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Infertility
Planning for a child can be a joyous and exciting experience.
But if the attempts to become pregnant are not successful, other
emotions can take over. Fear, anger, guilt, resentment, frustration
and other painful feelings can wash into the lives of those longing
for a child of their own. When nature doesn't cooperate, month after
month, a couple may suspect a problem with fertility. Often times,
the infertility problem can be diagnosed and treated. Reproductive
medicine has become a highly specialized field, bringing successful
pregnancies to many awaiting parents. If you suspect a problem with
infertility, the first important step is making an appointment with
a specialist who can provide you with the answers and guidance that
you need.
In
order to better understand the problems that can cause infertility,
let's first look at the physiology of normal reproduction.
Physiology of Normal Reproduction
Despite how easy becoming pregnant appears to be for some people,
reproduction is actually a very complex process. A detailed sequence
of events must take place in the woman's
body to produce an egg. This egg must be united with a sperm
cell, which is produced in the man's
body, in an equally detailed and complex process. Fertilization
of the egg by the sperm requires a specific cascade of events to
occur. These events are orchestrated by important hormones and chemical
reactions. Even when both the woman and the man are fertile and
without any reproductive problems, the chance of getting pregnant
in any given month is about 20 %. It often takes six months to a
year for a couple to conceive, even under the best circumstances.
About Infertility
Infertility is defined as the inability to become pregnant,
or to carry a pregnancy successfully to delivery, after one year
of trying to become pregnant. In
the United States, about 10-15 % of couples experience infertility.
Approximately 30% of these cases are due to problems surrounding
ovulation, another 30 % of infertility cases are from problems with
the fallopian tubes, and about 30 % of infertility cases can be
attributed to problems with sperm production, function or delivery.
The remaining 10 % of couples have infertility of unknown cause,
and no obvious problem is diagnosable. Regardless of the cause,
the problem of infertility should be held as a problem to the couple,
and not blamed on one or the other partner.
Preconception Counseling
Some
fertility clinics offer preconception evaluation and counseling.
This type
of counseling can help improve a woman's
chance of getting pregnant and having a healthy pregnancy. Additionally,
nutritional
guidelines and vitamin-mineral
recommendations are usually made to help prepare the woman's
body for a new life.
Psychological
support might also be provided at this early stage of consultation.
The difficult emotions resulting from infertility can put a strain
on a relationship. The financial cost incurred with ongoing infertility
treatments can add another burden. Dealing with emotions and choices
associated with unexpected infertility
can be overwhelming and consultation with a trained couple's
therapist may be beneficial.
Diagnosing and Treating Infertility
If the
couple wishes to proceed with medical evaluation, an infertility
workup is the next step. This will involve an extensive interview
with the couple, along with physical exams and a number of tests
to detect fertility problems related to the woman, the man or both.
Once tests are completed, a diagnosis can usually be made and treatment begun.
The cause of the infertility may lie with the woman, the man,
or a combination of both. Unfortunately, about 10 % of the time
the cause for infertility cannot be determined. Without a diagnosis,
there are no good treatment options. However, some of undiagnosed
couples do spontaneously get pregnant, in time. For those individuals
who receive a diagnosis, infertility is often treatable. In recent
years, there have been encouraging advances in treating
female as well as male
infertility. Many are helped with fertility
drugs used to correct many infertility problems. A relatively
new and high-tech medical field called Assisted
Reproductive Technology (ART) has enabled many hopeful individuals
and couples to become parents.
Resolution
Unfortunately,
infertility treatments are not successful for all couples. It's
important for couples to know when to 'let go' and stop treatment.
The fertility clinic or specialty physicians involved can offer
guidance about when the time for this is right. When the decision
is reached, couples face painful disappointment and must somehow
cope
with the realization that they are not likely to conceive a
child. Counseling
or support groups can help couples and individual partners learn
to accept infertility, learn about options, and find joy, meaning
and purpose in life again.
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