"I had the coil [IUCD] fitted at 19 but it caused me great pain and I had it removed at 21," says Ruth. "I was later found to be infertile."

"But I also had ovarian cysts and tubal problems so I can't prove the coil was the main cause of my infertility.

"I think linking tubal damage to life-style is a whole grey area. Some women must obviously come to regret the fact that they had a good time when they were younger and did not realise the outcome. I don't think this way and don't blame myself, because I will never know, but for some women it must be an added sadness.

Ruth has since had two daughters by assisted conception: "I feel strongly that when they grow up and want to have sex I will explain to them that their fertility is one of their greatest gifts and really needs to be taken care of. I don't know whether the surgeon who dealt with me all those years ago looked at me as a child-bearing person and if a different approach could have minimised my scar tissue. With my own daughters I will discuss contraception and protection very carefully indeed."