Facing Infertility: Navigating the Ups and Downs

The excitement and anticipation of starting a family can quickly fade when time passes without positive results. Instead, feelings of doubt, heartache, and many questions arise. Cuyuna Regional Medical Center’s OB/GYN Rachel S. Cady, MD, FACOG said the medical community is seeing higher rates of infertility, which they define as unprotected sex for a year or longer, and not getting pregnant. “The rates are going up, and there are probably many reasons for that, but one of the most discussed is that people are putting off childbearing until later in life.” Fertility declines with age in both men and women, but the effects are much more significant in women. Whereas men will continue to produce sperm, women are born with a set number of eggs, and reserves deplete. “The older women get, especially 35+, we see higher incidences of not as many eggs, and the egg quality diminishes,” said Dr. Cady.  According to the National Institute of Child Health and Human Development, studies suggest that after having one year of unprotected sex, 12-15% of couples are unable to conceive.

Having irregular periods can be an indicator that something is amiss. Regular periods are 4 to 8 days, occurring every 24-35 days. If you’re having irregular cycles, an evaluation is needed, stresses Dr. Cady, calling the menstrual cycle a vital sign for women. “Polycystic Ovarian Syndrome (PCOS) is a common reason a woman may be having irregular periods. It could also be weight fluctuations, extreme or high levels of stress or anxiety, thyroid abnormalities, and sometimes side effects of medications. All of these are signs that you need to see your doctor.” Working alongside your OB/GYN you’ll work towards finding a solution. “If someone is ovulating, we’ll have them download a period tracker app to get their history, use ovulation kits, and run some blood work to see if someone has ovulated. Outwardly, there should be signs as well. During ovulation, women will notice clearer and more elastic lubricated discharge during their fertile window,” explained Dr. Cady.

If someone is over the age of 35, blood tests are run. Your doctor may be looking for Follicle-Stimulating Hormone (FSH) levels and a number relating to your egg count, called an Anti-Müllerian Hormone test. “An AMH less than 1 is concerning and may be indicative of less ovarian reserve. Sometimes, we give medications to help with ovulation and other times, we will send the patient on for evaluation with an infertility provider who can speak with them about banking their eggs, embryo adoption, In Vitro Fertilization (IVF), or Intrauterine Insemination (IUI),” said Dr. Cady.

While it’s often assumed women are to blame for fertility issues, Dr. Cady stresses that is not necessarily the case. “The one thing that gets missed a lot is the male factor in fertility. It is quite common that there is a lower sperm count.” About 9% of men and about 11% of women in the United States have experienced fertility problems, according to the National Institute of Child Health and Human Development. “About 50 percent of infertility issues are linked to women, 40 percent male, and 10 percent the cause is unknown. We know that smoking and alcohol use decreases sperm count. Typically, when we see issues in men, is it because they may have experienced trauma, chemotherapy, Cystic Fibrosis, or mumps,” explained Dr. Cady. For patients interested in a semen analysis, they can purchase a kit and mail it in to get a sperm count.

Facing infertility can present numerous hurdles and be emotionally devastating for those hoping to begin or grow their families. It can impact both your personal connections and mental well-being. If you’re struggling to conceive despite your best efforts, it might be beneficial to reach out to a healthcare professional. They can assess potential causes and explore treatment avenues with you. While many couples do conceive over time, some choose to explore reproductive technologies or adoption.