Deep Dive into Reproduction with LIFE by Dr. Pat
Deep dive into reproduction and fertility treatment by LIFE by Dr. Pat Clinic and Dr. Patsama Vichinsartvichai
Deep Dive into Reproduction with LIFE by Dr. Pat
Exploring Age-related Fertility Decline and Delayed Childbearing
Life by Dr Pat Leading innovation in fertility excellence Deep dive into reproduction with Life by Dr Pat.
Speaker 1:Age-related fertility decline and delayed childbearing. Welcome back everybody for another deep dive. This time we're going all the way to Thailand to uncover some surprising truths about fertility. Ever wonder how much people actually know about what affects their ability to have kids?
Speaker 2:It's a great question.
Speaker 1:You might be surprised.
Speaker 2:Yeah, and what's so fascinating is that we often think about fertility as purely biological. But you know, this research really highlights how intertwined it is with social perceptions, cultural beliefs and even government policies.
Speaker 1:Exactly Today, we're going to be looking at three sources A 2018 study on fertility knowledge in Bangkok, a chapter from a 2019 book about Thailand's experience with assisted reproductive technology. And a YouTube video from a leading Thai fertility clinic.
Speaker 2:And by examining Thailand's specific context, we can actually uncover broader trends and challenges that are relevant to people trying to conceive all over the world.
Speaker 1:Absolutely Okay, let's dive in. This 2018 study had some pretty shocking stats about age and fertility. Are you ready for this? Only 13% of the participants correctly identified the age when female fertility starts to decline. Wow, that's between 30 and 34.
Speaker 2:And even fewer participants knew that the decline for men begins around 40 to 44.
Speaker 1:Yeah.
Speaker 2:So this isn't just about societal pressures or lifestyle choices. It's really about the fundamental biology of reproduction. With age, women experience a decrease in both the quality and quantity of their eggs.
Speaker 1:Right.
Speaker 2:While men may see changes in sperm health.
Speaker 1:So, even if someone isn't planning to have kids right now, why is this lack of awareness such a big deal? What are the implications for our listeners?
Speaker 2:Well understanding this biological timeline is absolutely key for making informed decisions later on. Right, Imagine this. The study found that women often perceive their fertility declining five years later than it actually does.
Speaker 1:Yeah.
Speaker 2:This gap between perception and reality can lead to some really difficult situations down the line.
Speaker 1:Wow, that's a real wake-up call. I have to admit, even I find myself sometimes buying into the idea that with modern science we can just fix any age-related issues Like is that a real thing?
Speaker 2:It's a very common misconception and while advancements in fertility treatments like IVF have been remarkable, they can't completely reverse the effects of aging on eggs and sperm. That's why accurate information and realistic expectations are so important.
Speaker 1:Absolutely so. We've got age as a major factor. The 2018 study also looked at lifestyle choices and no big surprise most participants knew that smoking, alcohol and STIs can impact fertility.
Speaker 2:Right, those are all very well-established risk factors.
Speaker 1:Yeah.
Speaker 2:And public health campaigns have really done a good job raising awareness.
Speaker 1:But here's where it gets interesting. Only half of the participants knew that obesity negatively impacts fertility.
Speaker 2:That's a significant knowledge gap. It makes you wonder are we as a society prioritizing certain health risks over others?
Speaker 1:Yeah.
Speaker 2:Perhaps public health messaging around obesity and fertility hasn't been as strong.
Speaker 1:And that's what I love about these deep dives. You know, we uncover these subtle trends that impact our health and well-being. So let's unpack this further. How does obesity actually affect fertility on a biological level?
Speaker 2:So obesity can disrupt hormone balance, leading to irregular ovulation in women. It can also increase inflammation in the body, which can interfere with both egg and sperm health.
Speaker 1:This is all starting to paint a more complex picture of fertility than I think many people realize. It's not just about finding a partner and deciding you're ready. There are all these other factors at play.
Speaker 2:Exactly, and it's not about placing blame or making people feel guilty. It's about empowering them with knowledge so they can make informed decisions.
Speaker 1:Absolutely OK. So we've got age and lifestyle, but there's another major trend that's changing the fertility landscape Delayed childbearing. Our 2019 chapter highlights this as a global phenomenon, and Thailand is no exception.
