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Why Are Some Women Still Unaware of the Risk of Delaying Pregnancy?

A blog by Rhonda Levy, April 3, 2013

The constant media glorification of celebrity pregnancies really troubles me, especially when the celebrity is in her forties. Newspapers and magazines extol these pregnancies as though they are easy to come by when, in fact, nothing could be further from the truth. This, together with the terrible job we do as a society to educate men and women about the decline in a woman's fertility with age, is a dangerous combination. The advent of "egg freezing", an option I am wholly in favour of, has the potential to worsen the situation if it causes women to assume that frozen eggs represent the guarantee of a baby. I worry that this amalgam of circumstances lulls women into a false sense of complacency causing them to delay the formation of their families to a point in their lives when it is sometimes too late. And I worry about it a lot, since I have a front row seat to the immeasurable heartache and despair that is a byproduct of this unfortunate state of affairs.

Don't get me wrong. I don't for one minute think that celebrities have an obligation to disclose to the public that they used donated eggs to create their babies, if that is the case. That is their private medical information, which they are not morally bound to reveal. And although I believe that egg freezing is an option worthy of serious consideration by women who are lucky enough to be able to afford it, I do believe that fertility clinics have an obligation to emphasize that the freezing of a woman's eggs represents the hope of a baby rather than a guarantee.

As for our obligation as a society, I have strong feelings about that too. For far too long, we have not done enough to teach our children about the realities of reproductive biology. While we go to great lengths, within our school systems, to teach them about contraception (preventing a pregnancy), most of our children make their way well into adulthood never once having been exposed, in an academic setting, to even a shred of information about the need for "fertility" in the creation of a pregnancy. That has got to change. Our children must be taught about the decline in a woman's fertility with age. They need to know that:

  1. A woman's ability to have a baby without assisted reproductive technology (ART) and with her own eggs over the age of 40 is as low as approximately 5-7%. This ability drops steadily over time so that by the time a woman reaches age 45, her ability to have a baby without ART and with her own eggs declines to approximately 1%.
  2. Therefore, most women over 40 are unable to have a baby without turning to ART.
  3. In 2012, the last year for which we have publicly available success rates for fertility clinics in the U.S., women over 40 had, on average, the following likelihood of achieving a "live birth" with IVF upon the transfer of embryos created with their own eggs:
    Women age 41-42: 16.3% (fresh embryos) / 26.4% (frozen embryos)
    Women older than age 42: 6.1% (fresh embryos) / 17.8% (frozen embryos)
  4. Therefore, even when they do turn to ART for help, the majority of women over age 40 do not become pregnant when embryos created with their own eggs are transferred into their uterus.

We owe it to our children to educate them about their fertility; to make sure that they will not be lulled into a false sense of complacency, and to protect them from experiencing infertility, to the extent that we can. Our children need to be taught that if women delay attempting pregnancy until they are 40 or older, it is unlikely to be a walk in the park.

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