The recent announcement regarding enhancements to insurance coverage for female athletes, following the Carney review, has been positively received (Landmark changes to insurance cover for female athletes to be implemented, 30 March). It is about time that issues such as contraception, pregnancy, menopause, and other health matters that predominantly affect women receive the attention they deserve.
However, a significant issue remains overlooked: fertility. Elite female athletes often subject their bodies to extreme conditions, characterized by low body fat and rigorous training regimens, which can lead to hormonal imbalances and irregular menstrual cycles. Research indicates that nearly two-thirds of these athletes experience either irregular periods or amenorrhea, both of which can have adverse effects on fertility.
The years when athletes are at the height of their competitive careers often align with their peak fertility years. Unfortunately, many choose to postpone starting a family to focus on their athletic careers. For those who wish to conceive, the presence of fewer or missing menstrual cycles complicates natural conception efforts, alongside the natural decline in fertility that occurs with age.
There have been some advancements in this area: for instance, last year, the WTA Tour took a significant step by ensuring that tennis players who take a break for fertility procedures, such as egg or embryo freezing, can maintain their rankings. It is crucial that paid and protected leave for fertility evaluations and treatments becomes a standard practice across all women’s sports. Female athletes should not have to face the dilemma of choosing between their careers and motherhood, a choice that is seldom imposed on their male counterparts.
It is essential to recognize the importance of fertility in the broader context of athlete health, to provide adequate support and flexibility, and to offer timely options for fertility preservation. Failing to address these concerns could undermine the progress these new reforms are intended to achieve.
Dr. Mireia Galian
Medical Director, IVI London
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