Kate* and her husband Greg of Greenville, N.C. struggled to conceive for a year-and-a-half before making an appointment with an infertility specialist. Although both were young – she was 31 and he was 27 – and in good health, Kate struggled to quit smoking – a known risk factor for infertility and something she says she wasn’t ready to admit was likely affecting her ability to conceive. And although Greg’s sperm count and motility (the ability to move) were also ranked on the lowest end of average, their doctor wasn’t concerned.
Kate was prescribed the drug Clomid to stimulate ovulation, and she underwent three cycles of intrauterine insemination (IUI), and one cycle of IUI with injectable hormones, yet nothing worked. She convinced her doctor to ask her insurance company to approve her request to go ahead with in-vitro fertilization instead of going through two more rounds of IUI, and they agreed. Yet Kate’s doctor was only able to extract five eggs and on the day of the transfer, only one embryo was viable.
After her doctor told her that he rated her single embryo a two on a scale of one to ten, she refused to go through with the procedure but he convinced her to proceed anyway. She agreed but wasn’t hopeful that it would work. After she took the blood test to determine if the IVF was successful, she even told the doctor’s office to call Greg with the results so she wouldn’t be upset at work.
When Greg came home, Kate remembers that when he hugged her, she was convinced he was consoling her. Instead, he was congratulating her because she was indeed pregnant – and elated. “I was confident, I was happy, and I didn’t want to hold it in any more after so many people saying, ‘When are you going to have a baby?’ I wanted to scream at the top of my lungs, ‘I’m going to have a baby!’” And on Thanksgiving 2005, Kate gave birth to a healthy baby boy.
A Common Problem
Infertility is a common problem for couples looking to start families. About 6.1 million women ages 15-44 have difficulty getting pregnant or staying pregnant and more are turning to infertility specialists than ever before. According to a 2009 Centers for Disease Control and Prevention report, the number of deliveries using Assistive Reproductive Technologies (ART), like IVF, nearly doubled from 2000 to 2009.
It is important to note, however, that although ART has increased, fewer than three percent of women actually need IVF. So why is it the first thing we think when we hear the term “infertility?” “Maybe because it’s sexier to talk about,” suggests Erika Johnston-MacAnanny, a reproductive endocrinologist and an assistant professor of reproductive medicine at Wake Forest Baptist Medical Center in Winston-Salem, N.C. Johnston-MacAnanny says that because IVF became available only within the last 35 years and is often linked to the controversy surrounding stem cell research, we hear about it more often than other procedures that can be just as effective.
The Culprits
There are several risk factors that can affect a woman or man’s fertility, like age, weight, health conditions, as well as smoking and alcohol use. Yet this recent surge in assistive reproductive technologies can be attributed to some major trends.
As women continue to pursue advanced degrees and focus on their careers, starting a family is often put on the backburner. According to the American Society for Reproductive Medicine, about 20 percent of women wait until they’re 35 to start having children. Yet as eggs start to age during the late 20’s and early 30’s, infertility becomes a problem, particularly after age 35.
“The biology is cruel,” said Dr. John Buster, a reproductive endocrinologist and associate director of the Center for Reproduction and Infertility at Women and Infants Hospital of Rhode Island. Buster, who directed the team that conducted the first embryo transfer in 1983, says women in this age group also tend to develop problems like fibroid tumors and endometriosis, which further impacts fertility. More women are also being diagnosed with STD’s like chlamydia and gonorrhea—two diseases that can cause significant damage to the fallopian tubes or even block them completely.
A Woman’s Problem?
Although infertility is typically thought to be only a woman’s problem, only one third of cases are due to women’s problems. One third of problems are due to men, and the final third is a result of both partners or simply unexplained. Some experts suggest that because men are being exposed to unidentified environmental pollutants, they develop elevated levels of estrogen and in turn, infertility. “Fertility in and of itself is a taboo topic for couples,” said Johnston-MacAnanny, who says that although our society doesn’t openly discuss infertility, women are more likely than men to confide in their friends.
*Names have been changed
Julie Revelant is a freelance writer specializing in parenting, health, and women's issues and a mom. Learn more about Julie at revelantwriting.com
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