Public awareness of the biological clock and the reproductive process in general continues to be an important goal of our profession. Just as other medical specialties attempt to increase public awareness of health maintenance and disease-prevention strategies, so must our profession try to make the public aware of the biological clock and of strategies designed to prevent infertility. In contrast to other medical fields, our attempts are hampered by political interference that actively seeks to limit access to all forms of reproductive care. The recent nomination to the Supreme Court of a judge who has been vocal in her opposition to reproductive choice further underscores the ongoing difficulty in providing information as well as increasing access to reproductive care (1).
Antichoice activists are most vocal about limiting access to abortion, but the collateral damage is their opposition to the dissemination of information about reproduction in general. “Abstinence only” education is an example of suppression of information that is available to students in secondary schools. Most dangerous to our profession are proposed bills that seek to define “personhood” as beginning at the time of oocyte fertilization (2). If any of these were to become law, damage to a human embryo in the laboratory would logically be equated with assault and battery, possibly with murder. Our best defense against these types of misguided unscientific laws is science and education.
This month, this journal presents two studies examining the understanding and decision making among reproductive-age subjects relating to fertility and fertility preservation. Briana Rudick, a member of the editorial board, puts these studies into perspective and presents an argument for a more holistic approach to reproductive education (3). The inclusion of fertility awareness in the traditional “health class” curriculum is arguably the most effective way of disseminating this information to the population at large. Our field needs to argue that understanding reproduction and avoidance of infertility is in the same category as understanding atherosclerosis and avoidance of heart disease.
The other featured articles span a range of topics. Is it possible to administer letrozole for ovulation induction in a single dose rather than over the standard 5 days? Can glucocorticoids improve pregnancy rates in women with primary ovarian insufficiency? Does parental consanguinity predispose men to azoospermia? Does laparoscopic excision of deeply invasive rectovaginal endometriosis expose the patient to a risk of uterine rupture? Do antioxidants actually improve the quality of sperm in infertile men?
This issue is our third, all three having been published during the pandemic. We look forward to effective vaccines and treatments of COVID and look forward to studies of how COVID changed fertility care. We hope that all of those studies will be retrospective!
Footnotes
You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/posts/xfre-d-20-00233
References
- 1.Niederberger C., Feinberg E., Pellicer A. For the Supreme Court: choose another. Fertil Steril. 2020;114:941–942. doi: 10.1016/j.fertnstert.2020.10.041. [DOI] [PubMed] [Google Scholar]
- 2.Paulson R.J. The unscientific nature of the concept that “human life begins at fertilization,” and why it matters. Fertil Steril. 2017;107:566–567. doi: 10.1016/j.fertnstert.2017.01.002. [DOI] [PubMed] [Google Scholar]
- 3.Rudick B. From sex-ed to fertility ed: a more holistic approach to reproductive education. F S Rep. 2020;1:166–167. doi: 10.1016/j.xfre.2020.10.007. [DOI] [PMC free article] [PubMed] [Google Scholar]