Infertility: Myths and Facts
By: Sandra Glahn
From "The Infertility Companion" By Sandra L. Glahn, ThM and William R. Cutrer, MD
Myth: Infertility is the same thing as sterility, and it’s rather rare.
Fact: Sterility is the complete inability to reproduce; infertility is “subfertility,” or impaired fertility. A sterile person cannot reproduce; about 65 percent of those who seek treatment for infertility will eventually go on to have a baby. The World Health Organization (WHO) estimates that infertility affects more than 80 million people worldwide. The American Society for Reproductive Medicine (ASRM) estimates that infertility affects 6.1 million American women and their partners, which adds up to about 12.9 percent of married couples of reproductive age.
Myth: Women are having babies well into their forties, so it’s probably safe to delay childbearing.
Fact: Fertility rates are definitely age related. Studies suggest that, on average, female fertility declines slightly starting at age 27, but drops off in a clinically meaningful amount around age 35 and then dramatically at age 40. Thanks to vigorous exercise, a woman who is 35 may have the cardiovascular system of a woman in her twenties, yet her ovarian function is still that of a 35-year-old.
Myth: Infertility is mostly a woman’s problem.
Fact: A survey conducted by the British Broadcasting Corporation (BBC) found that more than two-thirds of people interviewed thought infertility was associated with a woman’s fallopian tubes. A similar number of the 1,300 men and women interviewed did not realize that half of all infertility cases are caused by male problems. Abnormal sperm function is the major cause in one-third to one-half of all cases of male infertility, and the underlying problems are correctable about half the time. Male infertility is often easier to detect but more difficult to correct than female infertility.
Myth: At least infertile couples are “having fun trying.”
Fact: In a study of more than 2,000 Christian women, “lengthy infertility treatment” was listed as one of the four key causes of sexual aversion. (The other three were childhood sex abuse, rape, and painful labor and delivery.) Most couples report a decrease in the frequency of sexual relations after a diagnosis of infertility. What was once a source of emotional intimacy often becomes “love by the calendar,” and infertile couples say they feel a loss of privacy, sometimes even envisioning a doctor in the room during sexual intimacy. Both male and female infertility patients report a decrease in their level of sexual satisfaction, with the women also reporting that they feel less comfortable with their sexuality. More than one infertility counselor has told us, “I’ve never seen a couple going through fertility treatments who felt they had a great sex life.”
Myth: Infertility is caused by the need to relax. (“Just relax.”)
Fact: Looking at the above statistics about the causes of infertility, we can see that about 80 to 85 percent of the time, doctors find a diagnosable medical cause, for which no amount of relaxation will help. And in cases of unexplained infertility, often the problem is due to subtle or rare problems that are impossible to discover through a routine workup. Chronic stress and fatigue do alter hormones, but most fertility drugs can compensate in cases where hormones fall outside of normal ranges.
Myth: A woman must have an orgasm to conceive.
Fact: Approximately one in ten married women has never experienced an orgasm, and millions of these women have conceived. Additionally, many people believe that when a woman achieves climax—especially after the man does—fertility may be slightly increased due to enhanced sperm movement created by a small suction effect that’s thought to pull sperm into the women’s uterus. There’s a certain logic behind this theory. Yet while studies have shown that such a “vacuum effect” exists, whether it actually brings about a higher pregnancy rate is as of yet unproven.
Myth: Adoption cures infertility. (“Just adopt and you’ll get pregnant.”)
Fact: Of those adoptive families who have experienced infertility, approximately half have endured medical treatment for an average of three years prior to adopting. It has been estimated that between five and 14 percent of couples who quit treatment and pursue adoption eventually go on to conceive. That’s about the same percentage as for couples who quit treatment, choose not to adopt, and subsequently conceive. The “just adopt” advice is a variation on the “just relax” theme. The flawed idea behind it is that if couples stop thinking about getting pregnant, it will happen.
Myth: You can always adopt. (“If you adopt, the pain will go away.”)
Fact: Adoption is a wonderful solution for many couples, but it does not erase all the pain of infertility. For some infertile couples, the greatest loss is the inability to participate in the wonder of creating a child together—a key loss not solved by adoption. The suggestion that all the pain of infertility can be magically wiped away by adoption is clearly a simplistic answer to a complicated scenario.
Myth: Most infertile couples seek high-tech medical treatment.
Fact: Only about ten percent of infertile couples seek assisted reproductive technologies (ARTs). In fact, fewer than half of infertile American women even seek treatment, let alone high-tech treatment. The number of Christian couples pursuing high-tech treatment is probably much lower, because many Christians hesitate to seek even the simplest forms of infertility diagnosis and treatment out of concern that doing so might demonstrate a lack of faith.
Myth: Doctors take huge risks with embryos in high-tech programs, making these options unethical.
Fact: When looking at ART cycles, we find that the statistics do little to help us to assess the actual risk taken with human life. So the above statement may be partially true, depending on whether the patients take a proactive role in managing their treatment. Patients can take a proactive role in managing their treatment by insisting that all attempts are made to minimize the risk to the embryo. It is possible to use ARTs without compromising a high view of life. For example, couples can limit the number of potential embryos (that is, the number of eggs exposed to sperm) to the number they are willing to carry to term in that cycle, thus avoiding the ethical minefield of pregnancy reduction.
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