Hansard

I thank Mary Scanlon for bringing this debate to the chamber. I am pleased that the Parliament is debating infertility, as there is no doubt that it desperately needs wider public discussion.

For most people who are affected by infertility, it is an extremely private issue that can cause mental and emotional anguish, and can lead to long-term problems such as depression and the breakdown of relationships. The nature of the condition and the complexity of the emotions involved mean that many of those who are affected avoid speaking openly about their experiences, even with the closest of family members. For women, feelings of sadness, jealousy, anger, grief and loneliness are all associated with the experience of infertility. Equally, men can suffer from emotional anxiety, stress, feelings of inadequacy and low self-esteem.

A sad result of the trend is that we rarely have open, honest or poignant discussions about infertility in the public domain. Those who are unaffected by infertility are therefore too often reliant on sensationalist reporting and public discussion, such as the recent outrage over the case of 66-year-old Romanian mother Adriana Iliescu, which can form their perception of the condition and its treatments.

In reality, of course, the sad truth for infertile couples is far more fundamental and heart-rending than such high-profile cases sometimes suggest. An estimated one in seven Scottish couples experience fertility problems. Waiting lists can be as long as four years. As Mary Scanlon pointed out, a cut-off age of 38 for IVF treatment for childless women, plus an average two-year wait before GP referral, means that the real cut-off age for discovering fertility problems is closer to 32.

In a country where political will is being applied to tackle a declining population, surely it is time that our society recognised that infertility is a legitimate health care need that requires nationwide commitment. We have to open up widespread discussion of infertility to ensure that there is greater understanding of all the issues involved.

As important as the need for a comprehensive and consistent nationwide approach to infertility is the need for a dedicated strategy to tackle the underlying causes of the condition. While current levels of involuntary childlessness can be attributed to different factors, such as women waiting longer to start families, previous illness and a fall in the average sperm count—as outlined by Mary Scanlon—the alarming rise in sexually-transmitted infections in Scotland in recent years could override all those contributing factors as the main cause of infertility in coming decades. It is therefore fitting that this debate should follow the Minister for Health and Community Care's statement on a sexual health strategy for Scotland.

As many as one in 10 young people in this country could have the sexually-transmitted infection chlamydia without knowing it. In some areas of Scotland, clinics have reported finding that as many as one in four young women are infected with the disease. The silent harm of chlamydia is of great concern. In a significant proportion of cases—particularly among women—it can be asymptomatic, and so can remain undetected, which puts women at risk of developing pelvic inflammatory disease and infertility. It is essential that we take action. Money that is spent now on better information services and testing the population, coupled with a national screening programme such as that in Sweden, could save us a great deal in future decades.

There are other causes that require attention. Once again I draw attention to endometriosis, which we debated four years ago. I wish to put some questions to the minister. In 2001, the estimated waiting time for the diagnosis of endometriosis was seven years, which highlights an urgent need for better understanding. Could the minister investigate whether the diagnostic situation has improved? Will she reconsider the possibility of having a public awareness campaign to encourage greater interest in and understanding of the condition among the public, the medical profession and the scientific community?

Once again, I thank Mary Scanlon for raising the subject of infertility. In the spirit of talking about it, I say that my husband and I have personal experience of infertility, having tried unsuccessfully for a number of years to start a family. We were extremely lucky to conceive without IVF—it was a miraculous occurrence—but I have not forgotten the emotional turmoil at the prospect of not being able to have a child. I hope that the forthcoming review of guidance on the provision of fertility services in the national health service will result in improved services and greater reassurance for couples that their decision to try to have children will be supported and resourced.