As you report, changes to insurance cover for female athletes following the Carney review are welcome (Landmark changes to insurance cover for female athletes to be implemented, 30 March). Addressing contraception, pregnancy, menopause and other health conditions disproportionately affecting women is long overdue.
Yet one crucial blind spot remains: fertility. Elite athletes push their bodies to extremes, often with low body fat and intense training, which can disrupt hormones and menstrual cycles. Nearly two-thirds experience irregular or absent periods, which can affect fertility.
Competitive years often coincide with peak fertility, yet many athletes delay motherhood to prioritise their careers. For those trying to conceive, fewer or absent cycles make natural conception more challenging, and age-related fertility decline must also be considered.
Some progress exists: last year the WTA Tour committed to protecting the rankings of tennis players who took time out to undergo a fertility procedure such as egg or embryo freezing. Paid, protected time off for fertility assessment and treatment should be standard across women’s sports. Female athletes should not have to choose between career and parenthood – a choice rarely asked of male counterparts.
Recognising fertility as part of holistic athlete health, providing support and flexibility, and offering timely fertility preservation options are essential. Anything less risks undermining the progress these reforms aim to achieve.
Dr Mireia Galian
Medical director, IVI London
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