With our World Fertility Day fast approaching on Nov 2nd, and our campaign #fertilityhindsight just around the corner, I wanted to share with you the story about my friend, and the hindsight I passed on to her
I (Sara, co founder of IVF babble) am 46 years old now, and thanks to the miracle of IVF, I am the proud mummy of IVF twin daughters. However, having gone through so much “infertility trauma”, I find myself wanting to tell anyone around the age of 30 to be “fertility aware”, in an attempt to save them from the pain I went through
I know having a baby is the last thing any young person wants to think about, but if we could just give them a heads up – just a few pointers to bear in mind, we could save them so much hassle (huge understatement!) in the future.
Obviously I shouldn’t assume everyone is going to struggle to get pregnant naturally, but with the odds so high, (approximately 1 in 7 couples struggle to conceive naturally and this figure has increased and will continue to increase as we are all choosing to start our families at a later age), it’s not something that should be overlooked.
So, as I stood with a friend of mine the other day, I just couldn’t help myself asking her if she had ever considered egg freezing
I asked her this question as she went to light her cigarette.
My friend is incredible – she works in TV. She is beautiful, 30 years old and single. She loves her job and she loves her life, but with no boyfriend, babies are absolutely not on her radar, nor it seemed was egg freezing.
She lowered the unlit cigarette from her mouth, looked at me with sheer horror and replied “No. Should I? Why? “
I found myself scrambling for the words to make her realise that she needn’t panic, but that it is a good idea to think about her fertility before it is too late
She raised her cigarette to her lips to light it, and then took in the longest drag ever.
“F**k” she said as she exhaled an epic cloud of smoke.
I wish I had been able to hand her a piece of paper, with some points on, for her to glance over later with a glass of wine. So, this is why I decided to ask an expert for help. I turned to Dr James nicopoullos at the Lister Fertility Clinic and asked them to answer a few questions that I could then pass on to my friend without scaring the life out of her.
(If you are about to embark on IVF, or if you have been through IVF, you will no doubt be thinking this is of no use to you, but if you know anyone who you think would benefit from this advice, please do pass it on!)
At what age should you really start to get yourself “fertility fit”? (Is this the same for men and women?) What does “fertility fit” even mean?
The worst case scenario for any couple is to have been trying naturally for some considerable time and only then to find out that there was a significant factor that was potentially treatable that could have been impacting fertility all along. So it is probably sensible to consider a Fertility MOT whenever you are thinking about beginning to start a family. In essence, this will confirm that you are fertility fit and there are no underlying factors that might cause you a problem. This should include any factors, such as a low egg reserve, that may make you consider starting earlier and should also include an assessment of any lifestyle factors that could be improved to maximise chances.
Can you be fertility fit if you are single? (It’s a bit of a catch 22 situation if you are single. To find a partner, you want to date – to go out for great meals, drink lots of wine, get drunk together, be reckless as you learn about each other.)
Although there is a lot of talk about the impact of lifestyle and diet on reproductive outcome, in truth the key remains age, and in particular female age, as the most important factor of success. Most studies have not shown an increased risk of infertility or IVF failure with moderate levels of alcohol intake, so like all things, it is about moderation.
If you are a single 30-year-old woman or man who loves smoking, do you have to give up now if you want to eventually get pregnant?
The one thing that I do try and make a point of is the impact of smoking on both male and female fertility, affecting the quality of both sperm and eggs, decreasing the chance of getting pregnant both naturally and through IVF and studies have also shown a potential risk of early menopause in women who smoke. So in short, yes!
Is there a way of assessing your fertility now? Is there a test that might tell you if you are going to run in to problems later with conceiving? What does the test involve? How much does this test cost?
As the most important factor is egg reserve, the key tests are a scan and a blood test called AMH that can give us an idea of the stock of eggs you have compared to the normal for your age. This can hopefully then give enough reassurance to allow you to delay as required.
If the test shows that everything looks good, can you carry on as normal with your wine and cigarettes?
Yes to moderate wine intake but no to cigarettes, as the numbers may be ok but the quality may not.
Why would you advise a woman to freeze her eggs?
There is a limited drop in fertility and chances of IVF success up to 35 years of age, this drops slowly to approximately 37 and then declines more rapidly. So if you are approaching your mid-30s and life or work factors make it unlikely that you are going to be able to start a family in the near future, then you need to be aware that it may become increasingly difficult. Although there is no guarantee that frozen eggs may work in the future and the number of babies born through frozen eggs remains limited, it is all about maximising the reproductive choices in the future. And this just might be your best hope at a later stage.
What is the best age window to freeze eggs?
The main benefit of freezing eggs at a younger age is that it “locks in” the quality of a woman’s eggs at that age and also you tend to produce more of them. These eggs can be used at a later stage when the quality of her own remaining eggs may be significantly reduced in comparison. So, the easy answer would be as early as possible but it is not as simple as that.
The problem is that the earlier you freeze them the less likely you will ever need to thaw and use them in the future, as the chances of a natural pregnancy will be higher. In contrast, waiting to your late 30s or early 40s would allow you more time to start a family naturally. However, at this point the expected success rate of eggs frozen is significantly lower and the number required to give you a reasonable chance of having a baby are also significantly higher.
So my feeling is that if you are approaching your mid-30s and starting a family is not on the horizon, this may be the optimal time.
How much does it cost and how much time off work would you (my friend!) need to have off?
A cycle of egg freezing costs approximately £4, 500 – 5,000 and some hospitals offer a package of three cycles as this may be required. Most people manage their cycle whilst working and often the logistics of juggling treatment and work is the hardest part of the cycle, rather than any physical factors. Many have found this to be less of a burden during the COVID pandemic as more people are working from home. It usually involves five or six visits over the course of two weeks. I would recommend to any friend of mine to save up annual leave for a nice holiday after it is over.
Huge thanks to Dr James Nicopoullos for his wise words. For more information, click here