June marks Infertility Awareness Month, a time dedicated to shedding light on the challenges faced by those struggling to conceive and the importance of offering support and understanding.
Infertility affects a significant number of couples around the world, including many in New Zealand. Despite its prevalence, infertility remains surrounded by misconceptions and emotional challenges.
This blog aims to provide a comprehensive understanding of infertility, debunk common myths, and offer ways to support those on this journey. This discussion is particularly relevant as advancements in treatments like in vitro fertilisations (IVFs) offer hope, but also come with their own set of challenges and misconceptions.
What are the Causes of Infertility?
Infertility can arise from issues in either partner or both. It encompasses both "primary infertility," where someone has never been pregnant, and "secondary infertility," where a couple cannot conceive after previously having a child. Approximately 1 in 4 New Zealanders experience infertility and 1 in 8 require some form of medical assistance to achieve pregnancy, according to Healthify.
In Men
Fertility problems in men can result from various factors affecting sperm quality and function:
- Sperm Issues: Low or absent sperm count, or abnormal sperm movement or shape.
- Testicular Damage: Can occur due to infections, testicular cancer, surgery, injury, or undescended testes.
- Medical Conditions: Conditions like flu or COVID-19 can temporarily impair sperm quality.
- Substance Use: Cigarette smoking, anabolic steroids, chemotherapy, and illegal drugs like marijuana and cocaine reduce sperm quality.
- Anatomical Problems: Issues such as the absence of the vas deferens or varicocele (enlarged veins in the scrotum).
- Ejaculation Problems: Including those caused by certain medications.
In Women
Fertility problems in women often stem from issues with ovulation or damage to the fallopian tubes:
- Ovulatory Problems: Conditions like polycystic ovarian syndrome (PCOS) or premature ovarian failure.
- Tubal Damage: Often due to pelvic infections such as chlamydia, or conditions like endometriosis.
- Fibroids: Non-cancerous growths in the uterus can contribute to infertility.
- Medications: Some chemotherapy drugs and antipsychotic medications can impact ovulation.
How to Increase Fertility
There are lifestyle changes that can help increase fertility for both men and women:
- Regular Sex: Have intercourse every 2-3 days leading up to ovulation.
- Avoid Smoking: Smoking reduces fertility in both genders.
- Limit Alcohol and Caffeine: Excessive consumption can affect fertility.
- Healthy Weight: Maintain a BMI between 18.5 and 25.
- Avoid Illicit Drugs: Drugs like marijuana and cocaine can reduce fertility.
When to See a Doctor
You should consult a doctor if you haven’t become pregnant after 12 months of trying (6 months if over 35 years old) or if you have conditions such as PCOS, endometriosis, or irregular periods. Men should see a doctor if they have had previous surgery on the testes or other fertility-impacting conditions.
Infertility Testing
For Men:
- Semen Analysis: Checks for sperm count and quality.
For Women:
- Hormone Testing: Includes FSH, oestradiol, progesterone, and prolactin levels.
- AMH Test: Predicts ovarian response to IVF.
- Tubal Patency Tests: Such as Hysterosalpingo-Contrast Sonography (HyCoSy) and laparoscopy.
Treatments for Infertility
Various treatments are available, depending on the cause:
- Medication: To improve ovulation, such as clomifene or letrozole.
- Surgery: To address anatomical issues like endometriosis or fibroids.
- Insemination: Using partner's or donor sperm (IUI).
- IVFs and ICSI: In vitro fertilisations and intracytoplasmic sperm injection.
Emotional Impact and Support
Infertility is not just a physical condition but also an emotional one, often leading to stress, grief, and a sense of isolation. It is crucial to provide emotional support through:
- Listening and Validating Feelings: Be empathetic and understanding.
- Avoiding Unsolicited Advice: Respect their experience and offer support without giving unhelpful advice.
- Respecting Privacy: Understand that not everyone is comfortable discussing their infertility.
- Providing Practical Help: Assist with daily tasks and accompany them to appointments.
- Encouraging Professional Support: Suggest counseling or support groups.
Fertility Myths Debunked
- Myth: Stress causes infertility. Reality: While stress can impact health, infertility is a medical condition that often requires treatment.
- Myth: Relaxing or going on holiday will solve infertility problems. Reality: Infertility typically has a medical cause that relaxation alone cannot resolve.
- Myth: Adoption increases chances of conceiving. Reality: There is no evidence that adoption affects pregnancy chances.
Infertility is a complex condition that requires understanding and support. By debunking myths and providing accurate information, we can create a more supportive environment for those facing infertility. Recognising the emotional and physical challenges involved is crucial in offering meaningful support and compassion. This Infertility Awareness Month, let's commit to being informed, empathetic, and supportive.