Young people will be better prepared for infertility

Professor Adam Balen

Consultant in reproductive medicine in Leeds and recent past-chair of the British Fertility Society

Professor Joyce Harper

Deputy Chair, British Fertility Society (Institute for Women’s Health, University College London)

Professor Jacky Boivin

Deputy Chair, British Fertility Society (Fertility Studies Research Group, Cardiff University)

Could you have been better prepared to face fertility problems? If you are trying to get pregnant in your 30s or 40s the answer is almost certainly yes.

Teenagers sit in a classroom, failing to supress laughter while their teacher rolls a condom onto a banana. She goes on to tell them that condoms are the best way to prevent unwanted pregnancy and protect against STIs (sexually transmitted infections). Sound familiar? That is what most people in their 30s and 40s remember of sex education.

Perhaps the old model helped prevent teen pregnancies and protected the sexual health of young people. But as the age at which people begin trying to become pregnant rises, and family structures change, we notice a major gap in relationship and sex education.

Unprepared for fertility issues

People in their 30s and 40s are totally unprepared for the fertility difficulties that they or their friends are experiencing. Nobody told them that women’s fertility typically declines gradually from their 20s and falls off a cliff after the age of 35. And recent research shows that men’s fertility also declines throughout adulthood, dropping quickly after the age of 45.

Technological, political, and legal developments have made it easier for single people and LGBTQI+ people to become parents too, but they don’t necessarily know that reproductive technologies are available to all people, regardless of their marital status or sexuality.

And although we are taught that condoms prevent STIs, many young people don’t know that some STIs can affect their fertility.

Teaching young people

Beginning this academic year and rolling out through 2020, there’s a big difference in relationships and sex education: young people will now be taught about “the facts about reproductive health, including fertility and the potential impact of lifestyle on fertility for men and women“.

We have produced resources, including two animations and a fertility education poster to support the new curriculum.

Research shows that young people want and benefit from fertility education but it needs to be tailored to their specific ages.

Career or babies?

People are choosing to wait until into their 30s or even 40s to have children for a number of reasons. For many, starting a family means addressing conflicting timelines (self versus partner, biological versus psychological). For some it is also about becoming established in their career before taking time out to become a parent.

Many people are not in a relationship and want to wait until they are. And among those women who choose to preserve their fertility by freezing eggs, the reason is more commonly that they have yet to find a partner they wish to parent with.

Preserving fertility through freezing eggs or sperm is an option, but it is not an easy one and is no guarantee of success.

Currently there is also a 10-year limit on the storage of frozen eggs or sperm for ‘social reasons’, which is simply not long enough for many people to plan their family.

The new curriculum deals with the technologies available to support fertility so that young people are firstly aware of their existence and, secondly, have a realistic expectation of treatment and success.

Don’t despair

The next generation should be better prepared. And we can help some of those who are currently struggling.