Sterile Fantasies

Often under the influence of professors, a growing number of university students around the world decide to delay parenthood and family life. Do the students who make such decisions realize the biological challenges they may face as a consequence of such delays? A new Danish study reveals that many university students remain woefully ignorant of the biological and medical realities that make it unlikely that they will ever actually realize the family life they believe they are only delaying. 

Affiliated with Denmark’s Copenhagen University, Metropolitan University, and Zealand University, the authors of the new study probe young Danes’ understanding of reproductive biology in large part because of their concern about the number of young people in Western countries, including their own, who are delaying parenthood. In recent decades, the researchers note, “many countries have seen a marked increase in parental age.” In Denmark, they report, since 1986 the average age of first-time fathers has risen by three years, to 31.3, while the average age for first-time mothers has climbed by four years, to 29.1. 

Parallel developments are manifest in other Nordic countries, with Finland, Norway, and Sweden all reporting “similar patterns . . . regarding postponement of family formation.” The researchers point out that although “postponement of family formation was seen across all educational groups, . . . the postponement was more pronounced among highly educated women.”  

Nor are higher ages for first-time parents peculiar to Nordic countries: the authors of the new study see “similar trends . . . in other countries,” with the age of first-time mothers now standing at 30.6 years in Italy and 30.4 years in Spain. And although the average age of first-time mothers is notably lower in America (26.0 years in 2013), the researchers stress that “in the USA the proportion of mothers 35 years or older has steadily increased over the last 25 years.”

Inevitably, fertility delayed often translates into fertility denied. The authors of the new study understandably highlight delayed parenthood as a reason for the “decline in total fertility rate (TFR) [that] has been seen in OECD [Organisation for Economic and Co-operative Development] countries, where the average TFR dropped from 2.7 to 1.7” between 1970 and 2009. With a Total Fertility Rate now at 1.69, Denmark appears quite typical of affluent Western nations with fertility well below the Zero Population Growth level of 2.1 lifetime births per woman.

Beyond the social and economic issues inherent in the sub-replacement fertility it fosters, postponed parenthood brings a number of other troubling problems. Cataloguing some of these problems, the authors of the new study point out that “higher maternal age is . . . associated with an increase in pregnancy-related complications and adverse outcome in the offspring such as prematurity and foetal death” and that higher paternal age predicts an increased risk of “pregnancy outcomes such as miscarriage.”  

Twenty-first-century medicine does give couples who have delayed parenthood the option of medically assisted reproduction (MAR), but the Danish researchers stress that “the biological decline in fertility by advanced parental age cannot fully be compensated for by MAR, and consequently society as a whole is affected.” What is more, the researchers worry about the “psychological strain of undergoing fertility treatment,” giving as a reason for particular concern a Finish study finding an alarmingly high rate of psychiatric hospitalization among women whose MAR treatment had not resulted in childbirth.

The authors of the new study realize that young people delay parenthood for “several reasons, including contemporary norms, the rise in access to and effectiveness of contraception, and an increase in women’s level of education and labor-market participation.” Given the negative consequences of delayed parenthood for fertility and pregnancy, the authors of the new study regard it as desirable to determine whether “general lack of fertility knowledge, including the age-related decline in fertility, may also be a central and contributing factor.”

To determine the level of fertility knowledge among young Danes, the researchers surveyed 517 male and female students enrolled at the Metropolitan University College in Copenhagen. The data collected from these students intensified rather than allayed concerns about whether young Danes delaying parenthood really understand the consequences. 

Overall, the researchers find that the young Danes they surveyed “generally lacked knowledge on fertility issues,” with “no substantial differences between the two genders.” This lack of knowledge about fertility surfaces on a number of matters. For instance, most of the young Danes surveyed did not realize how soon and how markedly a woman’s fertility declines. The Danish researchers report that “half of both genders thought a slight age-related decline in female fertility has its onset beyond the age of 30 years (correct answer: 25–29 years).” Even more fundamental misunderstanding appears among the “more than 35% [of students surveyed who] believed that a marked decrease [in female fertility] does not occur until 40 years of age (correct answer: 35–39 years).”  Astonishingly, more than 10% of the Danish students surveyed believed that a marked fertility decline does not occur until age 45!

Ignorance about natural fertility among the Danish students was matched by their ignorance about possibilities of Medically Assisted Reproduction (MAR): the researchers report that the success rate of MAR was “grossly overestimated” by both male and female students: “the majority [of the students surveyed in this study] . . . overestimated the probability of achieving a child from IVF treatment,” with 55% of males and 69% of students pegging the probability too high, many of them quite markedly too high. (The actual success rate for MAR runs less than 30%.)  

Since the researchers found that “the majority of participants [in their study] . . . want[ed] two children,” they have to wonder about the apparent “disparity between what is desired and the actual outcome.”  

The Danish researchers see this unfortunate situation manifest in “other studies [that] have time and again found similar limited knowledge [about fertility] among university students” in Europe and the United States. The researchers find this widespread ignorance of fundamental fertility issues to be “of particular concern, as a sizable percentage of [young people] intend to have their last child at the age of 35 years or older, whe[n] a marked decline in female fertility is a reality.”

With good reasons, the Danish scholars fear that “both men and women are making the decision to postpone parenthood without being aware of possible consequences.”

The authors of this new study call for measures “to increase knowledge and awareness of reproductive health” among young people.

Unfortunately, among young people for whom parenthood has become a secondary or even tertiary priority—whether in Copenhagen, Cairo, Cape Town, or Calgary—desire for such knowledge may yield to stronger desire for illusions. 

(Nina Olsén Sørensen et al., “Fertility Awareness and Attitudes towards Parenthood among Danish University College Students,” ReproductiveHealth 13 [2016]: 146, Web.)