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Egg Freezing: Helpful or Pressurising?

egg-freeze

(Please note: I use this image ironically.)

Yesterday, Professor William Ledger wrote an opinion peice in The Age on fertility and the problem of an aging population. Ledger is head of UNSW Medicine’s School of Women’s and Children’s Health and professor of obstetrics and gynaecology. You can read the opinion piece here:

http://m.theage.com.au/comment/ivf-isnt-a-fixall-for-those-choosing-to-delay-adulthood-20150531-ghddn9.html

I also attended Ledger’s lecture last night, entitled, “The Ticking Clock: Demographic Change and Future Families” presented with social researcher Mark McCrindle at UNSW. I appreciated how Ledger’s discussion of IVF in older women was preceded by McCrindle’s thoughtful analysis of demographics in Australia and how they have changed. There were moments, particularly at the end of Ledger’s question time, when he seemed to be suggesting that it was a simple thing for women to choose to have their families earlier, that they should be prioritising finding their partners and ‘settling down’ over career or other goals. I found this uncomfortable on a number of levels, not the least of which was the suggestion that women should settle with a partner they might not otherwise have wanted children with, just because they feel the pressure of their ‘ticking clock’. McCrindle’s demonstration was a welcome relief to this simplistic idea of young women’s lives. McCrindle argued that society is changing, and that the pressures of housing and income make the fairytale of ‘a house and kids’ less available to most young people.

Of course I am not ignoring the fact that while our generation can expect to have a longer lifespan than any before it, and therefore to spread out our life experiences, a woman’s window for fertility does not change. Certainly, I am taking what I consider Ledger’s most helpful piece of advice to dinner conversations with friends: if you are over 30, and not sure when you plan to have kids, get your AMH tested so that you have some idea of how many fertile years you have left. The AMH test is a simple blood test, and should cost less than $100. For giving yourself some indicator of when menopause will happen, this seems like a good investment. If you find out that you are one of the unlucky ones who will run out of eggs sooner rather than later, then you have the option to freeze some eggs, and keep them in the bank for later.

The thing that surprised me the most about sitting in this lecture was watching the audience’s reactions. I had not realised how few people understood that IVF does very little to fix the age of eggs. In fact, women in their 40s usually have the same chance of conceiving naturally as they do with IVF. So long as there are no ovulation or fertilisation issues, which there usually aren’t, IVF cannot yet do anything to solve the fundamental problem in getting pregnant at this age: that a woman’s eggs are not as chromosomally capable as they once were. This means that the egg is unable to develop an embryo, which needs all of the power of the egg to combine the DNA from egg and sperm into a new baby’s individual DNA.

Ledger mentioned some emerging research looking at how to help older eggs repair DNA more efficiently, which may reduce the aging process, but is still in the early stage of development and a long way from clinical applications. It was all too clear listening to Ledger that the research needs more funding also, and the research that is being done is primarily directed at this ‘older egg’ problem, rather than younger women’s fertility issues such as Polycystic Ovaries and Endometriosis. While I wholeheartedly agree with the fundamental premise that women and men need more education about fertility, I am also wary that pressuring young women to think about their fertility may cause unnecessary anxiety, particularly in women who are likely to have no problem conceiving once they decide that that is a life course they want to take. Ledger mentioned that, to date, the overwhelming majority of eggs frozen by young women have not been used, suggesting that these women did not need the procedure in the first place. One cannot help but be curious what advantage it is to the business model of IVF clinics to be able to extend their market into the entire demographic of women in their 20s and 30s, not just women who have been unsuccessfully trying to conceive. Perhaps I am synical, but how many more patients and cycles can be marketed and invoiced if this huge new population of women were enticed into the market?

Ledger’s one piece of advice that he would give to a woman in her 30s right now, if she wasn’t in a relationship, would be to freeze her eggs. While I think this suggestion is rather extreme, I would suggest that if you are in your 30s, and definitely know that you want a child, but don’t know how or when that will happen, at least get your AMH test done. It’s quick, it’s simple, and will more than likely let you know that you have another decade of reproductive years ahead of you. If that test tells you that you would be better off to freeze some eggs, then at least you have that option, and those frozen eggs will be ready for whenever you and your uterus are ready to use them.

My first Elephant Journal article

I’m excited to announce I have been published by Elephant Journal! Check it out here:

http://www.elephantjournal.com/2013/12/self-awareness-for-goddesses-karen-anne-wong/

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Self-Awareness for Goddesses

I recently read this thought-provoking article entitled Dating a Yoga Goddess and it’s resulting comments. I couldn’t resist responding.

