Thursday, October 14, 2010

Great expectations?

I found a great article in the National Post this week about people's inflated expectations of what infertility treatments can do. I'm really not sure how many women go around cavalierly thinking, "Oh, I have plenty of time, because there's always IVF..." -- but I do agree that women are really not as aware as they should be about how quickly their fertility declines. And I most certainly agree that there are a LOT of misconceptions related to infertility & infertility treatment.

It's not just the fact that women who may need treatment have these false expectations that bothers me -- the general public has this perception too. Ergo, if I'm living childless, I really must not have wanted children very much -- because there's always IVF (if not adoption), right?? Very little is said about the fact that these treatments often don't work (& that the odds decrease dramatically as you age), let alone the financial, physical, mental & emotional stresses that accompany them.

I read another article somewhere recently about 30- & 40-something women attending a seminar on egg freezing, which is now being offered by a local clinic... the part that stuck in my mind was that when the clinic staffer leading the session said the cutoff age for the program was 36, there was a collective gasp in the room.

Loved the points about family drs (much as I love mine, he could stand to read this article, based on the advice I got from him...) & employers, too.

*** *** ***

Women delay childbirth due to false fertility expectations

Tom Blackwell, National Post · Wednesday, Oct. 13, 2010

Women are delaying childbirth until later and later in life partly because they have an exaggerated belief that fertility treatments will help them get pregnant well into middle age, suggests new Canadian research.

Media accounts of older celebrity mothers and even advice from ill-informed family doctors is fuelling unrealistic expectations about in vitro fertilization (IVF) and other reproductive technology, said Judith Daniluk, a psychology professor at the University of British Columbia.

Women who responded to a recent survey by Prof. Daniluk suggested they expected to delay childbirth until much later than even they considered ideal, and that they believed fertility treatments were far more effective later in life than is really the case.

In fact, the efficacy of treatments for infertile women declines precipitously after the age of about 34, with the technology-aided birth rate hitting barely 1% for those age 46.

“There is an assumption that if women are in good shape, if they’re physicially fit, they can turn to IVF,” said Prof. Daniluk, who counsels fertility patients. “Most people don’t know that, No. 1, IVF is expensive ... and, No. 2, it can’t fully compensate for age-related fertility decline.”

She said more education is needed to drive home the limits of the technology.

She also said that labour policies should be changed to make it easier for women to get pregnant in their peak child-bearing years, without sacrificing careers.

Other experts agreed on Tuesday that misconceptions about reproductive science are helping fuel the steady increase in the age at which Canadian women have children. Close to 49% of women who gave birth in 2005 were over age 30, almost 2½ times the rate in 1974, according to Statistics Canada.

Often, perceptions about fertility medicine seem to arise from the pages of supermarket tabloids, said Dr. Roger Pierson, a Saskatoon physician and spokesman for the Canadian Fertility and Andrology Society.

Fertility clinics constantly encounter women who have read about an actress in her late 40s or 50s who just got pregnant, and wonder, “can you do it for me?” he said.

A 49-year-old patient asked during an appointment recently if she could have eggs frozen for when “she might want to use them.”

“Women are, I think, bombarded with misinformation,” Dr. Pierson said. “What we hear is medicine and science can solve anything, and that simply isn’t true.... It’s sad. These are desperate people who have made incorrect decisions”

Prof. Daniluk said she has seen a dramatic change in the make-up of fertility-clinic patients since the mid-1990s, when most were heterosexual couples who needed treatment because of male fertility problems. Now a third are single women, many of whom have waited too long to get pregnant.

In a presentation to the society’s recent conference in Vancouver, Prof. Daniluk offered up preliminary results of an online, self-administered survey that received more than 1,000 responses between April and June this year.

About 86% thought the ideal age for having their first child was between 20 and 30, but 44% expected to wait until the were between 31 and 35, and 28% until they were over 36.

Most said they would undergo in vitro fertilzation and close to 30% said they would use a surrogate mother if necessary to have a baby.