Speaker 2:Yeah, the statistics are quite striking. In Thailand, the percentage of first-time mothers over 35 has doubled since 1998.
Speaker 1:Wow, doubled. That's a huge jump. What kind of ripple effects does this trend have, both for individuals and society as a whole?
Speaker 2:Well, on an individual level, delaying childbearing can mean lower natural conception rates and a higher likelihood of needing fertility treatments. Right, this isn't to say that having children later is impossible or wrong. It's just about understanding the potential biological challenges.
Speaker 1:And what about the broader societal impacts?
Speaker 2:Well-delayed childbearing contributes to aging populations, which can put a strain on social safety nets and have significant economic implications. Right, but the 2019 chapter makes a really important point here. Instead of judging women for sleepwalking into infertility, we need to understand the pressures they face.
Speaker 1:Absolutely. There's a powerful quote from the chapter that really stuck with me. It said we should understand the pressures they face. It's a reminder that these are complex decisions influenced by a lot more than just individual choice. So why are people waiting longer to have children? The 2019 chapter mentions a study called the VFAS, which surveyed women over 35 seeking fertility treatment in Thailand. What were some of their findings?
Speaker 2:So the top reasons for delaying childbearing were financial security, not having a partner, and career goals. These are all very understandable and relatable concerns reflecting the realities of modern life.
Speaker 1:Right. People are pursuing higher education, navigating uncertain job markets and redefining gender roles. It makes sense that these factors would influence when they feel ready to start a family.
Speaker 2:Exactly, and these trends are playing out globally, not just in Thailand. The VFAS study also revealed that the participants' ideal age for a first child was 28.7 years.
Speaker 1:Okay.
Speaker 2:Significantly earlier than when they actually sought treatment. That gap between aspirations and reality is something worth thinking about.
Speaker 1:It suggests that, while people may have a vision for when they'd like to start a family, that vision often clashes with the practicalities of their lives. So, knowing this, what kind of support would actually encourage people to have children earlier, closer to their ideal age?
Speaker 2:The VFES study asked participants that very question and the top answers were actually pretty clear Paid paternity leave, longer paid maternity leave and access to high-quality, affordable child care.
Speaker 1:Those are some pretty tangible needs. It speaks to the idea that people need practical support to balance the demands of parenthood with their financial and career aspirations.
Speaker 2:Exactly. It underscores the need for supportive social policies that make it easier for people to start families when they feel ready both emotionally and practically.
Speaker 1:Now let's shift gears a bit and talk about assisted reproductive technology, or ART. The VFAS study also explored perceptions of different fertility treatments. What did they find?
Speaker 2:They found there's a hierarchy of acceptability when it comes to different ART treatments. Iui and IVFICSI, which use the couple's own gametes, were seen as the most acceptable. Social egg freezing, which allows women to preserve their fertility, was moderately acceptable. But here's where it gets interesting. Donor gametes, sperm or eggs were viewed less favorably, even ranking lower than adoption.
Speaker 1:Now that is interesting. Why do you think there's such a difference in perception between those treatments?
Speaker 2:It likely reflects a complex interplay of factors. There might be cultural or religious beliefs about lineage and biological kinship that influence these perceptions. There could also be a lack of knowledge about donor conception and the long-term well-being of children conceived this way.
Speaker 1:It's a reminder that there's often a gap between the science of fertility and the social perceptions surrounding it. Speaking of social perceptions, our 2019 chapter dives into the Thai art landscape.
Speaker 2:It describes a booming industry, but also highlights some key issues Right One of the most important is that Thailand's art industry, while rapidly growing, is heavily concentrated in private clinics.
Speaker 1:Right.
Speaker 2:This raises concerns about accessibility and equity, suggesting that access to these potentially life-changing treatments may be limited to those who can afford them.
Speaker 1:That's a big concern. It creates a system where fertility care becomes a privilege, not a right. And here's another intriguing fact the number of art cycles per million people is actually much lower in Thailand than in Canada.
Speaker 2:Oh, wow.
Speaker 1:Even though Canada has no public health coverage for art. What do you make of that?
