Fertility problems in the 21st century

[Odie]

I think this varies a lot. Some I am sure have this ideal of The Family and children need to be a part of their life. To me, it's different. I don't feel I need a child to fulfill my life, and if I couldn't have conceived, I don't think adoption would have interested me. Parenthood in itself has not been something I have been after, as I don't consider it imperative.

However, I am now extremely excited about getting to meet MY daughter in a couple of months. Having a child is still not the end all and be all for me, and I know in the past people have been adamant they want a large family and would never even date somebody who could not have children. This thinking is totally alien to me. Sure, if my SO had been infertile I might always have wondered what it would be like, but I am sure our lives would have been fine anyway.

Yes, this. Totally. Well, mostly. I see infertility in a spouse as a HUGE BONUS. ;) But if things were different, we'd talk about the issue obviously but since it's a non-issue I'm damned happy with that outcome as well.

Unless of course one of you sickos want to impregnate me ;P That'd be one hell of a way to get perma-banned, that's for sure! :lol:

As for the original topic, yes, fertility treatments should be avaliable under a UHC system IF there is a documented fertility program. That being said, the smartest way to limit such a system would be a financial cap. Every citizen (not couple, citizen, given the divorce rate in most places) gets X-amount of dollars from the government system, to go toward fertility treatments after a positive identification of a biological issue has been identified. After that, you'd have to go to private funds and/or private insurance.

That way, you can let people decide when in their lives they would take advantage of such treatments, but you limit the amount the gubnerment supplies toward this venture. If you have fertility problems, you can potentially have a child pregnancy or two (since obviously more than one child can be conceived, esp if you're on fertility drugs). If you want a larger family, you're welcome to do so, but you're on your own.

[Whitestripe]

As for the original topic, yes, fertility treatments should be avaliable under a UHC system IF there is a documented fertility program. That being said, the smartest way to limit such a system would be a financial cap. Every citizen (not couple, citizen, given the divorce rate in most places) gets X-amount of dollars from the government system, to go toward fertility treatments after a positive identification of a biological issue has been identified. After that, you'd have to go to private funds and/or private insurance.

That's actually a very reasonable solution.

As for the assumption that infertilty = older parents, not necessarily. I would have had just as hard a time having a baby at 24 as I did at 34.

[Datepalm]

I haz links!

I really like this blog, which i've been reading for a while, that takes on demographic issues with a bit more depth and nuance than "Not enough babies in europe, muslim hoardes will take over."

A recent Is European Fertility Rebounding, which points out that birthrates in Norway have sort of evened out with older women catching up, and (extremely long)from last year about Italy's ultra low birth rates, arguing they might be caused by some thing related to the boy-man situation Minaku points out.

Equally, far from being marked by weak family ties and a strong drive toward individualism, Italy is striking for the strength of its family ties.

...

In 1994, for example, 21% and 22% of people aged 25-29 were living with their parents in the UK and France respectively. The comparable figures were 66% for Italy and 65% for Spain. In 1995, 71% of all Italians aged 20-29 were living with their parents, compared to 33% in France and 31% in the UK.

...

survey after survey seems to show that fully-employed young Italian adults find it to their liking to remain in the parental home, where they typically pay almost nothing for their upkeep, have their mother do all their cooking and wash, and can spend money on cars, vacations, discos or whatever.

...

What Livi-Bacci effectively argues is that it is the intense inter-connection between generations which leads to a prolonged period of dependency in the younger generation, and that this leads the younger generation to avoid, postpone, and finally limit their assumption of parental responsibilities and commitments. Although this theory is an extremely hard one to test, the argument is an attractive one and, given the prominent place occupied by familistic societies among the pioneers of very low fertility, certainly worth examining closely.

Edited to get rid of exccesive spacing.

[RhaegarTar]

I read a great article a few years ago about why it was better for women to have children relatively early, if they are career-minded. The argument went that basically if a women graduates from college and then immediately gets a professional degree or goes into the working world, and then the 28-40 range quits or reduces greatly her work to have a few children, when she tries to reenter the workforce she will have damaged her employment potential and set her career back quite a bit.

The suggested alternative was to, when possible, have children say, right after college (lets say 22) and then when they are in elementary school go to get your masters or start working full-time. At that point the woman would have, starting around 28, 40+ years without anticipated interruption from which to follow her career-dreams.

