WHAT YOU NEED TO KNOW ABOUT INFERTILITY
National Infertility Awareness Week April 21 - April 27, 2019
Infertility is defined as a couple failing to become pregnant after 1 year of attempting every month or a woman becoming pregnant but not having the ability to maintain pregnancy to child birth. In women 35 or older, infertility is defined as attempting to become pregnant for 6 months without success.
Who Does Infertility Affect?
- According to the CDC, 1 out of 8 couples have difficulty becoming or maintaining pregnancy
- Studies have shown African American women are twice as likely to be infertile when compared to Caucasian females of the same age and economic status
- African American women have the highest risk of infertility followed by Asians, Hispanics, then Caucasians. Reasoning behind differing prevalence is unclear although is suspected to be due to socioeconomic factors (access to healthcare)
- According to the National Survey of Family growth, non-Hispanic black women are 1.8 times more likely to have infertility compared to Hispanic or non-Hispanic white women.
What Causes the Disparity in Infertility?
There are multiple reasons:
- Studies have also shown that African American females are more likely to wait longer to visit a doctor concerning issues of infertility when compared to Caucasian females. This increased time before treatment can lead to decreased positive fertility outcomes.
- There is disparity in access to treatment
- The average cost of a cycle of IVF is $20,000. Even non-IVF fertility treatment can be very expensive. Infertility treatment and IVF are not covered by insurance in most states. This represents a financial barrier to many patients.
- Cultural and societal factors. In some cultures, there is a stigma associated with being “infertile”.
- Infertility treatment schedule can be burdensome with time missed form work
- Geographical distance from an infertility treatment center could pose a barrier to many.
What Causes Infertility?
- Improper Testicular Function
- Abnormal structure of tubes carrying sperm
- Abnormal sperm level or motility
- Problems with Ovulation - If a woman’s ovary does not release an egg during ovulation, she cannot become pregnant. Estimated to be the most common female cause of infertility
- Damaged Fallopian Tubes (24 % 27% of African American infertility and 27 % Hispanic infertility respectively, compared to 5% in Caucasians)
- Coital problems
- Cervical factor
- Structural problems of Uterus and Cervix
What Puts You at Risk for Infertility?
Women: bacterial vaginosis, endometritis, pelvic inflammatory disease (PID), abscess of tube-ovarian complex (TOA), obesity and induced abortion (IAB), increased age of the mother (above 35), smoking and alcohol abuse, high caffeine consumption, high levels of stress, abnormally low weight, history of sexually transmitted diseases such as Chlamydia and Gonorrhea, and a history of polycystic ovarian syndrome.
Men: inflammation of the prostate, cystic fibrosis, premature ejaculation or sexual dysfunction, and enlarged testicular veins.
What Can You Do to Improve Fertility?
- Reduce risk factors for infertility (listed above)
- Ensure you are having sexual intercourse at the correct time each month – The most fertile period starts 5 days before ovulation and ends the day after ovulation. It is recommended to have intercourse 2-3 times during the week leading up to ovulation.
When Should I Involve My Doctor and What Can They Do to Help?
- Don’t keep silent! When you and your partner meet the definition for infertility seek expert consultation from your doctor for fertility tests.
- It is important to consult your doctor when planning to conceive as your doctor is equipped to educate you on positive practices to improve success of conception and maintain pregnancy to child birth.
Common Initial Tests
- Semen analysis (males)
- Hormone levels related to ovulation (females)
- Imaging of uterus and fallopian tubes (females)
Remember, if you and your partner are experiencing difficulty conceiving, YOU ARE NOT ALONE! Talk with a health professional. Additionally, you may consider joining a support group. Infertility is more common than you realize, but often couples are silent about what they are going through.
I have gone through the infertility battle myself. At age 26, I was diagnosed with premature ovarian failure / premature menopause. I was told that there was less than a 3% chance that I would ever ovulate. My husband and I went through IVF with donor eggs. However, the IVF failed. Four years after failed IVF, we conceived spontaneously (our daughter)! Several months after she was born, we conceived spontaneously again (our son)! These are my miracle children and true gifts from God. As I tell my patients, “We are doctors, but we don’t know everything. God is the doctor that knows all.”
Kirstie Cunningham, MD, FACOG
President, Metro Health and Wellness, LLC