The fertility merry-go-round: why obfuscating science and playing age-old gender stereotypes helps nobody

Once again there are a number of newspapers covering a story about women’s fertility, many of which have the message of falling fertility after age 35 years. ‘Fertility warning to women over 37’ ran a Daily Mail headline. The Mirror said ‘Fertility warning: Women leaving it too late to have children because of ‘miracle’ celebrity babies’. What many of the stories fail to mention or convey adequately to the public is that the underpinning research focused on women over the age of 37 years, who were undergoing fertility treatment.

To be clear, the study, referred to in such headlines, recruited women who were aged over 37 years and were undergoing fertility treatment. One cannot then extrapolate to the wider population. The fertility of women with known fertility problems poses distinct issues from the fertility in the general population of women age 37 or older, but the headlines generalise to all women. What we have are sensationalist headlines rather than accurate reporting of science.

If you are in doubt about the study, then the lead author clarifies the findings at Sense about Science: “Our study did not look at the fertility of all women but just of those over 37 years old with fertility issues who came to our clinic. We looked at the chances of a live birth following a single fertility treatment with a fresh embryo transfer and any subsequent frozen embryo transfers. We found that success rates declined significantly with age. These findings are useful for doctors to give their patients precise information regarding their real chances of success of having a baby with IVF, using their own eggs at that age.” (Dr Marta Devesa, Departamento de Obstetricia, Ginecología y Medicina de la Reproducción, Hospital Universitario Quirón – Dexeus in Barcelona, Spain)

Sense about Science have also quoted Clare Murphy, Director of External Affairs, British Pregnancy Advisory Service as saying: “The suggestion that fertility declines so rapidly they should aim to start their family before they turn 30 is not borne out by research. While it can become more difficult for women later in life, particularly over 40, for the vast majority of women in their 30s their chances of conceiving and having a healthy baby are very good”

There are two issues that appear again and again in stories about women’s declining fertility: their poor understanding of their fertility (we’re all idiots apparently) and the focus on women in discussions about fertility. I’ve previously written about the use of science and fertility around age 35. Here, I shall focus on the latter: the way such stories place the emphasis on women for what is, for many couples, a joint decision and experience to bring life into the world.

Women are asked to think about not privileging their careers over starting a family, their diets and lifestyle, their ignorance over the ‘evidence’ of declining fertility. Women, including ‘educated women’, take a battering for their ‘ignorance’ by Prof Charles Kingsland in a recent Telegraph article. Prof Stuart Lavery, consultant gynaecologist, is quoted in the same article, as saying that he wished the findings would “guide realistic expectations” among older women hoping to start a family. However, heterosexual women require a male partner with whom to conceive, so do those men not merit inclusion in discussion on when people should, ideally, be starting a family?

Excluding men from this discourse silences men’s role in this decision and their need for support and information, which is unfair to men. Men may require wider support to be active parents and partners, including parental leave and supportive societal norms for childcare and sharing domestic duties. We should be having more of these discussions as a society. After all, decisions about starting a family occur against a backdrop of powerful gender norms and expectations, which affect men as well as women. Women may be anxious about starting a family and being burdened with childcare, and may have concerns about motherhood affecting their career aspirations. But equally men may wish a greater involvement with their family life but face barriers. These issues so rarely arise within articles about fertility. We need to stress that fertility decisions are made, commonly, in the context of relationships. How can couples be better informed to make decisions within the context of their relationships, and be more open in discussing various barriers to choosing to start a family, including affordable childcare.

In Scotland, the Scottish Government, commendably, is extending the number of hours of childcare available for pre-school children, but the issue is focused on the number of hours being offered, which sadly narrows the debate. Free childcare can, for example, keep parents out of poverty and therefore affect decisions on when to start a family. A meaningful discussion on how couples can talk to each other about starting a family, how they can balance this with work or other commitments and the role of the state and society in this would be a more healthy discussion.

This means there is an important role for sociological analysis alongside life sciences research. I would welcome science reporting that not only conveys the research more accurately, but is also cognisant of a wider body of evidence on these issues.