How Did I Get Here?

Protecting Yourself & Future Generations From Infertility

Remember way back when you thought of infertility as a word that had nothing to do with your own life?

It was something that happened to other people, out there, somewhere...

Remember how you felt when you first worried something might be wrong? Who can forget their first appointment talking with a medical practitioner about trying to get pregnant?

From that point on, your life was different than your dreams. How many times since that point have you found yourself thinking, "If only..."

So why bother with regret? The past is passed, you're here now. What's the point in thinking about how you got here?

The answer is simple: if you're trying hard right now to become a parent, then you want your future children to have what you didn't, including the chance to get pregnant and have a baby without the harsh experience of infertility.

It's up to those who know to educate those who come later.

Teaching Points

STD

The hard truth is that some people become infertile as a direct result of their own actions -- without their even knowing it was happening. One of the most common causes of infertility is sexually transmitted disease (STD). STD's are insidious microbial infections that are passed through sometimes loving, sometimes casual acts and that are, for the most part, silent but fertility-endangering.

Some STD's are worse than others when it comes to causing infertility. Generally, the result of untreated STD is damage to the internal organs responsible for reproduction.

Few young people seek treatment, for several reasons:

  • they don't have access to healthcare
  • they're too embarassed to talk with a professional about any symptoms they've had
  • they have no symptoms that concern them

Add to the above information the growing documentation that chlamydia, in particular, is spreading like wildfire, and you've got even more young people bound for infertility. A nationally representative study presented in July 2005 concluded that 2.2 percent of the U.S. population aged 14 to 39 has chlamydia. The highest proportion -- nearly 1 in 20 women between the ages of 14 and 19 are infected.

Most of them won't know they're infertile until they try to get pregnant -- and can't.

Sound familiar?

Other Infections

Recently an unusual outbreak of the formerly common childhood illness called mumps has occurred in parts of the midwestern U.S., leading to a Centers for Disease Control Health Advisory issued April 14, 2006. At that time, the CDC counted 605 suspected, probable, and confirmed cases in the state of Iowa, with additional cases being investigated in eight neighboring states.

What does this have to do with infertility?

Some cases of mumps, a viral infection with varying intensity of symptoms, can cause a number of fertility-related complications, including orchitis (swelling of the testicles), oophoritis (swelling of the ovaries), and spontaneous miscarriage.

Of special concern in this outbreak is that most cases are occurring in people aged 18 to 25, and many were vaccinated as children.

As future parents, you will be directly impacted by your community's recommendations and regulations regarding pediatric innoculations against diseases like mumps. Take a look at the CDC advisory for more information.

More Touchy Subjects

Smoking

Some of you reading this could be more fertile if you'd never smoked cigarettes. Most people who smoke get started as teens or young adults, and they've heard all the warnings -- lung cancer, emphysema... How many times did you hear that smoking could impact your fertility?

The chemicals that are inhaled while breathing in smoke have been shown to wreak havoc on women's estrogen levels, thereby disrupting ovulation. There's even some evidence that women who smoke may produce eggs that are more prone to genetic abnormalities.

Weight

Here's another point that's tough to hear -- the ASRM estimates that 12 percent "of all infertility cases are a result of a woman either weighing too little or too much." Similar to smoking's effects, under and overweight women often develop problems with estrogen levels, resulting in irregular or lack of menstrual periods (amenorrhea) and inadequate or even totally absent ovulation.

Women are barraged with negative body image messages in our society. That makes it a very difficult subject to bring up in the exam room. Hearing weight issues discussed in the same objective manner as other health issues, before the patient is already distressed about not conceiving, might be one step toward helping future moms-to-be achieve their dreams. Remember that moderation is the key -- when it comes to conceiving, you really can be too thin (or too heavy.) Panic-dieting to quickly shed pounds can be just as harmful to your crucial hormonal balance as being overweight. Envision your body as healthy and do what it takes to get there.

Age

Something else no one really wants to hear -- the biological clock is more than just an idea, it's reality. While science and medicine have managed to find ways around it, more times than not ART works better for younger women. The evidence is overwhelming. There's even some data that implies men's gametes, sperm, might fare worse as they age.

Just 20 years ago, many of us were (and many still are) living our lives as though we could have children whenever we wanted, on our own timetable. Now, aside from very expensive rolls of the treatment dice, we're facing the reality that everything, including fertility, has an endpoint.

Been There, Done That

Again -- what's the point in reflecting on your past?

Every generation has something they yearn to transmit to those behind them. Children of today are growing up in a world that can provide an incredible amount of hope for treatment of their future infertility.

But wouldn't it be nicer if they didn't even have to make use of that treatment?

How will they know, if they are not told, how to protect their fertility -- so they can get pregnant and have babies when the time is right for them?

We may have had to settle a bit on altered dreams, but maybe we can prevent others from having to do the same.

More resources for teaching:

ASRM's Protect Your Fertility Campaign

CDC's STD Fact Sheets

RESOLVE's articles on Optimizing Your Fertility

The American Fertility Association's articles on Trying to Conceive

Thanks to Dr. Arthur Wisot of Reproductive Partners Medical Group in California for his medical and editorial expertise in preparing this information.