- The CDC reported U.S. fertility rates declined by 2 percent between 2017 and 2018.
- The current rate is now at a historic low that follows a pattern of continual decline over several years in the United States.
- Experts say the declining rate is due to many contributing factors, including obesity, pollution, lower teen pregnancy rates, and decisions to start families later in life.
The end of society as we know it, according to Margaret Atwood’s “The Handmaid’s Tale,” is precipitated by a single, unexplainable medical phenomenon: widespread infertility.
For avid followers of the book, now also a television series, the latest news from the Centers for Disease Control and Prevention (CDC) that fertility rates have reached an all-time low might raise alarm bells.
But is the news as dire as it sounds?
According to reproductive endocrinologist Dr. Aimee Eyvazzadeh, the self-proclaimed “Egg Whisperer,” there are a lot of contributing factors to the current fertility decline, including:
- Obesity. “Obesity and infertility go hand in hand,” Eyvazzadeh told Healthline. “As our society continues to struggle with obesity, the same will be true with fertility.” She explained this would likely be the case because obesity has been shown to pass down through generations and is
linked to fertility issues.
- Pollution. “The man-made chemicals that are making their way into our environment (and bodies) are responsible for shifts in hormones and reproductive function. And it’s not just happening on land, but with our mammal friends at sea, too,” Eyvazzadeh said. She pointed to reports that endocrine disruptors have been found in bottlenose dolphins to back up how widespread this issue has become.
- Personal timelines. Many people are deciding to start families later in life, which can present added challenges for some women when they do decide to conceive. “Older men can still have kids, but older women have to accept that they either have to freeze eggs or use an egg donor when they’ve run out of healthy eggs,” Eyvazzadeh explained. “I joke when I say this, but it’s oh-so-true that there is no Botox for your ovaries.”
- Lack of parental leave and good childcare. One reason many people are choosing to have children later in life is a lack of family-friendly policies from their employers. Jobs with limited or no paternal leave coupled with the rising costs of childcare are factors that are causing many people to put off having kids until later in life — sometimes until it’s too late.
- Climate change. Eyvazzadeh pointed out that recent research has found a potential link between climate change and male fertility, which may also be a factor contributing to the declining rate.
Dr. Rachel A. McConnell, reproductive endocrinologist at Columbia University Fertility Center, chimed in to add that there’s no one particular reason we’re seeing this decline, but that it’s a combination of things instead.
“We’re seeing more male factor infertility, with low sperm counts and low motility,” she explained. “And we’re also seeing where a lot of women are delaying [a check on their] fertility until much later.”
The teen birth rate also declined by 7 percent.
This drop may be partially due to an increased use of birth control and improved sex education, but
While that may seem like a good thing to some, Eyvazzadeh pointed out that some reasons teens are having less sex could present bigger issues for them later in life.
She cited two articles from The Atlantic which suggested that increased video game use, increased smartphone addictions, and the general Tinder culture of connecting virtually, rather than in person, may all inhibit those in younger generations to make intimate connections.
It’s a trend she said she expects will continue to become more widespread in the future.
However, McConnell added that the 7 percent reduction in live birth rates among teens could also be tied to better birth control options.
“Most teenagers, and even women into their early 20s, struggle with remembering to take the pill. But these days we have so many more long-term contraception options, IUDs and implants under the skin, for instance.”
While there are a number of factors that are contributing to the reduction in live birth rates among teens, none of them appear to be due to infertility among young people.
If you’re under the age of 35 and have been trying to conceive for at least a year, McConnell says it’s time to head into a fertility specialist for an evaluation.
For those over the age of 35, McConnell says getting in after the six-month mark is a good idea. “They shouldn’t delay it. They should go see a specialist and get some testing done.”
In Eyvazzadeh’s office, that means you should “Get your tushy checked, of course!” she said enthusiastically, referring to her TUSHY Method for fertility screening.
She also suggested being proactive about your fertility, even long before you hope to conceive. This is especially true for females, who she says should be engaging in regular fertility testing as early as their 20s.
In fact, she gave Healthline these “Egg Whisperer golden rules,” she advises her patients to follow:
- Get your fertility levels checked by the age of 21 if you have a family history of early menopause or endometriosis, or if you’ve had an ovary removed.
- No matter what, get your fertility levels checked by the age of 25 and every few years after.
- Freeze your eggs by the time you’re 32 if you haven’t started your family yet and think you may want more than one baby in your lifetime.
- If you haven’t started a family or frozen your eggs by the time you reach 37, freeze embryos. You may want to consider IVF over other methods to preserve your fertility.
“When you’re 40 and ready to have a baby and find out it’s also normal to be in menopause at a time when you also want a pregnancy, it can be heartbreaking,” Eyvazzadeh said.
But as McConnell points out, simply being in your 40s doesn’t mean starting a family is impossible. There are a number of things people can do that can help make having children easier in their later years.
“It’s an important message, being aware of where you are in your life and what your goals are. There are techniques and things we can offer to patients, even if they’re not ready [to have children yet],” McConnell said.