The Sensitive Topic: Infertility

Infertility is a sensitive topic that most couples experience in their everyday lives. When someone cannot seem to get pregnant, even after trying for 6 months to a year, they are infertile, or unable to successfully conceive a baby. Woman unable to stay pregnant can be considered infertile as well. It is a common problem that not only affects women, but also men. Infertility in both genders can be caused by several things that are harmful to sperm and egg fertilization. The inability to get pregnant can lead to psychological, social, moral, and ethical issues that can cause a family pain if not addressed.

Being infertile means that a couple is unable to get or stay pregnant. According to the CDC, about 10 percent of women in the U.S. between the ages of 15-44 have trouble conceiving or keeping a baby. Pregnancy involves many processes – ovulation, fertilization, implantation. Most cases of female infertility occur during the ovulation phase; eggs can have an inability to travel down the fallopian tube into the uterus. This prevents the whole process of fertilization in which the sperm and the egg produce a fertilized ovum. The most common cause of ovulation problems and infertility in women is polycystic ovarian syndrome (PCOS). PCOS is a hormonal disorder causing large ovaries with small cysts on the outer edges. Primary ovarian insufficiency (POI) can be another cause for women over the age of 40. Lesser common causes are blocked fallopian tubes caused by pelvic inflammatory disease, endometriosis, or ectopic pregnancy surgery, physical problems with the uterus, and uterine fibroids. There are other factors that increase a woman’s risk of infertility like age, drug or alcohol use, stress, body weight, poor diet, athletic training, STIs, etc. Age is the most important factor that contributes to this risk. With the increasing number of women waiting until their 30s or 40s to have a child, this is has become a growing cause of infertility. Over time a woman’s ovaries become less able to release eggs, her egg count decreases, the health of the eggs deteriorate, and she is more likely to have a miscarriage. Tests that can be performed on women to conclude if they are infertile or not are hysterosalpingography and laparoscopy. However, the problem can sometimes take many tests to figure out. With the help of surgery and medicine, infertility in women can sometimes be treated. Artificial insemination is a treatment most commonly practiced; it involves a woman being injected with specially prepared sperm. Medicines for other treatments include: clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), Gonadotropin-releasing hormone (GnRH), metformin, bromocriptine.

Men can also be infertile when trying to get a woman pregnant. It is estimated that one-third of infertility issues are because of the man. A man’s infertility can be caused by a problem called varicocele, which can heat the sperm cells above what they can handle. It can also be caused by factors that make sperm production too low and movement of sperm. Sometimes a man can be born problems having to do with his sperm or he can develop them later in life, such as cystic fibrosis. These problems are checked by the testing of semen, with doctors looking at the number, shape, and movement of the sperm. Like women, there are factors that increase the risk of a man’s infertility as well. These factors are drug and alcohol use, age, environmental toxins, health problems, medicines, and treatments for cancers. A man’s infertility in most cases are treated with drugs or surgery.

Dealing with infertility can be an emotional rollercoaster for most couples, causing several psychological problems. So much that most say that the problem of infertility was the most upsetting experience of their lives. Studies show that women who have this problem are just as depressed as people diagnosed with cancer, hypertension, or recovering from a heart attack. This proves the theory that psychological distress appears most prevalent in the partner with the issue. While age seems to the most important risk of infertility, there are many reasons why some modern couples don’t have children right away. They often express need to find stability in their life and career. Some couples seem to have to choose between starting a family and pursuing their careers, usually going with the latter. However, with age-related increase in infertility can mean that wanting to have kids can take a toll on a women’s body, causing physical stress for both the mother and baby.

In addition to psychological issues, infertile couples can experience social ones as well. They can feel as if they do not relate to the fertile world due to lack of empathy from family and friends in their time of despair. In some countries, being fertile and being able to have children is assurance of survival in it’s economy. So, infertility is looked down upon because it shows the opposite; those people are seen defective or incompetent. Infertile women describe social settings as one of the most difficult parts of their issues. They can sometimes develop a jealousy or envy towards women who have children or are expecting. According to a report by the world Health Organization, some childless women choose suicide over trying to cope or deal with the issues at hand.

Women and men can use different strategies to cope with the problem of infertility. Because it is the job of a women’s reproductive system to conceive a baby, the resulting distress that they feel when conception does not occur is greater than that of male. Her self-esteem can lower, or she can feel a sense of ‘failure’ not being able to carry a baby. Most infertile women who have used any form of contraceptives in the past can feel as though they are being punished because of this usage. They can be prone to become obsessive with achieving conception, putting their life and career on hold in most cases. In treating infertility, women are almost always the partners who undergoes fertility treatments regardless of who the fertility impairment lies with.

Men tend to experience damage to their self-esteem, feeling responsible for not being able to help their wives have a child. Unlike women, research on U.S. shows that men use fewer coping strategies. They deal with the issues by getting themselves more involved in their work or other activities. They find the transition to having a lifestyle with no children easier than their wives. However, they are more likely to hide any emotions to show their wives support during a hard time which leads to an underrepresentation of actual levels of infertility distress in men. Furthermore, some men experience doubt in their sexual performance and can show episodes of impotence.

A couple’s moral and/or ethical issues can come into full circle when faced with infertility treatments, especially bringing a third party or surrogate into the reproductive process. Cost of these treatments can also bring on stress to the already distressed couple. Since most of the treatments tend to be expensive, it can put a strain on their finances. Stress can also influence these infertility treatments. The level of distress in infertility patients tends to increase throughout the duration of the treatments. For example, many In Vitro Fertilization (IVF) patients report feelings of depression prior to starting the treatments. They express a stress of psychological background rather than physical regarding their IVF treatments. When treatments fail, it is not rare for IVF patients to express depression, anger, anxiety, and isolation symptoms. 

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