Infertility: Guide to what is it, causes and different treatments
Infertility. The World Health Organization (WHO) defines it as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. Learn what it is, causes, treatments, and impact in this useful guide.
What is infertility?
Infertility has now become a well-known topic that many researchers have attempted to explain. Infertility refers to the inability to conceive children. Throughout the years, scientists have come up with innovative procedures for infertility. There are many different causes for which a person may be infertile. Rates of infertility and miscarriage MAY increase with age. A woman’s fertility peaks in her late twenties. Then gradually begins to decline in her early thirties. Around her mid-30s, there’s a greater drop in fertility and increase of miscarriage. This is primarily due to the aging egg supply, egg quantity, and quality begins to decrease. Male fertility also declines with age but it is a more gradual decline for women. Before we get ahead of ourselves, let’s discuss different ways both men and women can become infertile. Fertility problems have many causes involving the woman’s, the man’s, or both reproductive systems.
The most common is low sperm count. Men who are affected by low sperm count could have A hormonal problem in the testicles or pituitary glands which releases hormones that stimulate the testicles to produce testosterone.
The most common is endometriosis, which happens when tissue that lines your uterus also grows outside your uterus. These growths often attach to the ovaries or other organs, and they may bleed during your period or cause pain. This may result in difficulty to conceive.
It is also caused by age; as age increases, a women’s egg count and probability for reproduction decreases. However, there are a few more common causes of infertility. A highly common cause is problems in a woman’s fallopian tubes. There may exist scarring of fallopian tubes linked with past pelvic surgery, which may have been caused by ovarian cysts or uterine fibroids.
Impact of Infertility
Psychological impact of infertility
Much research has been conducted to report the impact of this condition on women. Studies have found that women with infertility felt anxiety symptoms or depressed as those diagnosed with cancer, hypertension, or recovering from heart attack. Less research has been done on men, however, studies show that when the problem is diagnosed in their partner, men do not report being as distressed as women do. But when men learn they are the ones who are infertile, they experience the same levels of low self-esteem, stigma, and depression as infertile women do. The psychological impact may lead to less communication between the couple, making it difficult to connect to each other.
Psychologically, infertility is experienced as a loss. Examples of these losses include:
- Loss of the experience of pregnancy and birth
- Loss of opportunity to pass on family genetics
- Loss of chance to contribute to the next generation
- Loss of chance to parent or become a grandparent
- Low self-worth and self-esteem
- Loss of family stability
- Loss of sense of control over destiny
- Loss of sense of hope for the future
- Loss of work productivity
All these losses affect the couple’s relationship to others.
Social Impact of Infertility
Infertility is a poorly-controlled, chronic stressor with severe long-lasting negative social and psychological consequences. Therefore, it may also impact a woman’s relationship with other family members and friends. Infertile women may feel out of sync with siblings as developmental stages are no longer shared. They may also experience a lack of empathy and support and insensitivity from close friends. Resulting in strained or broken friendships.
Financial Impact of Infertility
Treatments can be extremely costly. The average cost is around $8,000 for a cycle of IVF and around $3,000 to $5,000 for the fertility drugs required for each cycle. These are not covered by insurance, so if individuals can’t afford it, it can contribute to feelings of hopelessness and helplessness. Even people who do have insurance may find the coverage is limited and that they must pay significant amounts.
Tips on how to connect with your partner through the process
Here are some tips to cope during the process:
- Getting in touch with your feelings will help you know what you need. Once needs are identified, clearly and specifically tell your partner how to help you.
- Recognize the psychological and emotional differences between men and women.
- Communicate openly with each other.
- See if you can teach each other some of the skills you’ve learned from your own life experiences.
- Ask your partner what she/he needs rather than assuming that you can/can not give it.
- Share more in the treatment process, both the burdens and joys of your different perceptions/experiences of infertility.
In the U.S, around 6% of married women aged between 15 and 44 years fail to achieve pregnancy after one year and about 12% of that age group, regardless of marital status, have impaired fecundity
Treatment of Male Infertility
Men’s options can include treatments for general sexual problems or lack of healthy sperm. Treatments may include:
- Different lifestyle factors: improving lifestyles and behavioral factors may improve chances for pregnancy. Discontinuing non-prescribed medications, reducing any harmful substances such as alcohol or drugs, improving frequency and timing of intercourse and exercising more.
- Medications: Certain medications may improve a man’s sperm count and the likelihood of pregnancy. These medicines could increase testicular functions including sperm production and quality.
- Surgery: surgery could reverse sperm blockage and restore fertility, which may improve overall chances for pregnancy.
Treatment of Female Infertility
For women, there may be one or two therapies needed to restore fertility. There are also several different types of treatment that may be needed before she’s able to conceive.
