The place of fertility education in UK schools

Last month, the draft statutory guidance on sex education (now known as Relationship and Sex Education (RSE) and health education for governing bodies, proprietors, head teachers, principals, senior leadership teams and teachers) was presented to UK government for debate.

This follows a highly publicised public consultation last year that we contributed to on behalf of the Fertility Education Initiative. This is a special interest group of the British Fertility Society (BFS) that I founded when I was chair of the BFS back in 2016, following the highly successful Fertility Health Summit.

The summit was held at the Royal College of Obstetricians and Gynaecologists (RCOG) in April of that year, when the Progress Educational Trust (which publishes BioNews) also hosted a highly stimulating debate entitled 'The Birds and the Bees and Fertility Treatment – a Sting the Tail' (see BioNews 848).

We are therefore delighted that the new guidance includes the need to educate young people about 'the facts about reproductive health, including fertility and the potential impact of lifestyle on fertility for men and women'. 

The bulk of the guidance naturally deals with general health and wellbeing, the foundation of healthy relationships and all aspects of physical, emotional, mental, sexual and reproductive health and wellbeing. There is also reference to understanding the various forms of sexuality and sexual relationships and 'that others' families, either in school or in the wider world, sometimes look different from their family, but that they should respect those differences and know that other children's families are also characterised by love and care'. There is emphasis on age-appropriate information and when specific topics should be discussed.

The inclusion of information on fertility in the guide is a huge step forward for fertility education, which until now has been largely overlooked, poorly taught and not even properly covered in most biology syllabi, let alone PHSE (personal, social, health and economic education) or RSE lessons. 

Why the need for a Fertility Education Initiative?

The need for fertility education arises from changing patterns of family formation in recent times, including starting families at an older age and changing dynamics of 'modern families'. Young people feel unprepared for how best to plan their career and family.

While they feel they have control over contraception, they have little idea of the various factors that may influence their fertility later in their life – whether related to lifestyle, diet, smoking and recreational drugs or the natural biological changes associated with getting older. Studies have found that adolescents do not know much about this, would like to know more and need the information to be conveyed in a way that is engaging and helps them to integrate it at their current life stage. 

It is well known among reproductive biologists that female fertility declines progressively as the number of eggs a woman is born with are lost over time. In the UK, the average age of first-time mothers is rising and an increasing proportion of women in the UK have never had a child (20 percent, compared with 10 percent just one generation ago).

This is for a variety of reasons. And, while approximately 15 percent of the population experience fertility problems, treatments do not always work and their success declines with the increasing age of the woman. When people attend fertility clinics they are often surprised by these facts and wish they had been better informed when they were younger. 

Who is the FEI?

We therefore founded The Fertility Education Initiative (FEI) to improve people's knowledge of fertility and reproductive health in the UK. It has been exciting for me to lead the FEI together with my co-chairs Professor Joyce Harper (Institute for Women's Health, University College London) and Professor Jacky Boivin (School of Psychology, Cardiff University). We have brought a number of partner organisations to the project, including RCOG, the Faculty of Sexual and Reproductive Healthcare, Sex Education Forum, Brook, Sexpression, Teenage Pregnancy Knowledge Exchange, Fertility Network UK, Fertility Fest and Public Health England. 

Vision and Aims of the FEI?

Our vision is to ensure that people have a greater understanding and awareness about fertility and reproductive health, so they can make an informed choice about their own fertility journey, or that of others they may have an impact on. You can read a full outline of our aims in Reproductive Biomedicine Online. 

In brief, our three key aims are:

1. Understanding human fertility: 
a)    human reproduction 
b)    male and female reproductive health, including the reproductive life cycle; fertility and infertility; signs, symptoms and preventable causes of fertility issue; and planning for a healthy pregnancy

2. Understanding modern families
a.    Societal and cultural variations in family building
b.    Routes to parenthood; for heterosexual, LGBTQ+ and single people with and without fertility issues; assisted conception techniques for family building; other routes to parenthood (such as adoption, fostering, step-families); and living a life without children

3. Understanding current reproductive technologies

Here we hope to help educate people about what reproductive technologies can and cannot do and how they might impact on how human beings are made in the future.

We aim to achieve this by raising the profile of education in reproductive health and broadening the scope of RSE in schools and colleges. We will create greater awareness and understanding about fertility and reproductive health among parents and other key influencers.

We are developing materials to improve the quality of teaching about fertility and reproductive health in schools and colleges and also to provide health professionals, particularly those working in primary care (such as GPs, practice nurses) as well as school nurses and midwives access to information and resources on fertility and reproductive health.

We are developing age-appropriate educational material, some of which is already available on the BFS website and a series of animations, the first of which was written by Grace Dugdale and released in January at Fertility 2019.

The second animation is shortly to be released and will cover modern ways of forming families and routes to parenthood for heterosexual, LGBTQ+ and single people with and without fertility issues. These animations have been informed by the great research of Jacky Boivin and funded through grants from Cardiff University. 

Alongside the series of animations will be educational material that can be used in different ways to ensure that young people are empowered with the knowledge to make decisions about how and when to start a family.