Dana Drake is an award-winning documentary television producer and Editor In Chief of TalkingFertility.com- a virtual community and resource to support people who are trying to conceive. Dana struggled with infertility for years before having her two boys.
Unprotected sex = pregnancy. By the time I was in high school that was one fact I knew as well as my name. It was drilled into my head growing up – both at school and at home. The propaganda surrounding unplanned pregnancies and STDs aimed at teens worked well on me. I was definitely scared into abstinence. I was always worried that I might accidentally get pregnant. Not that I might one day have trouble getting pregnant.
Even in college, I didn’t know that much about the ovulation process. I thought, if I didn’t use birth control, I could get pregnant, no matter what time of month it was. I may have spent a few sleepless nights worrying about a risky encounter. Did the condom go on too late? Did I remember to take my birth control pill? After college, I wasn’t thinking about my biological clock, I was busy focusing on my career and hoping to find my Prince Charming. So, even if there had been an alarm going off as I was nearing my 30’s – a warning that my fertility window was limited and waning - I would have probably hit the snooze button.
When I got engaged in my early 30’s and visited my gynecologist, I was completely shocked when she said: “You know, your eggs are as old as you are, you might want to think about fertility testing.” I thought, “Wait a minute – I’m not ready for all of that. And why would I even need those tests?” Once I was married and starting to think about starting a family. It dawned on me that I had never in my life actually tried to get pregnant. Freedom from the fear of an unplanned pregnancy was soon replaced with a lot of questions and brand-new concerns like: Did I wait too long? Did radiation from the x-rays I had as a child damage my eggs? Then the revelation came with the realization that I didn’t know much about my own fertility.
It turns out I was not alone. There have been several studies regarding public knowledge about fertility. Last year the Fertility Centers of Illinois did an interesting study to collect insights about women of childbearing age, who don’t have children. One of the areas of their focus was the awareness and level of education about infertility. Nearly half of those surveyed had no idea that while it’s common to get pregnant after 35, ovarian reserve (how many eggs you have) declines, miscarriage rates increase, and pregnancy is considered high-risk.
Dr. Edward Marut, IVF Medical Director and Reproductive Endocrinologist with Fertility Centers of Illinois: “While I make no assumptions about any patient’s knowledge of reproduction, I give each one a primer in the elements of fertility. This leads to the more complex discussion of diagnosis and treatment, and at least 25% (and 50% of males) are blindsided by the information.”
A little more than half of the women over 35 who participated in the FCOI survey, said they would have made different life choices if they had known about infertility at a younger age. “The lack of awareness of the deleterious effects of age and lifestyle including advancing age, smoking, alcohol, drugs, and weight extremes is often shocking. Many women think that being healthy means being fertile. While good health and habits help, they do not insure fertility, and this misconception is especially damaging for the older woman,” said Dr. Marut.
So why are so many women and men clueless when it comes to fertility? Why is there fertility education gap? Most people who participated in the Illinois study agreed that information about fertility should be included in school sex education classes, as well as introduced by a physician at an annual OB/GYN wellness visit. Dr. Marut says, “Despite the public availability of information on reproduction and fertility, many patients fail to take the time to learn about themselves. I also think primary care and General OB/GYN physicians don’t take the time to ask about family planning from a positive viewpoint. Time goes on with the patient ignorant to the inevitability of wasted time. They can take steps to avoid the later shock and disappointment of beginning the process at 40.”
Sharla Smith, HIV/STD Prevention Education Consultant for the California Department of Education agrees that including the topic of fertility in health education must be a priority. “We want students to leave school knowing not only how to prevent pregnancy and sexually transmitted diseases, but how to have positive healthy relationships and how to plan for pregnancy when they are ready.”
The California Department of Education is a national leader when it comes to teaching much more than just prevention-based sex education. California passed a state law in 2016 that made it mandatory for schools to provide a comprehensive and medically accurate sexual reproductive health curriculum. Smith says, “The new law now allows education about sexual reproductive health to be just as important as the rest of the academic curriculum. It’s essential to know that at some point you may want to conceive and the actions you take today can positively or negatively impact your fertility in your 20’s and 30’s.”
It’s comforting to learn that there are states where young women will grow up knowing more about their fertility and how their reproductive system works than I did. But, unfortunately there are still many teens who won’t be learning about it in schools – at home – or even at their doctor’s office. Many doctors don’t have the time or feel comfortable bringing up the topic of fertility with their patients. So it’s up to the “sisterhood” to make sure this crucial information gets out there to all young women – so they can be prepared to make important decisions that will impact their future fertility.