BERLIN — There we were, a group of female friends in their early 30s sitting around the dinner table one evening and, somehow, the conversation turns to having children. We all agree it would be nice to be a young mother because it is strangely cool being a young mum. But we all have jobs, plans to travel and want to reach some level of self-fulfillment. Children yes, but not right now, thank you very much. Maybe later … at some stage.
We would rather suppress the thought that having children at a later stage may already have been decided for us. One of our friends, a doctor, says that it is probably not easy to have children later on, that the possibility of having a disabled child increases as we grow older. But we just roll our eyes at the warning and switch topics and talk about things we want to do before our lives are glued in place by our babies' hunger.
We don't mention the topic of in vitro fertilization (IVF) and, like many people our age, fall into the trap of thinking that we can have children whenever we want to. Without any trouble. Even if we are in our late 30s or even early 40s.
Indeed, 10% of German women are 38 years or older when giving birth to their first child. The reproductive medicine market is booming. About 96,000 IVF treatments were conducted in Germany alone in 2015.
Women's decisions to have children later in life is the main reason for the increase in IVF treatments but it's not the only one. The desire to have children among homosexual couples has become more recognized and accepted by society. With just a few clicks, information on IVF and sperm donation are easily available online.
"Those who come to my practice are usually well read on the subject," says Andreas Jantke, head of an IVF clinic in Berlin, adding that visiting an IVF center is in vogue at the moment.
It was quite a different story 10 or 15 years ago. "Infertility has always been a stigma," says medical technician Claudia Wiesemann, who, as a member of the German Ethics Council, deals with the ethical implications of reproductive medicine. But now, it is considered acceptable to have "assistance."
Late pregnancies are become normalized. Risks are not mentioned as much because of the promises made by the reproductive industry and the grateful silence of couples who underwent successful treatment. Biological facts are omitted.
Many couples do not address the subject of parenthood until much later in their lives. By then, often the only way to have a child is through the help of reproductive medicine. The reason for this being that many people are misinformed when it comes to reproductive health. The only thing we hear when we are young is to not have children and, under no circumstances, before we have finished our education.
We neglect to educate couples that women only have a handful of fertile days in each menstrual cycle and that we only have a 25% chance of getting pregnant on one of those days. We do this because we want youngsters to always have safe sex. But we should, between the ages of 17 and 30, also consider the finitude of our fertility. Many women misjudge the restrictions of their own fertility.
"Studies have shown that nearly half of all Germans think that the fertility of women only begins to decrease aged 40," says Jantke. But the chance of having a successful IVF treatment at that age is comparably low. Wiesemann therefore believes that reproductive health education should begin at a young age. For both women and men.
This is crucial knowledge nowadays as there are many reasons to postpone having children: A boss who thinks children are a setback to their employee's career and insufficient childcare arrangements. The arguments for waiting do not evaporate just because we are more familiar with the biological facts. But it enables us to put everything into context.
Female fertility begins to decrease at age 30. At first slowly and then very rapidly from age 35 onward. The quality of eggs that a woman carries from birth decreases with age. Even IVF treatment cannot succeed if there are no good-quality eggs left.
"Many people have exaggerated expectations towards reproductive medicine," says Jantke. His website clearly states that not even half of his treatments, 44.7% to be precise, were successful last year. Most of his female clients are in their mid-to-late 30s.
IVF treatments are not only quite expensive but come with a considerable psychological burden. "We offer psychological care from the very beginning," says Jantke. Most couples are, after all, already stressed by the time they choose to visit a clinic as many of them have been trying to conceive for years.
But does someone who sees a pregnant mid-40s celebrity or hears of a friend who just had twins in her late 30s think of all that? Probably not.
The discussion about reproductive medicine and its societal consequences have to be intensified. It maybe worth listening to your doctor friend at your next gathering of women when she says that having children is not that easy.