Sarah Harris
Thousands of Kiwi couples will have their baby plans dashed this year as they discover they can’t conceive naturally. Holding their child and watching them grow up will become a dream out of reach for one in four women who try — unless they choose to get assistance.
Infertility is defined as not conceiving after 12 months of trying.
The trend is rising — five years ago, one in six women experienced problems, support organisation Fertility NZ figures show.
There are about 5000 first-time fertility clinic appointments every year.
Fertility Week, which starts today and is run by charity Fertility NZ, aims to raise awareness around what it takes to have a child.
It turns out, Kiwis aren’t very aware. Around 85 per cent of women can’t identify their fertile window and people underestimate what effect age has on fertility, according to Dr Antoinette Righarts from the University of Otago.
The main factor in increasing infertility is couples choosing to have children later in life, Fertility Associates’ Auckland medical director Dr Simon Kelly explained.
“Women are expected to have a career now and a family. There are no signs this is going to change.”
In 1970, the median age a woman had her first child was 23, in 2016 it was 29, Statistics NZ reported.
Kelly urged couples to plan for their last child and not their first. For a 90 per cent success rate to have three children naturally, a woman needs to start trying at 23, the Oxford journal of reproduction found.
If they want two children, the woman should start trying at 27, and if they want one for a 90 per cent success rate, they should try no later than 32.
“If someone has a plan about what their ideal family size is, then take into account Maximum female age to start trying for 90 per of achieving desired family size. when you start trying,” Kelly said.
“Say if someone starts at 35 with a view that they want three children. If they have one at 35, by the time they’ve had that baby and are thinking about number two they could potentially be 37 — the chance of conceiving may be reduced and you might need treatment.
“If they are successful, by the time they’re ready for number three they could easily be in their 40s.”
Increasing obesity could also be a factor in rising infertility. New Zealand is now the third fattest country in the world according to a recent OECD report. One in three Kiwis was found to be obese.
Juanita Copeland, 40, had her daughter after five years of trying. She started at age 30 and went through five rounds of IVF and two frozen embryo transfers to the tune of $50,000. Her husband’s vasectomy reversal had been unsuccessful and she had some unexplained infertility.
Copeland knows how lonely the infertility journey is. The Fertility NZ executive committee member encouraged Kiwis to be aware of their fertile window and contact their GP if they have any concerns — as IVF is not a silver bullet.
Her heart breaks when she hears people say “I thought we had heaps of time but we left it too late”.
“There is nothing worse than buying a house you want to fill with children and finding out you left it too late.
“It’s an incredibly harrowing thing to happen. It is life changing. You just feel so powerless.
“You want something so, so, so badly and you feel like you’re doing everything right. It’s very hard for couples to articulate.”
People can be fixated on the “Kiwi dream” that life has to happen in a certain order — house, marriage, baby — Copeland said. But prioritising children may save you grief later down the track.
Fertility declines sharply for women from age 35. But men and women are equally responsible for fertility issues. Infertility is 30 per cent due to the man, 30 per cent to the female, 30 per cent to both and 10 per cent unexplained.
An international study found sperm counts have dropped by more than 50 per cent in less than 40 years among men in Western countries — including New Zealand.
Some studies show a reduction from age 40 in men for couples trying to become pregnant naturally, and from 50 when using IVF.
Common medical conditions which reduce the chance of having a baby naturally are polycystic ovarian syndrome, endometriosis and male factor infertility.
The stress of fertility issues can break relationships, Copeland said. And when men discover they are the reason the couple can’t conceive they take it very personally.
“[Male infertility] can be almost harder for a couple to deal with. For men fertility is connected with sexuality and a sense of manhood and men are less likely to talk about it.
“Women tend to be fixers, they say ‘I wish it was my fault then I’d take all the Chinese herbs and do everything’. Generally speaking, men are not as proactive but take it really personally. Those couples are under quite a lot of strain.”