Books

01.25.14

Test Tube Generation: The Fertility Lie for Women

A provocative new book says that women are being sold a lie that they can have it all and get easily pregnant in their late thirties and forties—and that we’re experimenting with fertility across a whole generation.

Gossip magazines are constantly touting the baby bumps of celebrities well into their forties. Halle Berry just had her second kid at 46; two years ago, Mariah Carey gave birth two twins at 41; and Kelly Preston gave birth when she was 46 to her second child. Everywhere you look, women are easily having babies in their late 30s and early forties. Stars, they are just like us. Or are they?

So imagine Tanya Selvaratnam’s surprise when she had her first miscarriage at 37, and then another, when she was 38, and yet a third when she was 40. Like a lot of women, Selvaratnam, a film and theatre producer, actress and activist based out of New York City, thought that 40 was the new 30 and that she could have a baby whenever she wanted. And if she couldn’t, well, there was IVF (In Vitro Fertilization) for that. Her new book, The Big Lie: Motherhood, Feminism, and the Reality of the Biological Clock, chronicles her own personal journey through three miscarriages, her trials with IVF, her shocking cancer diagnosis, and her own personal tribulations with her marriage. But it also delves into the deeper issues surrounding infertility in America, namely that women’s pursuit of career first, family second, may come back to haunt them. (Full disclosure: Selvaratnam and I are friends.)

big-lie-bookcover
The Big Lie: Motherhood, Feminism, and the Reality of the Biological Clock By Tanya Selvaratnam 300 pages. Prometheus Books. $19.95. ()

“I really I admit I didn’t know how hard it was until I tried to have a child myself and that was when I was in my mid- to late 30s,” she said. “I also saw quite a few friends having kids in their late 30s and I didn’t think it would be an issue for me.”

The Big Lie might seem to be a scare-mongering title, but, says Corey Whelan, the Program Director of the American Fertility Association, it’s a sadly accurate one. “Yes, without a doubt,” said Whelan, women do think they can have a baby whenever they want. Both Selvaratnam and Whelan say that the media often sends conflicting messages to women. They can have it all, except when they can’t.

“There are a number of factors resulting in baby madness in the media. Part of it is that there’s more scrutiny in general of the minutia in people lives with the telephoto lenses and tabloid culture,” said Selvaratnam.

But that scrutiny and openness is carefully calculated. “They are sharing the things they want you to see. They don’t want to share the pain,” she said, with a few exceptions. Hugh Jackman and his wife were open about their difficulties conceiving, as was Mariska Hargitay and Brooke Shields. But when someone like Halle Berry, a seemingly ageless woman who epitomizes youth and beauty gets pregnant apparently with ease and doesn’t mention if she had IVF or had other help, it’s easy to overlook the facts. “Even with these realistic stories, we still hold on to the fantasy when we see someone like Halle Berry, when she’s 46, 47, getting pregnant.”

“You’re 42 and IVF will get you pregnant. And that unfortunately is very far from truth.”

One of the big messages in Selvaratnam’s book is that education around fertility issues starts far too late. The author thinks that girls should know about the timeline for fertility as young as their teens, when sex education is generally being taught.

“She’s right,” said Whelan. “A number of infertility diagnoses will be given to teens,” she says, naming endometriosis and Primary Ovarian Insufficiency Syndrome as two fertility issues that can be diagnosed in women as young as 15. And Whelan says that because sexually transmitted diseases, a person’s body mass index, and even the food that you eat, can affect fertility for both men and women, teens should be taught that along with sex ed.

“For long-lasting substantive change, sex education has to change,” said Selvaratnam. “We don’t wing it when we learn how to read and write.”

Perhaps, armed with that knowledge, Selvaratnam said, women might not put their careers so firmly first, and they might make better choices when they are dating in their 20s and early 30s.

