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More than 10 to 15 percent of Australia and New Zealand couples struggle with infertility. Although you can't do much to turn back the biological clock, technological innovations now make it possible for more to bring a child into the world.
What is happening
Getting pregnant and carrying a body to term may seem like the most natural thing in the world--until the requisite healthy machinery, exquisite timing and luck aren't on your side. Consider what's involved. Well-shaped, active sperm must enter the uterus and swim up into the fallopian tube (s) at a time when one of the ovaries releases an egg. A single sperm has to wiggle its way into the egg, fertilising it. The newly formed embryo must then wed its way down to the uterus and snuggle firmly into the uterine wall.
If this scenario doesn't play itself out after 12 or more months or regular, unprotected sex infertility is diagnosed. Having repeated miscarriages is also a form of infertility. The situation can leave you angry and heartbroken. In one in five cases no cause can be found, even after a full medical workup. Sometimes a problem with the male partner can be spotted and treated (see shortly). Often--in a third of cases--there's an issue with both partners. For women, age is always a factor. You're born with a finite number of eggs that start to run out in a fairly predicatable way after age 30.
In most cases doctors eventually identify and treat the problem. Nearly 30 percent of women with infertility, for instance, have fallopian tubes that are blocked, preventing the egg from travelling through the tubes into the uterus. Pelvic inflammatory disease, a prior pregnancy is one of the tubes (called an ectopic pregnancy), endometriosis or pelvic surgery can cause this kind of blockage. Another 20 percent of infertile women have an ovulation disorder, often infrequent ovulation because of hormonal imbalances, weight problems, athletic training of stress. Disorders of hormone-producing glands such as the thyroid and pituitary can also interfere with ovulation. And in 20 percent of cases, fibroids or another disorder of the uterus disrupt embryo implana-tation or cause miscarriages.
LIKELY FIRST STEPS
Whether you'll end up conceiving and carrying a baby to term depends on many things from what's causing the problem to how severe it is. Proper timing of intercourse is crucial, of course. Hormone imbalance problems often respond to ovulation-promoting drugs. One in ten women turns to high-tech options like in vitro fertilisation (IVF). Surgery can repair damaged reproductive organs. And even if experts can't pinpoint a cause, it's extremely heartening to know that 60 percent of couples get pregnant within three years anyway.
More than 10 to 15 percent of Australia and New Zealand couples struggle with infertility. Although you can't do much to turn back the biological clock, technological innovations now make it possible for more to bring a child into the world.
What is happening
Getting pregnant and carrying a body to term may seem like the most natural thing in the world--until the requisite healthy machinery, exquisite timing and luck aren't on your side. Consider what's involved. Well-shaped, active sperm must enter the uterus and swim up into the fallopian tube (s) at a time when one of the ovaries releases an egg. A single sperm has to wiggle its way into the egg, fertilising it. The newly formed embryo must then wed its way down to the uterus and snuggle firmly into the uterine wall.
If this scenario doesn't play itself out after 12 or more months or regular, unprotected sex infertility is diagnosed. Having repeated miscarriages is also a form of infertility. The situation can leave you angry and heartbroken. In one in five cases no cause can be found, even after a full medical workup. Sometimes a problem with the male partner can be spotted and treated (see shortly). Often--in a third of cases--there's an issue with both partners. For women, age is always a factor. You're born with a finite number of eggs that start to run out in a fairly predicatable way after age 30.
In most cases doctors eventually identify and treat the problem. Nearly 30 percent of women with infertility, for instance, have fallopian tubes that are blocked, preventing the egg from travelling through the tubes into the uterus. Pelvic inflammatory disease, a prior pregnancy is one of the tubes (called an ectopic pregnancy), endometriosis or pelvic surgery can cause this kind of blockage. Another 20 percent of infertile women have an ovulation disorder, often infrequent ovulation because of hormonal imbalances, weight problems, athletic training of stress. Disorders of hormone-producing glands such as the thyroid and pituitary can also interfere with ovulation. And in 20 percent of cases, fibroids or another disorder of the uterus disrupt embryo implana-tation or cause miscarriages.
LIKELY FIRST STEPS
- Lifestyle measures, such as tracking ovulation cycles and keeping your weight within normal ranges.
- Treatment of underlying medical causes of infertility, such as fibroids, endometriosis and menstrual problems.
- Drugs to boost ovulation.
- In more complicated cases, artificial insemination or assisted reproductive technologies with or with out super-ovulation drugs.
QUESTIONS TO ASK
- What is the success rate of your fertility clinic and how does it compare with others?
- Are any of these hormones dangerous for me?
- Could there be something in my life that I'm not focusing on that could be preventing me from getting pregnant?
- I keep miscarrying. What are my options?
- How much will this fertility therapy cost?
Treatments
Whether you'll end up conceiving and carrying a baby to term depends on many things from what's causing the problem to how severe it is. Proper timing of intercourse is crucial, of course. Hormone imbalance problems often respond to ovulation-promoting drugs. One in ten women turns to high-tech options like in vitro fertilisation (IVF). Surgery can repair damaged reproductive organs. And even if experts can't pinpoint a cause, it's extremely heartening to know that 60 percent of couples get pregnant within three years anyway.
Treatment Options
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Chart your cycle Take your temperature to determine ovulation.
----------------------------------------------------------------------------------------------------------------------------------------------
Improve your diet Limit alcohol, caffeine; eat well; take vitamins.
-----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Consistently, but not too vigorously.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Clomiphene citrate Induces ovulation.
