We marvel at the wonder of life when a new baby is born. And while the process is magical, it is also helped along by a lot of science and the admirable work done by a swathe of medical professionals. The field of reproductive medicine deals with the prevention, diagnosis, and management of reproductive issues. Its main goal is to improve or maintain the male and female reproductive systems, giving people choices over when and how they decide to have children. This multidisciplinary branch of medicine combines anatomy, physiology, and endocrinology, as well as some aspects of molecular biology and biochemistry. It also overlaps with several other medical professions, such as gynecology, obstetrics, urology, genetics, and even psychiatry.
Reproductive medical specialists treat and advise on any issues that may be impacting a couple’s or a person's ability to conceive a child. Depending on the needs of the patient, this may include fertility testing, ovulation induction, laparoscopic, open surgery, and assisted conception like in vitro fertilization (IVF) or frozen embryo replacement (FER). And while this particular branch of healthcare can often involve some delicate (or embarrassing) conversations between doctors and patients, it is an extremely rewarding career path for any aspiring medical professional. After all, the work you do will help bring babies into the world, making the dreams of would-be parents finally come true.
So if this sounds like the right career for you, here is everything you need to know about studying reproductive medicine.
Get ready to do some serious studying
There is no getting around this part -- qualifying as any medical professional requires years of hard work, dedication, sacrifice, and lots of long, lonely hours in the library or studying at home.
But the very first thing you'll need is a good high-school education, with top grades in biology and the other sciences. After that, it's time for a three- or four-year undergraduate degree, followed by postgraduate study and residencies in a hospital (or another medical setting).
Graduates who have already decided on reproductive medicine can go straight onto a specialist MSc program. Postgraduate programs cover all the fundamentals of reproductive medicine but also branch off into more specialist areas; these include psychosexual therapy, sexual health counseling, and women's health. In other words, there is much more to reproductive medicine than just helping people make healthy babies. Instead, it covers many mental and physical health issues that can impact our overall well-being. And with a chance to study essential topics like HIV medicine, you can go on to help generations of people from all across the globe.
Why is reproductive medicine so important?
Although reproductive medicine helps bring new life into the world, its focus on issues such as birth control, sexual education, and mental health are as equally as important in creating balanced and sustainable societies. Preventing unplanned pregnancies not only reduces poverty infant mortality rates, but it also eases the strain on overstretched social services, as well as empowering millions of women all over the world to build successful careers or pursue other personal ambitions before starting a family.
The economic, social, and cultural benefits of effective birth control and safe sexual practice should never be underestimated. In fact, many sociologists see the wide availability of the contraceptive pill as one of the most significant developments of the late 20th century. The term birth control was coined by Margaret Higgins Sanger, who worked as a nurse before becoming one of the century’s most prominent feminist thinkers. She wrote, “Birth control is the first important step woman must take toward the goal of her freedom. It is the first step she must take to be a man’s equal. It is the first step they must both take toward human emancipation.” In other words, access to birth control enables men and women to take charge of their future.
The philosophy of reproductive medicine
While there's plenty of hard science involved in reproductive medicine, it's not just a matter of facts, figures, and percentages. In fact, the subject touches upon some of the most profound philosophical challenges of all time.
For almost half a century, the birth rates in highly industrialized societies have been in decline. Today, the birthrate in Western Europe is below replacement level, with only two countries, Albania and Iceland, producing more than two children per couple. To put this into context, one of East Africa's most recently formed sovereign states, Eritrea, has a rate of 4.13 births per woman. Subsequently, populations in developed countries like Germany, Japan, and the UK are aging. And if the trend continues, some studies suggest the number of working-age people in Europe will fall from 70% to well below 50%. Such a drastic demographic shift raises several critical issues, including shrinking economic and cultural production, as well as stretched health and social care systems.
Many intertwining economic, cultural, and even historical factors are driving declining fertility rates. Socioeconomic incentives encourage people to delay childbearing, and many are now deciding to have fewer children for personal, financial, and economic reasons. There are also many institutional pressures, including the modern labor market, the lack of affordable childcare, and rising house prices.
Moreover, while the feminist movement and other sexual revolutions liberated millions of people, they also impacted sexual dynamics across the developed world and radically altered our notion of the 'traditional' nuclear family. To look at this another way, declining birth rates seem to be an inevitable consequence of a culture that becomes almost too 'successful' -- or reaches a heightened form of self-awareness. Ancient historians have pointed to plenty of evidence that shows how the great civilizations of the past, including the Roman and Babylonian Empires, often experienced declining birth rates once they broke through to a certain level of economic prosperity and social stability.
Some of the world's greatest historians, philosophers, and doctors have written lengthy books on the subject of declining birth rates, but none have managed to come up with a solution to the problem within its own terms. Could you be the first?
The future of reproductive medicine
During his long and successful career as an obstetrician/gynecologist specializing in reproductive endocrinology, Dr Eric J. Forman, Medical & Laboratory Director at Columbia University Fertility Center, has helped hundreds of couples have healthy babies via in vitro fertilization (IVF) and other assisted reproductive technologies. Without these very modern treatments, patients with blocked Fallopian tubes, severely low sperm counts, or other fertility issues may never have had children of their own.
But in addition to the enormous sense of personal satisfaction involved in helping people conceive, Dr Forman found himself questioning the moral and ethical side of IVF, leading him to speculate on what the future of reproductive medicine might look like and how political and cultural attitudes may shape its future.
He writes, "The status of preimplantation testing of human embryos is a complex ethical and emotional issue. Some people believe that life begins at fertilization and, since every life has inherent value, we should not “play God” by choosing not to implant some embryos. Others recognize that embryos have the potential to create a child but require many more steps, and that most embryos are actually incapable of creating a baby."
IVF works like this: several embryos are grown in the laboratory for up to six days. Cells are then removed from the embryos for genetic analysis, after which the embryos are frozen. The DNA is assessed for a variety of genetic disorders, and the healthy embryos can be injected into the prospective mother's uterus. From a purely scientific viewpoint, this is amazing -- but it is also an ethical minefield, because it involves a subjective assessment of the quality or potential of a life and then leads to myriad questions arising from this. Almost every step you take in this conversation leads towards another controversy, including one of the most fiercely debated topics of the modern age: at what point does life actually begin? Whatever one’s opinion is on this issue, the debate (or final answer) will continue to be informed by reproductive medicine for a very long time to come.
So if you’d like to help bring babies in the world, help the fight against life-threatening diseases, or tackle some of the greatest ethical questions ever posed, then reproductive medicine is the place where you can do it all.