{"id":15241,"date":"2021-01-01T20:46:55","date_gmt":"2021-01-01T20:46:55","guid":{"rendered":"https:\/\/givelegacy.wpengine.com\/?post_type=resource&p=1764"},"modified":"2023-06-14T13:45:29","modified_gmt":"2023-06-14T13:45:29","slug":"the-future-of-fatherhood-fertility-2021","status":"publish","type":"post","link":"https:\/\/www.givelegacy.com\/resources\/the-future-of-fatherhood-fertility-2021\/","title":{"rendered":"The Future of Fatherhood & Fertility, 2021"},"content":{"rendered":"
\n

Looking back at the previous year’s fertility trends, and predicting what’s to come in 2021.<\/p>\n

In 2020:<\/span><\/h2>\n

The pandemic changed our plans<\/span><\/h3>\n

The COVID-19 pandemic that began in March has changed almost everything about our lives, and family planning is no exception. As health concerns\u2014<\/span>especially for pregnant people<\/span><\/a>\u2014and financial uncertainties loom, many have delayed their childbearing timelines.<\/span><\/p>\n

In Modern Fertility\u2019s <\/span>\u201cState of Fertility 2020: Career & Money\u201d survey<\/span><\/a>, nearly half (49%) of respondents who want children are delaying parenthood, and nearly a third (31%) said COVID-19 has changed their fertility or family-planning decisions. Of those who are waiting to have kids, the primary reasons are financial\u201460% are delaying because they don\u2019t have enough money saved. Even those who aren\u2019t pausing are feeling the pandemic pressure: 61% of respondents reported that they\u2019re more anxious about their ability to have children right now.<\/span><\/p>\n

\"Future<\/p>\n

A <\/span>Fortune<\/span><\/i> survey<\/span><\/a> of would-be parents revealed some of the same grounds for delaying pregnancy during the pandemic. Concerns about health (47%), finances (25%), and COVID-related restrictions (16%) were the top three reasons cited for those putting off expanding their family.<\/span><\/p>\n

Interestingly, that survey found that some respondents\u201434%\u2014are actually choosing to <\/span>move up<\/span><\/i> their family timelines, having children sooner than they otherwise would have. Why? It\u2019s possible that pandemic-era workplace changes, such as remote employment, actually offer a lot of much-needed flexibility for those who hope to have kids (or more kids).<\/span><\/p>\n

But overall, it\u2019s expected that 2020 will be a \u201cbaby bust.\u201d <\/span>The Brookings Institute predicts<\/span><\/a> the US could experience as many as 500,000 <\/span>fewer<\/span><\/i> births next year, based on economic studies of fertility behavior and data from past pandemics. This mirrors predictions <\/span>we reported earlier in the year<\/span><\/a>\u2014that we won\u2019t see birth rates bounce back until 10 or more months post-pandemic (and we\u2019re not there yet).<\/span><\/p>\n

Virtual and mail-in services became even more important<\/span><\/h3>\n

Many \u201cnon-essential\u201d in-person services were suspended this year to stop the spread of coronavirus. Between March and May, fertility care was put on hold based on the guidance of the American Society for Reproductive Medicine (ASRM). Many fertility physicians shifted to virtual consultations, so that patients who were trying to conceive<\/a> could still plan for their treatment.<\/span><\/p>\n

And as people self-isolated to stop the spread of coronavirus, many sought testing options that they could complete at home and mail in. The <\/span>USPS reports<\/span><\/a> that package shipping increased by 50% this year, and that trend included health services.<\/span><\/p>\n

Examples include LetsGetChecked, a company that offers at-home blood and urine tests for a variety of illnesses and hormones, including an at-home nasal swab for COVID-19. <\/span>Earlier this month<\/span><\/a>, they reported that demand was up 880% over 2019\u2019s orders. And it\u2019s not <\/span>all<\/span><\/i> due to COVID tests\u2014competitor Everlywell states that demand has doubled for most of its at-home testing options, including those that detect vitamin deficiencies, Lyme disease, and sexually transmitted diseases.<\/span><\/p>\n

\"Future<\/p>\n

The fertility space followed suit. Modern Fertility, a female hormone test kit, partnered with fertility clinics early in the pandemic to offer reliable fertility testing from home; their interface allowed customers to send results directly to their doctors. <\/span>Their CEO reported<\/span><\/a> that, in April of this year, they experienced some of the strongest days their business has ever had.<\/span><\/p>\n