Right off the bat, let’s address the term ‘Goddess’. In many yoga classrooms throughout the West, women refer to themselves as ‘Goddesses’. As a political move, there is nothing wrong with this, it does the feminist work of reclaiming our bodies and celebrating them, denying traditional patriarchal control over them. However, remember that the use of this term is to remind us that everybody has a piece of the divine/universal love/cosmic within. This means that the limber ladies who do yoga everyday are Goddesses to the same degree as those outside the studio smoking and drinking a coffee. If we really want gender equality than we should be talking about ‘Gods’ just as much as ‘Goddesses’, and realise that neither is discriminatory.

This also leads us to the idea of following an Eastern Philosophy/yogic path within a Western world. If you believe you are leading an ‘authentic’ yogic life, or are a yoga ‘purist’, you may need to look into the history of yoga more. There is no and never was one true, authentic, pure form of yoga. The first yogis to pen their practice did so in the Upaniṣads (written between 800 and 400 BCE), Patañjali’s Yoga Sūtras (between 500 and 300 BCE) and the Bhagavad Gītā (between 500 and 300 BCE). The Maitrī Upaniṣad details a six-fold yoga method, namely, breath control (prāṇāyāma), withdrawal of the senses (pratyāhāra), meditation (dhyāna), placing of the concentrated mind (dhāraṇā), philosophical inquiry (tarka), and absorption (samādhi). Five of these six elements (excepting tarka) are also found in Patañjali’s Sūtras. But Patañjali introduces three new elements: ethical conduct (yama), self-discipline (niyama), and physical postures (āsana). Mark Singleton is right when we says that modern yogis usually cite the Sūtras as the canonical text of yoga, but ‘confine their discussion of the text to the [incredibly brief] aṣṭāṅgayoga section (II.29–III.8) as if this were the sum of Patañjali’s message’ (Yoga Body 27). Meanwhile the Bhagavad Gītā lists only a three-fold path of yoga.

In fact, if you are a woman who jumped in a tardis-style time machine and found yourself practicing yoga in India 2000 years ago, you would likely feel very out of place. Yoga was a purely male practice until the 20th Century. The first women to practice yoga were not in India. They were in church halls and school gymnasiums in Britain. Caught up in the broader physical culture movement of the early 20th Century, colonialist Brits aided Indian men to bring the practice to the mother-land and meld it with calisthenics and gymnastics. This was also the first time that yoga was taught to groups of people, rather than one-on-one, guru-to-student style. At the time, the only other place that that happened was in Indian public schools, where the British introduced military-style group exercise, in a effort to raise the moral and physical ‘worth’ of the Indian ‘race’ through training young boys. Women first started to become yoga teachers only about 60 years ago, and only since 1970s feminism has it become a popular and acceptable profession.

And yes, I do mean acceptable. In her article, Alex Smith claims that yoga ‘Goddesses’ ‘don’t like societal rules and conventions. And most of us don’t adhere to them and have dedicated our lives to living outside boxes in some way or another.’ I am afraid to point out the obvious, but if you have a reasonably stable income, take money from your students/clients as they enter the door, pay rent and wear lululemon you are smack bang living within societal rules and conventions. You may have rebellious streaks which deny certain restrictions/conventions but please open your eyes enough to realise that most people do this in some way, not just people who practice yoga. Smith pins the tail on the donkey when she says that yoga ‘Goddesses’ are material girls who have grown up on a diet of fairytales featuring prince charmings. There is nothing wrong with that, they are conventional ideas but that doesn’t make them more or less valid (or feminist) than the yogic path you aspire to.

Finally, in addressing the main thrust of Smith’s article, that yoga ‘Goddesses’ challenge men in such a way that relationships become difficult, I would like to respond both yes, and no. Yes, I see many self-identifying yoga ‘Goddesses’ who cook their partners dosha-balancing meals and ask them ‘Where do you feel it?’ and ‘Have you surrendered?’. But the only relationships I see where this works are when the ‘Goddess’ genuinely doesn’t think that their partner needs raising up to the same level of spiritual devotion that she has. This is simply a yogic take on trying to improve someone rather than accept them. A good relationship, like good teaching, is about meeting the other person where they’re at, having empathy, and thinking through the world in their terms. The best relationships are founded on the knowledge that neither person is better than the other, just different, but with common concerns expressed in different ways. This is another way of reminding us of two of Patañjali’s yamasahimsa (non-violence) and satya (truthfulness). Practice the deepest form of non-violence by understanding the other person, and be truthful with yourself about who you are.

Namaste.

On International Women’s Day and the Disability Discrimination Act

I am incredibly lucky to have this amazing woman in my classes at the University of Sydney. Take a moment to hear her eloquent and timely speech on International Women’s Day and the Disability Discrimination Act.

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