Background

The Fertility Education Initiative (FEI) is a group of senior professionals from health, education and government who want to improve people’s knowledge of fertility and reproductive health in the UK.

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. 

The FEI is led by Professor Adam Balen, a consultant in reproductive medicine in Leeds and recent past-chair of the British Fertility Society and the deputy chairs are Professor Joyce Harper (Institute for Women’s Health, University College London) and Professor Jacky Boivin (Fertility Studies Research Group, Cardiff University). The FEI is a special interest group of the British Fertility Society and partners include the Royal College of Obstetricians and Gynaecologists (RCOG), the Faculty of Sexual and Reproductive Healthcare (FSRH), Sex Education Forum, Brook, Sexpression, Teenage Pregnancy Knowledge Exchange, Fertility Network UK, and Public Health England. 

A high profile, national event to kick-start the programme was organised in April 2016, at the RCOG. The Fertility Health Summit was attended by 200 people including celebrity speaker, Alex Jones from BBC’s The One Show as well as expert speakers from health and education from the UK and abroad. The event attracted strong media interest and resulted in a high level of support and commitment from all in attendance, to drive towards better education about fertility and reproductive health amongst young people.

Overall vision

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. Our three key aims are:

Understanding human fertility

1. human reproduction
2. male and female reproductive health:

• reproductive life cycle (puberty to menopause)
• fertility and infertility
• signs, symptoms and preventable causes of fertility issues
• planning for a healthy pregnancy

Understanding modern families

1. Societal and cultural variations in family building
2. Routes to parenthood, including:

• 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)
• Living a life without children

Understanding reproductive technologies

What they can and cannot do and how they might impact on how human beings are made in the future.

Strategic goals and objectives

1. To create greater awareness and understanding about fertility and reproductive health.

2. To create greater awareness and understanding about fertility and reproductive health amongst parents and other key influencers.

3. To improve the quality of teaching about fertility and reproductive health in schools and colleges.

4. To provide health professionals, particularly those working in primary care (GPs, practice nurses) as well as school nurses and midwives with access to information and resources on fertility and reproductive health.

5. To actively influence and lobby senior policy makers in education and health for equal access to Relationship and Sex Education (RSE – formerly SRE).

6. To create a programme that is self-funding through appropriate commercial sponsorship and grants.

Overarching principles

1. Comprehensive involvement of various groups of people throughout FEI work.

2. Inclusivity on the basis of gender, sexuality, race, age, disability, belief and other characteristics.

3. Accessibility for all ages and levels of knowledge.

4. Coordinated thinking between the four ‘Ps’: policy-makers, professionals, patients, pupils.

Website and Animations

Our website www.fertilityed.uk (a satellite site on the main British Fertility Society website) contains clear information about reproductive health and we are developing a series of educational animations which can be seen both on the website and our YouTube (FertilityEd). These have been written and produced by Miss Grace Dugdale and funded both by the BFS and grants obtained by Jacky Boivin from Cardiff University.

Your Fertility Matters https://youtu.be/ETwDCKBaYd4

Fertility Technologies Shaping Modern Families https://youtu.be/dOi08g3CLOc

UK Department for Education White Paper, 2019: The FEI also responded to the Government’s consultation on Relationship and Sex Education and was successful in getting matters relating to fertility and reproductive health onto the national curriculum. 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. 

Relationships Education, Relationships and Sex Education (RSE) and Health Education: Draft statutory guidance for governing bodies, proprietors, head teachers, principals, senior leadership teams, teachers

UK Department for Education |  25 February 2019

The FEI helped to fund and participated in the Modern Families Project  and The Fertility Festival, both held in London, 2018.

Publications

Boivin, J., Koert, E., Harris, T., O’Shea, L., Perryman, A., Parker, K. and Harrison, C., 2018. An experimental evaluation of the benefits and costs of providing fertility information to adolescents and emerging adults. Human Reproduction, 33(7), pp.1247-1253. https://doi.org/10.1093/humrep/dey107

Boivin, J., Sandhu, A., Brian, K. and Harrison, C., 2018. Fertility-related knowledge and perceptions of fertility education among adolescents and emerging adults: a qualitative study. Human Fertility, pp.1-9.

https://doi.org/10.1080/14647273.2018.1486514

Harper, J.C., Hepburn, J., Vautier, G., Callander, E., Glasgow, T., Balen, A. and Boivin, J., 2019. Feasibility and acceptability of theatrical and visual art to deliver fertility education to young adults. Human Fertility, pp.1-7. https://doi.org/10.1080/14647273.2019.1570354

Harper, J, Boivin, J, O’Neill, H, Brian, J, Dhingra, J, Dugdale, G, Edwards, G, Emmerson, L, Grace, B. Hadley, A, Hamzic, L., Heathcote, J., Hepburn, J., Hoggart, L., Kisby, F., Mann, S., Norcross, S, Regan, L, Seenan, S. Stephenson, J. Walker, H. Balen, A.  (2017)  The need to improve fertility awareness.  Reproductive Biomedicine Online, 2017;18–20 DOI: http://dx.doi.org/10.1016/j.rbms.2017.03.002