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The Start of the Next Health Crisis

It turns out that when you get rid of vaccines, you bring back infectious diseases that otherwise wouldn’t rear their ugly heads.  For instance,  we’re seeing outbreaks once again of diseases such as measles or whooping cough.  While the conversation around vaccines is complicated, seeing the benefits of vaccines is not: vaccines protect individual and public health by eradicating harmful diseases.

So that’s where this starts.

I was reading an article recently on the anti-vaxxer movement, and I started thinking about all the shitty advice individuals and the media dole out when it comes to fertility and whether we are witnessing the start of the next health crisis.

Because we’ve definitely moved from the Louise Brown, IVF-as-a-last-resort phase into an you-can-always-do-IVF ideology.  In fact, it’s become so commonplace — this thought of getting assistance to conceive — that we now have egg freezing parties.  Egg freezing parties.  I mean, I’m all for egg freezing, especially if you need egg freezing because you’re not currently in a space for family building or you are engaging in a therapy that will compromise your fertility.

But when did we take our fertility out of the doctor’s office and into the cocktail bar?  Or to a random woman’s living room as if our ovaries are a Tupperware container?  Is the casualness we’re bringing to the discussion creating the next anti-vaxxer-like situation; where we’re going to need to live the outcome of our choices down the road?

It’s one thing for a doctor to discuss the possibility of egg freezing with a patient, knowing her situation.  It’s another for a business to encourage women to freeze their eggs so they don’t feel that silly pressure to… you know… build their family.

Is all of this — the mainstreaming of IVF or egg freezing — really going to ensure that more people can become parents?  I really don’t know.  I think that it will help certain individuals become parents whom without egg freezing or the like would find the task impossible.  But I think collectively, in terms of public health, we’ll see lives changed by this conversation.  And not in a good way.

At least, that is my fear.

Did we know how those first celebrities would affect public health when they first took to Twitter or gave interviews with their anti-vaccination comments?  Probably not.  And I don’t think we know now how articles like this one will inform a woman’s decision to delay child-bearing.  (Really?  “Whether it’s a case of art imitating life or the other way around, the over-40 baby boom shows no signs of stopping. Check out which celeb mamas haven’t let their biological clocks get in the way of important family business.”)  Or whether celebrities like Maria Menounos are helping or hurting when they actively promote egg freezing.

It’s complicated, and the two situations are not comparable.  But I do think that we should look hard at the messages of yesterday and how they affect the reality of today.  It will help us to speak carefully today in order to not negatively affect tomorrow.

There is enough infertility in this world without adding more people to the statistic by making them believe that their biological clock will keep ticking as long as they wish it to tick.  Fertility has a shelf life, and we need to talk about that, even if I love the fact that Kim Kardashian can talk about doing IVF and no one bats an eye.  That is a good side to the you-can-always-do-IVF ideology.  Sometimes it feels wrong to kiss one cheek while slapping the other.

12 comments

1 Jenn { 07.22.15 at 9:31 am }

You lost me with comparing people who don’t vaccinate to egg freezing. Once you mentioned celebrities, I stopped reading. My choices about vaccines have nothing to do with what anyone else does. Also, there are two strains of whooping cough and the vaccine only covers one of them.

2 Mel { 07.22.15 at 10:07 am }

It’s too bad that you didn’t give it a careful read before judging. The post has nothing to do with vaccines beyond using it as an example, and I point out in the post that the two situations are not comparable.

3 Working mom of 2 { 07.22.15 at 10:24 am }

Yeah, they’re different in that your choice not to vaccinate affects EVERYONE ELSE whereas infertility choices affect only you.

But that aside, I don’t share the same fears necessarily. On the one hand when over 40 celebs have babies there is a little bit of “it’s possible, don’t worry” attached to some stories. But overall I think IVF bring more mainstream in the news is a good thing, and the discussion of egg freezing hopefully will get women in their 30s really thinking about their fertility vs. thinking “ok I can just wait”.looking back I feel I was somewhat naive and it seems there’s a lot more info out there now. I of course wouldn’t change anything bc I got my 2 beautiful children. But I was lucky. In retrospect I waited too long to see an RE, and even then I didn’t realize how dire things were for a while.

