Affording IVF

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How to deal with infertility on Valentines Day

This sappy image could be your wallpaper, all you have to do is click on the picture..
This sappy image could be your wallpaper, all you have to do is click on the picture..

Infertility has a way of taking the romance, and fun out your most intimate moments. Sex can quickly become just a means to an end, and if you have been trying for while, a forced reminder of your difficulties or even your perceived failings. Things like tracking ovulation cycles, or, if you have been seeing a specialist, injections, blood draws and lot of poking and prodding just doesn’t do much in the romance aspect for most people. Don’t even get me started on the stress of infertility… Let’s be frank, fertility woes can add bucket loads of tension to the healthiest of relationships.

When you are dealing with infertility it is easy to lose your perspective. You can get so caught up in the process of timed intercourse, medications, and treatments that you can forget the most important thing. Your relationship with your partner. Whatever happens with your fertility journey it is important that you don’t forget to put the time and energy in to keeping your loving relationship going. With Valentines Day just around the corner, this makes it a perfect time to strengthen your relationship.

Love it or hate it, Valentines Day is coming up once again (hint.. it is this Thursday). I know it has become hyper-commercialized with sappy cards, jewelry adverts.. the list goes on. Many of us (myself included) would rather ignore the hype. No matter what your thoughts are, the core idea of Vday is a great one. It is supposed to be a day where you make that extra effort to make sure your partner, boyfriend/girlfriend, etc, feel special and loved. An idea anyone can get behind.

Regardless of your thoughts about Valentines Day, you should take the time this year to make your partner feel loved. If you are fighting with infertility, my advice is to take the day off (or maybe a day this weekend) from all the infertility stuff and focus on each other. No matter what you consider a good time, be it a nice walk together, a movie, or maybe a nice dinner out, make sure you do something together. Just spend time with your partner and reconnect. Whatever you do, make sure you finish the day in bed… without any thoughts of conception!

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What are some common causes of infertility?

Infertility can be cased by many things
Knowing the cause of your infertility can help reduce the stress and empower you to solve/treat the problem
Infertility refers to an inability to conceive a child despite unprotected intercourse for a period of at least 12 months. Infertility is a frequently reported issue that may be associated with trivial lifestyle or dietary irregularities requiring modifications or it may also be associated with strong medical, hormonal or surgical abnormalities that require treatment. It is very important to understand the primary cause of infertility in order to know the proper way to treat the root cause. Infertility can expensive enough without wasting time and money on improper treatments.

Why is it important to know the cause(s) of infertility?

It is very important to know the nature and severity of defect that is interfering with conception in order to manage or treat infertility effectively. Moreover, your choices of fertility treatment depend on the cause of infertility. With advancing age, hormonal and structural changes in the female body affect the ability of a woman to become pregnant. However, having difficulty in conception is different from being infertile. Similarly, as opposed to popular misconception, men can also be the cause of infertility. According to research statistics, men are responsible for almost 40% cases of infertility.

Some of the main causes of infertility in women include:

  • Hormonal irregularities: In order to get pregnant, it is very important to have normal concentration of all the hormones in the body. Abnormalities of hormones like thyroid hormone, prolactin hormone, estrogen or progesterone defects, Cushing syndrome, uncontrolled diabetes and systemic medical problems like kidney and liver may affect the ability of women to become pregnant
  • Long standing pelvic infections: Egg is released into fallopian tubes each month on 14th day of ovarian cycle and if intercourse is performed while egg is still in fallopian tubes, the chances of conception are very high; however, in cases of long standing pelvic infections, pelvic surgeries and untreated sexually transmitted infections, the chances of tubal scarring is very high that prolong the conduit of sperm for fertilization. Other conditions include abdominal surgery or pelvic surgery.
  • Structural abnormalities of female genital tract: In some cases, genetical or acquired abnormalities of female genital tract like bicornuate uterus, bifid uterus, history of uterine fibroids, cystic ovarian masses and other abnormalities can also lead to infertility.
  • Nutritional defects: Dietary irregularities deficiencies or nutritional is one of the most popular cause of infertility in women that is mostly overlooked. Obesity (having a BMI of more than 30) is a risk factor for infertility that leads to hormonal aberrations that may become a cause of infertility. Same is true for anorexic and underweight women

What are some of the main causes of male infertility?

