The End for Baby Making Sex? No!

Maybe fertility medicine will transform to such a rapid degree in the next 30 years that we will be living in a world previously only imagined by sci-fi writers, where pregnancy is hyper-managed, as Djerassi describes. I think it's far more likely that we will continue to want to have our babies the old fashioned way

In yesterday's Telegraph, Professor Carl Djerassi claims that in just over 30 years' time sex will be redundant as the main means of having a baby and we will all be using IVF as our 'go to' method instead. If I wasn't so helpless laughing as I read that, I'd be crying. Djerassi has a new autobiography out, which I suppose explains the attention grabbing headlines. He says that by 2050 he expects that men and women will choose to freeze their eggs and sperm when young before being sterilised. He says that advances in fertility treatment make it much safer for patients without fertility problems to consider and that progress will give rise to a 'manana' generation who are safe in the knowledge that parenthood can be delayed without repercussions.

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The fact is that IVF isn't all that effective even though it's almost 40 years since the first IVF baby was born in 1978. Average success rates across the UK still languish down at the 25% mark. Yes, some clinics achieve better rates than that but many couples are still unaware that they are more likely to talk away from an IVF clinic without a baby than with one, certainly at the first attempt. One woman I met recently said that her husband sat in shocked silence all the way back from their first fertility clinic appointment because it had only just hit home that their chances were only 40%. (She thought on the other hand that 40% was actually quite good odds but then she had been doing the background reading.)

As well as the relatively low success rates of IVF, there are the risks to consider. Professor Geeta Nargund summarised these at The Fertility Show recently, where she discussed the increased risks of pre-term labour and low birthweight of babies born after IVF and the risks of ovarian hyperstimulation syndrome (OHSS). According to HFEA data over 18,000 women produced more than 20 eggs in one IVF cycle in the last 5 years. Producing more than 15 eggs per cycle increases the risk of OHSS with no related increase in the pregnancy rate. It's one thing to weigh these risks if you have diagnosed infertility and quite another if you don't. Djerassi is completely out of touch with normal people if he thinks they would rather go the medical route- the vast majority of well informed couples I see would do anything to avoid IVF if they could.

It is true to say that egg freezing has recently become 'a thing' with egg freezing parties in New York (and surely coming to London any day soon). You can go along with your friends, have a few drinks and canapes and listen to Eggbanxx's sales pitch about why you should be freezing your eggs now. The trouble is the technology is really very new and not very effective, with only a 25% success rate if you freeze your eggs before the age of 30, and that was for those who had three embryos transferred.

As Rachael Forrest, Fertility Acupuncturist, says "It's ridiculous to think that instead of rearranging society so that couples are supported in having children earlier when the odds are with them, they're making medicine all powerful and trying to gain even more control of people's lives." My prediction is that there will be a swing back in terms of the relatively recent trend to have babies later. Those of us who were raised in the 70's and 80's, whose mothers warned against the perils of 'early' pregnancy, will be saying something different to our own kids. I, for one, will be telling my boys that when they find a good woman they should listen when she says it's time for babies - even if that's when they're still in their 20's. I hate to nail my colours to the Kirstie Allsopp mast but I do think it's important that boys get positive messages about embracing fatherhood early.

Who knows - maybe fertility medicine will transform to such a rapid degree in the next 30 years that we will be living in a world previously only imagined by sci-fi writers, where pregnancy is hyper-managed, as Djerassi describes. I think it's far more likely that we will continue to want to have our babies the old fashioned way, that young women and men will make more informed choices in the next generation and that the fertility fashion pendulum will swing back the other way.

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