Best fertility advice? Forget the Femtech and just do what comes naturally

“Isn’t it weird that an expensive technology that is stressful and not particularly successful is being positioned as a standard medical procedure that should be as available as vaccinations or Pap smears?” writes Ramona Koval.

Don’t you know there’s an app for that? I’m told this by the younger women in my family when I venture to advise on biological matters.

I realise it has been nearly 50 years since I had my first child, but that’s not a long time in evolutionary terms. Not nearly long enough to change the basic principles of reproduction, surely?

But now we have Femtech, a digital health industry of products, software and services to answer questions such as “what’s your fertile window?”, when to expect menopause, any developmental news on what your fetus is up to, and something mysterious called sexual wellness. Fortune magazine says the global Femtech market was worth $US6.69bn ($10.02bn) in 2023 and is projected to grow from $US7.75bn in 2024 to $US29.62bn by 2032.

It’s all about giving women the information we need to empower us. Yea. And to enrich those who have had all these marvellous ideas about what we might need to know. There are now cybersecurity concerns though, and it’s possible to get your menstrual cycle or sexual wellness hacked by data traders and privacy pirates.

In the olden days, you found out about your fertility the day you had that pregnancy test result telling you that you were in for a happy event, or else that you better start looking for a kind doctor to help you reverse the process.

No one wants to go back to the bad old days, to the anxiety and inconvenience of it all. Today you can spit in a vial or pee on a strip in the privacy of your own bathroom to find out if you have Covid or a baby or, according to the article in this newspaper last month, you can take your own blood sample and send it off to see if your Anti-Mullerian Hormone levels are high enough to give you a decent egg count for harvesting at the time you are ready to use them.

There are many such websites, and they are welcoming and reassuring, slick and pretty, as are the accomplished professional women whose stories they tell. They offer to give you the data you need to make the best choice about how you want your future to unfold.

A 2021 Sydney University study of Australian and New Zealand fertility clinic websites concluded that several had “statements about the utility of the AMH test that are not supported by the evidence. This highlights the need for higher standards for information provided on fertility clinic websites to prevent women being misled to believe the test can reliably predict their fertility”.

The trouble is this test is not necessarily indicative of your likelihood of conceiving a baby. That depends on your age and on other factors not measured by the test. This is not immediately obvious from the websites promoting these options for the modern gal.

The small print reveals that the test might help determine part of what your capable of in the baby-making department, but you must also read carefully between the lines.

If your egg count looks to be low, they offer to discuss “next steps”; for example, the shiny road to egg freezing, a practice originally used for those patients about to undergo cancer treatment but is being taken up with enthusiasm by young women these days.

It’s called “social egg freezing”, marketed as a way to stop your biological clock while you sort out whether you are going to have a baby with a partner or alone or after the next big promotion at work. The unchanging fact is that from her early 20s a women’s fertility declines, and it is much harder to become pregnant when you reach the mid-30s and beyond.

Egg freezing success rates aren’t great. In one 2022 study the chance of a live birth from frozen eggs was 39 per cent. Long-term reliable data on the procedure is scarce, in part because more than 85 per cent of people worldwide who’ve frozen their eggs haven’t returned to use them. Not all eggs survive the thawing process and the older you are, the more eggs you need to freeze to enable only a few to be used. That means more expensive and uncomfortable retrieval cycles. Using the eggs requires IVF or a related technology. And in practice the costs add up.

If you work for Google, Apple, Facebook, Goldman Sachs or the like, you might be offered a package that pays for your egg freezing. And it’s hard to look a gift horse in the mouth, but why would they do that? Because they know it’s expensive and they’d like to keep you at your desk for as long as possible. Put your idea of having a baby right in the box marked “future”. And since you have your eggs on ice, you have all the time in the world, don’t you? You are a Time Lord, lady.

If it’s too costly where you live, there’s an app for that too. Or at least a company that can arrange your egg retrieval somewhere else at a lower cost, and you can combine this with a little holiday as well. Take a group of girlfriends too. Egg retrievals all round! Now you have moved from the digital realms of Femtech into the squishy, leaking biological world of reproductive technology, or Reprotech.

Kamala Harris

Donald Trump

Even the US elections are keeping up to the mark. The Democrats are claiming they are the party that will make IVF available to all and that the Republicans won’t – a women’s right to abortion is morphing into her right to Reprotech.

(Only last week Donald Trump said in an interview that if he’s elected, his administration would not only protect access to IVF but would have either the government or insurance companies cover the cost.)

Isn’t it weird that an expensive technology that is stressful and not particularly successful is being positioned as a standard medical procedure that should be as available as vaccinations or Pap smears? If you need the technology, I’m OK with that, but why arrange your life around it and end up running into problems where there were none in the first place?

The upshot in advice from this crone? You can’t have it all, at least not in the order that suits your 10-year spreadsheet plan. Time is not your friend, and that’s something you can’t control. Just stop wasting it, and your money, and get on with doing what comes naturally. And you don’t need an app for that.

Ramona Koval is researching a book on the future of human reproduction. She is an Honorary Fellow in the School of Communication and Creative Arts, Deakin University.