Fertility Treatment: Why Wait? A New Generation of Women Take Reproductive Health into Their Own Hands
Since its advent in the 1980‘s, the fertility clinic has been both a godsend for childless couples and a hothouse for ethical debate. Bioethicists, activists, and politicians alike continually question how much control humans should have over their reproductive cycles.
The latest issue to enter debate arises from a recent trend among American women: more and more, women in their twenties are turning to fertility clinics for assistance. Recent government studies show that 23 percent of college-educated women in their twenties are seeking help from fertility specialists. A surprising statistic, considering that women are shown to be most fertile in their early-to-mid twenties.
In fact, a BBC study from 2005 reveals a push among European governments to encourage women to have children at a younger age. Afraid that too many women are postponing pregnancies until their late thirties and forties, many European countries have introduced policies and tax incentives targeted at younger women.
The message, says Dr Allan Pacey of the British Fertility Society, is that “the sooner you do it, the more likely it is you will be able to conceive without medical assistance.”
This push may strike some as paternalistic; after all, why should the government have the right to tell women when to reproduce? Women of the Baby Boomer generation and beyond have benefited enormously from postponing childbirth, able to pursue their careers and establish financial stability before starting a family. True, it is more difficult for older women to conceive—hence the proliferation of fertility clinics—but that is a sacrifice many women have been willing to make to in order to achieve their personal and professional goals.
Meanwhile, young American women seem to be declaring an opposite philosophy: if they want to get pregnant, and they want to get pregnant now, who’s to stop them?
After all, these women are flocking to fertility clinics for a reason. Even if a woman in her twenties is healthy with no reproductive setbacks, getting pregnant still takes time. Most doctors advise waiting at least a year before seeking reproductive assistance. For many young women, this is simply too long.
"Even though I am young, it still seemed like time was going by so fast," said 22-year-old Meredith Whetzel in a recent Wall Street Journal article. "I don't want to be 35 and wondering if I can get pregnant."
Whetzel and her husband had been trying to conceive for just four months before visiting a fertility clinic, where doctors tested her hormone levels and ovary function, and prescribed the ovarian-enhancing drug Clomid. The Journal points out that women like Whetzel “represent a new face of infertility patients: young and college-educated, impatient, and acutely aware that their optimum time to conceive is while they're still in their twenties.”
Doctors, too, are taking notice, reporting increasing numbers of young patients who have only been trying to get pregnant for a few months. Even though the American College of Obstetricians and Gynecologists defines infertility as being unable to conceive after 12 months of trying, women want to know right away if they have any potential setbacks. Twenty-six-year-old Christy Harvin of Arkansas, for example, sought medical help at age 20 after failing to conceive. She was soon diagnosed with polycystic ovarian syndrome, a hormonal imbalance that keeps her from ovulating regularly. She has since been taking fertility drugs. Although she has not yet conceived, Harvin maintains, “the one good thing I did do is start when I was 20. Now I have time left to try."
Still, some doctors warn that women should not become overly-zealous in seeking treatment. Mere impatience is hardly enough to justify the risks and side effects associated with fertility drugs, in vitro fertilization, and other treatment options. Drugs such as Clomid can cause nausea, mood swings, and hot flashes, and injectable drugs can greatly increase the chance of multiple births. In vitro fertilization carries the risk of ovarian hyperstimulation syndrome, where the ovaries become swollen and painful, along with the risk of abdominal pain, nausea or vomiting, shortness of breath, and weight gain. Doctors advise trying less invasive methods first, such as carefully monitoring ovulation.
For some women, however, the stakes are simply too high to wait.
The increasing prevalence of sexually transmitted diseases such as human papillomavirus, or HPV, inevitably raises fertility concerns among young women. Up to 75 percent of sexually active women become infected with HPV at some point during adulthood, and although most cases cause few to no symptoms, certain strands of the virus can cause genital warts or cervical cancer. Most women contract HPV in their late teens and early twenties. Thanks to the consistent use of the pap exam in this country, the majority of American women are able to detect the virus sometime in their twenties. After being diagnosed, these women are given treatment and informed of the risks involved, including that of cervical cancer.
Although HPV itself does not cause infertility, the treatment can lead to cervical problems that can compromise a woman’s ability to get pregnant. And while cervical cancer doesn’t usually show up in HPV-positive women until their thirties or forties, these women are well aware of the risk that they may not be able to get pregnant later in life. To counter the odds, many women seek fertility treatments such as cryogenic egg preservation. An online support group at Baby Center provides evidence of this trend, as anonymous posters share their fears and experiences surrounding HPV and infertility:
"I found out I have HPV about one and a half years ago, after three to four years of abnormal pap exams. I had cryogenic freezing a year ago. My [domestic partner] and I starting trying for our second child two months ago. Hopefully it will happen soon,” says one woman.
Another 22-year-old woman with high-risk HPV expresses her concerns about postponing pregnancy:
“It seems the longer I wait to have children, the more opportunity there is for any [cervical cell] change to occur. I just don't want to be older and run into problems and look back on a time when I was healthy enough to have a baby successfully (which is now). I didn't plan on having a baby anytime soon, but I'm starting to rethink my plans. I want to take advantage of a time where I know I'm not at high risk.”
The attitudes of Harvin, Whetzel and the women of the Baby Center support group reflect changes in the way young women of the Y-generation treat and understand their bodies. The last century has brought about immense improvements in women’s health education, with the advent of Planned Parenthood and increased public dialogue around sex and reproduction. Although it is probably appropriate for healthy young women to forgo the risks and cost of fertility treatment for at least a year, women with HPV and other potential reproductive setbacks are finally able to take control of their reproductive health.
“It has given me the peace of mind that having children is still a possibility,” says a 19-year-old Baby Center member. “I am beginning to have a better attitude about this. I cannot change it, and I am still alive, so I want to find out where to go from here.”
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