“Being a young actress and facing a pregnancy is not easy. And I want to have the freedom to choose when to have a child.” Matilde Gioli, doctor Giulia in the television series “Doc. testimonial at “Ferty Check”, an awareness-raising initiative on prevention and fertility, on the occasion of the Fertility day on 22 September.
The phenomenon of denatality
The Istat 2021 Report confirms the decline in births in 2020: ranging from – 2.7% in the first 10 months of the year up to -8.2% in November and -10.3% in December, corresponding to the conception of the beginning of the 2020 pandemic. The all-time low of births per year, from the unification of Italy to today: the new births were 404,104 (-3.8% compared to the previous year). Added to this is the constant decrease in the average number of children per woman, which today stands at 1.29. In the face of real fertility that has been steadily declining for at least 10 years, however, Istat notes that Italians continue to want to have two children, throughout the country.
The right age
One of the problems is that couples delay too much, then fail and arrive at medically assisted procreation techniques when the woman’s age does not allow for a good chance of conception. In fact, in recent years, one third of PMA treatments have been performed in couples in which the woman is over 40, with negative repercussions on the birth rate. “In 1965, on average, Italian women had their first birth at 23, in 2017 over 70% of women who underwent assisted fertilization treatment were over 35”, she explains Filippo Maria Ubaldi, president of the Italian Society of Fertility and Sterility-Reproductive Medicine (Sifes) and scientific director of GeneralLife. “The possibility of obtaining developmental embryos, even in vitro, is significantly reduced especially after the age of 40 and the chances that the embryos obtained are chromosomally normal are reduced already after the age of 35”.
Cryopreservation for cancer patients
With years of delay compared to the United States, even in Italy more and more women, especially during these years of pandemic, have chosen the cryopreservation of oocytes. “This is a path created to safeguard the reproductive health of cancer patients, who undergo therapies that can irreversibly compromise the possibility of having a child”, explains Ubaldi, who is also a member of the technical table for research and training in prevention. and infertility treatment of the Ministry of Health.
But social freezing is proving to be a valid option also for all those who have to postpone the time to look for a child, for example, due to the lack of a partner or a stable job. “In our 7 centers in Italy – says Ubaldi – we noticed a positive trend, over the last 6 months of 2021, compared with the first half of the pre-pandemic year, 2019: treatments for the preservation of fertility they increased, even doubled in the months of April, May and June, in spring, when conditions are optimal, before the summer holidays. Of course, these are still limited numbers: in 2021 in these three months 46 women underwent the treatment cycle, compared to 21 in the relative quarter of 2019. And, in total, in the first 6 months of 2021 we performed the same number of preservations (about 80) throughout 2020. In this case the Covid-19 effect is weighed, but speaking with the patients we realized that this pandemic has also led them to decide to put their oocytes ‘in the bank’, looking forward to better times to have a child “.
Beyond cryopreservation, prevention is also essential to preserve fertility: “Alcohol, smoking, sedentary lifestyle, overweight or on the contrary underweight, are often involuntary behaviors that, if avoided or reduced, can make a difference when it is time to try a child. You have to think about being parents at least 10 years before, taking care of your health in order to reduce risk factors for infertility. It is something that young people absolutely must know “, Ubaldi insists.
How social freezing is done
In addition to not being informed, some women do not consider cryopreservation because they fear it is a painful or dangerous medical intervention. “The path of preservation of fertility – he explains Laura Rienzi, clinical embryologist and scientific director of GeneraLife together with Ubaldi – provides for a hormonal stimulation protocol to be carried out with specific drugs, the collection of oocytes through a small surgical intervention in sedation, lasting a few minutes, and their cryopreservation in the laboratory by vitrification , a now widespread and very valid technique to keep the characteristics of the eggs unaltered, to be able to use them even many years later “.
In addition to the lack of information, what keeps girls away from cryopreservation is also the fear of undergoing very heavy treatment: “We must dispel the myth that hormonal stimulation sends menopausal women early because in reality it acts on oocytes that form naturally but it simply makes them all ‘mature’, it is as if it saved them. And then it is not true that girls are bombarded with hormones and among other things, today it is scientifically proven that there is no increase in the risk of cancer, so much so that cancer patients also undergo it ”, explains Ubaldi. Unfortunately, cryopreservation is only reimbursed for cancer patients and is therefore paid for by women. On average, the costs are around 3 thousand euros. If the eggs were not used where do they go? “They could also be donated as 99% is currently imported from abroad”, replies Ubaldi.
Il Fertilty Day
On the occasion of Fertility Day, which is celebrated on 22 September, the GeneraLife centers will offer a free fertility check on Saturday 25 September 2021.