Unspo­ken Real­i­ties Of The Jour­ney Through Fertility

by Michelle
Journey through fertility, infertility, fertility, women infertility, male infertility, couples infertility, societal norms, fertility journey, infertility talks, this is what infertility looks like, the surprising truth about making babies late, ted talk pregnancy, pregnancy problems, pregnancy, miscarriage, Reise zur Fruchtbarkeit, Unfruchtbarkeit, Fruchtbarkeit, Unfruchtbarkeit bei Frauen, Unfruchtbarkeit bei Männern, Unfruchtbarkeit bei Paaren, gesellschaftliche Normen, Ted Talk Schwangerschaft, Schwangerschaftsprobleme, Schwangerschaft, Fehlgeburt, Kinderwunsch, ungewollt kinderlos, Unfruchtbarkeit Ursachen

You can‚Äôt have a baby? Must be a female prob¬≠lem! Be care¬≠ful with such state¬≠ments because they are not (always) true! It is one of the com¬≠mon mis¬≠takes in talk¬≠ing about infer¬≠til¬≠ity. But let us have a deeper look into what is behind those soci¬≠etal norms and expec¬≠ta¬≠tions for cou¬≠ples who wish for a child! Dr. Michelle tells us about the men¬≠tal and phys¬≠i¬≠cal prob¬≠lems in the jour¬≠ney through fertility:

Fer¬≠til¬≠ity today has trans¬≠formed its def¬≠i¬≠n¬≠i¬≠tion into some¬≠thing that has been cloaked in shame. It is a sub¬≠ject that is often whis¬≠pered among hushed tones, pep¬≠pered in a lot of stress and anx¬≠i¬≠ety. Approx¬≠i¬≠mately 15 % of cou¬≠ples around the globe doc¬≠u¬≠ment infer¬≠til¬≠ity. This amounts to mil¬≠lions! Yet we do not talk about how cou¬≠ples tackle this jour¬≠ney through fer¬≠til¬≠ity with both its men¬≠tal and phys¬≠i¬≠cal facets. When research¬≠ing infer¬≠til¬≠ity, some of the first thoughts are often the meth¬≠ods to achieve fer¬≠til¬≠ity again. How¬≠ever, the less-dis¬≠cussed aspect is the sti¬≠fling bur¬≠den that infer¬≠til¬≠ity has on rela¬≠tion¬≠ships and indi¬≠vid¬≠u¬≠als reduc¬≠ing their worth to their abil¬≠ity to procreate. 

Infertility‚Äôs Male vs. Female Dilemma 

Fer¬≠til¬≠ity is often depicted as a strug¬≠gle for a per¬≠son with a uterus to get preg¬≠nant. Unfor¬≠tu¬≠nately, this is due to the con¬≠nec¬≠tion built between the uterus and the baby. In many parts of the globe, par¬≠tic¬≠u¬≠larly rural sec¬≠tions, men¬≠stru¬≠a¬≠tors are sub¬≠jected to years of rig¬≠or¬≠ous test¬≠ing and ther¬≠a¬≠pies. This is with¬≠out con¬≠sid¬≠er¬≠ing a poten¬≠tial bio¬≠log¬≠i¬≠cal male cause, pri¬≠mar¬≠ily because soci¬≠etal norms have not allowed the pos¬≠si¬≠bil¬≠ity of a inef¬≠fi¬≠ciency by non-men¬≠stru¬≠a¬≠tors. The CDC high¬≠lights that there is about 35 % of a male fac¬≠tor along with a female one among cou¬≠ples who are unable to con¬≠ceive. Sev¬≠eral fac¬≠tors con¬≠tribute to fer¬≠til¬≠ity in non-men¬≠stru¬≠at¬≠ing indi¬≠vid¬≠u¬≠als. These include gen¬≠eral health and well¬≠be¬≠ing, semen and sperm qual¬≠ity and quan¬≠tity, med¬≠ica¬≠tions, under¬≠ly¬≠ing med¬≠ical con¬≠di¬≠tions, and even men¬≠tal health. 

For men¬≠stru¬≠a¬≠tors, there are many more aspects that are explored to con¬≠clude a diag¬≠no¬≠sis of infer¬≠til¬≠ity. A com¬≠pre¬≠hen¬≠sive exam¬≠i¬≠na¬≠tion of the repro¬≠duc¬≠tive tract, hor¬≠mones, under¬≠ly¬≠ing med¬≠ical con¬≠di¬≠tions, med¬≠ica¬≠tions as well as lifestyle fac¬≠tors is gen¬≠er¬≠ally con¬≠ducted. While we are aware of an equal pos¬≠si¬≠bil¬≠ity, the psy¬≠cho¬≠log¬≠i¬≠cal impact is higher among men¬≠stru¬≠at¬≠ing peo¬≠ple to con¬≠ceive. Resul¬≠tant ther¬≠a¬≠peu¬≠tic mea¬≠sures are largely aimed at repro¬≠duc¬≠tive sys¬≠tem of peo¬≠ple with a uterus, enhanc¬≠ing their chances of get¬≠ting preg¬≠nant. And a failed attempt is brushed aside with¬≠out explor¬≠ing the impact it pos¬≠si¬≠bly could have had on the men¬≠stru¬≠a¬≠tor and the couple. 