4 Jenn { 07.22.15 at 11:40 am }

“Is the casualness we’re bringing to the discussion creating the next anti-vaxxer-like situation; where we’re going to need to live the outcome of our choices down the road?” Right there you compared them and I have no idea what you mean. The only similarities I see are that both are medical choices and they get some press.

As for the fertility part of it, though I don’t have personal experience with infertility and IVF, I have read a little and know there are lots of concerns that could come up down the road. Things from the medium used for the eggs not being disclosed because it is a trade secret, to messing with the natural process of fertilization, and the risks to the children and mothers with the process. I by no means think fertility treatments should be taboo but it should be used as a medical procedure and not some sort of boutique party idea. I like people being able to have options but one of the things that needs to change is women being stigmatized and less than men in the work place for having children.

5 torthuil { 07.22.15 at 12:41 pm }

Good questions: no easy answers! Personally I think it is foolish to consider fertility treatments a first, rather than last resort: do people know how emotionally, physically and financially draining they are? Perhaps if you just read a news story with a picture of a happy family and the aside that “oh, they did IVF” you think it’s easy. But it’s not. Unless the technology gets way better, which is possible I guess.

6 Cristy { 07.22.15 at 3:15 pm }

Thanks for tackling this topic, Mel. It’s one that does need to be discussed.

Like you, I believe there is a need for egg freezing. But I worry greatly that it’s being used for the wrong purposes. As someone who has endure 4 rounds of IVF, I can easily state that it’s not a procedure anyone should consider as an option for delaying family building. Pamela wrote a nice piece about this for WIRED magazine (http://www.wired.com/2014/10/egg-freezing-risks/) discussing this.

But the other part that you touch on is how IVF has become sort of a default. I’m all for IVF becoming more mainstream, but people aren’t educating themselves about the procedure and what it entails. Instead it’s being used as a way to shut people down when they talk about infertility. Kinda like suggesting that someone who has Type II Diabetes simply needs to go on a diet and lose weight.

Infertility is a multifaceted disease. There’s no one cause and, hence, we need to be promoting research. Instead there’s a push in the industry for egg freezing parties. And that is not right.

7 a.t. { 07.22.15 at 6:01 pm }

this touches on something I’ve been thinking about a lot –
although it is great that ivf and other options such as egg freezing are becoming more openly discussed, and available, – I think you are absolutely right that publicity and dishonest role models (as in the mmr vaccination case) can have an immense knock-on effect that is very hard to fight or even predict.

For me, the issue at the moment is that all this publicity is creating a mindset of either “you left it too late to start trying” if you do ivf and it doesnt work, and “well you can’t really have wanted a family” if you don’t try ivf at all… – it somehow negates other choices, like accepting the body that you’ve been dealt, even while still wanting kids.

(Egg freezing is a bit different because I am pretty sure that most people are doing it because it is their last option to have a chance in the future, not because they are using it to delay trying.)

But all this publicity comes with a very strong subtext of blame, blaming women for leaving it too late, while at the same time trying to panic them into going for a more medicalised option – the private clinics want to push people into doing ivf sooner and sooner because it gives them better success rates.

What we need to work towards is better education of primary point-of-care physicians, so that they actually listen to medical histories and can provide honest statistics. How many of us have been told by a gp just “to relax”, even though you are trying to tell them that it doesnt look like you ovulate.. or “see, at least you can get pregnant” after a loss after years of trying…, and then later down the road, find out that there was a reason for all that and it was dumb stupidity to have kept on blindly trying and thinking it would work.

