Megan and her husband of Perry decided it was the perfect time to start a family. After six months of trying, she was convinced that stress was to blame. During the course of the year, Megan was dealt several hardships including a mother with a fractured hip, a new demanding boss at work, and a best friend who was transferred to South Carolina. She began to wonder what it means to be infertile and if it could happen to her.
Many Central Georgia women silently ponder the same question. “In general, infertility is defined as the inability to achieve pregnancy after a year of unprotected intercourse,” states Dr. Paul Harnetty of Cornerstone Ob/Gyn of Warner Robins. They may think the stressful aspects of their life are the cause and do not take other factors into consideration.
“Stress in itself has not been proven to be a source of infertility,” Harnetty affirms. Stress has, however, been linked to other health complications. It is advised to schedule an appointment with an obstetrician/gynecologist. “The recommendation is that if the woman is under thirty-five and has been trying for a year and is unsuccessful, she should seek consultation. For women thirty-five up to forty, that is six months. For a woman who is forty and above, even as little as three months of not being successful should have a consultation,” informs Dr. David Carnovale of Central Georgia Fertility of Macon.
Know what to expect at your visit.
“In the consultation we take the history of both the female and male partner and a physical of the female. Then, recommendations are made. If we expect any further testing or treatment, that would be indicated,” explains Carnovale.
Infertility is not a hopeless diagnosis.
“With evaluation and treatment, a good percentage of patients achieve pregnancy,” says Harnetty optimistically.
There are some lifestyle choices that are in your control.
“We are seeing the impact of weight is important in the male because of disruption of hormones. Overweight and obese men have lower sperm counts,” tells Carnovale. He also notes that many women are waiting to become pregnant because they are pursuing professional ambitions, which is another factor. “I really recommend people think about trying [to get pregnant] before thirty-three,” advises Carnovale.
Infertility does not discriminate.
“For most people, age is not a factor as far as getting pregnant until you reach closer to forty. The fertility rate will fall at that time,” tells Harnetty. Either partner can be responsible for infertility. “Forty percent of the sources are female origin like tubal blockage or endometriosis. The other forty percent are male like low sperm count. Twenty percent of the sources are unknown,” reveals Harnetty. Most of the time, it is not genetic.
Sometimes a preexisting medical condition can hinder fertility.
“Polycystic ovarian syndrome and endometriosis are the two big ones,” tells Carnovale. Other times, it is because the woman is not ovulating on a regular basis. “If you ovulate just three to four times a year, then you have only that many chances to get pregnant as compared to somebody who ovulates every month,” explains Thekkepat Sekhar of Physicians for Women of Warner Robins.
Weight loss may improve physical functioning.
“Many patients after they lose weight find that their ovulation returns and get back to having normal menstrual cycles,” tells Sekhar. Sekhar also names tubal blockages due to infections and past tubal ligation as causes of infertility. “The common one we see where the tubes are blocked is pelvic inflammatory disease (PID) and endometriosis for causing scar tissue damage and blocking to the tubes,” he says.
Testing is usually performed.
“Possibly an ultrasound, blood work, examination, or special tests can be performed to evaluate the status of the patient’s fallopian tubes,” says Harnetty. There is a wide range of choices for treatment. “There are options out there from simple medications and monitoring them to see if they ovulate on a regular basis with ultrasounds to looking at your ovaries and seeing if you develop an egg all the way up to high tech ones where you have in vitro fertilization where you give a lot of medications that get you to form eggs, retrieve them, fertilize them, and put them back in the uterus to see if you can get pregnant,” Sekhar summarizes. Some people view in vitro fertilization as a cure-all, but it is not. “In vitro fertilization can achieve pregnancy rates of about forty-five to fifty-five percent,” informs Sekhar.
High tech options tend to be more expensive as well. Remember, treatment is individualized. “For most women, it is going to involve some form of stimulation of the ovaries and possibly insemination, which is placing the partner’s sperm into their reproductive tract. In a lesser number of cases, they will be indicated to go through in vitro fertilization,” tells Carnovale.
Do not compare yourself to someone else who is infertile.
“Some patients require surgery, some require hormone medications, and some require injectable medications,” tells Harnetty. Males go to a fertility specialist for a comprehensive evaluation. “The standard thing would be a semen analysis to check the number of sperm, the appearance and how they are moving,” explains Carnovale.
Remember that pregnancy should involve both partners, even though they may not always go to the specialist together. “It is up to the patient’s preference. Fifty percent of
the time the male partner comes along,” Harnetty says. Decide with your partner and the guidance of your doctor what plan is appropriate for you. Sure, infertility can make you feel stressed, but aren’t you relieved at the numerous options? #