Baby Talk: Why We Need To Start Talking About Our Fertility

Cast your mind back to last year, and you’ll remember that Facebook status that went viral. I’m talking about one by US-based freelance writer, Emily Bingham. Alongside the image of a random ultrasound photo, she criticised the way it’s commonplace for women or couples to be asked when they’re planning on starting a family. “You don’t know who is struggling with infertility or grieving a miscarriage or dealing with health issues. You don’t know who is having relationship problems or us under a lot of stress or the timing just isn’t right. You don’t know who is on the fence about having kids or having more kids,” she wrote. “You don’t know who has decided it’s not for them right now, or not for them – ever. You don’t know how your seemingly innocent question might cause someone grief, pain, stress or frustration,” she continued. “This is just a friendly PSA that people’s reproductive and procreative plans and decisions are none of your business.”

It went viral and hit a chord because it’s a sentiment – and a pressure – that so many of us share. I bring it up because the issue of our fertility has never felt quite as relevant as it does now. Each day more and more women in their late twenties and thirties are coming forward about their struggles with conception. It begs the question: what are we doing that’s different to our mothers because our ovaries and reproductive systems haven’t changed? We’re all still born with a few healthy million so what’s prompting the shift?

It was Chrissy Teigen’s teary appearance on Tyra Banks’ new daytime talk show, FABLife that first got me thinking. In the episode, she opened up about her struggles with fertility – and the barrage of questions she’s been subjected to while privately going through treatment. “I will say honestly, John and I are having trouble,” she confessed, revealing that, like so many women, she’s struggled facing constant questioning. “We would have kids five, six years ago if it’d happened,” she said. “But my gosh, it’s been a process! So, anytime somebody asks me if I’m going to have kids,” she continues, “I’m like, ‘One day, you’re going to ask that to the wrong girl who’s really struggling, and it’s going to be really hurtful to them.”

Baby Talk: Why We Need To Start Talking About Our FertilityShe’s not the only one. Tyra Banks, Sarah Jessica Parker, Nicole Kidman, Halle Berry, Jennifer Lopez, Gabrielle Union and both Khloé and Kim Kardashian have all spoken candidly about their struggles with conceiving. Just to be clear, infertility is officially defined as the inability for a couple to get pregnant while having regular unprotected sex over a period of two years. Whether that was true in each of their cases is unclear but it does seem to suggest that there’s a generational problem as far as our fertility is concerned.

“I would say the generation of women who are now in their 30s were not well education about their fertility,” fertility expert, Emma Cannon tells me. “But equally, they grew up being told not to get pregnant and to put their careers first by women who had fought had for their right to work. I think this has had an impact on that generation – we grew up on the message of working hard to have a good life. But of course, eventually when they wanted children, many found it hard.” Emma is quick to add that it’s not just about age though. Environment, lifestyle, health, weight and genetics all play a part.

There’s no doubt that we’re having children later, though. In an era where there’s so much for us to play for in the work place, it’s no wonder more of us are holding out on starting a family until our late thirties. Birth rates for women aged 35 to 39 increased almost 50% between 1990 and 2008, according to Pew Research, and the number of us having children after 40 has tripled over the same timespan. It makes sense. If we’re able to Lean In, why wouldn’t we? It seems only logical to stay at the table for as long as possible before taking our foot of the gas. Only, while our opportunities have improved, science and biology hasn’t quite caught up. The number of eggs at our first menstrual cycle is said to be around 300,000 to 400,000. By age 30, we’re down to between 39,000 and 52,000 (13% of the eggs we had at puberty). By 40, we’re down to around 9,000 to 12,000 (3% of the eggs we had at puberty). Remember, not all of those eggs will be viable too.

According to Emma, there’s a lot more to the problem than age. “I think our priorities have changed so sex (baby making sex) might be lower down our list. By the time we decide we’re ready, it might be that our sex lives just aren’t what they were at the start of our relationship,” she argues. “It takes quite a lot of sex to make a baby. Years of smoking, drinking along with weight and environmental toxins, all take their toll on fertility. Stress is a big factor too. I really believe that we’re producing too much adrenaline. Our bodies are responding by tell itself that it’s not the optimal time to conceive.”

So are we really gambling with our chances of having children if we leave it to our thirties, I ask? Is it really so wrong for us to assume that we’ll be able to have kids the moment we want to? The short answer is, yes. “It’s very individual but if you do intend on having more than one child, you probably want to start in your late 20s and early thirties,” she advises. “Unless you freeze your eggs, of course, but yes, waiting is a gamble.”

What makes the baby delay so do-able today I guess, is the advances in fertility treatments like IVF, egg freezing and the like. So broad are our options perhaps, that more of us are completely ignoring our biological clocks altogether? According to Emma, while the options are vast, many of the treatments are not as easy as they sound, nor are they guarantees. “Egg freezing is similar to IVF, in that you take drugs to produce multiple eggs, which are then collected and frozen. It’s important to point out that egg freezing is very different to embryo freezing, where the eggs are collected and then fertilised by the sperm. This procedure has been part of IVF for a long time and has a long history of working. Freezing eggs tends to be less successful,” she explains, “because eggs are more fragile than embryos and don’t freeze well. I have had several patients lose all of their eggs once they’re defrosted.”

Baby Talk: Why We Need To Start Talking About Our FertilityBefore you panic, Emma is in no way telling you to rush of and start thinking about freezing your embryos or eggs while they’re in their optimal quality – right now you might be ready to even entertain the idea of starting a family. What she does encourage is for us to have an open conversation about it and be a proactive. In her mind, doing so now could make things easier when you are ready to start trying.

There a whole host of things you can do now. A good way to start is by getting a snapshot of your reproductive health. Most gynecologists will be able to do this for you and the whole idea is to create a benchmark now, when you’re in your reproductive prime, to judge against as we age and our ovarian reserves change. The premise is simple: if you don’t have a benchmark to test against, how will you ever know whether any problems you face later on down the line is a recent issue, or something you’ve had without realising for years. It may sound drastic but it can truly help. A friend of mine was in her early 30s when she decided to try to have her first child, only to discover that she’d been suffering from a long underlying issue that prevented her from getting pregnant for five years. While her career dictated that she had her first child later, the delay caused by the problem has left her doubting whether she’ll have a second. Nowadays you can even go for ovarian tests to measure your fertility outlook for the next couple of years and you can even check your fertility and hormone levels to equip you with everything you need to make a plan.

I was on a trip recently with a fellow journalist who blamed her mother for her fertility issues. “I just never thought about it. I was brought up to push in my career. I always took for granted that when I wanted to have children, I just would,” she explained. It took half a decade of IVF before she gave birth to her son aged 42. “Looking back, I wish mum had said, ‘You might not want kids in your twenties and early thirties, but there might be a time later on when you do, so think about how to prepare yourself for that.’”

“That’s why I’m passionate about getting women to engage in their fertility at an earlier age,” Emma tells me. It’s important, because while we’re all more successful and accomplished than ever, our bodies haven’t progressed at the same speed and have no idea.