Of course, that requires a willing spouse. In my experience, outside of unexpected pregnancies or being a Mormon, people aren't having kids at times which were average in the past (no duh). Until their early 30's, most women want bad boys and most men want video games and beer. Then again thats just me being 26, single and bitter :)

[Chaldanya]

The problem, however, as you point out, is the "willing spouse".

Or maybe the woman doesn't want children at that age. There's no way I'd have contemplated having a child at 22 - it seems more feasible now that I'm 30

N

[Annelise]

The problem, however, as you point out, is the "willing spouse".

Or maybe the woman doesn't want children at that age. There's no way I'd have contemplated having a child at 22 - it seems more feasible now that I'm 30

N

I never wanted a child until my late 20's. That is, I didn't want to have any, ever, prior to that.

[Hereward]

Until their early 30's, most women want bad boys and most men want video games and beer. Then again thats just me being 26, single and bitter :)

Hey, don't sell yourself short. If, and I emphasise the if, women actually do want bad boys, a white supremacist, would be genocidal maniac is definitely tipping into the "bad" camp.

[mouse]

My state mandates that insurance companies provide coverage for 2-4 rounds of IVF treatment. (Specifically, if one of the first 2 treatments results in a live birth, insurance will then cover up to 4 treatments. If one of the first 2 does not work, insurance coverage ends.) This seems to be reasonable and to cure concerns people have expressed about unlimited spending. It also should alleviate concerns about people who are "too old" abusing fertility treatments, because the chances of conceiving even with IVF fall as a woman gets older.

[Annelise]

Hey, don't sell yourself short. If, and I emphasise the if, women actually do want bad boys, a white supremacist, would be genocidal maniac is definitely tipping into the "bad" camp.

I hate to disagree, but I really think this is the way to go:

They “share†household and child-rearing tasks equally - which isn’t really equal at all because they don’t care about a clean house or a well-reared child anywhere near as much as their wives do. In short, each one seems set to spend his life taking orders from a perpetually dissatisfied Mrs. who sounds to me - forgive me but just speaking in all honesty - like a bloody shrike. Who can blame these poor shnooks if they go out and get drunk or laid or just plain divorced?

I’m the old-fashioned King of the Castle type: my wife knew it when she married me, she knows it now, and she knows where the door is if she gets sick of it. And you can curse me or consign me to Feminist Hell or whatever you want to do. But when you’re done, answer me this: why would a man get married under any other circumstances? I’m serious. What’s in it for him? I mean, marriage is a large sacrifice for a man. He gives up his right to sleep with a variety of partners, which is as basic an urge in men as having children is in women. He takes on responsibilities which will probably curtail both his work and his social life. If he doesn’t also acquire authority, gravitas, respect and, yes, mastery over his own home, what does he get? Companionship? Hey, stay single, dude, you’ll have a lot more money, and then you can buy companionship.

All right, I know, I’m a mean old man. But I’ve also been blissfully married for 30 years to a woman who wakes up singing. I think some of these young guys have been sold a bill of goods, I really do. I think they’ve been told what they’re supposed to be like and have sacrificed what they are like. Maybe their marriages are more “fair†than mine but just looking at them, I think they’re miserable. And I suspect, deep down, their wives are probably miserable too.

If you ask me, they’d be better off staying in Vegas.

http://www.salon.com/opinion/greenwald/2009/06/25/klavan/

Damn, if only I were single again...

[Mlle. Zabzie]

I am going through hell and high water to have a baby. We're paying for most of it out of pocket (insurance covers my prescriptions that are related to one of the underlying medical conditions, but that's about it). Like Lady Whitestripe, I would have had the same set of problems at 21 as I'm having at 31 - I just wouldn't have been able to afford the treatments or had the internal emotional strength to handle this situation at 21. Also, even if I'd somehow managed, looking back at the person who my partner was at that age, he certainly didn't have the emotional strength to deal with either fertility issues or the challenges of an infant. It took a while to find the right person, but it was worth the wait. I have read the same articles as RT regarding having children early. I call BS on that, for law. I can't imagine handling or affording law school with young children around.

[Lupigis]

Specifically, if one of the first 2 treatments results in a live birth, insurance will then cover up to 4 treatments. If one of the first 2 does not work, insurance coverage ends.