Speaker 2:Well, it likely reflects a complex interplay of factors, including cost, cultural influences and possibly even a degree of underreporting of art cycles. It's a reminder that raw numbers don't always tell the full story of who is accessing treatment and why.
Speaker 1:You mentioned underreporting. That brings us to another surprising finding about fertility tourism. Despite Thailand's reputation as a hub for this industry, officially reported foreign art cycles are surprisingly low.
Speaker 2:It's a bit of a paradox. This discrepancy hints at the possibility of significant underreporting, potentially driven by the legal and ethical complexity surrounding certain aspects of art like surrogacy.
Speaker 1:Which brings us to the 2015 Protection for Children Born from Art Act, a piece of legislation that has had a profound impact on Thailand's art landscape.
Speaker 2:This act was enacted in response to a series of high-profile surrogacy scandals that damaged Thailand's reputation. The goal was to protect vulnerable parties, such as surrogate mothers and children born through RT, and to curb exploitation within the industry.
Speaker 1:So what exactly did the act do? What were the key changes that it implemented?
Speaker 2:So it banned commercial surrogacy and gamete donation for foreigners. It also requires extensive documentation for all couples seeking RT, regardless of their nationality. The intention was to create a more ethical and regulated system.
Speaker 1:On the surface that seems. That seems reasonable. But were there any unintended consequences of these prohibitions?
Speaker 2:Unfortunately. Yes, while the act had noble intentions, it also pushed some practices underground, potentially making them even riskier for surrogates, intended parents and the children involved.
Speaker 1:It's that classic case of trying to solve a problem with regulations but then creating new problems in the process.
Speaker 2:Exactly, and by limiting access for some local couples, the act may have unintentionally created further inequities in access to fertility care. It's a complex issue with no easy answers.
Speaker 1:It really highlights how challenging it can be to regulate something as personal and complex as reproductive technology. There are so many ethical and social considerations to navigate.
Speaker 2:Absolutely, and it's a reminder that there are often tradeoffs involved in any policy decision.
Speaker 1:Now I want to circle back to something we touched on earlier the influence of cultural beliefs on fertility. Our 2019 chapter reveals that in Thailand, these beliefs go far beyond the walls of the clinic.
Speaker 2:It's fascinating how these traditional beliefs intersect with modern medicine. For example, the chapter describes belief that certain foods, like blue-shelled duck eggs, can boost fertility, as well as the use of unproven supplements and rituals at fertility shrines.
Speaker 1:It's a reminder that people's understanding of their bodies and their fertility is shaped by a multitude of factors, not just scientific knowledge.
Speaker 2:Exactly, and it underscores the importance of understanding the broader context in which people make decisions about their reproductive health.
Speaker 1:There's one detail I found particularly striking the belief that prolonged contraceptive use causes infertility. This belief is surprisingly prevalent, even though research has debunked it. What do you think this tells us about how people form beliefs about their bodies?
Speaker 2:It highlights the critical need for us to really evaluate information, especially when it comes to our health. We need to be discerning about the sources we trust and seek out credible, evidence-based information.
Speaker 1:It's so easy to get caught up in misinformation, especially when it comes to something as personal and emotionally charged as fertility.
Speaker 2:Absolutely, and that's why these conversations are so important.
Speaker 1:We've covered a lot of ground already. Before we move on to the last part of our deep dive, I want to introduce our final source, a YouTube video from a leading Thai fertility doctor, dr Patsama Vichensartvichai, who discusses her clinic's 2024 IVF success rates.
Speaker 2:This video offers a really unique glimpse into how RT is being marketed and perceived in Thailand, directly from someone on the front lines of fertility care.
Speaker 1:It's a perspective we don't always get to hear, and I'm curious to see what Dr Vichensar Pichai has to say. We'll be back after a short break to delve into this final source.
Speaker 2:Yeah, it's interesting to consider how doctors balance, you know, promoting their clinic's success while also managing patient expectations. Fertility treatment can be such an emotional journey.
Speaker 1:Yeah, you're right.
Speaker 2:It's a delicate balance. Let's discuss that after we watch Dr Vichensart-Fichai's video. Okay, so we just finished watching Dr Vichensart-Fichai's. Youtube video and I have to say her approach was really refreshing.