And our <\/span>at-home sperm testing kit<\/span><\/a> offers an alternative for those who want a clinic-grade analysis, without actually having to go to the clinic. By August, our order volume was six times higher than it had been at the beginning of the year. \u201cMuch easier than going to the REI right now!\u201d one client wrote in a July review.<\/span><\/p>\n

At-home services mean wider access<\/span><\/h4>\n

The shift to at-home fertility health services has one interesting benefit: It increases access to this type of care, which has historically been difficult to obtain for those outside major cities. <\/span>A 2017 study reported<\/span><\/a> that 40% of women live in areas with one or fewer fertility practices, and a third had no reproductive endocrinologists in their geographic area at all.<\/span><\/p>\n

And it\u2019s not just access to testing that\u2019s valuable. Legacy clients, for example, have the option to discuss their results with one of our world-class male fertility specialists, like urologist Dr. Ramy Abou Ghadya, and get expert guidance no matter where in the country they live.<\/span><\/p>\n

\"Future<\/p>\n

Source: Harris et al, 2017<\/a>.<\/em><\/p>\n

There was a focus on freezing<\/span><\/h3>\n

For many of us, this year meant reassessing timelines around relationships and family planning. Single people had a more difficult time dating, engaged people postponed their nuptials, and coupled people were less likely to have a baby right now (see above)\u2014with no clear end currently in sight.<\/span><\/p>\n

Early in the spread of COVID-19, there was a huge unanswered question: Will infection affect fertility? For men? Women? Both? We are now closer to understanding <\/span>how COVID-19 affects male fertility<\/span><\/a>: we\u2019re seeing inflammation in the testicles, lower sperm counts, and poorer sperm quality among COVID patients, though we can\u2019t be sure yet how lasting the impact will be. (<\/span>COVID-19 doesn\u2019t appear to affect female fertility<\/span><\/a>, although a symptomatic infection may dampen your response to fertility treatments<\/a>.)<\/span><\/p>\n

As a result of these uncertainties around health, fertility, and timelines, we saw a huge surge of interest in fertility preservation (the umbrella term for egg, embryo, and sperm freezing for later use). At NYU\u2019s Langone Fertility Center, <\/span>there\u2019s been a 32% increase<\/span><\/a> in women freezing their eggs in 2020. The Colorado Center for Reproductive Medicine, also in Manhattan, <\/span>reported as early as March<\/span><\/a>\u2014starting just after the first case of COVID-19 was diagnosed in NYC\u2014that they were already seeing a 25% increase in egg freezing consultations.<\/span><\/p>\n

\"\"<\/p>\n

This has been reported internationally. <\/span>In the UK<\/span><\/a>, egg freezing inquiries at some clinics are up by 25% compared to last summer. <\/span>And in Vancouver<\/span><\/a>, Olive Fertility Centre saw cycles increase by 30% year-over-year. Annual metrics for fertility preservation consultations and cycles are up nearly everywhere, <\/span>despite<\/span><\/i> most clinics being closed for 6\u20138 weeks early in the pandemic.<\/span><\/p>\n

We are seeing this trend at Legacy, as well. The number of men who have frozen their sperm with us has tripled since March. Sperm freezing<\/a> became more important\u2014and <\/span>popular<\/span><\/a>\u2014as we saw increasing evidence for COVID-19\u2019s impact on male fertility.<\/span><\/p>\n

While this particular surge is fueled by the pandemic, it comes as part of a long-term trend toward fertility preservation, especially as technology improves and costs drop. <\/span>According to the Society for Assisted Reproductive Technology (SART)<\/span><\/a>, egg and embryo freezing for the future has increased 79% between 2014 and 2018, and the increase is accelerating. Unlike these treatments that require a fertility clinic\u2019s oversight, we don\u2019t have national numbers for sperm freezing\u2014but anecdotally, demand is up as awareness about men\u2019s fertility issues spreads.<\/span><\/p>\n

We embraced technology as part of the pre-conception process<\/span><\/h3>\n

More than ever, couples who are trying to conceive are utilizing technology, like wearables, apps, and algorithm-based guidance, to get pregnant more quickly and detect issues earlier.<\/span><\/p>\n

Ovulation tracking tools are one example. Women have been tracking their menstrual cycles for centuries, although the modern method for estimating the fertile window\u2014basal body temperature tracking\u2014was developed by a gynecologist in the early 1900s. Apps, often paired with a thermometer (like Natural Cycles) or a wearable (like the Ava bracelet), make the process nearly error-proof.<\/span><\/p>\n

