.  Some of you may remember that a couple of months ago The Telegraph was “revealing” that the National Sperm Bank had just five donors. In fact, that story and the two articles in The Telegraph used quotes and figures from Banking on Birmingham a BBC Radio 4 documentary I’d made with producer Steve Urquhart which had been broadcast a few days earlier – where the fact that only five donors had been recruited was discussed and put into perspective.

Today’s story was very much focused on the “just” nine donors recruited by the National Sperm Bank but in fact that’s almost double the number of donors in June which would suggest that recruitment is on an upward trend. Recruiting donors is not easy – many men who initially express an interest are put off when they discover the commitment involved and many others who would like to donate are not suitable – on average, just one in every 20 men who applies to donate will be able to as the sperm has to be very high quality and they must also get through screening tests to ensure they do not risk passing on any genetically inherited diseases or sexually transmitted infections.

To learn just weeks after we thought the National Sperm Bank had five donors that it actually has nine can only be a positive step forward; let’s hope that the coverage today will encourage many more men in the Birmingham area to come forward. But do bear in mind that every time the National Sperm Bank is in the news, it doesn’t just lead to more donors in Birmingham but to more donors across the UK – so it’s good for other banks too.

You can find out more about the National Sperm Bank here and more about donating in general here 

Kirstie Allsopp speaks out on fertility

I have a new-found respect for TV presenter Kirstie Allsopp for speaking out about fertility and the biological clock. If you haven’t heard about it, you can read her comments in an interview in the Telegraph here, but to summarise she said she thought we needed to be more honest about the biological clock. She suggested that as we all lived much longer, it was perhaps time to think differently about the order in which we did things and that having children and settling down earlier, and going to university later might be a better way.

Inevitably, she’s come in for a lot of criticism – often from people who haven’t read what she actually said and from those who see her thoughts as some kind of reactionary anti-feminist stance. In fact, what she’s suggesting is far from reactionary or anti-feminist.  It’s actually quite radical, and I think she may be right.

She went on to explain herself very clearly in this debate on Newsnight, where she spelled out that she wasn’t just talking about young women thinking differently, but about young men thinking differently too. We may live longer, but the average age of the menopause hasn’t changed and if people want to have families, it’s both men and women who need to think carefully about when they do this.

We don’t want to scare young women, to make them limit their choices or to prevent them achieving their full potential – but doing things in a different order doesn’t have to be limiting. As a society we tend to have rather negative and judgmental views of women who have children very early, but the handful of women I know who had children in their late teens and early twenties have all gone on to have very successful and fulfilling careers – and are getting on with the rest of their lives post-children at a time when many of their contemporaries are finding themselves on the fertility treadmill.  Maybe it’s time we did rethink the way we do things?

You may not think Kirstie is right, and of course it isn’t always going to be right to have children earlier for all kinds of reasons – but hats off to her for being brave enough to speak out and raise the issue.

How late is too late?

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.

Sperm donors – getting it right…

You could be forgiven for being confused by a recent article in the Telegraph titled The Private Lives of Sperm Donors which looked at the “real men” who chose to donate sperm – I certainly was.

I thought the article was going to be a serious exploration of the reality of sperm donation, but realised something wasn’t right when I got to the description of a man who decided to “eschew the anonymity provided by sperm clinics” (In fact, donating through a clinic is not “anonymous” as the piece repeatedly claims – all donors who go through clinics in the UK have to agree that identifying details will be made available to potential children once they are adults).  This chap apparently felt clinics were too impersonal and wanted to get to know people he was donating to through online chat forums. He liked doing it this way because it allowed him to decide (over a short meeting in a cafe) whether the couple concerned would make “fit parents”…

Alarmingly, the piece then went on to describe a catalogue of experiences from men who were donating privately which had led them to conclude that couples would not be “fit parents” with stories of men climbing out of windows to escape “psychos” and being threatened with knives for asking too many questions.  (I’ve met many dozens, in fact probably hundreds, of people who’ve used donor sperm over the years and can safely say I have not come across any “psychos” or people who would be whipping out knives.  The whole thing sounds hugely unlikely to me, and I can’t help wondering whether there may have been some tall tales told here under the veil of anonymity, but if it were true, it would only serve to highlight the risks of not using licensed clinics.)

These donors were all portrayed as generous fellows who weren’t interested in money, and one, who had allegedly fathered over 100 children, asked recipients to keep in touch with him so he could make sure the children didn’t get romantically involved with one another as they grew older. (Rules in the UK limit the number of children any one donor can father, so a case like this would never, ever occur at a licensed clinic but the piece didn’t mention that.)

These men had, according to the article, found “approaches to sperm donation that worked for them”. Whether these approaches were safe, sensible or legal was not up for discussion.

The piece went on to talk about the “legal minefield” that donors faced (there is no “legal minefield” for men who donate through clinics) and the fact that a “landmark case” where a donor had been ordered to pay maintenance had led many to decide to donate privately so that government-approved clinics didn’t have their details. (The “landmark case” had only come about because the donation was made privately through a website so this has no relevance whatsoever to clinics keeping men’s details and it is private donors who may put themselves at risk of being chased for maintenance by the Child Support Agency, not those using clinics).

It’s a shame that the article failed to discriminate between private donation and licensed clinics in any meaningful way.  There  was no mention of any of the risks of using donor sperm from someone you meet on the Internet, no mention of any of these generous donors having checks for sexually-transmitted infections, for HIV or for any hereditary genetic conditions, no suggestion as to why clinics might be a safer choice for both donor and recipient.

Perhaps it was a useful in that it highlighted the danger for those who don’t research the risks of private donation, but probably not in the way it intended.