It's one of those big, ugly words that you don't know much about, and you hope you never have to find out.
Then if it does happen to you, you're suddenly thrust into a world with way too much information.
The worst part? Most of your family and friends are still in the don't-know-much-about-it camp and it's hard for them to relate or understand.
I put together this very basic guide to help give you an idea of what the infertility world is like. If you're starting to think that you may be having fertility struggles or if you have a loved one who is currently suffering from infertility and you just want some information to help you understand, I hope this helps.
This information is compiled from the following websites (plus a little touch of my own personal experience): Coastal Fertility Specialists, Resolve: The National Infertility Association, and the American Pregnancy Association.
What is infertility?
Infertility is a disease which causes an inability to conceive a viable pregnancy after 12 months of regular, unprotected sex. This can also include the ability to achieve pregnancy but suffering from recurrent miscarriages.
This disease affects 1 in 8 couples, so there's a good chance you know someone who suffers from infertility - even if you're not aware of it.
There are also families who suffer from secondary infertility. In this case, the couple is suffering from infertility after successfully conceiving previous children without medical assistance.
What causes infertility?
Infertility can be caused by a wide range of underlying issues from physical problems to hormonal irregularities. It can be caused by issues with either the female partner or the male partner or a combination of both.
For men, there's really only one thing that needs to be checked: the sperm. There are 3 characteristics of semen that are checked when a couple is facing fertility challenges -
1. Sperm Count: Are there enough swimmers?
2. Sperm Motility: Do they swim and function correctly in a healthy/normal way?
3. Sperm Morphology: Are they shaped correctly or are there abnormalities/deformities?
For women, fertility challenges can be more complicated. There are several different checkpoints in the reproductive system where things could go wrong. The uterus, fallopian tubes, and ovaries all have specific parts to play in the reproductive process - not to mention the hormones that keep it all working.
This is just a short sampling of the possible causes for female infertility: Polycystic Ovarian Syndrome (PCOS), Endometriosis, uterine abnormalities, fibroid tumors, luteal phase defect, ovulatory disorders caused by hormone problems, premature ovarian failure, a blockage in the fallopian tubes, etc.
When should you consider seeking medical help?
There are some symptoms and conditions that may warrant medical help sooner, but the general rule is:
If you are under the age of 35 and have been having regular, unprotected sex for at least 1 year without successfully conceiving,
If you are over the age of 35 and have been having regular, unprotected sex for at least 6 months without successfully conceiving, you may want to speak to your OBGYN.
The first step is usually the OBGYN. He or she can often run some preliminary tests to rule out any obvious issues and can sometimes treat more minor causes of infertility. If your condition requires further assistance, you will be referred to a fertility specialist.
What is a fertility specialist?
A fertility specialist is a Reproductive Endocrinologist (RE).
REs are experts in the field of infertility. Just like any other field of medicine, different doctors will have different approaches and treatment plans. You will want to find the RE that you feel most comfortable with.
Don't be afraid to ask questions. Ask about success rates and treatment options. Ask about the embryologists, ultrasound techs, and other medical professionals involved in the process. Ask about ANY concerns you have. This is a huge decision and not one you should take lightly.
What can you expect when you first visit a fertility specialist?
Your first visit will likely be information overload. Bring something to take notes and a list of questions you might have.
You'll go over your medical history and the events that led you to the fertility specialist's office in the first place. They may have further questions about other medical events, like thyroid problems, that could be related.
The doctor should go over all of the tests you will need and the possible treatment plans. You may also meet with the financial advisor in the office who will go over typical treatment costs as well as any possible insurance coverage and financing options.
What treatment options are available?
Treatment will be entirely dependent on what is causing the infertility in the first place.
Many people have heard of in vitro fertilization (IVF) where sperm and eggs are retrieved and embryos are created in a lab before being transferred back to the mother's uterus, but they may not know that there is a whole battery of other treatment options depending on the situation.
There are surgeries available that can correct uterine abnormalities. Medicines can be used to treat hormone issues or some ovulation disorders.
A procedure called intrauterine insemination (IUI) is sometimes used where sperm is taken from the father and injected directly into the uterus of the mother, who has sometimes been given medication to induce ovulation when necessary.
The most invasive and most expensive treatment is the one most people have heard about. IVF is a long process of hormones, egg retrievals, and sperm samples followed by creating embryos. Then if all of that is successful, the mother has to prepare her body with hormones for the implantation of the embryo.
There are some diagnoses that require skipping straight to IVF, but often couples who are going through IVF have tried other treatment options first.
This information is just a very small glimpse into the world of infertility. The truth is every case is different because every couple facing infertility has their own unique combination of medical causes. Some couples will respond well to less invasive treatments and conceive quickly with treatment. Others will go through years of different treatments before finally finding something that works.
If someone you love has trusted you enough to share their plans to seek fertility treatment, the most important thing to know is that they have likely already been through a lot of frustration and disappointment and heartbreak before coming to this point. You may only see this one part of their story that they are sharing. You may not know everything that has been going on under the surface.
A little bit of grace and a lot of love and support go a long way.
If you are in the beginning of your infertility journey and have any questions, please reach out. I would be happy to answer any questions I can or tell you the best person to ask if I can't!