What IS infertility treatment, exactly? (Part 2)

26 Jul

Yesterday, we left off on hormone therapy- generally the first option for people experiencing fertility issues.  Today, we’ll discuss what people do when hormone treatment alone doesn’t lead to a pregnancy.

The next stage is usually small surgeries. There’s a lot of them, so I won’t go into exhaustive detail.  Basically, if the hormones are all in order, the problem might lie in a physical problem in the reproductive system.  There’s a lot of ways things can go wrong when a little sperm is trying to reach a little egg.  These surgeries, for example, might ensure that a man’s sperm gets out of his penis as it should, or that a woman’s fallopian tubes are clear for the eggs to pass through. If these fix-ups don’t solve the problem, the next basic step of treatment involves making the journey to the egg easier for the sperm. 

This kind of treatment is generally in the form of an artificial insemination.  Pretty simple and not too costly, it goes pretty much how you’d expect (except no turkey baster is involved, unless the participants prefer to do it that way, I suppose).  A woman’s cycle is monitored so that the sperm can be injected after an egg is released.  The sperm is injected, she tries to be pretty immobile for thirty minutes or so, and then she goes about business as usual.  This might happen twice in a cycle, for the best chances. 

Alternatively, washed sperm can be deposited directly into the uterus in a process called intra-uterine insemination.  This simply makes the trip to the egg even shorter for the sperm.  If these processes don’t result in pregnancy, or if a couple is diagnosed with a condition that makes these treatments unlikely to work, the next stage of treatment will probably be the big IVF, which we will cover next time.

Have a nice weekend!

What IS infertility treatment, exactly?

25 Jul

Sorry about the scarcity of posts lately- I’m trying to transition from student anthropologist to real-life, paid anthropologist, and it’s taking a lot of effort. If anyone who sees this knows of someone hiring a qualitative researcher/ethnographer/anthropologist, send ’em my way 🙂

Anywho, I thought that today, I should address perhaps the first question that comes to mind when someone you know mentions that they will be undergoing infertility treatment or that they’re just generally having fertility issues. That question is, of course, what exactly IS infertility treatment? Most people have very vague ideas of the concept, usually involving turkey basters and petri dishes (or worse, test tubes). So, let’s review:

-Infertility is medically defined as the inability to conceive after a certain period of unprotected intercourse. This would generally be one year for couples under 35 and 6 months after the age of 35. This definition is pretty common in the United States, but varies elsewhere and between health organizations.

-After this point has been reached, a couple might talk to a family doctor about the problem, and at this point, their infertility treatment will consist of a lot of tests. For a man, this involves testing for sperm production and checking other things about the sperm. For a woman, this involves testing to make sure monthly egg production is going on as it should be. In order to tell, doctors test for hormones that should be present, and do a number of physical exams. The results of these tests decide where treatment goes next.

-If a man has a sperm problem, he might try a number of lifestyle changes or hormone treatments to remedy the situation. If the sperm issue is related to the physical form of the sperm, or their ability to move to an egg, treatment will be different. As for a woman, if the doctor feels she is not ovulating optimally, she will also get hormone treatments. These hormone treatments are designed to reproduce the process in which a woman’s hypothalamus (brain part) prompts her pituitary gland to release luteinizing hormone and follicle stimulating hormone.

After these processes are regulated, couples can give the whole baby-making process another shot. Since this post is getting a little long and infertility treatment is pretty complex, I’ve just decided to split this lesson into segments. Class dismissed for now- tune in later to continue this wonderful journey through the ovaries.

Monies.

15 Jul

Here’s a link to a pretty great article for the friends and family of people in treatment with some more tips on what not to do (left in a comment on a previous post. Thanks for the input!):

http://www.huffingtonpost.com/liz-kozak/10-things-not-to-say-to-someone-going-through-fertility-treatments_b_3131800.html

It brings up an interesting question- how much is your loved one’s fertility treatment costing them?  I actually won’t go into it at great length here- you could get the price range pretty easily by googling.  Basically, it doesn’t really matter.  Bottom line, it can be pretty expensive.

I’m not saying your curiosity about the cost is rude or unnatural.  We live in a world where money/ money questions/ money problems are everywhere.  I, for one, often have trouble not asking how much things cost because I’m constantly thinking about my own budget and how I would fit things into it. 

