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The Birds, the Bees and Fertility Treatment: A Sting in the Tale?

25 April 2016

By Dr Rachel Brown

Appeared in BioNews 848

Granted I left school 10 years ago, but I still don't remember much of my sex education. I suspect that, like the vast majority of people I know, what I was taught amounted to very little at all.

Many have argued that this lack of sex and relationship education (SRE) is doing a disservice to young people, and that there is a greater need for the Government and schools to expand the amount of mandatory SRE in the National Curriculum. Many others have argued the converse, raising concerns that increased sex education is unnecessary or could even be detrimental to young people.

It was in this contentious environment that 'The Birds, the Bees and Fertility Treatment: A Sting in the Tale?' took place, providing an opportunity to further discuss whether fertility (and infertility) should also be a part of the curriculum. The event was produced by the Progress Educational Trust (the charity that publishes BioNews), and was sponsored by the British Fertility Society.

The event began with a panel of four speakers, chaired by Professor Adam Balen of the British Fertility Society. Dr Melanie Davies, a consultant at University College Hospital, set the scene by providing a medical context to fertility and infertility. She explained that, while lifestyle choices such as smoking and diet can influence fertility, the primary cause of decreased fertility is age.

The ability to conceive is related to the number and quality of a person's eggs, both of which decrease with age. While 'social' egg freezing is widely promoted as an effective way for younger women to delay motherhood and 'have it all', Dr Davies also cautioned that the procedure is expensive, invasive, and not guaranteed to work. She went on to add that age is also associated with increased miscarriage rates and pregnancy complications. In a time where the majority of schools focus on promoting contraception to prevent teenage pregnancy, Dr Davies outlined the long-term view that delaying pregnancy is also not without risk.

Susan Seenan, chief executive of Infertility Network UK, followed with a more personal account of her work with people directly affected by fertility issues. She described how, time and time again, people express sadness at not having a better understanding of the lifestyle factors that influence fertility, leading them to ask 'Why did no one tell me?'

Seenan went on to explain the success of her charity's regional Scottish Education Project - the first of its kind in the UK - which was developed in order to help prevent future distress by informing younger people about lifestyle choices they can make to preserve their fertility. Now in its fourth year, the project provides fertility education and awareness through universities and via GPs.

Helen Fraser, chief executive of the Girls' Day School Trust, aimed to offer the 'bigger picture' by describing the various competing pressures that young people are under - the need to get a degree, a career, somewhere to live, to pay off debt, and all the while trying to find a committed relationship. She stated that simply teaching young people about fertility is not enough; they also need advice and education to make wise choices about relationships. She was, however, the first speaker of the night to stress that we need to ensure that fertility lessons do not add to the pressure already faced by teenagers.

The final panel speaker was SRE educator and creator of the website Bish, Justin Hancock. To a smattering of laughter from young and old alike, started with a joke about the irony of his name. He continued with a self-described 'rant' about sex education, in which he said that 'often it is what we don't teach which can have the most powerful learning outcomes'. A lack of time and resources to properly teach SRE has led to a culture in which young people are only taught simple take-home messages. This is turn creates misconceptions and confusion, and fails to empower them to make their own informed decisions.

The panel session was followed by what rapidly became a lively audience discussion. Many argued that fertility education is vital and that the limited, and polarised, focus of the current SRE curriculum is problematic. There were numerous disheartening accounts of how a focus only on the merits of contraception to prevent unplanned teenage pregnancy and STIs can cause unfounded anxiety (eg, 'I have had unprotected sex and not become pregnant, so I must be infertile') or paradoxically led to the very problem it was trying to prevent (eg, 'I have had chlamydia so I must be infertile and so do not use a condom'). Nonetheless, others raised concern that widening the over-filled curriculum would be overwhelming to an already pressured generation and create new problems of its own.

What was more interesting to me than these arguments were the questions posed by the numerous teenagers in attendance. Each spoke eloquently and honestly about their concerns about sex education, maturely explaining that, while information on how to prevent unwanted pregnancies and STIs is needed, they nonetheless do want more information about fertility. Surely the opinion of the generation at the centre of this debate is the one that should be given precedence?

Hancock suggested that one way forward would be to make SRE teaching more 'holistic' - a topic that it is taught across the curriculum. For example, while some basic fertility facts could be taught in biology, the more nuanced nature of relationships could be taught in English classes. He added that parents could also be given lessons on how to talk to their children, as he suggested that there is yet to be a generation that has had satisfactory sex education. The onus is on each of us to self-educate and, in doing so, bring about a change in culture, to one in which open discussion is possible.

'The Birds, the Bees and Fertility Treatment: A Sting in the Tale?' was a night of engaging, impassioned, but also divisive discussion. I firmly believe that current SRE leaves much to be desired, but this event made me realise the importance - and challenges - of getting the balance right. And so, rather than offering a final opinion on the matter, I'll use a quote from someone in the audience: 'This is a big topic, and one that only got bigger over the last hour.' With this in mind, I hope that we continue to discuss whether (in)fertility should be a part of secondary school education, but always remembering the importance of including the voices of those to whom this debate is most relevant.

The Progress Educational Trust's next free-to-attend public event is 'Can Women Put Motherhood on Ice?', taking place in Edinburgh on the evening of Wednesday 15 June. See here for further details.

SOURCES & REFERENCES

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

04 July 2016 - by Dr Rachel Brown 
Nearly one-fifth of women aged 35 to 44 years have had problems conceiving, according to a survey of over 15,000 British people...

18 April 2016 - by James Brooks 
Primary school children should be given sex and fertility education to help them make informed family-planning choices in later life, fertility specialists in the UK have said...
04 April 2016 - by Dr Geeta Nargund 
Complete reproductive education, including regarding fertility issues, is the right of all our young people...
01 September 2015 - by Ann Furedi 
I was recently struck by the extent of media interest in the rising age at which women have babies - and the obnoxious arrogance of some of the related commentaries. Everyone, it seems, has a view on the right time for a woman to have a family...

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