Have we been sold a fertility lie?

Looking at the fearmongering and negativity bias at the root cause of our baby anxiety

Sarah Jessica Parker on the set of Sex and the City, pregnant at age 37

Curious Chat is back after a summer hiatus. I spent the past few weeks visiting family and friends, taking on more assignments to pay for the wonderful surprise that arrived before I got health insurance, and tweaking my editorial plan for CC. A lot of people are writing newsletters now, and I’ve been feeling Substack fatigue for the past few months—I want to ensure my newsletter is a place where you can find original thoughts, relatable stories and actually useful expert advice. I’m excited for you to see what I have lined up for fall 2024.

“Is there any chance you’re pregnant?” the nurse asked me.

I was at a clinic just outside of Paris, completing the health portion of my immigration process—getting a chest X-ray that checked for tuberculosis. 

“Definitely not,” I replied.

See, I had just gotten engaged. And in case you need a reminder, this is a very big deal for a woman in her mid-thirties. I was going to be a bride. For the first time in about a decade, a baby was the last thing on my mind. I also knew I wouldn’t be able to get pregnant naturally.

Let me explain: In the past ten years, I had two doctors warn me I’d have trouble conceiving due to polycystic ovaries and a barely-there cycle. Plus, as I mentioned, I’m in my mid-thirties, which means I’ve absorbed about 15 years of arguably unhelpful reproduction facts the media has pelted at me, like how fertility drops at age 35 (great—what do I do if I’m not in a position to try to conceive yet?), and how freezing your eggs is the only way to have a fair chance at being a mom later in life (wonderful—who’s paying?).

Shall I go on? I know countless people, both personally and distantly via social media, who’ve faced significant trouble getting pregnant, some who eventually were successful, and others who still aren’t. What chance did a woman—who’s fallen off the fertility cliff and has ovulation issues—have at conceiving without exactly trying?

You know what’s coming: Two weeks after my X-ray, I found out I was six weeks pregnant.

Here’s the thing: I’m extremely happy and grateful to be pregnant. (Aside from the fact that I had an X-ray in the first trimester, but my doctor reassures me the baby’s fine.) And being a bride is now the last thing on my mind. Or at least the second thing.

However, I’m also extremely frustrated that I, and so many women I know, have spent so much of our twenties and thirties living in fear we may not be able to have a baby if we don’t start trying right now when the reality is we’re more likely to be able to conceive than not.

Infertility is a serious issue. It’s clinically defined as being unable to get pregnant naturally after trying for a year. It affects one in six people globally, and about 3% of people with infertility require advanced treatments like IVF, which, as anyone who’s gone through it will tell you, is a hellish experience both physically and mentally.

“I have spent 12 years trying and failing to have a baby,” British journalist Elizabeth Day said in a new interview with ABC iview. “I have had multiple rounds of fertility treatment, recurrent miscarriage, the whole gamut.” At age 45, she’s recently found peace by accepting she won’t be a “mother in the conventional sense.”

Her interviewer (whose name I unfortunately cannot find) replies: “I’m 36, all my friends are single. We’re all, sort of, facing this down together. I spend so much time thinking about [my fertility]. I’m at sea with it. We always have these conversations that are like, OMG what’s going to happen to us all? We’re all freezing our eggs.”

That—right there—is what I’m talking about. Single women of a certain age are at a place where they assume they’ll have fertility troubles, which does nothing but consume a hefty amount of brain space and steal their peace.

Here’s the reality: While some women post-35 will experience trouble conceiving, the decline isn’t a cliff, but a continuum and differs from woman to woman. A Danish study looked at 3,000 women who had sex twice or more a week and found that 84% of those aged 25 to 29, 88% aged 30-34, and 73% aged 35-40 got pregnant in about a year.

So, here’s what I’m wondering: What’s causing us to worry so much, and why?

Fertility Fearmongering

It’s not our fault we’re womb worry warts: “The media significantly contributes to fear and anxiety among women of reproductive age,” says Krista Roesler, a registered psychotherapist and life coach at Psych Company in Toronto. That’s because they tend to “exaggerate the risks associated with pregnancy and fertility.” For example, warning women about the fertility drop at 35 is misleading and often creates undue worry.

“Additionally, commercial interests often exploit these fears to promote products or services,” says Roesler. Before I was pregnant, it felt like wherever I scrolled and whichever podcast I listened to I’d be served an ad for an at-home fertility test that would check my ovarian reserve to ensure I was still fertile. “[These products] create an environment where women feel heightened anxiety and pressure regarding their reproductive health,” she says. If there’s nothing we can do about our current situation, meaning we can’t improve our egg count or try to conceive immediately, these tests do nothing but stir up anxiety.

And then, when we eventually try to conceive, we’re anxious about it and could have a more difficult time. “High anxiety can make it harder to conceive by disrupting hormonal balance and affecting reproductive health,” says Roesler.

What’s more, some of the information we’re being fed isn’t even accurate—take egg freezing, for example. We’re told it’s best to freeze our eggs as young as 27 when they’re most viable. But in reality, age 37 makes more sense. Not only is there proof that eggs at this age can be just as viable, but also, at 37 you give yourself more time to conceive naturally instead of shelling out about $10k for the egg freezing process plus 10+ years of annual frozen egg rent fees. Another fact: Most people don’t end up using the eggs they freeze. (For more on that, read Business Insider’s piece The egg-freezing industry’s shady sales pitch.)

Doctor Language

I mentioned earlier that two doctors warned me about my likely fertility troubles in a way that instilled a long-lasting fear in me. Last year, however, I visited a gynecologist and reproductive specialist in Paris and was delivered the same news (polycystic ovaries = irregular cycle = hard time getting pregnant) in a different way. After an ultrasound, he told me my condition was an easy fix and prescribed me a natural supplement that would help regulate my cycle. He also said nothing about my age nor my partner’s (who’s a fair bit older), and when I asked him if it was a concern, he looked at me confused: “Bah, non?”

Roesler says such positive language (bah—or at least not negative language) around fertility helps keep anxiety at bay (which, as we know, aids in fertility). She encourages her clients who are looking to conceive to “avoid all negativity and triggers, requesting doctors and healthcare providers not to emphasize scary statistics.”

And while we’re at it, let’s also ask them to refrain from using terms like “geriatric pregnancy,” which is the outdated term for pregnant women 35 or older, and unfortunately, still used by the odd health practitioner today. (For the record, I don’t think the updated term, Advanced Maternal Age, is much better either.)

Negativity Bias

But of course, we (or more specifically, the content we’re consuming) could also be the reason we have so much fear around our fertility. “Social media amplifies exaggerated claims and negative outcomes,” says Roesler. It’s called the negativity bias—we tend to pay more attention to negative information and experiences than positive ones. 

It comes down to evolution: Our brains are wired to focus more on what could go wrong rather than all that goes right as a survival mechanism to help us prepare for potential threats. What that means is when we’re exposed to a significant amount of information about infertility and people’s struggles to conceive, we tend to overestimate our likelihood of experiencing these problems.

Here’s the tl;dr: If you want to be a mom but aren’t in a place where you can try to conceive, and if you have trouble accepting that people of reproductive age are more likely to be able to get pregnant one day than not, be good to yourself by reaching out to an expert. They can teach you ways to manage anxious thoughts so you can stop living in fear and lift that heavy baby woe off your shoulders.

Until next Sunday,

Renée