In The Big Lie she writes: “I have found myself wondering lately about the connection between feminism and my generation’s decision to delay motherhood. Did feminism devalue motherhood? Did it lure us to impossible expectations? Did it lull us into complacency? Or did it create a world full of new possibilities that enticed us to wait until it was too late?”

It’s an uncomfortable truth that many don’t want to address. Gavin McInnes, the libertarian writer and co-founder of the hipster magazine, Vice magazine caused a controversy a few months ago suggesting the very same thing.

“I always describe New York as an elephant’s graveyard for ovaries,” he said in a HuffPost Live debate that went viral for his explosive comments: “All these unhappy women, and I am talking about 100 percent of my friends waiting too long and regretting it. I see these 4- something women and they are fucking sad, they are taking hormones, they have to get a surrogate, they are making twins, because they are taking hormones and spending hundreds of thousand of dollars because they are taking so long to have kids.”

Selvaratnam says: “There’s more of a generational shift in terms of when people have babies. Our generation is the guinea pig for delaying motherhood. Before our generation you didn’t have women having babies in their 30s and 40s. There was more a set path.”

Though, said Selvaratnam, it’s not necessarily feminism’s fault. “I don’t blame anyone for this situation. Advances in reproductive science dovetailed perfectly with the liberating messages of feminism and made women feel they could do things on their own timetables…. Our biologies do not bend to feminist principles, and science can’t work miracles,” she said. “It is very feminist to arm women with knowledge so that they can make better decisions about their futures.”

In fact, feminism is needed more than ever, especially to push for a culture that supports working mothers rather than punishes them. “Women have to fit into a world that was structure by and for men, around men’s needs and schedules. There’s this anxiety that sets in for women that makes them feel like they have to choose between motherhood and careers. That job might not be waiting for you when you come back. You might not be seen as hirable.”

What’s striking about Selvaratnam’s story is not how unusual it is, but how common it is. She talks to dozens of women who went through one miscarriage after another or who tried for years to get pregnant using IVF. But one of the biggest ways women are failed is by their own doctors, many of whom do not advise women correctly or early enough.

That’s not shocking, especially when you consider a recent Duke University Medical Center study that found that doctors only spent an average of 36 seconds with their teen patients talking about sex during a visit.

OBGYN’s don’t fare much better with their adult patients. And when it comes to fertility, said Whelan and Selvaratnam, they are often misinformed and dole out bad advice.

After her first miscarriage at 37, Selvaratnam was told that she had plenty of time, but the numbers don’t lie. Forty percent of women over 40 will miscarry and as they age, women’s reserve of eggs drops to as low as 9000 (compared to over 400,000 when menstruation first starts).

“It’s a terrible mistake that gynecologists make,” said Whelan. “They don’t want to be intrusive. And doctors give them bad advice,” advising women to stay on a fertility drugs for a longer period than they should, or telling them to wait it out and keep trying naturally when they are already in their mid 30s.

“Gynecologists are not infertility specialists,” said Whelan. “They are like Marcus Welby.”

And part of the reason that women wait so long is that they falsely believe that IVF is the magic cure all for infertility.

“One of the things that women really do believe, because of the media and because they want to,” said Whelan, “is that IVF is what you do when you can’t get pregnant. You’re 42 and IVF will get you pregnant. And that unfortunately is very far from truth,” she said citing a success rate between 1 percent and five percent for women over 40. “That’s the ballpark,” she said. “It’s not a good ballpark.”

Selvaratnam writes about the many options that women do have if they are armed with knowledge (and also, money). Egg freezing, once considered experimental, is now open to anyone with cash (around $9,000 to $13,000 for one cycle); so is ovarian tissue freezing; and anyone can ask their doctor to get a simple blood test—an AMH test—which can predict a woman’s ovarian reserve. And, she stresses, that adoption should be foremost on the list of considerations.

As for Selvaratnam, her pursuit of becoming a mother is on hold—for now. “ I’m trying to live in the moment and take things one day at a time,” she says. “I was very happy to start a new year. I need that renewal right now.”