Strange. I would have thought it would be the other way around. What am I missing?

[Minaku]

Well, there's a guy who believes that feminism means hating men and disenfranchising them.

I thought it was an old stereotype about the whipped husband and the large, overbearing wife?

[Mlle. Zabzie]

I hate to disagree, but I really think this is the way to go:

http://www.salon.com/opinion/greenwald/2009/06/25/klavan/

Damn, if only I were single again...

Ooooo, he sounds like a peach. Maybe I'll trade mine in. My singing voice is terrible though. Would that be a problem?

[mouse]

Strange. I would have thought it would be the other way around. What am I missing?

I don't know for sure what the rationale was when the legislature passed the law, but my suspicion is that they didn't want to require insurance companies to keep paying money for a treatment that was (from the insurers' and legislature's point of view, not my own) not effective, but would require insurance companies to pay again for an effective treatment.

[mashiara]

Despite Greece having UHC fertility treatment costs are not covered unless someone goes to one of the dozen or so state-run clinics throughout the country. Trying to get into one of those requires a lengthy waiting period and most people understandably opt for private clinics and paying out of their own pocket, no matter how prohibitive the cost is. What insurance does cover is most of the cost for the medication for your first three attempts, which is better than nothing, I guess.

I do believe that there should be some coverage for at least 2-3 IVF attempts if a couple has an actual fertility problem. I don't think it should be limitless and I certainly wouldn't justify the state financing countless attempts.

As to the question of the right age for having children, in an ideal world it would be earlier in life rather than later but most women do need to get their lives in order first and get their careers started. And of course, you have to find the right guy first. :)

[Prince of the North]

This is a very interesting thread. My take on it is that essentially, what's happenning in developed societies is that significant education is required before beginning a career. Becoming "established" in one's career (over the 'dues paying' phase) takes a while longer, even, varying on the type of career.

Most women have or want careers now, and don't usually get married right out of college and have a baby (as I did; which was actually common in my area of the country). This is causing a rise in age at first marriage - 28 years old as compared to 18/21 years old just a decade or two ago.

Although I really do have every sympathy for people who experience fertility problems; in the US, I do not believe that the government has any obligation to assist (should some sort of national health coverage become available). This does not restrict fertility treatments to high earners. Actually, out of the three people I know who have had fertility treatments, only one has been a high earner. The other two couples were median income (around $60,000 a year). In case you're wondering how I know that, Darling helps them both with their taxes :) I realize this is anecdotal, but I'm sure that it isn't some sort of fluke, either.

Chataya,

Good point. As everyone probably knows, the extension of "childhood" in industrialized nations is something that's been on the radar for a few decades now. We're still trying to figure out just what effect(s) it's having, though. I mean, think about it. Both males and females biologically mature in their teens, right? But, in our cultures, that's certainly not when "childhood" ends and I'm not saying it should be but it certainly seems to be getting extended longer and longer. We graduate from high school at 18 and "childhood" is now extended into the early to mid 20s by college. Then, having children is put off through a "career-establishment" stage for financial reasons until the late 20s or early 30s (if we're lucky). It's easy to see how we got here but it's infinitely harder to see just what to do about it.

I know, in my and my wife's case, I sometimes think about how things could have been different had we gotten married and tried having kids much earlier in our relationship. You see, I was 27 and my wife was 24 when we met and both really just embarking on our career paths. So we had a good, although sometimes long-distance, relationship for about 5 more years. Then we finally got to be living permanently in the same town together and were married about 1 year later. So all of a sudden it's 6 years later and I was 33 and she was 30 when we got married. We were in a stable financial situation by then so we wanted to have children right away. Well, that's when we found out you can't necessarily take these things for granted. We found out my wife had a very severe case of endomitriosis so she had to have two surgeries before we could even try IVF. So it was another 4 years before our daughter was born and I was 37 and my wife was 34 by that time. We did IVF again 2 years later and had a son but I sometimes do the math and feel just a little twinge about thinking I'm going to be so old when my kids graduate from high school (not that the mid to late 50s are really that old but you know what I mean). I sometimes wonder if my wife's endomitriosis would have been as severe back when we first met and maybe things would have been much easier? I guess we'll never know :dunno: Like Ser Scot mentioned earlier, it will be just the two kids for us and we're very, very fortunate to have them :)

Oh, and on the topic of adoption vs. biological children. I'm definitely pro-adoption but there's a hierarchy for me. We wanted to explore our possibilities of having our own children first but, if we could not, we definitely would have tried adopting. If we have any more children it will be through adoption as my wife had a birth complication with our son resulting in a partial hysterectomy.