------------------------------------------------------------------------------------------------------------------------------------------
Follicle stimulating hormone Stimulates follicles, egg development.
-------------------------------------------------------------------------------------------------------------------------------------------
HCG or progesterone Improves implantation prospects.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Artificial insemination Sperm is inserted into uterus medically.
--------------------------------------------------------------------------------------------------------------------------------------------- Assisted reproduction Drugs incite ovaries to produce eggs.
-------------------------------------------------------------------------------------------------------------------------------------------
In vitro fertilisation Developing embryo transferred to uterus.
--------------------------------------------------------------------------------------------------------------------------------------------
Intrafallopian transfer Fertilised egg(s) placed in fallopian tubes.
TAKING CONTROL
There are lots of simple things you can do to boost your odds of getting pregnant. You're most fertile in the five days before you ovulate, so chart your menstrual cycle by recording your basal body temperature each morning (right after awakening) for several months. Look for vaginal discharge that has become copious, clear and slippery; this happens just before ovulation. Stay attuned to the slight pinching sensation in your abodmen that signals ovulation. At-home ovulation tests can also help identify the key time.
Many medications you might not suspect can compromise fertility--not to mention potentially endanger your pregnancy once it occurs--so review what you take with your doctor. Also, cut out alcohol. Even one drink a day has been linked to compromised fertility. Limit caffeine as well. More than two cups of coffee daily may put enough caffeine into your system to up your risk of miscarriage. (Fancy cafe brews tend to be particularly high-octane.) Cigarettes are also linked to fertility problems--yet another reason to stop smoking. Apparently smokers inhale a toxin that can trigger ovarian failure.
More than one in ten cases of infertility are linked to body weight, either too much or too little. So aim for a normal weight with a body mass index (BMI) of at least 20 if you're thin to start and a BMI under 27 if you're heavier (to figure out your BMI, see on later). Exercise, but moderately; working out too vigourously reduces hormone levels of oestrogen and progesterone, and ovulation may be inhibited or an embryo might not be able to implant in the uterine wall. Aim for the equivalent of a 3 km daily stroll. Eat a well-rounded diet and take basic prenatal vitamins.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Chart your cycle Take your temperature to determine ovulation.
----------------------------------------------------------------------------------------------------------------------------------------------
Improve your diet Limit alcohol, caffeine; eat well; take vitamins.
-----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Consistently, but not too vigorously.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Clomiphene citrate Induces ovulation.
------------------------------------------------------------------------------------------------------------------------------------------
Follicle stimulating hormone Stimulates follicles, egg development.
-------------------------------------------------------------------------------------------------------------------------------------------
HCG or progesterone Improves implantation prospects.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Artificial insemination Sperm is inserted into uterus medically.
--------------------------------------------------------------------------------------------------------------------------------------------- Assisted reproduction Drugs incite ovaries to produce eggs.
-------------------------------------------------------------------------------------------------------------------------------------------
In vitro fertilisation Developing embryo transferred to uterus.
--------------------------------------------------------------------------------------------------------------------------------------------
Intrafallopian transfer Fertilised egg(s) placed in fallopian tubes.
TAKING CONTROL
- Keep time on your side. Over age 30? If infertility is an issue, don't wait a whole year before seeing a doctor. And go after six months if you're over 35. Always go if you aren't mensturating, or if you have had three or more miscarriages or have a reproductive organ infection.
- Express your feelings. Infertility hurts your sens of womanhood, self-worth and identity. You may feel sorrowful, angry or with drawn. Relationships can fray from the pressure. Don't stuff these feelings away; many other women are experiencing them too, you can do to ease your pain. Talk to your doctor about counselling or finding a support group.
- Be wary of dietary supplements. Traditional treatments, from chasteberry to false unicorn root, may (or may not) work; there's no guarnatee that products contain what they claim. High doses of the antidepressant St John's wort, the cold-fighter echinacea and the memory-enhancer ginkgo may damage eggs, sperm and the fertilisation process. Bottom line: supplements are unproven, so never delay getting conventional medical help while you wait to see if a herb will work.
There are lots of simple things you can do to boost your odds of getting pregnant. You're most fertile in the five days before you ovulate, so chart your menstrual cycle by recording your basal body temperature each morning (right after awakening) for several months. Look for vaginal discharge that has become copious, clear and slippery; this happens just before ovulation. Stay attuned to the slight pinching sensation in your abodmen that signals ovulation. At-home ovulation tests can also help identify the key time.
Many medications you might not suspect can compromise fertility--not to mention potentially endanger your pregnancy once it occurs--so review what you take with your doctor. Also, cut out alcohol. Even one drink a day has been linked to compromised fertility. Limit caffeine as well. More than two cups of coffee daily may put enough caffeine into your system to up your risk of miscarriage. (Fancy cafe brews tend to be particularly high-octane.) Cigarettes are also linked to fertility problems--yet another reason to stop smoking. Apparently smokers inhale a toxin that can trigger ovarian failure.
More than one in ten cases of infertility are linked to body weight, either too much or too little. So aim for a normal weight with a body mass index (BMI) of at least 20 if you're thin to start and a BMI under 27 if you're heavier (to figure out your BMI, see on later). Exercise, but moderately; working out too vigourously reduces hormone levels of oestrogen and progesterone, and ovulation may be inhibited or an embryo might not be able to implant in the uterine wall. Aim for the equivalent of a 3 km daily stroll. Eat a well-rounded diet and take basic prenatal vitamins.
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