What Is Infertility, Exactly?

According to the dictionary...

Infertility is the inability to conceive children.

No shit, sherlock. 

To most doctors, infertility, is a disease characterized by the failure to establish a pregnancy after 12 months of regular, unprotected sexual intercourse and if you are over the age of 35, this time frame drops to 6 months. 

Some people think that "trying to conceive" is just ditching the pill and "pulling the goalie" so to speak.

Come on, you know what I mean.

Most doctor's won't take you seriously unless you have been trying for 6-12 months with timed intercourse around ovulation.  This means using home ovulating predictor kits each month, and having sex when you see a smiley face on the pee stick. Pregnancy is technically only possible during the five days before ovulation through the day ovulation actually takes place. These six days are the 'fertile window' in a woman's cycle, and represent the lifespan of sperm (5 days) and the lifespan of the ovum, a mature female reproductive cell (24 hours). So, yes, there are only 6 days in the month that you can "technically" get pregnant. 

They don't tell you this shit in health class. 

Or, you could skip the home ovulating kits and just have sex every day of the month. 

Because, we all have time for that, don't we?

Infertility comes in many, many forms and can be represented in the female, the male, both partners, or just plain, unexplained. I personally think unexplained infertility is the fucking worst. It's when a couple can't get pregnant, but no cause in either partner is found. About 15% of couples suffer from unexplained infertility. 

There are several causes of infertility, and it's good to get tested for these things early on so you know what you are working with. I am a firm believer in empowering young couples to think about this stuff before it's too late. 

Typically, with men, the cause of infertility lies with the swimmers

i.e. sperm, and is graded on these factors...

  • Count - the more swimmers the better, around 20 million per ML is considered normal
  • Motility - when they have trouble swimming 
  • Morphology - when the sperm themselves are morphed our abnormally formed, two heads are not better than one. 
  • Blocked sperm ducts - otherwise know as Vas Deferens Blockage. The Vas Deferens is the tube in which the fertile sperm are transported. This could be caused by varicose veins, of the testicles or  by an STD. 
  • Antisperm Antibodies - High numbers of sperm antibodies can make it difficult for the sperm to reach the egg, and/or fertilize the egg. Antisperm antibodies also may damage sperm that survive, which increases chances of miscarriage. Some women can actually have an allergic reaction to their partners sperm. 

Age doesn't seem to have much to do with sperm quality, however, drugs, alcohol and hot tubs can. I think the oldest man to get a woman pregnant was 94 years old.

Old, saggy balls, still got it!

With women, we don't have it so lucky. Age is a HUGE factor in female infertility.

The top factors of female infertility are...

  • Lack of ovulation - when you don't release eggs from your ovaries. There are several reasons why you may not be ovulating - poor nutrition/lifestyle choices, stress, underweight or overweight, or some sort of genetic predisposition.
  • Blocked fallopian Tubes -  and thus can't carry eggs from the ovary to the uterus. The main causes of blocked tubes are endometriosis, pelvic inflammatory disease (often caused from an STD), uterine fibroids or an ectopic pregnancy. 
  • Endometriosis - when excess endometrium lining of the uterus that normally grows in preparation for the implanting of the egg begins, does not completely shed during menstruation. It then begins to attach to other places of the body besides the uterus and then when your period comes not only does the lining in the uterus bleed the endometriosis that has grown in other places of the body also bleeds. It's fucking fabulous, let me tell you!
  • Polycystic Ovary Syndrome (PCOS) - a hormone imbalance that effects 1 out of 10 women. Women with PCOS produce higher than normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant. The term “polycystic ovaries” means that there are lots of tiny cysts, or little sacs, on the ovaries. Unfortunately, doctors don't know the cause of PCOS. 
  • Egg quality/reserve - poor egg quality or low egg count typically due to environmental factors, hormones in the diet, stress, lifestyle choices and aging.

Wasn't that fun and motivating information? 

Okay, look. This shit sucks. Infertility sucks. BUT, it's not the end all be all. You have options! None of these diagnosis's mean you can't actually get pregnant, they are just hurdles. Get tested early, know your options. Fertility treatments take time, and it's good to know what you are working with. 

You will get through this, and you will become stronger from it, I promise you that. 

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