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Infertility: The Real Facts of
Life
"Aren't you ever going to
have kids?"
For the 6 million Americans
struggling to get pregnant or carry a baby to term, that
question goes beyond nosiness. It's a painful reminder
that infertility often is ignored, misunderstood and even
dismissed by those who haven't lived it.
"Infertility is a very real medical condition -- one we
can trace to specific problems in the reproductive
system," says Seattle fertility specialist Michael R.
Soules, M.D., a past president of the American Society for
Reproductive Medicine (ASRM).
Thanks to progress in medication, microsurgery and test-tube
fertilization, more than half the patients who seek fertility
treatment can expect a successful pregnancy. Depending on the
problem, they can be treated by an obstetrician/gynecologist,
urologist or reproductive endocrinologist.
But the first step for infertile couples should be educating
themselves, says Diane Clapp, R.N., national medical
information director at RESOLVE, the National Infertility
Association.
"Infertility can make you feel isolated and out of
control," she says. "Getting the facts about
treatment options and knowing when to seek help empowers you
to take that control back."
To start, test your knowledge with the quiz that follows.
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Before seeking infertility care, all couples should try
conceiving on their own for a year.
True or False?
Answer: False. This may be sound advice for an
otherwise healthy couple in their 20s. But for some
women, it just delays vital evaluation and treatment,
Ms. Clapp says. A year is too long if a woman is 35 or
older; has had two or more miscarriages; or has a
history of irregular menstrual cycles, pelvic
inflammatory disease or pelvic surgery. In these cases,
a couple who fails to conceive after several months of
unprotected, well-timed intercourse should see a
doctor.
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Stress causes infertility.
True or False?
Answer: True. This occurs when stress interferes
with ovulation. But the reverse can be true, as well:
Infertility can cause stress. "Infertility is a
symptom of an underlying disease or structural
problem," says Dr. Soules. "To suggest that
relaxation is all you need for a pregnancy unfairly
minimizes a medical problem."
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Becoming pregnant with twins, triplets or higher multiples
is a risk in all fertility treatment.
True or False?
Answer: False. Only couples taking specific drug
therapies run the risk of multiple births -- and a lot
of infertility treatments don't involve these
therapies at all, says Dr. Soules. Even with these
therapies, single births are the usual outcome.
Multiple births also may result from assisted
reproductive technology, where eggs are fertilized
outside the body and placed in the womb. The ASRM
recommends transferring no more than two good-quality
embryos.
Patients seeking any fertility treatment should ask
about the risk of multiple births and how to lessen it.
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Female fertility drops a lot at 40.
True or False?
Answer: True. The 20s are a woman's peak
reproductive years. Between 35 and 40, female fertility
falls moderately. At 40, the drop is dramatic.
"The quality of the eggs deteriorates," Dr.
Soules says. "We're not sure if the eggs are
just older and don't work as well, or if nature has
a way of selecting the best eggs first."
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Infertility is mainly a woman's problem.
True or False?
Answer: False. The ASRM says infertility
problems are split between the sexes. Doctors trace 40
percent of cases to the man, 40 percent to the woman,
and the remaining 20 percent to a combination of
male-female problems.
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You can prevent types of infertility.
True or False?
Answer: True. According to the ASRM, these
factors can affect fertility:
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Age. Women shouldn't delay childbearing
beyond ages 35 to 38.
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Smoking. Women who smoke are less fertile and
face earlier menopause.
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Weight. Excessively thin or obese men and
women are less fertile.
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Sexually transmitted disease. Chlamydia
raises a woman's risk for fertility problems.
Women with more than one sex partner should use
condoms and seek chlamydia testing.
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"Once fertile, always fertile" is true for men.
True or False?
Answer: False. Previously fathering a child
won't bar future fertility problems, says Dr.
Soules. Men, however, can stay fertile well into their
senior years.
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