Male infertility refers to abnormalities in the sperm count, morphology or motility that impairs the ability of the sperm to reach the Fallopian tubes or it’s ability to successfully fertilize an egg. Defects of the male genital tract include:

  • Recurrent infection of the male genital organs including the epididymis, vas deferens, testicles or glands
  • History of trauma or surgery involving male the genital tract
  • Exposure to radiation, X-rays, environmental or occupational toxins likes pesticides, fertilizers and other industrial toxins.
  • Physical damage caused by cancer, uncontrolled medical illnesses like diabetes, uremia or abnormalities of the endocrine glands that are responsible for release of hormones necessary for reproduction.
  • Genetic or acquired defects like undescended testicles, obesity, or penile issues may lead to infertility in men.
  • Altered biochemical environment of the body that alters the secretion of seminal glands or prostate gland or affects the metabolic activity of the sperm also causes infertility and includes excessive alcohol intake, tobacco or illicit drug consumption and intravenous drug abuse.

Speak to your healthcare provider if you are having difficulty in getting pregnant or impregnating your partner for early detection and timely treatment.

Cheers!

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Available treatments of Infertility

infertility doctor
There are a wide range of treatments available to help couples concieve

I want to start off with a hypothetical story about a Jim and Sandy. They are successful business professionals living a happy and prosperous life with just one discrepancy. They wanted a child really badly but despite conscious attempts and unprotected intercourse for years, Sandy never conceived. It was pretty devastating for both of them but somehow they made peace with themselves thinking that they can never have a child of their own.

But was she really infertile?

Infertility is a fairly common issue and according to research statistics, more than 12 to 15% of all couples face some difficulty in getting pregnant naturally and almost 7% of all the couples are infertile and cannot conceive without some kind of medical intervention.

Thousands of couples make peace with themselves, just like Sandy and Jim thinking that there is no treatment for infertility.  That is simply not true. Nowadays there are a wide range of treatments available to help couple conceive ranging from the simple to the complex. The rest of this article will discuss some of the popular treatment modalities and interventions available today for couples fighting infertility.

What are some available treatments of infertility for women?

According to statistics, the primary cause of infertility is a defect in female in 40% of the cases that can be managed by medical or interventional methods of treatment available today.

Medicinal treatment:

In many women who present to fertility clinics, the primary defect is a hormonal imbalance that can be corrected by medications like Clomiphene citrate (Clomid). Irregularities of female reproductive hormones prevent ovulation, which is the primary cause of infertility in such cases. Restoration of ovulation by Clomiphene citrate induction involves increasing the release of female reproductive hormones from the pituitary such as FSH (Follicular Stimulating Hormone) and LH (Luteinizing Hormone); thereby helping women achieve a healthy pregnancy.

cure for infertility
Depending on your issue, medicine may beall that is required to help you get pregnant

Other popular medical treatments include:

  • Metformin is another medication that is employed in women with known history of polycystic ovarian disease.

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  • Human menopausal gonadotropin is a hormonal aid used in women who are unable to conceive because of advancing age or hormonal problems. This directly stimulates the ovaries to produce hormones that are able to support a viable pregnancy by signaling the body to releasing the eggs and preparing the endometrium for implantation.

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  • Hormonal therapy in the form of supplementation with estrogen or progestin during pregnancy that helps women with history of recurrent miscarriages; whereas Luteinizing Hormone is helpful in women who never ovulate because of LH surge failure.
  • Other popular medications include Bromocriptine, Human chorionic gonadotropin (hCG), Aromatase inhibitors and Gonadotropin-releasing hormone analogs.

Surgical treatment:

Sometimes long standing pelvic infections lead to scarring of fallopian tubes that becomes a cause of infertility and even with induction, the risk of ectopic pregnancy increases tremendously. In all such cases, the ideal treatment is tubal surgery or laproscopy to remove scarred segments of genital tract. Although, chances of conception are still low after that but it invariably helps a lot of women.

Uterine polyps and fibroids are two other common ailments in many women that will interfere with the proper implantation of a fertilized egg into the lining of the uterus. Depending on the severity of the condition different surgical interventions may be suggested. Operative hysteroscopy is the preferred method of treatment for polyps, and smaller fibroids as it is quicker and safer than older methodologies.

