niaw: so just what is infertility?

have you heard, it’s national infertility awareness week! and in honor of it, i have been doing a bunch of posts this week for all of my fertile friends and family to help inform them about infertility and the issues in our community.

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back in october, we came out of the IF closet:

infertility is a medical diagnosis, not a lifestyle problem. it is a failure of one of the many aspects of the reproductive system (for either party). statistics say that one in eight couples in the united states are infertile (although there is evidence that this number is underreported). infertility is the failure to conceive or carry a pregnancy to term for more than 12 months (6 if you are over 35).

our society doesn’t talk about infertility. it doesn’t talk about pregnancy loss. it makes people uncomfortable. all that talk about sex and pain and loss and grief is hard. but that silence needs to end. all it does it perpetuates misinformation and myths, shame and embarrassment, fear and isolation. it feeds into the belief that there is something wrong with being infertile, or in pursuing any of the many paths to resolve your infertility. and this silence makes in incredibly difficult to get the information, help, and support that you need to deal with this diagnosis.

at least one in eight couples is infertile. 7.3 million people. 12% of couples. i promise you, we are not the only couple you know. there are other people you love and care for, who are dealing with this in silence.

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the average couple has a 20% chance of getting pregnant in any given month. within a year, about 90% of couples will have gotten pregnant. and the rest of us need a little help. about a third of all couples facing infertility have a diagnosis for the female partner, one third with the male, and the remaining third are a combination of the two, or are unexplained.

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so it’s been a year of trying a still no baby. now what? you’re going to want to find a reproductive endocrinologist (RE) to begin testing. you can find clinics near you using the society for assisted reproductive technology’s search. (one thing i didn’t realize at first was that many clinics have multiple locations. i originally didn’t even consider the clinic we were successful at because they were 30 miles away. but what the search page doesn’t tell you is if there is an office that is more conveniently located to you.) you can find a great list of questions to ask a potential RE over at the stirrups queens.

but what about my ob/gyn? i love them. can’t they help? well, maybe. but most don’t really have the in-depth training you need on getting pregnant, just on what to do once you are. and this could be a long, involved process. you don’t want to waste your time, money, and hopefully insurance coverage on someone who isn’t going to give you your best chance at success.

ok. got an RE. what are they going to do? you’ll go in for an initial consult to discuss you health and concerns. and then the testing will begin. lots and lots of testing. invasive and uncomfortable stuff. my first clinic took 13 vials of blood. get used to needles. depending on when during your cycle you currently are, they might do a transvaginal (internal) ultrasound to see what is going on with your ovaries. they’ll order up a hysterosalpingogram (HSG), which is when they inject contrast into your uterus and check things out on the x-ray. this can show them if there are any issues with your uterus or fallopian tubes. you may also have a sonohystogram, which is a similar (but in my case less painful) procedure with saline and an ultrasound. your partner should also be prepared to provide a semen sample for analysis. most clinics will let you do this part at home and bring it right in if that makes him more comfortable. i highly recommend you check out the stirrups queens’ operation heads up for more details on these and other tests.

and then you’ll get a plan. there are many options for ART:

  • clomid and timed intercourse: this is relatively inexpensive and easy to start with. but that doesn’t mean it isn’t a serious course of action. clomid helps women ovulate. then you can make sure you have sex when you are ovulating to increase your chances. but here’s the thing: please do not take clomid without monitoring (going in for bloodwork and ultrasounds). i’ve heard tons about ob/gyns prescribing clomid without checking how it’s working and then – bam! multiples! if you are being properly monitored, a good doctor will cancel your cycle if it looks like you are going to ovulate more than one egg. also, it looks like most research says you shouldn’t continue with clomid for more than six months. and just beacuse it;s so important, i’ll say it again: no one should take follicle stimulating drugs (including clomid) without monitoring!
  • interuterine insemination: this is the next step up from timed intercourse. instead of relying on you and your man to do the deed at home, he will provide a sample that can be inserted right into your uterus to make things a little easier. also very handy for same sex couples using a sperm donor. IUI can me medicated or not, depending on what issues are going on.
  • in vitro fertilization: this is when egg meets sperm in the lab and not the fallopian tubes. since this is what i know the most about, i’m putting it into it’s own post next.
  • and of course there are cases which need to assistance of a third party, either through egg donation, sperm donation, embryo donation, or surrogacy. surrogacy can take two different forms: traditional surrogacy when the carrier’s own eggs are used, or gestational surrogacy, where the egg used was from the intended mother (or a donor egg or embryo). i strongly recommend checking out the stirrups queens’ operation heads up for more details.

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are you or someone you know dealing with infertility? i have some books that i don’t really need anymore that i would love to share with someone who could use them. i will gladly send them to anyone who wants them. just let me know!

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