Speaker 1:Yeah, I agree. And while she highlights her clinic's impressive success rates, she doesn't shy away from emphasizing that age still plays a significant role in IVF outcomes.
Speaker 2:Yeah, and I appreciated that she pointed out that many couples conceive on their first embryo transfer.
Speaker 1:Oh yeah.
Speaker 2:It's a good reminder that IVF isn't always a long drawn out process and sometimes success can can happen quickly.
Speaker 1:That's a good point. Yeah, I also noticed she specifically mentioned excluding cases involving donor gametes from her clinic's reported success rates. That stood out to me.
Speaker 2:Why do you think she made that distinction? It seems like an important detail to highlight.
Speaker 1:It could be for transparency. You know success rates can vary when using donor gametes compared to using a couple's own eggs and sperm, so it's important to give patients a realistic picture of their chances that makes sense. It could also be a nod to those cultural sensitivities surrounding donor conception that we talked about earlier.
Speaker 2:Absolutely yeah. It just goes to show how cultural context can influence how clinics choose to present their services.
Speaker 1:This video also gives us a glimpse into the evolution of fertility care in Thailand. This video also gives us a glimpse into the evolution of fertility care in Thailand, especially in the private sector. You know, dr Vichin Sarkvichai's clinic emphasizes personalized care and cutting-edge technology.
Speaker 2:It speaks to a global trend towards more boutique-style fertility clinics that cater to patients who are looking for a more personalized experience. They want their emotional and psychological needs to be addressed, not just the medical aspects of treatment.
Speaker 1:It's fascinating to see how the industry is adapting to meet those needs, but it does make you wonder. As these high-end clinics become more common, will fertility care become even more stratified? Will there be a divide between those who can afford these?
Speaker 2:premium services and those who can't. That's a really critical question to consider. It ties into this broader societal issue of income inequality and its potential impact on access to health care, including specialized services like RT.
Speaker 1:It's a reminder that advancements in technology are incredible and offer so much hope, but we can't ignore the social and economic factors that influence who benefits from those advancements.
Speaker 2:Well said. Now, before we wrap things up, I want to bring us back to the 2015 Thai RT Act and its ongoing impact on the industry. This legislation was meant to address ethical concerns and protect vulnerable parties concerns and protect vulnerable parties.
Speaker 1:You're right, it aimed to kind of clean up Thailand's RT industry, which had faced criticism for a more commercialized approach to surrogacy, especially for foreign couples.
Speaker 2:But it wasn't without its controversies. Critics argued that the act went too far, driving some practices underground and making them less safe. The act's impact on altruistic surrogacy is particularly interesting.
Speaker 1:For our listeners who might not be familiar, can you explain what altruistic surrogacy is?
Speaker 2:Sure, altruistic surrogacy is when a woman carries a pregnancy for another couple without receiving any financial compensation beyond covering her medical expenses and other reasonable costs. So it's different from commercial surrogacy, where the surrogate is paid a fee for her services.
Speaker 1:So how did the 2015 act change things for people who wanted to pursue altruistic surrogacy in Thailand?
Speaker 2:It essentially made altruistic surrogacy the only legal form of surrogacy in the country, and it's only available to married heterosexual couples who meet very, very specific criteria.
Speaker 1:So no more commercial surrogacy. Even for Thai couples, that's a big shift. What were the outcomes of that decision?
Speaker 2:Well, one outcome was that the number of surrogacy arrangements in Thailand plummeted. The strict regulations and bureaucratic hurdles made it much more difficult for couples to find willing surrogates.
Speaker 1:But it didn't eliminate the demand right.
Speaker 2:Exactly. Evidence suggests that commercial surrogacy didn't disappear, it just moved underground. It now operates outside the oversight of legal and ethical frameworks, which is concerning.
Speaker 1:It seems like that could make things even riskier for everyone involved the surrogate, the intended parents and especially the child.
Speaker 2:That's the fear when these practices are driven underground. It's much harder to ensure that everyone's rights and well-being are protected.
Speaker 1:It's a reminder that sometimes well-intentioned laws can have unintended negative consequences.