What are some available treatments of infertility in men?

Defects of sperm motility and morphology or a low count may all affect the ability of a man to impregnate his female partner. Sometimes, healthy lifestyle changes, dietary modification, abstinence from alcohol, tobacco and drugs may help but in majority of the cases, other treatments must be employed to treat infertility in men. These include:

           

  • Vitamin E therapy that helps in preventing oxidative damage to sperms and improves quality of semen.

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  • Selenium is one of the popular remedies that are employed in treatment of infertility due to poor quality sperms.

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  • Electric or vibratory stimulation is a technique used in males who are unable to ejaculate because of a spinal surgery, spinal injury or direct injury in the pelvic region that is interfering with the ejaculation. It is also helpful in males with history of pre-mature ejaculation.

What to do when nothing works?

In many cases, despite medicinal and interventional therapies, no fruitful results are seen. However, due to advancements in science and technology, there are a number of other interventions that can help infertile couples. Some of these treatments are:

Intra Uterine Insemination (IUI)

IUI is a procedure where processed sperm in injected directly into the uterus when the female partner is ovulating. The goal is to increase the number of viable sperm reaching the ovulated eggs. The procedure can help couples experiencing unexplained fertility, cervical issues, or other issues. This procedure is much less invasive and expensive than more complex treatments such as IVF and is often recommended to couples as a first line of treatment when there is not a solid reason to jump directly to more aggressive treatments.

In-vitro fertilization (IVF):

IVF or in-vitro fertilization is employed in women who are unable to conceive naturally because of a positive history of pelvic surgery, tubal pregnancy, pelvic inflammatory disease and other causes. The IVF procedure is made up of several key steps. First the stimulation phase, where the female partner takes medication to induce her ovaries to produce more mature eggs than she normally would. During this time she is carefully monitored to make sure the proper level of stimulation and that the eggs are properly mature for when they are retrieved. The doctor then surgically removes the mature eggs from the ovaries during the egg retrieval. These eggs are then fertilized in the embryology laboratory with the partner’s sperm (or donor sperm in some cases). The resulting embryos are carefully monitored and when the time is right(usually three or five days after the retrieval) are directly implanted back into the uterine cavity so they can develop normally.

In some cases, women are unable to produce healthy mature eggs at all despite stimulation or induction. In all such cases, IVF can be successful performed by using donor eggs.

Intracytoplasmic sperm injection:

Intracytoplasmic sperm injection is another well-known technique used in conjunction with IVF that is employed in cases where either male sperm count is deficient or most of the sperms are morphologically abnormal.  In this procedure, a normal sperm is directly injected into each mature egg obtained through an IVF cycle.

Surgical sperm aspiration:

This procedure is employed in males who cannot ejaculate successfully due to inflammation or infection induced blockade of male reproductive tract. Surgical sperm aspiration can be performed by aspirating the sperm directly from testicles, vas deferens or epididymis.

How to make use of Assisted Fertilization Techniques?

Although, assisted fertilization techniques carry a ray of hope for infertile couples, the chances of having a successful IVF or ICSI can be low. Research studies conducted by medical researchers in Harvard Medical School in Boston and Beth Israel Deaconess Medical Center identified that out of 14,248 IVF performed from 2000 to 2005 only 3,126 were successful and resulted in live-birth of full-term babies. In order to optimize your chances of conception, it is very important to consider following things and speak to your fertility doctor about it.

  • Maternal age: is a huge factor when determining your likely success rate. For example, the average couple under 35 can expect a success rate of around 60%, that rate drops to around 10% for the average couple over 42
  • Pre-implantation Genetic Diagnosis: In some cases when one or both genetic parents have a known medical condition, it becomes important to determine the the genetic combination of the embryos by Pre-implantation Genetic Diagnosis before implantation in order to increase the chances of producing an offspring free of the genetic disorder. This will likely reduce your chances as there is no way of determining if or how many your embryos will meet the requirements.

Speak to your healthcare provider in detail about the possible techniques or procedures that may be helpful for you and maintain a healthy and stress-free lifestyle to avoid gestational problems.

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Coping with Infertility around the Holidays

infertility holiday stress
The holidays can be extra stressful if you are dealing with infertility
Both the holidays and infertility an be stressful enough by themselves. Combine the two and you have a potential recipe for an unhappy season. I want to share a few tips both for couples trying to conceive and the friends and family of couples undergoing fertility treatments.