- Stimulating ovulation with fertility drugs: fertility drugs are the main treatment for women who are infertile due to ovulation disorders. These medications can regular or induce ovulation.
- Surgery to restore fertility: uterine problems such as endometrial polyps (one of the causes mentioned above), a uterine septum, or scar tissue can be treated with hysteroscopy surgery.
Technology has advanced to the point where in cases where spontaneous pregnancy does not occur, couples often still achieve pregnancy through the use of assisted reproductive technology. This form treatment for infertility is called In Vitro.
- Fertilization (IVF): In vitro means “outside the body”. IVF is a process where eggs are collected and then fertilized by sperm outside the body, in an embryology laboratory, which is then followed by the transfer of the embryos directly into the uterus, thereby passing the tubes. This form of treatment is supportive for women who are infertile due to damage in their fallopian tubes. How does it work? Step by step:
- The woman undergoes gonadotropin injections, which stimulate the ovaries to produce many eggs. Once the follicles (fluid-filled sacs containing eggs) reach a matured size, and HCG injection is administered which leads to the final development and maturation of the eggs.
- At this point, the eggs are retrieved under mild anesthesia in an operating room, which is done by ultrasound guidance when the surgeon uses a narrow needle to retrieve the eggs from the ovary through the vaginal wall. Once the eggs are removed, they are then handed to the embryologist who places them in tiny droplets on a petri dish and then fertilizes the eggs.
- After fertilization, one or two embryos are carefully and gently transferred into the uterine cavity. A pregnancy test is then performed in two weeks. Many couples have also chosen to involve a third party for reproduction. This is generally referred to the process where another person provides sperm or egg, or where another woman acts as a gestational surrogate.
- Sperm donation: the process by which sperm is donated and is then inseminated into the uterus.
- Egg donation: a process by which an egg donor undergoes and IVF cycle in order to obtain her eggs which are then donated.
- Embryo donation: a process where a fully developed embryo from another person in combination with donor sperm who underwent IVF is donated to another woman.
- Gestational surrogacy: the process where another woman will undergo an embryo transfer and carry the pregnancy for another person.
Infertility Treatment Risks
Any medical procedure has its risks.
- IVF: could possibly increase risks of premature delivery and low birth weight, miscarriage, egg retrieval procedure complications, birth defects among other things.
- Insemination risks: like IVF, insemination would also lead to low birth rate and premature birth, miscarriage. It could also lead to gestational diabetes.
- Gestational surrogacy: there are lots of emotional issues when it comes to surrogacy because the surrogate mother could form a strong connection with the baby while it is inside the womb and it could be hard to the surrogate mother when the time comes. Postpartum depression and even grieving are not uncommon.
Infertility Treatment Benefits
These forms of treatments have benefits, which are useful for women considering using an alternative method for getting pregnant. Benefits include:
- IVF: In vitro fertilization is not limited to just the mother, surrogates or gestational carriers are able to use it. You are also able to control over timing, for those who are career focused or may have a unique life situation which affects when they want their baby, they will find that IVF gives them a window of time to get pregnant.
- Insemination: since the sperm or egg is placed directly into the woman’s cervix, fallopian tubes, or uterus, it simply makes the trip shorter. Increasing your chances of getting pregnant.
- Gestational surrogacy: this form of treatment allows for those who struggle with infertility and LGBT couples to create a family. It is also likely to be successful due to a track record of carrying healthy pregnancies.
Tips on how to cope with infertility diagnosis
- Acknowledge your feelings: holding everything inside does not help. Seek a therapist.
- Practice relaxation: learning how to relax and calm yourself can help when feelings get intense during treatments.
- Talk to your partner: talk about your feelings together.
- Learn as much as you can: educate yourself about infertility, including alternatives like adopting etc.
- Don’t let infertility take over your life: make sure you fill your life and your relationship with other things.
Here is a video where Camille Preston speaks about the rollercoaster of dealing with infertility.
If you are having a hard time conceiving a child it’s important you visit your doctor before assuming anything. This is just a guide to infertility, however, each of our bodies is different. I hope you have learned something you didn’t know before! Feel free to leave a comment below!
WebMD. Infertility: Problems With the Man’s Reproductive System.
WebMD. Fertility Problems.
Mayo Clinic. Infertility.
Infertility. Retrieved from http://obgyn.ucla.edu/infertility
Harvard Health. The psychological impact of infertility and its treatments.
Jennifer is currently a senior at Mercy College from the state of New York, majoring in psychology with a minor in criminal justice. Jennifer is also an intern at a private practice in Midtown Manhattan. She aspires to be a clinical psychologist in the future working with inner city teens and adults who lack mental health resources. She also, enjoys learning anything and everything about human behavior.