Women and fertility: What if it’s been a 'Big Lie'?

We’ve all grown up with this same idea “First comes love, then comes marriage, then comes baby in a baby carriage.” But reality is that the society changes over time. For modern women, it’s a bit more like “First comes the education, then the graduate degrees and then having a good job and financial security” and only after all this come love, marriage and babies. But is this happy ending necessarily given??

As much as we would like to believe, we cannot control our biological timetable even with all the advances in reproductive science and technologies that we have.

Tanya Selvaratnam, the writer of the new book “The Big Lie: Motherhood, Feminism, and the Reality of the Biological Clock”, thought that she could do so and fulfill all her professional goal before trying for a baby.

But after 3 miscarriages, several IVF treatments and finally her divorce, she realized she has waited too long.

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Tanya wrote this book, to share her story, her mistakes and remind us to think about our future fertility before it is too late.

“The Big Lie” is also a call to action for women. In the last few chapters, Selvaratnam includes a well-researched chapter entitled “Action Items for the Future,” so that women are better prepared and more aware of their options. She wants to remind us to think and become really aware about the possible future fertility problems before it is too late.

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Frequently Asked Questions

At what age does female fertility start to decline in the UK?

According to the NHS, female fertility begins to decline more noticeably from around age 30, with a sharper drop after 35 and significantly reduced chances after 40. This biological reality affects all women regardless of their overall health or lifestyle, which is why fertility specialists encourage women to consider their family planning timeline early.

Can I get fertility treatment on the NHS if I've waited too long to try for a baby?

NHS fertility treatment eligibility varies by Integrated Care Board (ICB), but NICE guidelines recommend that women under 40 who haven't conceived after 2 years of trying should be offered up to 3 cycles of IVF. However, age limits and waiting times differ across the UK, so it's worth checking your local ICB's criteria as soon as you have concerns about your fertility.

How common are fertility problems in the UK?

According to NHS statistics, approximately 1 in 7 UK couples experience difficulty conceiving. This means fertility struggles are far more common than many people realise, and seeking help early can make a significant difference to your chances of success.

Should I get my fertility tested before I'm ready to have children?

Many fertility specialists now encourage women to consider fertility MOT tests, which can include AMH (anti-Müllerian hormone) blood test

What is the NHS waiting time for fertility treatment in the UK?

NHS waiting times for fertility treatment can vary considerably depending on your area, ranging from several months to over a year in some regions. If you're concerned about your biological clock, speak to your GP about a referral sooner rather than later, as diagnostic tests and investigations also take time before any treatment can begin.

Can lifestyle changes improve my chances of conceiving naturally after 35?

Whilst lifestyle changes cannot reverse age-related fertility decline, the NHS recommends maintaining a healthy BMI, reducing alcohol intake, stopping smoking, and taking folic acid supplements to optimise your chances of conception. Fertility supplements containing ingredients like myo-inositol may also support hormone balance and regular ovulation when trying to conceive.

What are my options if I want to delay having children but preserve my fertility?

Egg freezing is an option for women who wish to preserve their fertility for the future, though it's generally not available on the NHS unless you're undergoing medical treatment that may affect your fertility. The HFEA recommends freezing eggs before age 35 for the best chance of success, and costs at private clinics typically range from £3,000 to £7,000 per cycle, plus annual storage fees.