With a growing number of articles dominating headlines about miracle babies, in large part due to IVF, it’s no wonder people are under the impression that taking the leap to have children can wait.
A recent survey from the University of Melbourne by Eugenie Prior conducted on 1,215 students revealed that less than half could pick the age bracket for when fertility in women begins to decline, let alone for men.
Given an overwhelming percentage of participants disclosed their desire to become parents in the future, fertility specialist Dr Nick Lolatgis says there is a concerning lack of education surrounding the realities.
“Women are deferring their child bearing at a later age because of travelling, careers, finding the right man … but they don’t realise that their most fertile years are when they’re young,” says Dr Lolatgis, Honorary Lecturer in the department of Obstetrics and Gynaecology at Monash University, and Director of the Monash Family Planning Service, who has been working in the field for over 32 years.
“Women are born with two million eggs; at puberty they have 400,000. If puberty occurs at 12 and menopause occurs at 52, then they will only ever release 480 eggs,” he explains. For the record, women’s most fertile years are between the ages of 18 and 32, with fertility significantly declining from 34 to 40.
Based on those figures, at 30, the chances of falling pregnant each month are around 20 per cent, while at 40 it is just five per cent, and by 44 to 45 less than one per cent – a dramatic drop. As for those over 40, a successful pregnancy through IVF, can often mean using a donor egg – a costly procedure costing up to $10,000 out of pocket for just one round.
The numbers are staggering.
But it’s not just women who should be aware. While men do have a slightly bigger window of opportunity, from 40 on wards the quality of sperm is in decline, with infertility attributed to a low sperm count and poor motility.
“Where we thought men could have babies forever – and yes they technically can – the famous story of Anthony Quinn having a baby when he was 80, well that’s not normal,” says Dr Jim Tsaltas, a specialist at Melbourne IVF and head of the Gynaecological Endoscopy Unit at Monash Medical Centre and Southern Health.
“As sperm ages, firstly you reduce fertility in men because the sperm quality drops off, but just like women have an increased risk of down syndrome, there’s also an increase of abnormalities because of sperm issues as well.”
When it comes to fertility issues, men contribute to approximately 30 per cent of the reasons why couples struggle to conceive naturally, while women account for 45 to 50 per of infertility, and 15 to 20 per cent is unexplained.
The survey gained much media attention, particularly given that it highlighted what has been branded as a phenomenon of young people having “unrealistic
expectations” of life, and what they hoped to achieve before becoming parents, which doesn’t always align with their biological reality.
While the freezing of eggs has been common practice for women affected with diseases such as cancer, or endometriosis, which can reduce the number of eggs produced long-term, Dr Lolatgis says the service is becoming more mainstream as an insurance policy for future use.
“Other women now are becoming more and more aware; they haven’t met Mr Right, and they come along to freeze their eggs,” he reveals.
“If I had it my way, I would implore the government to fund the freezing of eggs for all 24-year-olds if they wish to do it, at no charge. Let them freeze 20 eggs, but if they ever use those eggs, then they have to pay for them. This would eliminate a lot of problems.”
But for what is essentially an elective process, Dr Tsaltas says tax payers shouldn’t be burdened.
“You have to have a balance of what is appropriate medical care and what’s not care. This is an elective process; you’re freezing your eggs because you would like to look at it as an insurance policy. The government doesn’t pay for my insurances for my life, I pay for that myself, and I think we should take the responsibility for our health in this area,” he says.
But what’s important to remember says Dr Tsaltas is that IVF doesn’t guarantee parenthood, with its success rate still very much dependent on age.
“The problem is we think that everything can be fixed medically. People think infertility specialists can fix everything; ‘Well I can do IVF and have a baby’. With IVF, the success rates are again purely dependent on the age of the individuals when they present. So the earlier someone presents … the more likely we are to help them,” he says.
But the prevalence of IVF hasn’t solely increased over the past 40 years due to people putting off having children until a later date. Infertility can affect anyone – it’s really the luck of the draw.
“Regardless of when a couple’s going to get pregnant, 12 per cent of couples will have problems whether they’re 25 or 45. You’ll always have men with sperm problems or women with blocked tubes who are not ovulating regardless of how old you are,” says Dr Tsaltas.
What’s clear is that more needs to be done at an educational level by schools, to raise greater awareness, starting as early as puberty.
“I think people should be aware of their reproductive health and their capacity from when they’re having their sex education talks,” says Dr Tsaltas.
“At 16 there’s no reason if you’re talking about contraception why you can’t say that there’s also a time to think about optimal conception if you’re in the appropriate relationship.”
While IVF is a remarkable service helping people around the world realise their dream to become parents, Dr Tsaltas says egg freezing should not be seen as an alternative to having children.
“The advice is, if you’re 33 or 34 – and I pick these ages because it’s when fertility starts to decline – and you’re with a life partner, you should start thinking about a family now. If you’re not with a partner, you can look at being a single mum or look at freezing your eggs as a backup until you find your life partner. That’s how I think we should be approaching it,” he says.
“People shouldn’t feel pressured, but they should be conscious of the timeline, and these are realistic timelines. I would rather not see my patients because they’re already pregnant.”