As for the original topic, yes, fertility treatments should be avaliable under a UHC system IF there is a documented fertility program. That being said, the smartest way to limit such a system would be a financial cap. Every citizen (not couple, citizen, given the divorce rate in most places) gets X-amount of dollars from the government system, to go toward fertility treatments after a positive identification of a biological issue has been identified. After that, you'd have to go to private funds and/or private insurance.

That way, you can let people decide when in their lives they would take advantage of such treatments, but you limit the amount the gubnerment supplies toward this venture. If you have fertility problems, you can potentially have a child pregnancy or two (since obviously more than one child can be conceived, esp if you're on fertility drugs). If you want a larger family, you're welcome to do so, but you're on your own.

Yes, this would seem to be a good way to handle this issue and it's really the way many private insurance companies already handle it (I think). I only have personal knowledge of Mailhandlers and BC/BS of North Dakota but they both had caps on fertility treatments. Here in the U.S., if we do end up with a public health coverage alternative to all the private options I would think the public entity should simply have a cap on fertility treatment coverage, as well.

[RhaegarTar]

I think what causes this unwillingness to "settle down" with a spouse before the late 20's (at the earliest) is a feeling that is exacerbated by our popular culture in that "settling down" means "selling". Like, there's somebody EVEN BETTER just aound the corner, or on e-harmony, or wherever. But, primarily, people don't feel like they're "ready" as people to commit to a relationship before they "know who they are" - ie, after they finish graduate school. Which is really silly, because you know who you are - additional school and beginning a career doesn't change that.

This made me think of an article I have read several times in the last year, called "My Single Identity Baggage." Basically the woman in article, (and I must couch this is from a young-Christian website where the readers are, at least in the theory, seeking to get married and have kids early) discusses all the baggage that a person accumulates in their 20's, and how this can make seeking a mate harder. Instead of two people meeting at say, 19, and growing together, they meet at 26 and have a long list of things they like/dislike/can't live without, which, in her opinion, make the compromises and mutual growth which are the bedrock of a relationship, harder.

I'd agree on the idea of society pushing people to think there is always "someone better." Seems these days i'm always in competition with the possibility of guys with 6-packs and big dollars. Probably how women feel with all the models parading themselves around 24/7.

[Lyanna Stark]

The NHS in the UK does have restrictions in place on fertility treatments. You do need to qualify to get access to free IVF, for example. These are the criteria they list on their home page:

The availability of IVF treatment on the NHS is subject to guidelines that are issued by the National Institute for Health and Clinical Excellence (NICE). These recommend that you should be offered up to three cycles of IVF if:

-you are between 23 and 39 years of age at the time of treatment, and

-one, or both, of you has been diagnosed with a fertility problem, or

-you have been infertile for at least three years.

Some PCTs (Primary Care Trusts) also have additional criteria that may affect your eligibility for funding. For example, some PCTs will not provide funding for couples where one partner already has a child.

Hence you cannot be in your 40s and get free fertility treament under the UHC in the UK. I think this is reasonable, but it worries me that not more is done to encourage parenthood earlier, through tax credits, higher maternity leave compensation and subventions etc. I would be less hesitant to have a baby in Sweden than the UK, for instance, purely because my financial loss will be smaller and my husband and I would be able to deal with the costs easier. £117 a week is just pitiful compared to a "real" salary, I'm afraid.

[mcbigski]

Women have far more control over when to have babies than men do. If enough men aren't willing/able/mature in their early 20s to have children then and a woman that age wants children, she should extend her search criteria to include a somewhat older guy.

[Chaldanya]

discusses all the baggage that a person accumulates in their 20's, and how this can make seeking a mate harder. Instead of two people meeting at say, 19,

I met my ex when we were 18 and we split up when we were 26. So that growing together stuff can be seen as bollocks. You're just as likely to grow together as you are apart.

Yet more anecdata for ya!!