From Sex in the City’s idealistic family proponent Charlotte, to Monica and Chandler’s journey on Friends, to a recent portrayal of infertility on Downton Abbey, we are often privy to only carefully crafted glimpses into how couples manage their heart-wrenching battle with infertility. But what do we really know about this life crisis that prevents so many couples from achieving their primary goal of building a family? How comfortable are we in talking about this private matter while contemplating our personal failure? What’s wrong with me? Is this ever going to happen for us?
Secret Visits to the Doctor
Downton Abbey’s Matthew and Mary are too ashamed to even talk to each other as they each harbor doubts about their own ability to conceive. Convinced they are each to blame for their failed attempts, they secretly go their separate ways to seek medical attention. Ultimately (spoiler alert!), Mary learns that she has a medical condition, which she covertly deals with by having a surgical procedure, with no supportive husband by her side. In one short program season, and with one simple, but mysterious, procedure, they miraculously conceive.
But… What happened at the doctor’s office? Why were they, and why are we, unwilling to discuss these matters more openly? Neither our beloved Friends’ characters nor Sex and the City’s dedicated couple were able to conceive. Both cases resulted in adoption, but we never learn why.
Many are surprised to learn that a startling one-in-eight couples, or 7.3 million Americans, suffer from infertility. Too often misunderstood by the general public, and even by many well-intentioned doctors, infertility is a medical condition defined as the inability to conceive after one year of trying for women under the age of 35, and after 6 months of trying for those over the age of 35. While most attention is often focused on women, termed female-factor infertility, increasing research points to a rise in male-factor infertility. Current statistics indicate that infertility is a 40/40 split between men and women, with 10% of cases resulting from combined factors between the couple and 10% of unknown cause.
Announcing a pregnancy is common practice for a workplace setting but declaring infertility has always felt like shameful business. With no basis for understanding their struggles, many couples go underground. We are often shocked to learn the truth about couples like George and Martha in Who’s Afraid of Virginia Woolf, (spoiler alert!) whose inability to bear a desperately sought-after son was famously devastating for their marriage.
Need for Support to Deal with Fertility Issues
Self magazine published a groundbreaking study that found that two-thirds of couples battling with infertility chose not to confide in even their closest friends and family, which only exacerbates their alienation at a time when support may be needed most. Couples navigating the world of infertility often face a great deal of stress when confronted with highly sensitive and complex decision-making. Infertility places a strain on virtually every area of a couples’ lives from the physical and professional to the financial and the social.
In the most comprehensive research to date on the emotional impact of infertility, a nationwide longitudinal study conducted in Denmark found that women suffering from infertility resulting in childlessness were significantly more likely to suffer from psychiatric disorders. A Finnish study found that the co-morbidity rate of depression and anxiety for clients who face infertility was extremely high. A clearer understanding of infertility’s complicating factors would better enable friends, family and professionals to support one another to access the help that couples need.
While myths and ignorance prevail, many factors and conditions contribute to infertility. We need to have a more open dialogue about the medical issues that can hinder our fertility and create insurmountable barriers to our family planning. Many conditions require proper medical attention, which in their advanced stages, is most effectively provided by reproductive endocrinologists.
TTC (Trying To Conceive)
Is there anything we can do to reduce the risk of infertility? For starters, if you have been trying to conceive (TTC) for over a year (six months for women 35 and over) and have not been successful, be sure that both you AND your partner go for a medical consultation with an appropriate specialist; the first stop for women should be with a gynecologist and for men should be with a urologist.
If you are looking forward to having a family in your future, but are not ready at the moment, research continues to indicate that fertility for women diminishes with age (see blog on postponing childbearing). If you suspect that you have a condition, than your risks increase accordingly. Similarly, advanced aged for men can also pose obstacles to sperm quality.
As it turns out, there are many precautions that men can take in the way of sperm care, some of which include switching from briefs to boxers, avoiding hot tubs, quitting smoking, slowing down on the booze, and considering your medication intake. Additional things to avoid include cooking with Teflon, eating canned foods or soy products, smoking marijuana, and excessive stress.
Finally, we’ve known for some time that laptops present their own hazards: anything warm on a man’s lap for an extended period, including sedentary behavior, is potentially bad news. For you men out there, if you are reading this article with your laptop perched on your lap as it was intended to be (as mine is as I write this piece), than you may also be hurting your chances to father your biological children. And for a final bit of irony, a recent Harvard study found that excessive television watching is a sure-fire sperm killer. Twenty hours a week of sitting on the couch resulted in a 44% reduction in sperm count and quality as compared to those that did not watch television. So… as you snuggle up to watch your favorite programs and see their characters grapple with these issues on the tube, you may in fact be jeopardizing your own fertility.
On the other hand, an active lifestyle has been proven to enhance healthy sperm production. Chalk up another win for regular exercise!
Debra Unger is a licensed Clinical Social Worker, specializing in Reproduction and Infertility Counseling. She is a Professional Member of RESOLVE: The National Infertility Association and a member of the American Society for Reproductive Medicine’s (ASRM) Mental Health Professional Group (MHPG).