Explor¬≠ing the Psy¬≠cho¬≠log¬≠i¬≠cal Aspect to Infertility 

For decades the com¬≠plete¬≠ness of a men¬≠stru¬≠at¬≠ing per¬≠son has been deeply inter¬≠twined with her abil¬≠ity to bear chil¬≠dren. This is why an inabil¬≠ity to do so often makes her/him feel inad¬≠e¬≠quate or defeated in life‚Äôs pur¬≠pose. At the sim¬≠i¬≠lar end of the spec¬≠trum, the inabil¬≠ity to impreg¬≠nate their part¬≠ners causes non-men¬≠stru¬≠a¬≠tors reflect on their ‚Äúmas¬≠culin¬≠ity‚ÄúWhile both part¬≠ners are often stressed about a sim¬≠i¬≠lar cir¬≠cum¬≠stance, the chan¬≠nel for dia¬≠logue is scarcely explored. This is due to the min¬≠i¬≠mal avenues for men¬≠tal health dis¬≠cus¬≠sions within the fer¬≠til¬≠ity ecosys¬≠tem. There is a huge strain within the rela¬≠tion¬≠ship caused as a result of infertility. 

To feed into the vicious cycle of fer¬≠til¬≠ity, the stress and anx¬≠i¬≠ety expe¬≠ri¬≠enced by the cou¬≠ple can fur¬≠ther reduce their chances of con¬≠cep¬≠tion. Men¬≠tal health con¬≠cerns that are not ade¬≠quately addressed are known to affect phys¬≠i¬≠cal func¬≠tions within the body such as the reg¬≠u¬≠la¬≠tion of hor¬≠mones and meta¬≠bolic func¬≠tions. Within the few stud¬≠ies that are con¬≠ducted con¬≠cern¬≠ing fer¬≠til¬≠ity and men¬≠tal health, women are often fre¬≠quent can¬≠di¬≠dates. Among the stud¬≠ies con¬≠ducted to doc¬≠u¬≠ment men¬≠tal health among men, there is a sub¬≠stan¬≠tial increase in anx¬≠i¬≠ety observed among the cases of infer¬≠til¬≠ity. Impacts on rela¬≠tion¬≠ships are prob¬≠a¬≠bly the most infre¬≠quently explored dimen¬≠sion in the jour¬≠ney though fertility.

Changes the Jour¬≠ney through Fer¬≠til¬≠ity needs 

Tack¬≠ling infer¬≠til¬≠ity beyond the scope of just a phys¬≠i¬≠cal inabil¬≠ity is high¬≠lighted as a basic human right by the WHO. There is a need to view cou¬≠ples as indi¬≠vid¬≠u¬≠als them¬≠selves that are beyond the realm of repro¬≠duc¬≠tive machines. While the men¬≠tal health of het¬≠ero¬≠sex¬≠ual cou¬≠ples is cur¬≠rently scarcely explored, it is safe to assume the strug¬≠gles that older cou¬≠ples, LGBTQ* cou¬≠ples, dis¬≠abled cou¬≠ples, rela¬≠tion¬≠ships with more than two part¬≠ners, sur¬≠ro¬≠gates, and even indi¬≠vid¬≠u¬≠als who wish to be sin¬≠gle par¬≠ents expe¬≠ri¬≠ence are not even on the radar. A few stud¬≠ies have doc¬≠u¬≠mented a pos¬≠i¬≠tive impact on address¬≠ing the psy¬≠cho¬≠log¬≠i¬≠cal needs of women on their jour¬≠neys through fer¬≠til¬≠ity. Addi¬≠tion¬≠ally, cou¬≠ples who are tack¬≠ling their fer¬≠til¬≠ity strug¬≠gles ben¬≠e¬≠fit tremen¬≠dously from coun¬≠selling, increas¬≠ing preg¬≠nancy rates as a consequence.

There are so many con¬≠cerns that are rarely voiced when man¬≠ag¬≠ing fer¬≠til¬≠ity largely due to the prover¬≠bial fin¬≠ish line of hav¬≠ing a baby. This has in turn diluted the joy that cou¬≠ples often seek when decid¬≠ing to have a fam¬≠ily. The bond is lost over a bar¬≠rage of med¬≠ical tests, failed cycles of IVF, and soci¬≠etal pres¬≠sure to pro¬≠cre¬≠ate. So, what does it need? The sys¬≠tem built to tackle fer¬≠til¬≠ity should invest in cul¬≠ti¬≠vat¬≠ing the indi¬≠vid¬≠ual and their needs. This means cou¬≠ples should feel that they always have a choice whether they wish to have a child or not. At no inter¬≠val must it appear to be a fail¬≠ure. Addi¬≠tion¬≠ally, cou¬≠ples must be encour¬≠aged to fos¬≠ter their rela¬≠tion¬≠ship through the process, and impor¬≠tance should be played on them ver¬≠sus their need for children.

Do you strug­gle with infer­ti­tity or have opin­ions on the topic? Share your thoughts, prob­lems, and your jour­ney through fer­til­ity in the comments!

Published at 15. November 2021
Dr. Michelle Frank is a healthcare consultant working towards building safe online health communities for women within the digital space. She is currently the Director of Health & Wellness at Naima (https://www.instagram.com/naima.cares/), which is an online pregnancy ecosystem for women. She resides in India, exploring different cities and opportunities as they arise. Feel free to join in for #MyHealthChat which she co-hosts every alternate Thursday on Twitter. Instagram | LinkedIn

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