I’m talking about fertility here and the very natural desire to try and regulate when you have a baby. As more women are carrying on their careers alongside having families, and even more are delaying starting a family, you would think that the recent announcement of an accurate test to determine when menopause will start would be very welcome.
And on some levels of course it is, but this blood test can tell a woman as young as 20 how long she has left to start a family and would predict when a woman will go through menopause to within four months. The kit, which could be on sale in three years, is in my view the classic two edged sword. For one thing, it is never wise to rely one hundred percent on any test to tell you something as critically important as whether or not you still have time to start a family.
It looks like this test is aimed at women in their 30s and 40s who want a guarantee that if menopause is fast approaching they can either decide to try for a family immediately or
freeze some eggs for use at a later date. The reality is that women are born with all the eggs they have and as we age they age with us. That means there are all the risks of later pregnancy and ageing eggs as pregnancy becomes both less viable and certain there is no guarantee – whatever the test says – that a pregnancy will happen, and be carried healthily to term.
This test subjects for this trial are an extremely small number – rather like the initial trials for HRT – but it was reported at the European Society of Human Reproduction and Embryology’s conference recently that their predictions for menopause have been accurate to within four months on average and the worst forecasts were only out by three to four years. That still seems like quite a wide margin of error to me, but undoubtedly by the time the test is launched commercially they will have sorted that out.
Stuart Lavery, a consultant gynaecologist and director of IVF at London’s Hammersmith Hospital, said: ‘Contraception has given women control over when not to have kids. This new technology is giving control in a more positive aspect, in terms of keeping options open to have children.’ But he also warned that a good test result does not necessarily mean women will conceive. Quite right, and if your forecast gives you 3 to 4 months it certainly does not give time to explore your own prenatal health or find out if your partner is fertile.
A more realistic view is taken by Dr Dagan Wells, of the Nuffield Department of Obstetrics and Gynaecology at the University of Oxford, who described the research as ‘very exciting, but even if it does turn out to be a very good estimate of the age of menopause, fertility is dramatically reduced in the years leading up to that. If menopause occurs at 50 or 52, fertility is really going to be over five years before that.’
In part two of this article I will discuss the problems associated with becoming a mother at an advanced age.