Confronting the Biological Clock

15 Apr

“I can’t believe I’m in your office after spending the majority of my life trying to prevent pregnancy!”

This is probably one of the most common things I hear from my patients at Sher New York’s clinic. Health and sex education are the norm in school curriculums – so growing up we learn the basics of where babies come from, and how to prevent pregnancy. More often than not, the reality of how challenging it may be to conceive is not realized until we are ready to start a family. No one tells you it might be tough to get pregnant – probably because in our teens and twenties it’s significantly easier. But with so many women and couples these days, delaying childbearing until their thirties and forties, perhaps a discussion or two of the potential challenges of conceiving at those older ages – discussing the biological clock – are appropriate when we’re younger.

As a fertility specialist, the patients I see are extremely eager to have a baby. They are all shocked when I tell them that a normal fecundability rate (conception rate) with each monthly cycle is ~20%, and after one year of trying without successfully conceiving that monthly rate drops to <5%. Upon hearing this most of my patients wish they had this information when they were younger. I’m certainly not diminishing the importance of educating youth as to how to prevent unwanted pregnancy, but young women also need to be given information about the likelihood of getting pregnant with each menstrual cycle – especially as they near an “advanced reproductive age.” If not in school, then once a young woman starts seeing a gynecologist for her routine annual care, it is important to touch upon fertility planning and management. Such information, and perhaps even bringing up the idea of egg freezing at a young age, may at least plant the seed in young women so it’s not a foreign concept. Early knowledge will decrease the number of women who first start thinking about egg freezing and/or trying to conceive in their mid-thirties or early forties.

I happened to see a new patient yesterday who just turned 30. Her 30th birthday gift to herself is to freeze her eggs for future use. She told me that she doesn’t even want to think about having children for at least 5 years, but doesn’t want to worry about having difficulties getting pregnant either. It brought a smile to my face – I’m hopeful that more and more young women are becoming aware of their fertility planning options!

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