In a March 2020 <\/span>study<\/span><\/a> of Australian women, nearly half were using phone-based apps to monitor their menstrual cycles. The good news? It works. <\/span>A 2019 study<\/span><\/a> demonstrated that <\/span>any<\/span><\/i> method of cycle tracking was associated with faster time to pregnancy, even for women who had experienced difficulty getting pregnant in the past.<\/span><\/p>\n

But as we know, fertility is not merely a women\u2019s issue. On the male side, the Legacy <\/span>sperm testing kit<\/span><\/a> utilizes technology to proactively address sperm<\/a> health. Our algorithm incorporates your lifestyle assessment, your semen analysis<\/a> results, and a specialist\u2019s inspection to give you a comprehensive understanding of your fertility. Your results will be accompanied by personalized lifestyle guidance to help you improve your sperm health<\/a> parameters on your own.<\/span><\/p>\n

Traditional advice recommends that couples try to get pregnant for 6\u201312 months before doing this kind of testing. But time is of the essence when it comes to fertility, and using technology can allow people to get pregnant on their own more quickly, <\/span>or<\/span><\/i> alert them that they may need help from a fertility specialist\u2014all for less than the cost of a consultation.<\/span><\/p>\n

\n

Looking forward to 2021:<\/span><\/h2>\n

We\u2019ll continue to see downward fertility trends<\/span><\/h3>\n

We reported <\/span>last year<\/span><\/a> that the US fertility rate hit an all-time low of 1.72 children per woman in 2019. That decline isn\u2019t <\/span>all<\/span><\/i> bad. Having fewer children is often the result of wider educational and professional opportunities, especially for women; better healthcare, which means children are more likely to survive to adulthood; and higher contraceptive use that allows couples to plan their families and lowers the rate of accidental pregnancies.<\/span><\/p>\n

But falling birth rates also point to other trends: increasing parental age and declining male fertility.<\/span><\/p>\n

In 1972, the average age of first-time fathers was 27. Now, it\u2019s around 31 years old\u2014and nearly 1 in 10 fathers are over 40 at the birth of their first child, <\/span>according to a 2017 study<\/span><\/a>. There are many influences that lead to having kids later in life; increased educational and professional opportunities come into play again, along with <\/span>growing monetary insecurity<\/span><\/a> for young people.<\/span><\/p>\n

While studies suggest that it <\/span>can<\/span><\/i> be financially, emotionally, and intellectually beneficial for children to have older parents, age is also one of the most important factors in fertility. We know that <\/span>sperm quality<\/span><\/a> declines with age, that <\/span>infertility is more likely<\/span><\/a> among couples with older fathers, and that older men are less likely to produce healthy offspring. <\/span>We also know<\/span><\/a> that there\u2019s a steep decline in egg quantity <\/span>and<\/span><\/i> quality (or genetic health) for women in their late 30s, bringing the chances of natural conception down to 10\u201315% per month.<\/span><\/p>\n

Increasing parental age is only compounded by the declining male fertility rates we\u2019re seeing across the Western world. According to <\/span>one study<\/span><\/a>, sperm count declined 50\u201360% between 1973 and 2011; <\/span>another study<\/span><\/a> found that sperm concentration has decreased by a third in the past 50 years. Sperm motility<\/a> has declined as well. <\/span>One group of researchers<\/span><\/a> found that the percentage of men with normal numbers of motile sperm had decreased by 10 points over 16 years.<\/span><\/p>\n

Why? Experts aren\u2019t entirely certain, but exposure to plastics, toxins, environmental pollution, and radiation; increasingly sedentary lifestyles; and the common Western diet may all be to blame.<\/span><\/p>\n

\"\"<\/p>\n

The COVID-19 conundrum<\/span><\/h4>\n

We\u2019re likely to see a significant drop in births for about 10 months post-pandemic, as people wait until they feel safer and more financially stable to grow their families. But we\u2019re also seeing significant impacts of <\/span>COVID-19 infection on male fertility<\/span><\/a>. One study found that men with moderate COVID cases have, on average, a third of the sperm concentration and half the percentage of motile sperm, compared to uninfected controls.<\/span><\/p>\n

Since COVID is a new illness, we don\u2019t yet know how long this effect will linger\u2014the longest follow-up study performed so far was 54 days post-infection. But it\u2019s possible that, in addition to the declining male fertility we\u2019ve been experiencing over the past few decades, we\u2019ll soon be seeing a lasting imprint of the pandemic on male fertility.<\/span><\/p>\n

We\u2019ll reconsider what the modern family looks like, and how it\u2019s built<\/span><\/h3>\n

We\u2019re no longer in a heterosexual male-breadwinner two-point-five-children world. Changing gender roles and wider acceptance of LGBTQ people means that the modern family is changing.<\/span><\/p>\n

