Condoms, Premature Education, and Fertility
February is recognized by the American Sexual Health Association[i] (ASHA) as National Condom Month--no doubt riding on the coat-tails of all the wild love-making supposedly going on during Valentine’s month. ASHA has resources about the benefits of condom use and answers to common questions, while college campuses promote the cause through funny slogans like “No glove. No love.”
RMA Long Island IVF is happy to do its part in spreading the word about condom month. But we’d also like to point out how sex education—with its limited focus on condoms, other birth control, and STD prevention—stops prematurely. And how it needs to go all the way.
Are you rolling your eyes at the irony as you remember all those years you used condoms (or other birth control) trying to prevent pregnancy—all those late-period pregnancy scares-- and all the money you could’ve saved had you known infertility treatment was waiting down the line? You’re not alone. Back then, scare tactics about birth control led us to fear we’d get pregnant nearly each time we had sex without birth control. We bought into that fear. But they only taught us half of the story and nothing has changed.
Today’s youth needs the whole story. If we’d had it, some of us might not be facing infertility challenges today.
They still need to understand the different birth control options and the importance of avoiding unintended pregnancy. They still need to understand how to prevent STDs as many can be fertility-compromising, life-threatening, or cause harm to their future babies. But they also need something else-- fertility education.
Fertility education will help them understand their reproductive health and that female fertility decreases with age-- sometimes much faster than normal for women whose egg quality and quantity decrease prematurely. They would learn the importance of getting a baseline fertility evaluation long before even wanting to conceive—just to rule out any fertility challenges like hormonal issues, uterine abnormalities, and premature ovarian failure, as well as male factor issues for men. They’d learn about fascinating fertility preservation options like egg freezing.
But the necessary “Don’t wait too long!” message to young adults has yet to be heard over the blaring message to “Always use birth control and don’t get pregnant!”. This leaves many of today’s young women uneducated about the realities of how fast their fertility actually may decline. And some find out too late that their biological clock has run down or that they have other unexpected issues causing their infertility.
It doesn’t help that celebrities are having babies later in life, --often without admitting they needed assisted reproductive technology or resorted to using donor eggs to conceive--leading young women to believe they, too, can conceive their own biological child easily and naturally in their late 40s or 50s without medical assistance. While donor egg is a wonderful family-building option for women who need to use the eggs of another woman to have a baby, it is rarely a woman’s first choice.
The sex education system is so focused on teens not getting pregnant that it fails to tell them they won’t be fertile forever or what steps they should take to keep on top of their fertility status over the young adult years. Do educators believe these are contradictory messages: Use birth control to avoid having a baby--but if you do that for too long, you may never have one? Or do they only care about stopping teen pregnancy-- since that’s the population they deal with-- without regard to what happens to them as adults? Is half of a sex education acceptable?
These messages aren’t contradictory. In fact, they are complementary, successive pieces of advice to guide women through the different phases of their reproductive years as their lives progress and their plans about family-building evolve over time. Is it really fair to these young teens to send them into the world –decade after decade--with nothing more than a pack of condoms?
The shocking truth is that health education—but not sex education—is all that’s mandated in New York State public schools. With the exception of limited mandated education about HIV/AIDS, individual school districts are largely on their own about what to teach about sex ed, resulting in broad fluctuations in the curriculum that leave most of New York State’s students uninformed--or even misinformed—about sexual health.
The New York Civil Liberties Union (NYCLU) reviewed New York school districts and found, among other things, “glaring inaccuracies” in teaching human anatomy and reproduction, the widespread use of non-certified health teachers, and reliance on outdated texts that teach abstinence-only contraception and little to no STD prevention.[ii]
Recently, New York City Mayor, William Di Blasio, committed to revamping the city’s public-school health education curriculum to include mandatory, comprehensive sexual education and initiated a task force in 2017 to make recommendations on what the curriculum’s content and focus should include. While many of the recommendations are long-overdue and needed changes, long-term fertility education was not specifically included in the July 17, 2018 “Findings and Recommendations Report” of the Sexual Health Education Task Force.[iii] Regardless of what ultimately becomes part of the new sex education curriculum, it only covers New York City public schools—the rest of the State of New York’s districts remain in the dark ages.
Do you think schools should teach fertility education to young adults so they can learn about factors that may impact their fertility beyond sexually transmitted diseases?