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Conquering InfertilityBy: Some people take their fertility for granted, but getting pregnant isn’t as easy as you might expect. For a couple between the ages of 29 and 33 with no fertility problems, there is a 20 percent to 25 percent chance of pregnancy in a given month, according to the National Women’s Health Resource Center. Conception is largely a matter of good timing. After an egg is released from the ovaries, it can survive for up to 24 hours. If it doesn’t become fertilized during that time, the couple must wait a month for another egg to be released.
When to See a Doctor Fertility problems only become apparent after a couple attempts to conceive for several months to a year. According to Dr. David Sable, the director of the division of reproductive endocrinology at Saint Barnabas Medical Center in Livingston, New Jersey, the first factor to consider is the age of the woman. If she is over age 35, she should see a doctor about infertility after six months of unprotected intercourse. A woman under age 35 with no known fertility problems should see a doctor after trying to get pregnant for at least six months to a year.
If the woman is over 40, the couple should see a reproductive endocrinologist as soon as they can because the potential for the doctor to improve the woman’s fertility begins to decrease at this age. Since a woman is born with all of the eggs she will ever have, by the time she reaches her late 30s or 40s many of her eggs have become less viable.
Finding a Doctor You Can Trust
The Root of the Problem Problems with fertility are not always easily explained, as they may stem from more than one source. About one third of all infertility cases are due to a combination of problems with both partners, according to the National Women’s Health Resource Center. To complicate things more, roughly another five percent of infertility cases remain unexplained, as was the case with Lisa French. According to Dr. Sable, problems with unexplained infertility are really more common than the statistics may suggest. He believes that most fertility problems are due to a combination of issues with both partners, even though some problems can be traced to a specific anatomical abnormality. The source of Lisa’s infertility was never determined with any degree of certainty. After a laparoscopy, a procedure that involves inserting a tiny scope into the abdomen to determine the condition of the reproductive tract, mild endometriosis was diagnosed. The exam also revealed several ovarian cysts, which could have played an additional role in her infertility, and Lisa had a prolonged blood clotting time, which might explain the recurrent miscarriages.
Like Lisa, many women who experience fertility problems do eventually conceive, but it can be a rocky road to pregnancy. After realizing there may be a problem, Lisa’s first stop was her Ob/Gyn. But when the initial tactics suggested by this physician didn’t help, she turned to a reproductive endocrinologist. Although 85 to 90 percent of all fertility problems are solved with medication or surgery, the French family is part of the five percent of couples who turned to assisted reproductive technologies (ART), and in vitro fertilization (IVF). After trying intrauterine insemination (IUI) several times, Lisa and her husband decided to try IVF. In vitro fertilization involves stimulating the ovaries to release eggs and then retrieving those eggs from the woman’s body via the vagina. The eggs are then fertilized outside the woman’s body in a petri dish. Once successfully fertilized, the eggs are placed in the woman’s uterus. In order to undergo ART, the woman’s eggs must be viable. As women age, egg viability decreases, which forces many women over age 40 to use eggs donated by other women rather than their own, according to the National Women’s Health Resource Center. The French family had a negative experience with their first reproductive endocrinologist, and the first stage of IVF yielded no eggs. This disappointment had the French family ready to give up on biological parenthood. But, a miscarriage a few years ago reinvigorated their quest for children and they decided to try again before it was “too late.” They began the IVF process again with a different physician. At age 38, Lisa found success and gave birth to healthy twins.
For Lisa, joining online communities provided a great source of comfort. Lisa didn’t know anyone who could relate to what she was going through and she wanted to find someone to talk to. She was able to get the support that she longed for in chat rooms and on message boards. Individuals dealing with fertility issues need to educate themselves about their condition. Some doctors are too busy to give patients all of the necessary information and some patients don’t know which questions to ask. By doing research online and connecting with individuals who are currently going through similar treatments, Lisa was able to learn many things that her doctors never told her. Dr. Sable agrees that patients should do their own research. He acknowledges that even in his own practice it can be difficult to give each patient the amount of information that they desire and deserve. Dr. Sable created a web site for his patients containing in-depth fertility articles, which he has written. He hopes that the web site will answer any questions that may pop up after office visits.
For more information: National Women’s Health Resource Center The CDC’s stats on infertility centers The American Infertility Association Resolve, The National Infertility Association The American College of Obstetricians and Gynecologists
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