7 Tips to help with the holiday stress

  1. Reserve the right to say no: With the holidays come holiday parties and get togethers. Think carefully about which events you agree to go to. If you know it is going to be too painful to be around a couple with a newborn, or visit with certain friends, it is OK to decline the invitation. At the end of the day your needs to come first, although often times visiting with friends and family can be a great stress reliever.
  2. Use your support system: The holidays are a great time to visit with the people who love you. Take comfort and strength from their love. If visiting is not an option, call someone who you can talk freely with and vent your frustrations or just use the time to catch up. If you haven’t told anyone in your family about your infertility troubles yet, then it might be a good time to broach the subject to one or more of them. Having at least one member of the family in the know can be boon as they can lend you strength and run interference for you.  Just talking about your troubles can lighten the load significantly, even if it does nothing to solve things.
  3. Prepare an answer to the “kids” question: If your infertility, or even desire to have kids is known you will likely be asked about it. A lot of the uncomfortableness around these conversations can be avoided if you plan ahead and have an answer ready. Remember, your friends and family probably mean the best, even if their good-intentions bring up a painful subject. Perhaps, if you are ready, the inevitable questions this year could precipitate sharing your burden of infertility. (#2)
  4. Look for the best in every situation: While it is OK to avoid events or people that will cause you distress or pain, but you shouldn’t shut yourself in this holiday season. If attending multi-function events pick and choose the parts that make the most sense to you. You can change your plans to either arrive or leave early or late to make things easier for you.
  5. Take a fertility vacation: If your infertility treatment is getting really stressful and you have failed one or more courses of treatment then maybe the best option is to take a break. Take a month or two off this holiday season, go on a vacation, or just unwind for a bit. Stress can be counterproductive for treatment, and strain relations with your partner. Take this time to do something you have always wanted to do. The holidays can be stressful enough without having to undergo fertility treatments. However, if you have met your insurance deductibles, and would be saving money by continuing your treatments the remainder of your calender year, or plan year then it might make sense to postpone your break.
  6. Find company in other couples: This holiday season remember you are not along in your struggle. Infertility is a common problem that affects 1 in 8 couples. It is very likely one of more of your friends have either already had treatment, are undergoing treatment, or will have to have medical help to conceive. Talk to your friends that have gone through this before, they will understand the stress and pain infertility causes you. Just spending more time with couples without kids can be a help. If you don’t know anyone who has gone through infertility before, there are always online chat groups, forums, and other support groups that can  offer support  during this stressful time.
  7. Start a new holiday tradition: This holiday why not take a ski vacation, or a romantic trip out of town with your partner. Do something fun and/or adventurous to take your mind off of your treatments. Taking a fresh approach to the holidays can make it much more enjoyable.

6 “Infertility Etiquette” Tips for Friends & Family:

  1. Don’t try to belittle the problem by talking about how hard it is to have kids, or how much worse things could be. Infertility can be a very, very difficult thing to go through, and no one wants their sufferings belittled.
  2. Don’t talk about your own pregnancies past or present, it is a very sensitive subject. Couples working through infertility hope for the day they will have to worry about morning sickness or swollen feet.
  3. Don’t try to tell the couple to relax. Although stress has been shown to correlate with infertility, the reality is the human reproductive system is quite complex and is affected by a large number of biological and physical factors. And for God’s sake don’t ever say anything along the lines of, “..if it is meant to be, it will happen.”
  4. Don’t tell them how to fix their problem, whether it is exercise, food, lifestyle. If the couple has seen a infertility doctor, they specialist has already covered these issues. It is common for people coping with infertility to blame themselves and the last thing they need to hear is that they are doing things wrong and are the cause of their own problems.
  5. Don’t push adoption. Every couple has their own  idea of building their family and are aware of the options. The decision to adopt or not is a very personal one that they may have already considered or struggled with.
  6. Do be supportive. Be there for them, be generous with hugs and encouraging words. Show them you care and how much you love them with or without a baby. Plan activities that don’t focus on kids. Your support and kindness can go a long way!

I hope these ideas help, if you have any comments or concerns please voice them with the form below

Happy Holidays!