Nitzan Peri-Rotem, April '16
“As an IVF clinician, every day I meet with women and couples facing the challenge of infertility, many of whom are shocked to learn that their difficulty to conceive is due to age related reduction in quantity and quality of eggs.” Prof Geeta Nargund, a senior consultant gynaecologist at St George Hospital in London, describes her experience, which led her to campaign for the inclusion of fertility education in secondary schools, as part of Sex and Relationship Education. “We need to empower our young people with education on fertility so that they can stand a better chance of falling pregnant when they choose to” Nargund writes. These arguments may sound very convincing. However, not everyone shares this approach. The idea of teaching about the consequences of delayed fertility in schools has been criticized for adding redundant pressures on women to have children early in life. Moreover, it has been argued that the majority of women are aware of their reproductive window and that other factors, such as finding the right partner or housing and financial concerns are more pertinent to the delay in family formation.
On 13 April, a public debate on fertility education (“The Birds, the Bees and Fertility Treatment: A Sting in the Tale?”) took place at the Royal College of Obstetricians and Gynaecologists in London. This event, which was organised by the Progress Educational Trust (PET), hosted a panel of speakers representing different views on the topic. One of the speakers was Susan Seenan, the Chief Executive of Infertility Network UK and Co-Chair of Fertility Fairness. Seenan is a keen supporter of increasing awareness about the causes and consequences of infertility in the school system and elsewhere. She argued that in most cases, young adults are unaware of the impact of age on fertility and are completely in the dark about the potentially negative consequences of smoking, heavy drinking or sexually transmitted diseases on future fertility. “Family planning is not just about contraception and preventing unwanted pregnancies” Says Seenan, “it is about having your family when you want to have a family”.
Helen Fraser, the Chief Executive of the Girls’ Day School Trust has voiced different concerns, focusing on the dangers of putting too much strain on girls and women: “[They have to] find a subject of interest, find a job, a career, a stable partner…” on top of that, adding pressure to conceive early in life would be unwarranted, Fraser argues. Instead, she suggests that society should think about how it can help women and men in having a career and a family: “The attitude of the employer is critical”, she says, “Employers don’t realise that mothers don’t want to be on the mummy track. They want a challenging career.” In addition, Fraser emphasised the importance of the partner’s contribution in the success of achieving both ends.
A different angle on this debate was provided by Justin Hancock, a Sex and Relationships Educator and a Trustee at Sexpression:UK. Hancock has called for a re-evaluation of sex education and suggested that it should include wider aspects of intimate relationships and a better information about human biology. He says that students are being taught about “penis and vagina sex” as the only sex and are led to believe that sex always leads to pregnancy. According to Hancock, providing students with only partial information about their body and how it works infantilises them and is also potentially harmful.
Whether or not fertility education should be added to the curriculum, there seemed to be wider agreement among the participants about the need to rethink sex and relationship education in the UK. In this context, one of the high school students in the audience told an anecdote about her friend who was convinced by her boyfriend that men “categorically enjoy sex more than women”. “No one has ever taught us anything about consent or having a healthy relationship” she said.
Apart from high school students, the audience included gynaecologists, academics, educators, members of NGOs and other members of the public. This has set the scene for a wide-ranging debate, touching on issues of sexual identity, parents-children relationships and whether sex education can also be taught in Biology or even in English Literature classes. Some have also questioned the relevance and effectiveness of teaching students about life style choices and future fertility. In response, Susan Seenan said that the couples she meets often say that they wished someone had told them about the risks of delayed fertility or about what they could have done differently. Conversely, another member of the audience expressed concerns about placing the blame on infertile people.
After the discussion ended, I had a brief conversation with Sarah Norcross, the Director of PET and one of the event’s organisers, who told me that she actually did not expect this issue to raise so many conflicts. Indeed, there is no simple answer to this question. On the one hand, one cannot dismiss the pain and frustration of people who are dealing with infertility. On the other hand, urging women to conceive at the ‘right time’ does not seem like an ideal solution either. The key should be in facilitating the accomplishment of family and career aspirations simultaneously. However, this is a more complex solution, which demands the adaptation of social institutions (e.g. family-friendly employment, affordable childcare and a more equal division of labour in the household). Nevertheless, since most people in the UK, as well as in other countries, do wish to have children, providing a truly supportive environment for childrearing would contribute to starting a family sooner rather than later.
 Nargund, G. (2015). Why Fertility Education is needed in schools. Facts, Views and Vision: Issues in Obstetrics, Gynaecology and Reproductive Health in Obgyn. 2015; 7(3): 189-91. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4788335/
 See: Minter, H. (2015). Fertility on the curriculum? The last thing we need is more scaremongering. The Guardian, 2 June 2015. http://bit.ly/1Q8cDTf; British Pregnancy Advisory Services (bpas). Women not ignorant about fertility – housing and financial concerns key factors in women waiting to start a family. 2 November 2015. http://bit.ly/1oBraxa
 Testa, M. (2012). Family sizes in Europe: Evidence from the 2011 Eurobarometer survey. European Demographic Research Paper, 2. Vienna Institute of Demography of the Austrian Academy of Science. Presented at the European Commission’s Expert Group Meeting on Demographic Issues, Joensuu, 19 March.