Ahh… October. Between the flannel shirts and cute boots I have in my closet, this time of year gets me feeling all warm and fuzzy. Better still, one of my favorite holidays is in October — and I’m not talking about Halloween. Today is October 3rd—Mean Girls Day, which is (you guessed it), inspired by the 2004 movie, Mean Girls. I’ve probably seen this one about 10 or more times, but when I saw it again on TV recently, I had an epiphany.
There’s a part of the movie where the students gather in the gym for sex-ed, which you can watch here. It is apparent that the school’s safe-sex education includes topics like abstinence, condoms, birth control pills, and IUDs. However, most of the lecture focuses on scaring the youngsters with the potential consequences of sex (did anyone else hear “You WILL get pregnant… and DIE!”?). Seeing this scene again got me thinking… since 1 in 8 couples struggle to get pregnant, who’s teaching students about infertility?
Let’s be honest — schools focus so much time teaching young people ways NOT to get pregnant that they might not know (as mature adults) what to do if they want to get pregnant, but can’t. So why not introduce infertility in sex-ed? To aid in the education of young minds, I put together some infertility-related topics that should definitely be covered “Your Body and You” style.
1. Infertility is a disease
Up until this point, you have likely been focused on protecting your reproductive and sexual health, and preventing unplanned pregnancies. However, it’s also important to know that when you are ready to start a family, getting pregnant may not actually be as easy as your gym teacher makes it sound. Infertility is a disease, defined as an inability to get pregnant following a period of regular unprotected sexual intercourse. If you’re under the age of 35, you can go about a year before you should seek a physician’s help; over 35, the standard rule is to wait about six months before checking in with a doctor.
Infertility can stem from many factors. Know that it’s definitely not your fault, and it’s not because you and your partner are doing something wrong in the bedroom. While Grandma might insist that you and your partner are simply not trying hard enough (and offer to tell you which position led to Uncle Ted’s conception—TMI, Grandma), it’s likely that you will have already tried everything you can think of, and still come up short; your best bet is to seek professional help.
2. Infertility isn’t just a women’s issue
If you paid attention in class to how a sperm and egg make a zygote (an early embryo), you’ll know that an embryo needs to implant in the lining of the uterus to form a pregnancy. But we all know that our bodies can be complicated—sometimes an embryo won’t implant, or even form at all, which means pregnancy will not occur. In this case, underlying factors of infertility may tell why a woman isn’t getting pregnant; however, fertility isn’t a women’s only issue! In addition to factors of female infertility, about 33% of couples experience male factor infertility. If you and your partner have trouble conceiving, consulting with your doctor is the best way to discover if your infertility stems from male factors, female factors, or a combination of both.
3. Alternatives to the ‘old-fashioned way’
In previous sessions of sex-ed, you’ve likely covered everything about making babies…naturally. But for those who may not be able to get pregnant on their own, in comes in vitro fertilization (IVF).
IVF on TV and in the movies looks like it’s super easy — you just go to a doctor and they’ll take some eggs from you, sperm from your partner and BOOM — you’re pregnant! Science! However, IVF is not the ‘30-minute, same day’ procedure you might imagine. Following an initial screening, you and your partner will have quite the road ahead.
Your IVF journey may include (but is not limited to): daily injections in the tummy and/or rump, early morning (we’re talking 6am) egg retrievals, phone calls with your embryologist, an embryo transfer procedure… you get the idea. The other news? Your transfer procedure might not result in a baby on the first go-round. If it doesn’t, you may want to pursue additional IVF cycles, meaning that you’ll go through the process all over again.
4. Infertile or not, you might experience a miscarriage
Okay, kids, this is a big one. (Deep breath) A heartbreaking reality of trying to conceive is miscarriage, and while it’s rarely discussed at the same time as teen pregnancy and STD prevention, miscarriages are very common—so much so, that 1 in 5 early pregnancies end in miscarriage1, often happening before a woman even knows she is pregnant. This risk applies to women of all ages.
Having a miscarriage can burden women with a lot of unnecessary shame, so you should know that having one isn’t your fault. Miscarriage can occur for many reasons, but a commonly observed cause is when an embryo has a chromosomal abnormality; this means that during cell division (which you learned about in biology) an embryo’s chromosomes might split unevenly, leading to a genetic imbalance that may not be compatible with life. These types of chromosomal abnormalities lead to about 50% of all pregnancy losses2. If you experience a miscarriage or recurrent pregnancy loss, you can choose to undergo miscarriage testing to find out the cause.
5. Fertility preservation
One of the main reasons to teach sex-ed is to encourage young people to make informed decisions that protect their health, and help them plan their futures. While some of you may think that having babies is far on the horizon, you should know that one’s fertility declines with age, and this is especially true for women. Advancing maternal age can impact an egg’s ability to form a healthy embryo, and therefore impact a woman’s chances of getting pregnant. With this in mind, young women who plan on delaying childbearing until later in life may want to consider freezing their eggs.
Women under 35 (some of college-age) might choose to freeze their eggs while they pursue higher education and a career (get it girl!). As mentioned during our section on IVF, you will undergo a series of hormone injections used to stimulate a woman’s ovaries before eggs can be extracted. Following an egg retrieval procedure, these eggs are frozen, and can be thawed down the road (for use in IVF) when you are ready to start your family.
6. Modern family building
I’m guessing that during the whole ‘condom-on-a-banana’ demonstration the last thing on anyone’s mind is getting pregnant via sperm donor. For some couples, however, options like this mean that they actually get to have a baby.
While no one wants to be given an infertility diagnosis, it can be comforting to know that there are treatments available, and several options to choose from. If you’re comfortable with exploring avenues like surrogacy, donor sperm, donor eggs, donor embryos, or even adoption, you will find other ways you can build your family. This also applies for situations where you’re a couple who can’t carry, a same-sex couple, a single parent, etc. No matter your situation, remember that you have options. Talk to your doctor and see what alternatives be right for you; ultimately, parenthood doesn’t require DNA—just love.
And there you have it! (From the comfort of home) You have now completed the ‘Infertility’ chapter of sex-ed. While I sincerely doubt that the narrative of modern sex-education will change anytime soon, perhaps, in time, sex-ed’s curriculum will grow to encompass more than abstinence and pregnancy prevention. While educators should absolutely continue to guide those of reproductive age towards taking precaution during sexual activity, solely covering how to delay pregnancy for later in life does not prepare students for all possible outcomes that nature has in store for them. Should nothing be added to health texts to educate the next generation of students on the ins-and-outs of infertility, those currently in the TTC boat can at least laugh at how ironic it is that high-schoolers are being made to believe that all pregnancies are as simple as 1-2-3.
- Choi TY, Lee HM, Park WK, Jeong SY, Moon HS. Spontaneous abortion and recurrent miscarriage: A comparison of cytogenetic diagnosis in 250 cases. Obstet Gynecol Sci. 2014 Nov;57(6):518-525. https://doi.org/10.5468/ogs.2014.57.6.518.
- Marquard, Fertil Steril. 2010 Sep;94(4):1473-7. Epub 2009 Jul 30. (https://www.ncbi.nlm.nih.gov/pubmed/15834243)