Two most common causes of childlessness could be avoided if women had babies younger and were monogamous, says expert
Autor: Sarah-Kate Templeton Fuente: Sunday Herald

Sunday Herald  Almost all fertility problems are preventable and women could avoid being left childless by getting married younger and remaining monogamous, a leading expert has said.
Professor Gedis Grudzinskas, director of the Bridge Centre, a private fertility clinic in London, has warned that women would be “wise” to strike a compromise between their career ambitions and having a family.

“Almost all cases of infertility are preventable. Two of the main causes of infertility – age and sexually transmitted disease – could be avoided. This problem could be dealt with by women marrying early and having one partner. Women are non-monogamous. Frequently, they have more than one sexual partner.

“The assumption is that concentrating on a career and deferring embarking on a family is not going to have consequences, but it does. If we look back at what was going on previously, women were marrying earlier, having monogamous relationships and having children early,” he said.

Grudzinskas said he was aware that his message would not be popular, but believes it is his responsibility as a fertility expert to point out the risks of delaying having children.

“Women will not like hearing it, but infertility is preventable and wise women would find a compromise between their career and having children earlier.

“It is my responsibility to say this. Society needs to be confronted with the fact that infertility is preventable. I don’t mean to be rude but it is important that, if women make different life choices, they should be aware of the consequences. They always say ‘it won’t happen to me’, but it does.”

And this weekend the charity Child Infertility Support Network Scotland has called for the causes of infertility to be taught to schoolgirls.

Sheena Young, director of business development, said: “What we really need is to educate women to be aware that if they wait until they are in their late 30s to have their first child then they are putting themselves at risk of infertility.

“Previously, women would marry at 18 and have their first child immediately. There is now a new generation of women who could not imagine doing that. We cannot make people marry early and have children early, but we can make them realise the risks.

“We have got to start in schools. There is nothing we can do for the generation who are in their late 30s. We have got to educate schoolgirls to let them know that their fertility declines in their 30s.”

Statistics published last week in the annual report by the Scottish registrar general’s office revealed that Scottish women are now waiting longer than ever to have children. It showed that last year, for the first time, more women in their early 30s had babies than those in their late 20s.

It was previously believed that a woman’s fertility began to diminish in her early 30s, with a more rapid decline from around 38. But research published in the journal Human Reproduction last year indicated that a woman’s fertility begins to decline in her late 20s and that male fertility also begins to wane with age.

Sexually transmitted disease is the second cause of infertility that Grudzinskas says women can avoid. The infection causing the greatest threat to female fertility is chlamydia, the most common sexually transmitted infection in the Western world, affecting one in 10 sexually active young women. Chlamydia is responsible for more than 50% of cases of pelvic inflammatory disease and ectopic pregnancy and a third of tubal infertility.

Gonorrhoea can also cause fertility problems if undetected. Cases of gonorrhoea have almost doubled in the past six years.

Grudzinskas argues that, in addition to women having fewer eggs which are of poorer quality as they get older, they are also more prone to compounding problems.

“Age will compound another problem and reduce the prospect of successful IVF treatment,” he said.

“What we have seen in the clinic is a new category of patients who suffer a combination of problems between the male and female partner. If a woman is in her 30s and the male partner has a marginally low sperm count, when the low sperm count is added to the woman’s age, this becomes a problem.”

Dr Stewart Irvine, a consultant gynaecologist at Edinburgh Royal Infirmary, agrees that society must face up to the fact that women who delay having children risk fertility problems.

“There is no doubt that age is one of the biggest issues in infertility. Couples come to us at an age when their fertility is reduced and our ability to help them is less because of that.

“It is inevitable that there is a tension between establishing a career and starting a family, but there is nothing we can do about the biology of ageing.”

Irvine added: “Patients, women and couples, should be in possession of the facts so that they know that, if they defer having a family for whatever reason – to establish a career or because they did not start a relationship early enough – there will be implications as a result of that.

“We tend to teach children that we are dangerously fertile and give the impression that a boy just needs to look at a girl at the other side of the room for her to become pregnant. We tend to ignore the important issue of infertility, which affects between one in six and one in four couples.”

‘We need education about infertility’

Julie Sandison, a hairdresser from Edinburgh, is 32 and has already had one failed IVF treatment. Julie did not meet her husband, Andrew, also 32, until her late 20s. By the time they tried to start a family they were already experiencing fertility problems.

Julie believes women underestimate the stage at which their fertility declines and warns that they cannot expect to slot in having a family after the next step on the career ladder.

“I had one failed IVF treatment in April. I’m only 32 and so is my husband. It annoys me so much when we hear people say they are going to try to have a baby after their next work commitment. It isn’t that easy. I think we have to educate people better about when women can lose their fertility.”

But Julie says women are not to blame. She points out that women are encouraged to become highly educated and establish a worthwhile career.

“I don’t think it is the woman’s fault. Young women are encouraged to make a life for themselves. At school girls are told that they have to get a good education and build a career. When they get to their late 20s, or early 30s, they then think it is the right time to think about a family but by then it can be getting too late.”
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