A woman's age is just one factor affecting fertility

Predictably enough, last week's short editorial in the British Medical Journal advising women that waiting until their thirties to start a family 'defies nature and risks heartbreak' generated reams of media coverage. The article itself blamed a 'distorted and uninformed view from society, employers and health planners', and called for more enlightened policies to make it easier for women to have children during their most fertile years. But many newspapers reported the story as an 'infertility warning' to women who delay giving birth - as if starting a family were solely a woman's decision, and also that her advancing age is the only factor that can affect fertility. Both assumptions should be challenged.

Many women are well aware that fertility usually declines after the age of 35, and that the risks of complications during pregnancy and birth increase. But often, women do not have the luxury of allowing biology to be the only factor in their decision to start a family - financial stability and job security loom large, as well as the small matter of meeting a suitable partner who also wants to have children. Deciding when to have babies involves men, too, so it is hardly fair to lay the blame for age-related infertility problems squarely at the feet of women.

Of course, it is important for people to realise that age affects fertility and the chances of having a healthy child - but it is just as important for men to grasp this fact as women. Also, age is just one of the many factors that affects fertility - smoking, weight, diet and alcohol consumption can all affect the fertility of both men and women. But even this list merely reflects general health advice. There are many couples who have trouble conceiving even though they are young and healthy, because of medical problems that have nothing to do with women trying to 'have it all'.

Around one in every seven couples in the UK experiences problems conceiving. In around a third of cases, the cause is female infertility, involving conditions such as endometriosis, polycystic ovary syndrome, past infections, blocked fallopian tubes and premature menopause. Another third are down to male infertility - low sperm counts, tube blockages, infections or hormone problems. The remaining third are caused by a combination of male and female infertility problems, or are diagnosed as 'unexplained infertility'.

So yes, employers and government need to make it easier for women to have children at a younger age, should they choose to do so. But even with a welcome shift towards a more family-friendly society, infertility problems will not disappear. The majority of people affected by infertility have a medical condition that requires prompt diagnosis and treatment - both of which depend on adequate funding. Age is an important factor for couples planning to start a family, but it is even more crucial to those who have problems conceiving and are awaiting fertility treatment.