Subfertility is a major and increasing problem in many countries. Having children is an important life achievement for many couples and facing a life without children or less children than wanted is a heavy burden for people to bear. In Belgium and surrounding countries, approximately one in ten heterosexual couples fail to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.

As a number of lifestyle factors have an impact on fertility, education on how to care for one’s fertility is important from a young age onwards. In current educational programmes, teenage boys and girls  learn how not to become pregnant at a young age (which is important), how to avoid sexual transmitted diseases (STDs), and how smoking, drinking alcohol and increased body mass index have an impact on health in general. Unfortunately, graduating students are not aware of the impact of age, STDs, tobacco, alcohol, environmental toxins and overweight on their fertility.

Moreover, fertility awareness is also low in adults, even in those who already have children. A large number of international studies found an unrealistic optimism about our reproductive capabilities and about assisted reproductive techniques. A large number of people think that fertility remains preserved until menopausal age and that reproductive techniques are effective in almost 100% of the cases. In reality, fertility starts to decline from age 30 in women and higher age also impacts the effectiveness of assisted reproduction.

Unfortunately, a lot of couples learn about these adverse factors only when they are faced with fertility problems. ‘If only I had known before’, is a remark often made by patients in fertility treatment.  Education is one possibility to increase awareness in young people; actively addressing family planning by primary health care workers is another track to encourage couples to discuss their future plans with a professional and each other.