The reason I suggest staying away from the money question is because it might just be another topic that your friend simply doesn’t want to discuss at the time- another topic you should only discuss if they bring it up first. Financial questions are nearly always stressful.  So many relationships (within friendships, families, and marriages) come under severe strain or even break up because of financial questions. If your friend is planning in vitro fertilization, for example, into their budget, odds are that this planning has not been pleasant.  Also, If the topic were discussed with you, as the author in the above article points out, this could lead to a discussion of general finances and those are often so very uncomfortable.

Another reason treatment cost could be a stressful topic is that very, very few insurance plans cover fertility treatments.  Even plans that do cover in vitro will only cover a certain number of treatments.  Or, the insurance might cover in vitro, but not the storage of frozen embryos. For people who place so much importance on adding a child to their life, this is certainly frustrating. 

Basically, the cost of infertility treatment is great and varied, and definitely not something anyone wants to think about and discuss more than is absolutely necessary. 

 

What if you’re having a baby while your friend is struggling to conceive?

5 Jul

If you’ve watched your friend or family member struggle through difficult infertility treatments, you may feel strangely guilty for becoming pregnant yourself.  You may also wonder how you’re supposed to announce your very happy news to someone who would really love to join you in your journey to parenthood, but has not yet been able.  It is indeed a tricky situation and also one that will be repeated in the years to come as you pass through events in your child’s life that would normally be enjoyed by all of your friends and family.

Not to worry- your loved one in treatment is still capable of being very happy that you will soon have your own baby.  It is unlikely that your friend feels that if she can’t have a baby, no one else she knows should get to have one either (or if she does, it’s only passingly).  However, you should be sensitive in sharing your good news.  This is because it’s very possible to be extremely happy for your friend but very sad about something in your own life at the same time.  Also, to many women trying to conceive, it can often seem like literally every other woman they come into contact with is pregnant, so your own pregnancy may feel like another added to the pile.  Therefore, I would suggest making the announcement privately, quickly, and in a way that gives the person time and space to deal with whatever emotions this might prompt.  For example, telling your friend you are pregnant while at a dinner with a group of friends might be a bad idea. 

If you already have children, you may have questions about how possible it is for your friend or family member to be at events that contain many babies/children.  Obviously, the willingness to be around many babies while undergoing infertility treatment varies.  The best advice is to offer your invitation to child-centered events in a way that makes it clear that your loved one’s presence would be welcomed and enjoyed, but that you understand completely if she simply doesn’t feel up to it.  After all, it might be a bit hurtful to leave your friend out of the event altogether, and it may be equally hurtful to fail to be understanding about why your friend doesn’t want to come to your child’s birthday party/christening/etc. All of this also applies to the male half of a couple in treatment, of course. 

It is also possible that even though your friend or family member is struggling to conceive themselves, your baby news doesn’t affect them negatively at all.  This is yet another situation where it’s up to you to gauge how to handle a situation.  Extra caution definitely won’t hurt.

PRIVACY.

3 Jul

Today’s subject: for the love of god, NEVER discuss a loved one’s infertility/treatment with other people unless you have specifically been told that it is okay.  So many times, I have heard horror stories from women in treatment about how they were approached by an acquaintance who made a comment about the treatment, and upon being asked how that person knew, were told, “Oh, [probably the mother-in-law] told me about it the other day.” 

If you are part of a close-knit group of friends or family, you may think, “But we all talk about what’s going on with each other and we’re really concerned.”  Well, no one can tell you what to do with your own friends/family, but I can give you a 99.5% guarantee that the person who is in treatment will not appreciate it if you were the person to reveal their situation to someone they know.  They also probably won’t appreciate it if you speak to them about their treatment in a way that implies that the group has discussed it and has come to some conclusions on their behalf (especially since it’s very likely you don’t have the information you need to draw any valid conclusions).  It’s generally not fun to think about how your whole peer group or family is sitting around talking about your problems and lamenting your fate. 

Why the secrecy?  It’s less about secrecy and more about respect for privacy.  People in treatment may tell everyone they know and discuss it often, or they may decide not to tell even their closest loved ones.  Some people talk about it easily during the first couple of infertility treatments, but decide to hold back later.  This is because, as discussed in previous posts, infertility is not just another common medical condition (though it does occur fairly frequently).  It’s not like you’re discussing a friend’s frequent back pain and talking about what other people you have known have done to do away with back pain. Infertility treatment can be incredibly difficult and painful, both emotionally and physically. The people dealing with these difficulties have the right share information as they see fit.

