Danish expert: Support young people to get pregnant, not to freeze their eggs

Danish expert: Support young people to get pregnant, not to freeze their eggs

Female employees in large American companies can have their eggs frozen and delay having children – as a workplace benefit. A leading Danish infertility expert recommends Nordic employers and governments take an opposite approach and support young people to have children while they are students or newly employed.

Infertility has become a serious public health issue in Denmark as well as in the other Nordics and globally. One in five face fertility problems and the fertility treatment market is booming. But inequality, major costs and a range of physical discomforts are associated with fertility treatments, which is why they should not be the sole solution.

That is the assessment from Lone Schmidt, one of Denmark’s leading infertility experts. She wants more fertility information aimed at young people and for them to be encouraged to have children early. Healthy women freezing their eggs for later use is something she describes as a “really bad” solution to the serious fertility challenges facing the world.

“Infertility is a widespread and serious public health issue across the world and also here in the Nordic region, and it has major personal and societal consequences. The Nordic countries should make sure fertility treatment is not the only solution. Our region can benefit from doing a lot to get young people to start having children earlier,” says Lone Schmidt. 

Lone Schmidt. Photo: University of Copenhagen.

She is a medical doctor and a professor with special responsibilities who has spent more than 30 years researching reduced fertility and public health at the Department of Public Health at the University of Copenhagen.

Nine in ten want two to three children

Some of her research shows that 18-22 year-old Danish men and women have a great desire to have children. Nine in ten would very much like to become parents and gladly have two or three children. At the same time, young Danes want to be active in the labour market, and the Nordic welfare model creates a unique opportunity for both wishes to come true, the professor concludes.

“Nordic societies, unlike those in the rest of the world, give families a lot of support. It is possible to work while also being parents to small children. The Nordics offer paid parental leave for both men and women, good childcare options and the world’s highest employment rate for both fathers and mothers."

Nevertheless, people in the Nordics have fewer children than they would like. They also have children relatively late and many need fertility treatment in order to get pregnant. 

The graph shows the number of children born in Denmark. Source: Statistics Denmark.

“Our research shows that there is a significant unmet desire among young adults in the Nordics to have more children, so we need to do something about the obstacles young adults experience in terms of having children earlier in life.” 

Economy is not one of the obstacles. Young people in the Nordics do not have to wait to have children until after they have finished their education, like in most South European countries, explains Lone Schmidt.

Job and career first

She and fellow researchers at the Department of Public Health have been investigating which obstacles young adults feel they have to overcome before trying for children. A large majority say they first must find a partner to share the responsibility with, be in a stable relationship and feel mature enough to become parents. 

More than four in ten also say they want to have a good economy, to have graduated, started a career and have access to a sufficiently large home before feeling ready to try to get pregnant. 

“We see that many young people put off having children, which increases their risk of infertility. A large number of them become dependent on fertility treatments and typically get started on this so late that a large proportion who have children as a result of fertility treatment are old, in a reproductive sense, when they become parents,” says Lone Schmidt.

Silent employers

She wants to see a broad debate in the Nordic countries that can challenge the expectations young people have of themselves before they feel ready to try to conceive. She calls for the social partners to take an active part in the debate and to promise young people who have children early that they too are attractive employees.

“It would have an enormous impact on young people if employers signalled that they are very willing to hire young women and men with two small children. I and other infertility experts have been trying for the past 15 years to engage major labour market organisations in this matter, but there is a deafening silence from the social partners.”

Large international and American companies are also not helping facilitate the direction of travel Lone Schmidt is calling for. On the contrary. Google, Facebook, Twitter/X and others have in later years been offering female employees paid-for “social freezing”, which is the harvesting and freezing of eggs to allow them to have children at a later stage.

“I have not heard of Danish employers paying for social freezing, and I hope that it is not happening because this is a really bad idea for healthy women. Becoming pregnant later in life is more risky, and leaves the woman with the entire responsibility to create a family. That is not the way things are in the Nordic countries, where men parent as much as women.” 

Many drawbacks

Harvesting eggs also means two to three rounds of intensive hormone treatment, which places a heavy burden on the woman’s body, explains Lone Schmidt. The treatment costs nearly 60,000 Danish kroner (€8,000). On top of that come the costs of keeping the eggs frozen for years. These are not expenses that should be covered by public expenditure, believes Lone Schmidt. 

“Studies also show that many of the women do not use their frozen eggs, which presumably is linked to the fact that they typically are in their mid-30s before choosing ‘social freezing’.”

Ideally, the eggs should be harvested when a woman is in her mid-to-late 20s, she explains. 

“Having children late also puts major pressure on the body, and children of old parents don’t get the same amount of time with their parents and grandparents that previous generations enjoyed. All these consequences are not talked about, and I don’t think young people are aware of them.”

More knowledge about fertility

She recommends a massive focus on information about fertility aimed at young people. In her opinion, young people know far too little about what helps and what reduces their ability to conceive.

The education system should also be even more parent-friendly, and the social partners should actively communicate and demonstrate in practice that young parents are attractive workforce candidates who do get recruited. 

Lone Schmidt, who is now 65, started trying for children when she was 24. Only because she wanted to and she did not make any detailed plans. She sees how her young students today think it is nearly irresponsible for young people to have children just because they want to.

“I have taught university students for 20 years and see a new generation of students who are very focused on planning. They have extremely high expectations of themselves as parents. There is something new at play here.” 

One in five have problems

Difficulties in conceiving a child are a reality for every fifth Dane, according to the first survey in recent times of the prevalence of infertility in the population, which Lone Schmidt has helped create. The survey “Infertility – Thematic Report, Health Profile for the Capital Region and Municipalities 2021” was published in March 2024.

It concludes that infertility is a general social problem that all types of people face, but there are great discrepancies in who receives treatment. Ethnic Danes and people with higher education are far more likely to have fertility treatment than others.

The survey was commissioned by the public health authorities in greater Copenhagen – the Capital Region. Lars Gaardhøj (Social Democrats) is the head of the regional council at the Captial Region. He promises to follow up on the survey and do something about the discrepancies in treatment.

“The survey clearly shows that infertility is not only a personal problem for those who struggle to conceive, but that it is a problem for society.

"This touches all population groups and for me, it is important that the help we offer people in the region is extended to everyone so that treatment is not a question of where you live or what your background is,” wrote Gaardhjøj in a press release coinciding with the publication of the report. 

Danish clinic bankrupt 

The Danish government has decided to double IVF treatment attempts from three to six and to make access to public health fertility treatments free also for child number two. 

Denmark is already at the forefront as one of the countries in the world with the highest number of fertility treatments per capita.

Infertility levels are not higher in Denmark than in other high-income countries, but the country offers sufficient access to high-quality treatment – an opportunity that Norwegian and Swedish couples made use of before fertility treatment legislation in Norway and Sweden was liberalised in recent years.

The liberalisation meant Danish fertility clinics lost customers. One of the clinics, Danfert & Stork Fertility in Copenhagen, has gone bust because many of their customers were Swedes and Norwegians.

They stopped coming when treatment was made available in their home countries. The bankruptcy created uncertainty around what would happen to eggs that were already frozen. The bankruptcy estate writes on the Danfert & Stork website that the eggs have been securely moved to a different clinic.