Dr. Emma Hostetter MD MPH "The Mom in Me: MD"">

When Infertility Comes Naturally

For many women, childbearing comes naturally. But for a significant percentage of women, infertility comes just as naturally (myself included). Don’t get me wrong, infertility is not just a female problem. Male factor infertility and combined infertility play significant roles as well. According to Resolve, The National Infertility Association, 1 in 8 couples struggle with infertility issues. With staggering statistics like these, it’s reasonable to be concerned if baby-making seems to be taking too long the “natural” way. As a woman who has gone through years of infertility treatments resulting in six cycles of IVF and one precious little girl to show for it all, I’m here to walk you through the ropes.

When should I be worried?

When the attempted baby-making timetable stretches from a few months into six months and then a year with only a menstrual cycle to show for it, it’s time to be concerned. While many couples will get pregnant naturally on their own within a few years, The American Academy of Obstetrics and Gynecology recommends that if you have actively been trying to get pregnant for a year without success, you should be evaluated. If you are over the age of 35 and haven’t gotten pregnant within six months of actively trying, have irregular periods or you or your partner have a known fertility diagnosis, then you should be evaluated right away.

Whose fault is it?

Infertility isn’t really anyone’s fault, but someone has to take the diagnosis. While the woman usually gets the finger pointed at her since she can’t get pregnant, interestingly, female factor, male factor, and combined/unknown cause infertility each make up about 1/3 of the diagnoses. Clearly, trying to assign fault only complicates an already stressful situation, but identifying the underlying source of infertility can help determine appropriate treatment options. So, women, bring your partner along to the infertility workup. Men don’t get a hall pass!

Does my age really matter?

While some women decide to start their families right away, in today’s society (Hamilton County included) many women put pregnancy on hold as they strive to gain a higher education and find their place in the professional world. When to start having children is a very personal decision, but the idea that a woman can easily start her family at any age or stage of life is misleading.

According to local Fishers mom and physician assistant, Olympia Ming, M.S, PA-C, women should be aware of the potential fertility complications that come with waiting to start a family. According to Ming, many women aren’t ready to start their families until they are in their 30’s, but they also haven’t been educated on how significantly their fertility declines each year after 30. Poor egg quality, genetic abnormalities, unexplained infertility – these are all potential fertility complications for many women. Olympia says that because a woman’s fertility outlook only gets worse with each passing year, physicians and health care professionals alike should be more proactive in educating women in their 20’s about the complications associated with delayed family planning. Young women should be made aware of potential ways to preserve their fertility through options like egg freezing and lifestyle modifications. While age isn’t the only factor affecting fertility, it does play a significant role.

Are infertility treatments safe?

Many couples are terrified by the thought of infertility treatments. Over the past twenty years the media has done an excellent job of highlighting rare situations such as octuplets. I don’t know about you, but the thought of eight children all at once is a little too fertile for me! Advancements in research and an increased emphasis on conservative numbers for embryo transfers have quelled many undesirable complications. That being said, infertility treatments such as IUI and IVF are still medical interventions with both risks and benefits. Talk with your doctor about what options may be best for you.

What resources are available to me?

For more information on infertility, visit these sources:

The American Congress of Obstetricians and Gynecologists
www.acog.org/Patients/FAQs/Evaluating-Infertility#should

The Centers for Disease Control and Prevention – Reproductive Health
www.cdc.gov/reproductivehealth/infertility/

Resolve, The National Infertility Association
www.resolve.org/about/fast-facts-about-fertility.html
Dr. Emma Hostetter is a Fishers family physician and public health specialist. Find her blog “The Mom in Me, MD” on the Hamilton County Family web site or visit her at www.themominmemd.com.

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