Understanding the reasons behind infertility
Content warning: This article mentions miscarriage.
Getting pregnant can be a wonderful thing. It can also be incredibly difficult. About one in eight couples in the United States struggle with infertility.1 But, there are not always specific reasons why this happens. While age and health status can impact fertility and pregnancy, unexplained fertility accounts for 20% of diagnoses.2 It can happen to healthy individuals, men and women alike.
Infertility can have devastating effects on mental health and make you feel trapped in your body.3 But no matter how hopeless you may feel, know that you are not alone in your struggle. In fact, there are nearly 6.7 million people annually who understand your pain.1 Luckily, there are several safe treatment options that can increase your chances of conception.
But what is infertility, and why does it happen? Let’s explore the definitions, treatment options, and self-care tips you may need when experiencing infertility.
What is infertility?
Infertility is an individual's or a couple's inability to conceive after more than 12 months of unprotected sex. Symptoms of female infertility include abnormal or irregular menstrual cycles, excess hair growth, decreased sex drive, or other symptoms of body imbalance. Symptoms of male infertility include low sperm count, erectile or ejaculation problems, or changes in sex drive. Sometimes there are no clear signs or reasons for infertility. This can make it more frustrating. If you’ve been trying to get pregnant for a year with no success, it may be time to make an appointment with your doctor.
What are the causes of infertility?
If you are trying to get pregnant, it can feel like pregnant women are everywhere, and that everyone is able to get pregnant with ease. This simply isn’t true. In fact, the natural fertility rate is only 20%.1 Fertility begins to decline for most women around age 35.1 I But this doesn’t mean having children later in life is impossible. There are many options available that can help increase your chances of becoming a parent down the road.
What are the treatments for infertility?
Most doctors will do an evaluation before recommending a fertility treatment for you.4 This evaluation can include questions about your sexual history, ovulation cycle, lifestyle, genetic history and lab tests. Once an infertility diagnosis is made, your doctor will then recommend a few treatment options based on your age, health status, and personal preference.
What is assisted reproductive technology?
There are many ART (assisted reproductive treatment) options for couples or individuals who are infertile. ART is any treatment that involves sperm and an egg. Some of the ART treatments and options for infertility5 include:
Fertility medication
According to VeryWellHealth, “ovulation disorders account for about 25% of female factor infertility cases4 Fertility medications can help stimulate ovulation and make it easier to conceive.6 This route is one of the most common treatment options for infertility.
Surgery
Sometimes infertility or repetitive miscarriages are caused by issues like fibroids or excessive scar tissue. These issues can be managed by a specific type of surgery.7
In vitro fertilization (IVF)
This multi-step procedure can be quite effective. Since IVF’s inception in the late seventies, almost 8,000,000 babies have been born from IVF treatments.8
Intrauterine insemination (IUI)
Sperm are inserted directly into the uterus during ovulation.
Cryopreservation
This method involves freezing embryos, eggs, or sperm for later implantation.
Surrogacy
A surrogate is a person who carries a baby to term for another couple. There are two types of surrogacy arrangements: gestational or traditional.9 Traditional surrogacy is when the surrogate's own eggs are fertilized by the father's sperm. Gestational surrogacy means the surrogate will go through an IVF cycle and have the couple's fertilized eggs implanted in their uterus. The couple or individual who has arranged for a surrogate will usually pay for the surrogate's maternity, prenatal care, and delivery.
Egg or sperm donation
This method is often used by same-sex couples or individuals who want to have children on their own. It is also a way people who are seeking donations can have a biological connection to their child. Egg donation allows for a genetic connection to the child through fertilization, while sperm donation with the intended parent's egg allows the same connection.
Infertility treatments are not limited to surgical or procedural interventions. Your doctor may recommend weight loss, lifestyle changes—like quitting smoking or reducing caffeine and alcohol—or more tests to see if you have any underlying conditions.
Are infertility treatments covered by my health plan?
Infertility and maternity care coverage, especially for reproductive technology, can be fickle. And infertility treatments can be quite expensive. Many insurance providers will not offer coverage for certain treatments unless infertility is officially diagnosed.
- The Affordable Care Act: The ACA doesn't consider infertility as an essential service. However, it does consider it as a pre-existing condition. Since 2014, insurance provided through the ACA cannot decline coverage simply because of infertility.
- State coverage: Nineteen states have mandated coverage of select infertility treatments, including IVF.X If you live in one of these nineteen states, check with your insurance provider to see what coverage you qualify for.
- Private insurance: Most private health plans have different categories for coverage that cover the spectrum. Before you schedule a consultation with your reproductive health care specialist, make sure you have infertility coverage included in your plan.
Unfortunately, these details do not often extend to LGBTQIA+ couples and individuals. But health insurance companies like Progyny are working hard to change the industry and break barriers to care.
ART infertility treatments didn’t work for me. Am I out of options?
One individual, whether in a partnership or not, tends to shoulder a lot of the blame when they cannot conceive. But an inability to get pregnant rarely lands with one person. Many experts follow the 30/30/10 rule with infertility.1 As stated before, sometimes there is no diagnosable reason. No one person should shoulder the burden. The path to becoming a parent can take so many turns. Adoption, fostering, volunteering with children, or being a fantastic aunt or uncle are all ways to embrace parenthood.
How can I take care of myself when dealing with infertility?
Dealing with infertility can be brutal. Being prepared and knowing your options are good ways to cope. But above all, remember to take care of yourself and each other. Embrace self-care during vulnerable times. Your health and well-being should be a top priority.
- Participate in activities or hobbies you enjoy.
- Know your boundaries. Some infertility treatment options can be quite invasive and a bit painful. They can also be a major expense. Some treatments may also not work the first time. Have a conversation with your partner, and yourself, about your financial, personal and emotional limits.
- Consider joining an infertility support grou11 While close friends and family members can provide support, and genuinely want to help, they don’t always understand what you are experiencing. A support group is a great way to connect with people who are going through a similar experience.
- Take a few days off from work to unwind or book a vacation to a place you’ve always wanted to go.
- Take care of your body. Exercise, eat well, limit your alcohol use and get plenty of sleep.
- Manage your stress. Some studies have shown that stress and anxiety can negatively affect fertility.12 Book a massage, pedicure, or other spa treatment for the ultimate in stress relief.
Getting pregnant can be incredibly difficult. If you are struggling with infertility, please don’t despair. There are many safe and effective treatments that can get you one step closer to meeting your newborn baby. Talk with your doctor, trust your body, and make sure to take it one step at a time.
1 https://www.fertilityanswers.com/13-stats-know-infertility/
2 https://www.nbcnews.com/id/wbna38311820
3 https://womensmentalhealth.org/specialty-clinics/infertility-and-mental-health/
4 https://www.verywellfamily.com/fertility-treatment-4157421
5 https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments
6 https://www.verywellfamily.com/anovulation-and-ovulatory-dysfunction-1959926
7 https://www.mayoclinic.org/diseases-conditions/infertility/diagnosis-treatment/drc-20354322
8 https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hysteroscopy
9 https://americanfertility.com/surrogacy-process/
10 https://resolve.org/what-are-my-options/insurance-coverage/infertility-coverage-state/
11 https://www.verywellfamily.com/resolve-infertility-support-groups-1960221