Better statistics (and accurate reporting, instead of anecdotal reporting) that’s what we need (for the vacc movement too). Because all this guff about “after 35” your fertility drops, is just a bit rubbish and the problem is that most of us dont believe it in our hearts because we know people that age who get pregnant at the drop of a hat – but what isnt rubbish is “if you are already 35 by the time someone notices that in fact you have a fertility problem, then maybe you are scr+++ed, (unless you have the type of mindset that is ready to jump up to ivf without the gradual build up of less successful, but less invasive procedures)”

anyway, sorry you touched a nerve here – as I am in the midst of deciding whether to do another round of ivf or not…

and, sorry for not saying hi in january when you asked if there were any lurkers! too shy 😉
keep up the good work, your blog is one of the high points of my night-time surf…!

8 Rachel { 07.22.15 at 6:35 pm }

Well I got what you were saying. Awareness is a great thing but the more common it gets it can sometimes chip away the seriousness behind it. I think the problem is that so often the whole story is not presented. IVF is emotionally, physically and financially expensive…if a whole generation of women were to freeze eggs and do IVF in their late 40s … Well who knows what would happen for the future generations – especially considering the fact that IVF rarely works every single time. Just like the few initially not getting vaccinated because of the risks of side effects didn’t foresee the way the campaign would take off and therefore the sudden recurrence of these old illnesses that were obliterated due to vaccines. Sometimes we learn by trial.

On a side note – I believe it’s a product of our first world where we see the side effects and chemicals in a vaccine as more harmful than a life threatening illness that hasn’t been around or studied (or has a modern treatment protocol) in 20 years. Working in oncology, I see first hand how detrimental and often fatal those illnesses recurring can be. It’s very scary, especially for imunocompromised patients.

9 Mel { 07.22.15 at 8:12 pm }

That is exactly it. It crosses over from being this wonderful thing into being this potentially damaging thing when we treat it so casually and only provide half of the story.

10 Mali { 07.22.15 at 11:32 pm }

What an interesting discussion. It’s hard isn’t it? On the one hand we want infertility to be discussed, and out in the open. But we also don’t want IVF or egg freezing to be seen as the “magic wand” – when clearly they are not, and can lull women into a false sense of security – any more than we want people to “just adopt.” I think there are more articles these days about the dangers of waiting too long to try (certainly more than back in the 80s and 90s), but these are probably drowned out by the sounds of magazine covers screaming successes of celebrities having children in their 40s and even later (without any discussion of fertility rates, donor eggs/sperm/embryos, etc). And yes, the vaccination debate is evidence that people often take advice from celebrities rather than from medical and scientific facts.

I also fear that the assumption that IVF and egg freezing are 100% effective will be used to further restrict women’s choices and career options, and increase the levels of judgement if they choose to have children when they are younger, rather than focus on their careers (Apple and Facebook, I’m looking at you).

11 deathstar { 07.23.15 at 12:39 pm }

The only people who have egg freezing parties are rich people who feel entitled to celebrate any change in their lives because any change is always better than being bored. I remember when I saw a celebrity on a talk show discussing IVF. Money is never a concern to them and since she was rich, white and thin and all glammed up, apparently it wasn’t that much of a drain for them. These people have assistants to walk the dog for them and access to lovely clinics and have no idea what it is to be shut up in a storage closet on a gurney trying not positive about their eggs implanting. I do appreciate the fact that they do manage to elucidate the general public in a few minutes but speaking as one for whom medical science did not triumph over my uterus, I would prefer more balanced conversations. And just to throw a bomb out there – I have heard of women over here throwing “chicken pox parties” where women gather their little kids together so they can get infected by chicken pox as opposed to vaccination. They’re not rich women, just crazy.

12 Sharon { 07.23.15 at 3:49 pm }

I think that egg freezing is great to the extent that it may allow women to keep the possible option of having biologically-related children open to them longer than they might otherwise have had it. It is, however, by no means a panacea for a number of fertility-related, or societal, problems surrounding the question of parenthood for the majority of women.

And I do think that its casual treatment in the media can create the false impression that it’s a cure-all for a complex problem.

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