Speaker 2:It's a classic example of that, and it underscores the need for ongoing evaluation and potential revisions of these kinds of policies.
Speaker 1:Now I want to go back to the VFAS study. It also looked at people's attitudes towards different types of RT treatments. What did they learn about how Thai women perceive these options?
Speaker 2:The study found a clear hierarchy of acceptability. Iui and IVFICSI, which involve using the couple's own gametes, were considered the most acceptable. Social egg freezing had moderate acceptance, but donor gametes, either sperm or eggs, were the least acceptable, even less so than adoption.
Speaker 1:That's fascinating. It seems like there's a clear preference for treatments that maintain a biological connection between the parents and the child.
Speaker 2:Right. It aligns with that cultural emphasis on biological parenthood that we discussed earlier.
Speaker 1:But why do you think donor gametes are viewed less favorably, even even compared to adoption, which doesn't involve any biological connection?
Speaker 2:It likely stems from a complex combination of cultural and religious beliefs about lineage and kinship. There might also be a lack of understanding about donor conception and how it works.
Speaker 1:It seems like there's a need for more open dialogue and education about donor conception so people can make informed choices based on accurate information, not just preconceived notions.
Speaker 2:I absolutely agree.
Speaker 1:We've covered so much ground today, from the biological basics of fertility to the cultural and social factors that shape people's choices, it's clear that fertility isn't just a personal journey. It's a complex interplay of individual decisions, societal expectations and global trends.
Speaker 2:That's a great way to put it. We've explored how age, lifestyle choices, delayed childbearing and access to health care all intersect to create this intricate tapestry of fertility experiences.
Speaker 1:Before we wrap up our deep dive, I want to take a moment to highlight the key takeaways for our listeners. What are the most important things you hope people will remember from our conversation?
Speaker 2:First and foremost, I'd encourage everyone to have open and honest conversations about fertility with their partners, friends and family members. Let's break down the taboos and normalize these discussions.
Speaker 1:It's so true. Keeping these things bottled up only creates more anxiety and shame. Sharing our experiences and questions with others can be incredibly liberating.
Speaker 2:Sharing can also help us realize that we're not alone in our struggles or uncertainties. It builds community and support.
Speaker 1:Absolutely so. Open communication is key. What else can our listener do to be proactive about their reproductive health?
Speaker 2:Be proactive about seeking information and understanding the factors that can impact fertility, both biological and lifestyle related. Knowledge is empowering.
Speaker 1:And don't be afraid to ask your doctor questions. You have a right to be informed and to make decisions that are right for you.
Speaker 2:I couldn't agree more. Another important piece is to think about the kind of support system you'll need if you're considering starting a family.
Speaker 1:Right.
Speaker 2:This includes both practical support, like child care and parental leave, and emotional support from your partner, family and friends.
Speaker 1:It takes a village, as they say, and building that village starts with recognizing what you need and asking for help when you need it Exactly.
Speaker 2:And finally, remember that cultural narratives and societal expectations can be really powerful forces. Be critical of the messages you receive about fertility and family building. Challenge those that feel limiting or judgmental.
Speaker 1:It's about creating space for a more diverse and inclusive understanding of what it means to build a family.
Speaker 2:Yes, let's move away from the idea of a single right way to do things and embrace the many different paths to parenthood.
Speaker 1:I love that We've talked about biological clock, but there's also this societal clock that can feel even more pressing, the pressure to hit certain milestones by certain ages.
Speaker 2:Yeah, it's a powerful force, isn't it? But what if we question those assumptions? What if we challenge the notion that there's a right time to have kids? What if we celebrated a more flexible and diverse approach to family building?
Speaker 1:That's such a powerful shift in perspective. It's about giving ourselves permission to define our own timelines based on our individual values and circumstances. Values and circumstances.
Speaker 2:Exactly. It's about recognizing that there are many paths to parenthood and that each journey is unique and valid.
Speaker 1:Well said and on that note, I think we've reached the end of our deep dive.
Speaker 2:It's been a pleasure exploring these complex and fascinating topics with you.
Speaker 1:A huge thank you to our expert for sharing your incredible insights.
Speaker 2:Thank you for having me.
