From movies to TV right down to the playground songs we learn as kids, the story is the same. “John and Mary sittin’ in a tree, K-I-S-S-I-N-G! First, comes love. Then comes marriage. Then comes Mary with the baby carriage!” Yep. And it’s all supposed to happen just as simple as that. But what happens when Mary can’t produce the baby for her carriage that easily? Yes, I know it’s supposed to go like this: Boy meets girl. Boy sweeps girl off her feet and marries her. Then girl starts poppin’ out babies as if she was related to our nursery rhyme matriarch, “The Old Woman Who Lived in a Shoe.” But what if girl and boy try for weeks, months and years and still have no baby to show for it despite the fact that their family pesters them about when they are going to hurry up and get pregnant and reminds them often they aren’t getting any younger? Then what?
Although having a baby comes as easily to most couples as saying, “I do”, the book “A Child Is Born” by Lennart Nilsson and Lars Hamberger estimates, “that every seventh or eighth couple has more or less serious difficulty becoming pregnant.” It goes on to say, “in an estimated 40% of cases of childlessness the problem lies with the man only; in another 40% with the woman only; and in about 20 % the problem has to do with the couple.” But with so many different conditions that cause or contribute to infertility, it may be difficult to navigate the explanations especially when emotions are running high. So let’s examine the most common Dxs (diagnosis’s) broken down in simple terms.
First on the male side there is low sperm count. A man may suffer from this for a host of reasons. It could be dietary or too much caffeine, nicotine, or alcohol. It also could be a hormonal deficiency, infection or virus. Sometimes it is a more serious condition like a varicocele (blood pooling in the vein of the testicle overheating the sperm and killing them) which must be corrected surgically. No matter what the issue, it can be easily diagnosed with a simple semen analysis in an urologist office.
But what about on the female side of things? One of the most commonly diagnosed fertility problems is endometriosis. In this disorder, the endometrial tissue that typically lines the uterus grows in other parts of the abdominal cavity. It could develop as cysts in the ovary called endometriomas (which you may hear referred to as “chocolate” cysts because of their color) or anywhere else in the pelvis causing adhesions and/ or a toxic environment preventing implantation of a fertilized egg. Strangely enough, endometriosis may have no symptoms in one woman yet may cause excruciating pain in another. Unfortunately, there is no blood test to diagnose endometriosis. A laproscopy is normally used to detect it (more on that in the 2nd part of this series.)
Another prevalent disorder that may cause infertility is PCOS (Polycystic Ovarian Syndrome). According to Toni Weschler, author of Taking Charge of Your Fertility (2002), “what essentially happens with this condition is that the developing follicles that are normally ovulated each cycle actually remain trapped inside the ovary. After awhile they swell with fluid and turn into cysts that develop on the internal ovarian wall. If not treated, a hard shell may also form around the outside of the ovary, which of course will make a successful ovulation even less likely in the future.” There are many ways doctors today are treating PCOS although there unfortunately has not been a cure developed yet.
There are numerous other conditions that contribute to IF including tubal/pelvic issues, ovulatory dysfunction, and immunological problems. But what happens after the Dx? Now that your OB has found something causing your IF what’s next? How will it be “fixed”? Better yet, CAN it be “fixed”? In the next part of this series we will examine these questions more closely.
Although Pocahontas is not a medical professional, she endured 17 months of IF diagnosis’s and treatments before finally conceiving her first born. So she wanted to share the vast amount of information she has learned and compiled in this 3 part series with women who may have to travel the same road to motherhood.