The bittersweet joy of yet another friend announcing “We’re expecting!” on Facebook, Instagram, or Twitter can send a couple struggling with infertility into a downward spiral of despair. In the midst of the challenges of infertility, it can often seem like the joy of new children is all around, blessing everyone else. Yet according to the Mayo Clinic, infertility, defined clinically as the inability to conceive after six months to a year of frequent and unprotected sex, affects 10-15% of couples in the United States. If you’re worried that you and your partner might be experiencing the difficulties of infertility, know that you are not alone. There are places to turn to for help, and most importantly, there is hope.
By Grace J. Humbles
When to see a Doctor
The Mayo Clinic reports that around 90% of couples get pregnant “after 12 months of frequent unprotected intercourse.” According to the U.S. Department of Health & Human Services Office of Women’s Health, women under age 35 should see a doctor after a year of trying to get pregnant. For women over 35, it would be useful to see a doctor after six months of trying to conceive. Although the absence of conception is the most common reason for seeking medical care, there are other factors that can signal it may be time to talk to your doctor.
Additional Risk Factors in Women
According to the Mayo Clinic, it may be time to see your doctor if you are attempting to conceive and are over age 40, have an irregular menstrual cycle, have had more than one miscarriage, are currently diagnosed with endometriosis or pelvic inflammatory disease, or have been treated for cancer. While none of these symptoms necessarily preclude pregnancy, they may be early indicators of problems with fertility.
Additional Risk Factors in Men
The Mayo Clinic goes on to recommend a man visit a doctor for an evaluation if he knows he may have problems with his sperm, has experienced swelling in his scrotum, has been previously treated for cancer, has had a vasectomy or a scrotal or inguinal surgery, is experiencing difficulties performing sexually, or has noticed a decrease in libido.
If you or your partner is concerned that you may have problems with infertility, do not hesitate to ask your doctor about options for testing. Your doctor may refer you to a specialist, give you a diagnosis, and help you begin to understand your options.
Hope Through Treatment
A diagnosis of any kind of infertility can leave partners devastated. As you allow yourself to emotionally come to terms with a diagnosis, it’s important to remember that there is often a light at the end of the dark tunnel of infertility – there is hope to be found in many possible treatments and procedures.
It’s important to remember that each form of treatment will come with both physical and psychological side effects, unique costs, and time commitments. When discussing options with your doctor, specialist, and partner, it’s important to thoughtfully consider the many facets of each treatment option before making a concrete decision. Continue reading to learn more about the options available if you and your partner struggle with infertility.
Understanding Success Rates
According to Dr. Barry Donesky, a specialist double board-certified in infertility and OB-GYN at Fertility Center, women 37 and under who undergo some form of assisted reproductive technology have, on average, a 50 to 60% chance of pregnancy. As a woman ages, this success rate declines, dropping to 30% for women ages 37 to 39 to 20 to 25% for women over 40.
However, these success rates can look much higher under certain circumstances. “For women who don’t have as many normal embryos the traditional way of doing IVF doesn’t work as well, but if they are willing to test the embryos genetically before
we put them in, pregnancy rates can be much higher than we are quoting,” says Dr. Donesky.
“Additionally, we can get up to 70% pregnancy rates if someone is willing to use donor eggs,” he adds. “As women age the issue is virtually never the uterus. It’s the eggs.”
Treatments & Procedures: Breaking it Down
As you meet with your doctor and a fertility specialist, you and your partner will most likely work out a treatment plan that may include one, two, or a combination of treatments and procedures. Descriptions of the following treatments and procedures from the Mayo Clinic may give you insight into a possible path.
Fertility Drugs – One of the most common causes of infertility is a woman’s inability to properly ovulate. Fertility drugs – which may include injected drugs or drugs in pill form – help induce ovulation and regulate a woman’s ovulation cycle.
Intrauterine Insemination (IUI) – This treatment involves both female and male partners (or donors). During an IUI, previously collected healthy sperm are placed into the woman’s uterus during ovulation.
Donor Sperm – If the cause of your infertility is found in a man’s sperm, there are options to procure sperm from a donor. Sperm donors may be either anonymous or from a known source.
Donor Eggs or Embryos – Similar to donor sperm, there are times when donor eggs or fertilized embryos may be used and implanted in the uterus. Again, these may be from a known or anonymous source.
In Vitro Fertilization (IVF) – One of the most well-known fertility procedures, IVF involves the fertilization of collected eggs and sperm in a lab and the implantation of embryos into a woman’s uterus.
Intracytoplasmic Sperm Injection (ICSI) – If it has been determined that a male partner’s sperm may be a cause of infertility, ICSI will inject a single healthy sperm into an egg.
Surrogacy – For women whose uterus is compromised or when a pregnancy may bring a risk to a woman’s health, a surrogate can carry the eggs and sperm of partners through IVF. Surrogates may also carry an embryo that includes donated eggs or sperm (or both).
Reproductive Surgery – A number of surgeries may improve a couple’s fertility. Your doctor or specialist can let you know if you are a good candidate for a reproductive surgery. Often women who have anatomical abnormalities and/or intrauterine scarring may be helped through surgery.
Gamete Intrafallopian Transfer (GIFT) – Similar to IVF, sperm and egg are collected and are brought to a lab. However, they are placed in the woman’s fallopian tubes before fertilization.
Zygote Intrafallopian Transfer (ZIFT) – Similar to both IVF and GIFT, an embryo fertilized in a lab is placed into a woman’s fallopian tube.
Ways to Cope & Maintain Hope
Thinking through the many facets of infertility can be overwhelming. According to Dr. Jessica Scotchie, a specialist double board-certified in infertility and OB-GYN at Tennessee Reproductive Medicine, infertility has a high association with depression and anxiety. “The fear of not realizing a long standing dream of becoming a parent can be paralyzing and significantly impair a person’s psychological well being,”
Dr. Scotchie says. Equally as overwhelming are the many possible treatments and procedures one might go through while looking for a solution.
As you take steps to cope with the stress of infertility, it is also important to find ways to confront your emotions. “Women and men struggle with feelings of inadequacy and guilt, and may have uncomfortable feelings of envy or resentment toward friends and relatives who are pregnant or have children,” Dr. Scotchie says. The Mayo Clinic suggests a variety of things that can help with these feelings, such as sharing your emotions with your partner, taking care to keep your support system close, and continuing to make healthy lifestyle choices in regards to sleeping, eating, and exercise. These simple measures can help you cope with the stress of infertility.
There is a deep and incredible pain that often accompanies infertility. But remember that there are an immense number of resources, friends, and medical professionals ready and willing to walk alongside you through that pain and onto the path of hope.