Speaker 1:And to our listener thank you for joining us on this journey. We hope this deep dive has sparked some new ideas and inspired you to think critically about fertility, family building and the choices that lie ahead. Keep asking questions, keep diving deep and keep challenging the status quo. Until next time.
Speaker 2:We're back for the final part of our deep dive into fertility factors and perceptions. I have to say, this exploration of Thailand's experiences has really opened my eyes to the complexities of this topic.
Speaker 1:It's been a fascinating journey, hasn't it? We've gone from the biological foundations of fertility to the social and cultural influences that shape people's choices and experiences. What has stood out to you the most?
Speaker 2:Honestly, I'm struck by how much fertility is not just about biology. You know we often hear about the biological clock, but what we've uncovered here is that there's a whole symphony of factors at play Societal pressures, economic realities, cultural beliefs, even government policies. All these things kind of weave together to influence when and how people approach starting a family. I completely agree. We can't look at fertility in isolation. You know it's deeply intertwined with the fabric of our lives, influenced by forces that extend far beyond our individual bodies.
Speaker 1:It's like we've zoomed out to see the entire ecosystem, not just the individual organism. Thinking about it this way helps us understand why there's no one size fits all answer when it comes to fertility.
Speaker 2:That's a great analogy and it emphasizes why it's so important to approach this topic with empathy and understanding, recognizing that that everyone's journey is unique.
Speaker 1:So let's bring this back to our listener. What can they do with this newfound knowledge, regardless of where they are in their own fertility journey?
Speaker 2:First and foremost, I'd encourage everyone to have open and honest conversations about fertility with their partners, friends and family members. Let's break down the taboos and normalize these discussions.
Speaker 1:It's so true. Keeping these things bottled up only creates more anxiety and shame. Sharing our experiences and questions with others can be incredibly liberating.
Speaker 2:Sharing can also help us realize that we're not alone in our struggles or uncertainties. It builds community and support.
Speaker 1:Absolutely so. Open communication is key. What else can our listener do to be proactive about their reproductive health? What else can our listener do to be proactive about their reproductive health?
Speaker 2:Be proactive about seeking information and understanding the factors that can impact fertility, both biological and lifestyle related. Knowledge is empowering.
Speaker 1:And don't be afraid to ask your doctor questions. You have a right to be informed and to make decisions that are right for you.
Speaker 2:I couldn't agree more. Another important piece is to think about the kind of support system you'll need if you're considering starting a family. This includes both practical support, like child care and parental leave, and emotional support from your partner, family and friends.
Speaker 1:It takes a village, as they say, and building that village starts with recognizing what you need and asking for help when you need it.
Speaker 2:Exactly. And finally, remember that cultural narratives and societal expectations can be really powerful forces. Be critical of the messages you receive about fertility and family building. Challenge those that feel limiting or judgmental.
Speaker 1:It's about creating space for a more diverse and inclusive understanding of what it means to build a family.
Speaker 2:Yes, let's move away from the idea of a single right way to do things and embrace the many different paths to parenthood.
Speaker 1:I love that We've talked about the biological clock, but there's also this societal clock that can feel even more pressing, the pressure to hit certain milestones by certain ages.
Speaker 2:It's a powerful force, isn't it? But what if we question those assumptions? What if we challenge the notion that there's a right time to have kids? What if we celebrated a more flexible and diverse approach to family building?
Speaker 1:That's such a powerful shift in perspective. It's about giving ourselves permission to define our own timelines, based on our individual values and circumstances.
Speaker 2:Exactly. It's about recognizing that there are many paths to parenthood and that each journey is unique and valid.
Speaker 1:Well said and on that note, I think we've reached the end of our deep dive.
Speaker 2:It's been a pleasure exploring these complex and fascinating topics with you.
Speaker 1:A huge thank you to our expert for sharing your incredible insights.
Speaker 2:Thank you for having me.
Speaker 1:And to our listener thank you for joining us on this journey. We hope this deep dive has sparked some new ideas and inspired you to think critically about fertility, family building and the choices that lie ahead. Keep asking questions, keep diving deep and keep challenging the status quo. Life by Dr Pat. Leading innovation in fertility excellence.