Men are taking more of a role in raising their children than ever before. The number of stay-at-home dads doubled between 1989 and 2012, according to <\/span>Pew<\/span><\/a>, and is likely to continue to rise. A 2015 <\/span>BabyCenter survey<\/span><\/a> of millennial dads revealed that 26% of respondents were the primary caregivers for their children, and the majority had at least partial responsibility for many childcare tasks. Today, couples are <\/span>embracing an egalitarian approach<\/span><\/a> to both their own partnership as well as parenting.<\/span><\/p>\n

We\u2019re also seeing a rise in families with LGBTQ parents. In 2019, <\/span>a Family Equality survey<\/span><\/a> reported that 63% of younger LGBTQ people had children or planned on having children, nearly double the number of older members of the community with children. It\u2019s possible that, even if older LGBTQ people wanted children, they simply didn\u2019t have access to\u2014or couldn\u2019t afford\u2014the medical technology (or adoption assistance) necessary to make that happen.<\/span><\/p>\n

But today, there are more options. Reciprocal IVF, a process in which one female partner donates her eggs to the other so they can both be involved in the pregnancy, is a growing practice. In April, New York\u2014one of the last three holdout states\u2014legalized gestational surrogacy, in a decision that was celebrated by fertility advocates and LGBTQ advocates alike (surrogacy is necessary for a gay couple to have a biological child). Soon after, journalist Anderson Cooper welcomed his first child via surrogate; Anderson is gay, and raising his son as a single dad.<\/span><\/p>\n

We\u2019re also seeing a new focus on fertility, specifically fertility preservation, for trans people<\/a>. For example, it\u2019s increasingly common for trans men to freeze their eggs prior to transition, and for insurance plans to foot at least some of the bill. Trans women can also <\/span>freeze sperm<\/span><\/a> prior to hormone treatment.<\/span><\/p>\n

We expect that the movement toward a more diverse picture of the modern family, and the modern father, will continue in 2021. Parents of the near future will likely share the playground with single dads, stay-at-home dads, queer parents, trans parents, and more.<\/span><\/p>\n

We\u2019ll squash fertility stigma\u2014and keep expanding awareness<\/span><\/h3>\n

We\u2019re talking about fertility more than we ever have before.<\/span><\/p>\n

Over the past few years, there\u2019s been a huge push by physicians to educate the public on their biology, as well as their fertility options. A <\/span>survey in 2016<\/span><\/a> found that the majority of both men and women were misinformed about female fertility decline and the impact of age on your ability to have a healthy pregnancy. Our own <\/span>2019 survey<\/span><\/a> found that almost 70% of respondents didn\u2019t know that age impacted sperm health. There\u2019s clearly still a gap that needs to be closed, and we predict that we\u2019ll make some progress on that in the coming year.<\/span><\/p>\n

One thing that helps spread awareness? Hearing people talk about fertility. Historically, it\u2019s been somewhat of a taboo topic. Superstitions and myths around fertility and pregnancy, a societal aversion to discussing \u201cwomen\u2019s issues,\u201d and the fact that many people struggling with infertility or miscarriage blamed themselves made it a difficult thing to talk about publicly.<\/span><\/p>\n

That\u2019s changing. Public figures as varied as Amy Schumer, Chrissy Teigen, the Kardashians, and Michelle Obama have gone on record to discuss their experiences with infertility, pregnancy loss, or prenatal difficulties. And on platforms like Instagram and Facebook, support communities have blossomed as more men and women are willing to share their stories in real time, posting images of their embryos, diagnostic results, and pregnancy tests\u2014both positive and negative\u2014under hashtags like #TTCjourney.<\/span><\/p>\n

It\u2019s happening offline, too. Respondents to the <\/span>Modern Fertility Career & Money<\/span><\/a> survey, for example, were surprisingly willing to talk about pregnancy and fertility concerns in the workplace\u2014where the stigma against these conversations still has a stronger hold. Nearly a third of women surveyed said they\u2019d talk about fertility treatments, infertility, or miscarriage at work; in addition, 28% would share early pregnancy news, 25% would share that they\u2019re going through the process of egg freezing, and 26% would share when they\u2019re actively trying to conceive.<\/span><\/p>\n

These conversations are likely to continue into 2021, and we predict they\u2019ll broaden to include less-told stories, such as male-factor infertility, single parenthood, and LGBTQ child-bearing. The more we talk, the more we learn\u2014and the more we learn, the better decisions we can make for our own lives and the lives of our future kids.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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