© andriano_cz / Adobe StockThe prevalence of infertility
Infertility is usually defined as not being able to get pregnant after one year of trying. It also refers to women who are able to become pregnant, but struggle to carry their pregnancy to term. Six million women are diagnosed with fertility troubles each year in the U.S., which equates to roughly 10 percent of women ages 15 to 44.Moreover, around 1 in 8 couples deal with infertility on their way to becoming a family. It’s a common problem, but it’s often kept quiet, as many couples feel shame, fear, or judgment around the issue.
© Prostock-studio / Adobe StockOverall, Western culture is becoming more open to discussing infertility. Maybe you’ve seen it addressed on TV shows like This is Us, Parenthood, or Friends. Maybe you’ve heard about the infertility journeys of celebrities like Kim Kardashian, Emma Thompson, and Gabrielle Union. Or, maybe you saw a friend post “I am 1 in 8” on social media. Though it’s not as taboo as it once was, it still can be difficult to know how to discuss such a personal issue.
Infertility Awareness Month is meant to help others see the wide reach of this disease and to give those struggling with it a way to start conversations with friends, family, and other loved ones.
Not just a woman's issue
Though people tend to think of infertility as a woman’s struggle, its causes are split equally between women and men. A third of infertility cases are caused by female reproductive issues, another third by male reproductive issues, and the remaining third by a combination of male and female or unknown issues.Male infertility issues tend to be a bit more straightforward; they’re usually caused by low sperm production, slow sperm movement, or variant sperm shape. Female infertility problems, on the other hand, can be very complex. Because many different organs and systems need to work together to produce a viable pregnancy, just one irregularity may prevent fertility.
Checking out the organs
Doctors will often check a woman’s uterus and fallopian tubes first to see if any tumors, polyps, or scars are present. The fallopian tubes can also be damaged in some way. The roles they play in fertilization are vital: Think of them not only as the intersection where the sperm and egg have their “meet-cute,” but also the romantic bistro where the relationship incubates and, finally, the minivan that carries the fertilized egg to its new home: 1000 Uterus Place.Unfortunately, fallopian tubes can swell, dilate, or even burst. If there’s anything wrong with them, it’s likely the woman will need to look into in-vitro fertilization (IVF) to get pregnant.
Parsing PCOS
Another common cause of infertility in females is polycystic ovary syndrome (PCOS). It’s unknown what causes this mysterious syndrome, but it’s quite prevalent, affecting 1 in 10 women of childbearing age. PCOS can manifest in myriad ways. Women with PCOS may experience irregular periods, excessive hair growth on their face, chest, or thighs, or male-pattern baldness on their head.Often, women with PCOS will develop multiple cysts on their ovaries (sometimes referred to as a pearl necklace — because of the appearance of the “chain” of circular cysts on ultrasounds). However, the presence of cysts isn’t necessary for a PCOS diagnosis. Doctors may also measure hormone levels, such as insulin, androgens, and progesterone.
Since PCOS interferes with ovulation (that interference is what can cause irregular periods), women with PCOS may have trouble growing the follicles that produce an egg to full maturity, and thus, have issues becoming pregnant. Thankfully, there are fertility medications that can aid ovulation, such as Clomid and Letrozole. If all else fails, IVF is another option for women with PCOS.
'Outside' fertilization (aka in vitro)
You’ve probably heard of in vitro fertilization (IVF) before, but what does it actually mean? In vitro is a Latin term that literally translates to "in glass." This refers to a glass test tube or petri dish where a doctor or scientist observes or performs an experiment. In contrast, in vivo is a Latin term that translates to "in the living." So, when something happens in vitro, it happens outside of a living organism.
© Hans Reniers / UnsplashBut to get to that “outside” fertilization, a lot of stuff needs to happen inside first. An IVF treatment cycle involves different courses of drugs and hormones meant to stimulate egg production and egg maturation. If the drugs work as planned, an egg collection and sperm collection are scheduled, and an embryologist will put the egg together with the sperm (this is the in vitro part). If this is successful, the egg fertilizes, and an embryo begins to form. A few days later, this embryo is placed in the uterus, and a pregnancy test is performed after a few weeks to see if the implantation worked.
Sadly, it often takes many cycles of treatment for IVF to be successful, and each procedure can be very expensive, time-consuming, and stressful. However, there are things people wanting to start a family can do to help. Explore this IVF cheat sheet to discover ways to improve chances at IVF success, learn common abbreviations and procedure names, and view ways to keep high spirits on this journey.
Infertility support
Whether those struggling with infertility are in and out of doctors’ offices, calculating an ovulation window, or trying to discreetly inject themselves with hormones in public, it’s easy to feel alone when undergoing infertility treatments. But there are organizations that exist to help women and families on this journey:- RESOLVE: The National Infertility Association exists to help all people on a family-building journey find knowledge, community, advocacy, and eventually, resolution. In addition to providing important facts about infertility, RESOLVE also helps connect people with medical professionals and support groups.
- Fertility Out Loud helps people struggling with infertility to understand cryptic insurance policies, learn how to reply to insensitive comments (like “Your clock is ticking! Better hurry up!”), and connect and share stories on social media platforms.
- Rescripted is an online community for those trying to conceive (TTC) founded by two women who underwent their own IVF journeys. Aside from articles and support stories, this site also has videos on how to perform common hormonal injections and a digital pharmacy where users can search for inexpensive fertility medications.