Knowledge of the reality of delayed pregnancy, and the value of fertility treatments was lacking, however. Most indicated, inaccurately, that overall fitness was a better indicator of fertility than age, while almost half either did not know or refuted the fact that a woman’s eggs are as old as she is.

About 63% said they thought reproductive technology could help most women get pregnant before the onset of menopause, which occurs at an average age of 51.

Prof. Daniluk said it appears to her that family doctors, struggling to keep up with rapid advances in numerous fields of medicine, can also be misinformed about the efficacy of fertility treatment. Patients who delayed child-bearing sometimes say their physician assured them “Don’t worry, you have time,” she said.

Many people do not realize “there is not a technological fix” for age-related infertility, echoed Abby Lippman, an epidemiologist at McGill University and former head of the Canadian Women’s Health Network.

She also called for employers to change their attitudes so women who want children can progress at a different pace than others.

National Post


  1. you always post such interesting articles!

    I really wish I hadn't waited so long... it just happened without me even thinking about it! And now I am starting to worry about the clock in trying for the next one...

    It's the burden of women's liberation - now we get to work our tails off AND try to have a family. I know I got caught up in a falsely satisfying career and wish I hadn't...

  2. This is really interesting. In my case, I had family aunts,sister who got pregnant late 30's(no issues) and my stepmom at 40. It didn't occur to me and I didn't look into the fact that getting pregnant later was going to be hard. Ignorance is no excuse but I certainly wasn't holding out knowing IVF was in my back IVF consult scared the wits out of one does that willingly. ;) Great post.

  3. Very interesting article, but you do always seem to find them :)

    I know I wasn't the most educated about fertility treatments when we began, and had a lot of misconceptions (Like that they'd work in the end... not true for everyone. That one stings a lot when people assume it...)

    Very thought provoking as usual.

  4. I think it is a dangerous situation because the media presents unrealistic promises (here's this celebrity, having a baby at 49!) I don't think people understand the cost and success rates with IVF. That it's art just as much science, and it won't work for everyone.

  5. Yeah, I was one of those people that assumed IVF would "fix" everything. Then again, I met DH when I was 33 and it took him 5 years to marry me, so trying to get pregnant probably wouldn't have been in the cards before then. No happy accidents for us, that should have been my first clue...

  6. For sure - if I knew then what I know now I certainly would have at least stopped paying for birth control sooner.

  7. I agree with the others here. I also wish I had known then, what I know now. Growing up in the 70s and 80s, it seemed that women almost had an obligation to use the opportunities we now had in terms of employment, and that having a baby too young was "copping out." Or at least, that's how I felt. And so when things didn't work out, I'd left it too late. And of course, only then did the media rather belatedly started publishing articles like this, about women leaving it too late. I felt as if I was being scolded repeatedly for my ignorance!

  8. I read this article and felt that it really hit the nail on the head with a number of the points that it made. Especially, though, for me, was this idiotic idea that women seem to have that if they are healthy (read: thin), then they can just wait forever and ever. The subtext there, of course, is that fatties can't get pregnant because they're fat. The misconception runs so deep that it just pisses me off sometimes. A number of people who know me presume that we pursued IVF because I have PCOS, neverminding the fact that my PCOS has been effectively treated for a number of years, and that (despite being overweight) I, too, fall into that "healthy" category-- they cannot fathom that my (thin) husband could be the one with the problem. Sigh.

    While I know that many women might put off children for career reasons, I know plenty more (especially in my age group for some reason) who didn't settle in to a good relationship until they were in their 30s (many friends had what one article deemed "starter marriages", who married young and briefly only to eventually settle down for "real" later on). I didn't get married until I was almost 30, so it's not that I felt that I needed to live life first, I just needed to find a partner who was one I wanted to actually be with for the long haul. I suppose if I had really prioritized having children, I could have settled for Mr. Wrong, but instead, I risked age-related infertility to wait for the right person.

    Very interesting article. I hope it helps women to realize that you really *can't* put things off forever.