Natalie Crawford, MD, a board-certified specialist in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility, discusses the alarming decline in U.S. fertility rates. She delves into how age affects women's fertility and men’s challenges, and the vital role of proactive options like egg freezing. The conversation also covers the intricate IVF process, including its success rates and the shifting social attitudes towards infertility. Additionally, Dr. Crawford highlights the political implications surrounding reproductive rights and accessibility to IVF.
The decline in U.S. fertility rates is influenced by personal choices, medical challenges, and age-related issues impacting conception.
IVF has emerged as a common reproductive solution, but political debates around embryo personhood may threaten access and regulation.
Deep dives
Declining Fertility Rates and Contributing Factors
The United States has experienced a significant decline in fertility rates, with the CDC reporting a record low of 1.62 births per woman. This decrease is attributed to a combination of factors including personal choices, economic considerations, and medical challenges faced by both men and women. Couples are increasingly delaying the start of their families, which reduces their reproductive window and heightens the risk of infertility as age increases. Additionally, there are alarming trends such as decreased sperm counts and rising rates of autoimmune and inflammatory disorders, further complicating the ability to conceive.
The Impact of Age on Fertility
Age plays a crucial role in fertility, particularly for women; statistics highlight that egg quality begins to drop significantly after age 37. While women can still produce viable eggs into their mid-40s, the chances of conception decrease, leading to higher risks of miscarriage and genetic abnormalities. For optimal family planning, experts recommend starting a family between the ages of 27 and 29, as waiting longer can result in a challenging journey filled with increased reliance on fertility treatments. The data shows that waiting until 40 or older dramatically lowers the chances of conception to just a 3% chance per month, underscoring the importance of early family planning.
Understanding IVF and Its Increasing Prevalence
In Vitro Fertilization (IVF) has become increasingly common, now accounting for approximately 2% of births in the U.S. The IVF process involves hormone treatments to stimulate egg production, followed by fertilization in a laboratory and embryo transfer to the uterus. The success rates for IVF vary, with a genetically normal embryo offering a 65% chance of a live birth, which increases cumulatively with subsequent embryo transfers. However, the discussion around IVF has also entered the political arena, where definitions of personhood for embryos could pose risks to access and regulation, highlighting the importance of public awareness and advocacy for reproductive rights.
There are fewer babies born in the United States these days than in years past. But is it all about choice, or could there be medical reasons, too? We’re talking about falling fertility rates, as well as the rise of IVF – including what it involves and why it’s sometimes put in the same conversation as abortion.
Our guest today is fertility specialist Natalie Crawford, MD. Dr. Crawford is board-certified in Obstetrics and Gynecology, and in Reproductive Endocrinology and Infertility, and she hosts the podcast “As a Woman: Fertility, Hormones and Beyond.”