You should never violate that right. 

Why is infertility treatment so hard? (Part 2)

2 Jul

One of the most prevalent themes of the infertility stories women told me during my research was basically (when distilled and boiled down) chaos.  So many elements of the modern American life go according to plan.  Things have meaning.  What I would encourage the friends and family of people in infertility treatment to think about is how a reproductive disruption can be totally outside of this system of meanings and plans, and how hard that can be. 

We all have an idea of how our lives will go, and depending on the individual, that idea of life course may be very specific or fairly general.  Me, for example- I have an idea that eventually I’ll get a job that uses skills I learned while getting my degree (a little difficult when your specialty is anthropology), and somewhere down the line I’ll try to get a husband and have some kids.  This outline may change If I happen upon a super rich husband, but the general plan stays the same, only altered to include world traveling and lots of leisure time. 

Basically, my point is that for most everything we do, we have a reasonable expectation that, if we work hard and take the appropriate actions, things will go according to plan.  Infertility may be the first event in many people’s lives that is completely unexpected, and doesn’t follow any rules.  This can feel catastrophic! 

I know that in the pursuit of my career, I may go through many failed interviews, but hopefully I’ll be able to draw conclusions about why I didn’t get those jobs, and the experience will still have a purpose.  A fertility treatment that doesn’t end in a pregnancy is different.  First, it is likely that adding a child to the family is the most important thing the person receiving the treatment has ever done – the stakes are extremely high.  Second, a treatment that doesn’t end in pregnancy may very well have no educational value.  Most of the time, there are no answers at the end of these cycles, no ways to ensure that next time, it’ll end differently.  When considering the fact that these infertility journeys can take a very long time, friends and family need to try to understand how this extended period of uncertainty can be so, so difficult. 

Just try to remember that, added to the pain and stress of treatment, your loved one might be experiencing the most ambivalent, unknowable period of their lives.  Try to think about how it would feel.

Why is infertiltiy treatment so hard? (Part 1)

30 Jun

We’ve all been through tough situations, and we’ve all had hard times.  So, if you’re hearing about the difficulties of infertility treatment from a loved one, you might be thinking (surreptitiously, to yourself), “Aren’t they being a little dramatic?  I know this is tough, but suck it up.” You might be thinking about how someone you loved had a serious medical condition and they bravely muddled through without much fuss, so how is this different?

Let me count the ways.  I’ll focus on female treatment for my purposes here- put yoruself in her shoes and consider how infertility treatment can completely disconnect you from the life you led before- 

1) First of all, it’s incredibly time consuming.  The doctor’s appointments needed to perform a complete overhaul of your reproductive system are numerous and stressful.  When added to the normal stresses of maintaining a career and a personal life, things can quickly get overwhelming.  Even if the origin of the infertility lies with a male partner, the woman will be the one who deals with most of the (often very invasive) treatment. Infertility treatment can be an everyday occurrence-even if you’re not at the doctor’s office, you are tracking your cycle, paying close attention to everything your body does, and giving yourself injections everywhere you go.

2) The topic of this blog overall- very few people actually understand what you’re going through, which could leave you feeling more isolated than you’ve ever felt in your life.  People don’t know what to say or how to act, and you can’t really explain.  Friends and loved ones who’ve always understood everything about you are suddenly unreachable during this extremely important endeavor.

3) You might feel as if, after so many years of relative peace, your body has suddenly turned against you (this goes for women AND men).  First of all, if refuses to perform a function that you probably always assumed would occur pretty easily.  For women, we learn from childhood that whenever we’re ready, we’ll decide to get pregnant and nine months later, we’ll have a new, adorable little baby friend.  As an infertile woman, you learn that you were wrong in this understanding, and that is very jarring.  Furthermore, you learn that the messages your body sends are no longer dependable.  Symptoms of pregnancy can closely mirror symptoms of an oncoming period, and the confusion can drive you insane.  This is especially true if you’ve spent the last three months of your life waiting for the one week in which you learn if you will have a period or a positive pregnancy test result.

Later, I’ll go into some deeper-seated reasons for why infertility can be so difficult, but for now, in summary, infertility can make your world into a whole new strange and stressful place.  As a friend, you can help by being a constant fixture.  You might not understand perfectly, but try your absolute best to be very patient.