Our Infertile Future

While most Americans were busy enjoying the lazy days of August, The New York Times ran an article that should have caused a civilizational earthquake. In our post-Puritanical era, when casual discussions of sex are ubiquitous, a troubling number of young people lack any real understanding of their own fertility, setting up aspiring parents for potentially gratuitous difficulties when they’re eventually ready to start their own families.

As The New York Times reported,  a study of over 1,200 Australian college students published in the journal Human Fertility found that “fewer than half of university students were able to correctly identify the age at which a woman’s fertility declines . . . and fewer than one in five knew when a man’s fertility declines.”

The study’s authors wanted respondents to know that a woman’s fertility declines between ages 35 to 39 and that a man’s fertility declines between 45 to 49. However, “about a quarter of men and nearly a third of women thought male fertility starts to decline only at 50 . . . . [and] about a third of men and women thought female fertility starts to decline only at 40.” Needless to say, respondents also overestimated a 40-year-old woman’s likelihood of success with a round of IVF—which is a measly 5%.

These numbers—and the ignorance they betray—are startling, but they also help to explain why so many Millennials have been content to delay parenthood. The Australian students in the study, along with their American counterparts (mistakenly) believe they have all the time in the world to pursue educational and leisure opportunities before having children. They are presumably tired of hearing about women’s biological clocks and believe IVF is a secure fertility safety net. 

The first part about the biological clock is understandable, if unavoidable. The second is a dangerously flawed assumption, especially for the Americans. Not only is insurance coverage for assisted reproductive technologies like IVF inconsistent across state lines, making it prohibitively expensive for most individuals, but the industry has a spotty record: success is anything but assured, especially for a 40-year-old woman. Women—and men—can experience fertility challenges at any age, but every individual is likely to face more difficulties than they otherwise might as they age. 

Discussions about assisted reproductive technology too often disregard the physical and emotional toll participants experience, as well as the difficult side effects that can be involved, especially for women. Daily injections can be painful, the flood of injected hormones can send a woman on an emotional roller coaster, and pushing a woman’s body to create multiple eggs in a single cycle can strain her body. We also still don’t have a great handle on the possible long-term side effects. This is to say, in cases where IVF is deemed medically necessary, adults may make the decision that the risks are worth the potential rewards; however, it is not something that should be undertaken lightly. 

All of this brings me to another important question I’ve spent some time pondering, which is: where did Gen Z (and Millennials) get these flawed ideas about having endless time to start a family? Some of it might be a matter of the fertility industry’s successful marketing and ability to integrate itself into Western society over the last two decades. Most people know someone who’s used IVF, so it all feels familiar. 

However, there’s also a potent cultural component. Not only are more celebrities flaunting baby bumps late into their 40s (likely using donor eggs) and public figures like U.S. Senator Tammy Duckworth being celebrated for giving birth at 50, but the entertainment industry also paints later pregnancy as not only possible but a realistic option for women more broadly.

Consider the USA series, “Suits.” A major plotline this summer involved law firm partner Louis trying to have a baby with his girlfriend, Sheila. Louis is 48. We don’t know Sheila’s age, but between Louis’ age and her being portrayed by the 50-year-old actress, Rachael Harris, she is presumably meant to be over 40 as well. In other words, obstetricians would consider both parties “geriatric” parents.

Yet, neither one seems terribly worried about how realistic their goal of parenthood might be. This is particularly surprising for Louis, who frets and obsesses about everything. Sheila decides to schedule an appointment with “the top fertility expert,” but only after a false positive pregnancy test, which had arrived shockingly fast for any couple not living life in 43-minute increments. Then, of course, because it’s TV, they don’t end up needing the specialist’s help: Sheila has a (miraculous) natural pregnancy. 

The challenge in this case, of course, is that while viewers may watch a show like this for escapism, many probably will not realize that this particular storyline is nothing close to documentary-level truth. The reality remains: if you’re interested in joining the ranks of parents, the average person is better off going with the flow of natural fertility, rather than fighting it. We need to start making sure all young people know that, sooner rather than later.

Melissa Langsam Braunstein, a former U.S. Department of State speechwriter, is now an independent writer in Washington, D.C. She frequently writes about culture, religion, and issues affecting families. She shares all of her writing on her website.