Couples today are facing some difficult choices when it comes to to career and family planning. Although there is pressure on both partners, women are biologically and historically assigned the role of the child bearer. In this day and age, some women choose to focus on career and enjoy the fruit of their earnings while others pick family and dedicate their time and care to the upbringing of a child.
Those who want both often find themselves waiting for the right time, or simply unsure of what they should do. While personal factors will always hold the most significant influence on the decision to start a family, external factors such as finances and job security are becoming increasingly more important. The Netherlands Department of Population released a document entitled “Infecundity: a result of postponed childbearing?” which concludes that “childlessness lurks behind the busy schedules of modern women striving for a career”. This document serves to caution their audience about the difficulties associated with advanced age reproduction. The polite term ‘advanced age’ has been loosely defined as 35+, representing the age when conception becomes considerably more challenging. Below are some facts for those women who find themselves flipping thorough fertility pamphlets with that plummeting line graph showing their ever-decreasing follicle count, panicking silently and wondering if it is true.
A woman’s fertility peak occurs in her 20s, and gradually declines in the 30s, particularly after age 35. This is because women bear an exact number of reproductive follicles from birth, which slowly decreases (in quantity, as well as quality) as we age. According to data from the Human Ovarian Reserve from Conception to the Menopause, a typical woman has 12% of her reserve at age 30 and has only 3% left at age 40. There are tests of ovarian reserve such as ovarian antral follicle count or those testing for a rise in basal FSH levels are available to predict the quantity, but not quality of oocytes a woman has left. High quality oocytes are essential for the proper formation and function of spindles, which are responsible for chromosome arrangement. This is why advanced reproductive age increases the risk of aneuploidy (too many or too few chromosomes) in the egg, which can lead to miscarriages or chromosome related disease. However, the sophisticated in vitro fertilization (IVF) techniques available today can make those later years just as fruitful. The fruit, however, comes at a high price. Assisted Reproductive Technology (ART) can be a very expensive and draining process, which is not usually covered by health insurance. Many countries in Europe offer complete public coverage of infertility treatment but here in Canada, in vitro fertilization (IVF) is fully covered only in Quebec. Close behind is Manitoba, where a generous tax break is offered to cover part of the cost of the procedure. In our province, the Ontario Ministry of Health and Long-Term Care proposed to expand it’s funding for infertility services starting in 2015, thereby providing IVF coverage for all women as well.
Since fertility difficulties associated with advanced reproductive age are most often caused by poor quality oocytes, women also have the option of cryopreservation, or oocyte freezing. This might buy some time for those waiting to finish their education or get started in their career. The cost associated with retrieval and storage of the oocytes averages around $10,000, plus the costs of fertility drugs and eventual implantation. It might be the availability of these technologies in combination with better contraceptive methods that is allowing women to relax and delay the process of childbearing well into their 30s. In fact, data from Statistics Canada in 2011 indicates that 52% of all Canadian births were to women who are 30 or older, compared to 24% in 1981. The demographic report indicates that for the first time in 2010, the fertility rate of women 35 to 39 is higher than that to women ages 20 to 24. Furthermore, the average age of a Canadian woman having her first child is 28, whereas 30 years ago, the average was 23.
These numbers prove that women are waiting longer and still having success with advanced age reproduction. Although this shift gives hope and comfort to those who are choosing to wait, we must not forget that even with our advanced technology, we cannot postpone the natural changes associated with aging. Because of this, many career women and our own peers and colleagues are experiencing this time-sensitive pressure on top of their graduate training.
[pullquote]There is no right time to start a family – it is always inconvenient, disruptive and very rewarding.
-comment left by a survey participant[/pullquote]In our anonymous survey completed by Immunology and Molecular Genetics graduate students, postdoctoral fellows and faculty, 100% of the respondents rated having children during graduate school as very difficult. In fact, many of us believe it’s still quite difficult during the postdoctoral fellowship years. One of the main deterrents, unsurprisingly, is financial stability. The current graduate student stipend is below the poverty line and postdoctoral fellows are not making significantly more after taxes either. According to a 2013 report by the Fraser Institute, raising a child in Canada is estimated to cost about $3,000 to $4,500 per year. Another publication, however, estimates annual costs at close to $13,000. In either case, it’s not something most graduate students can afford. The survey data identified that most students knew this, since starting a family after starting a job was ranked as the easiest and many commented that this was due to finances. Academia is not the only career path where finances play a role. In most cases, advanced age suggests more financial stability, higher income, and a better living environment. These are major contributing factors to deciding when to start a family and help explain why women are waiting.
To gain perspective on starting a family while in the academic field, we interviewed faculty and post-doctoral fellows who have children. Faculty predominantly cited that they felt supported by colleagues, the department and their labs when they decided to start a family. Postdoctoral fellows also felt supported, but described experiences of other PDFs in other departments and universities where there wasn’t much support. To further complicate matters, being able to put the individual’s research project on hold while taking parental leave, was an issue of contention. In the competitive world of academia, we are under significant pressure to publish, and abandoning our research for extended periods of time puts us at risk of falling behind. From a supervisor’s point of view, it is difficult to agree to put a project on hold while someone takes parental leave. As a result, many postdoctoral fellows take very brief leaves, typically only 3-6 months, instead of the full 12 months. For those lucky enough to have a partner who can also take parental leave, it works. It is now becoming significantly more common for men to take equal leave from work when starting a family. In this way, one parent can take the first 3-6 months and the other can take their time after or have some overlapping time. The fathers we interviewed expressed a great deal of admiration for the hard work their partners put in and almost unanimously agreed they felt it was harder for the woman to balance career and childbearing, at least in the beginning stages. Based on the survey data, career choice does have a significant impact on the decision of when to start a family. And while it may seem daunting within the wonderful world of academia, many of our colleagues and supervisors have done it and would do it again.
-Jelena Borovac and Ashleigh Goethel