Coping with infertility

Infertility and women in the military

Fertility issues may be common in women in the US military

A recent survey suggests that infertility may be a common problem among American servicewomen

How common are fertility issues among women in the US military?

According the Service Women’s Action Network, 37% of women from the various branches of the military (army, navy, air force, marines) surveyed experience difficulty in conceiving.

Is it easy to get infertility treatment in the military?

While treatment is available, respondents reported that treatment services were limited and difficult to access. Many basic fertility procedures such as IUI and access to a fertility specialist were unavailable on base, and for those who require advances treatments such as IVF, there are only a few military medical facilities which offer it. Frequently, those centers have long waiting lists, and require significant travel.

What about off base fertility treatment for service women?

Like other practices in different parts of the country, we are close to an active military base. Joint Base McGuire-Dix-Lakehurst is not far and we do participate with Tricare, so we do get to help many couples from the base seeking fertility treatment. The obstetricians and midwives in our practice also see many of the service women and family members for pregnancy care and gynecologic issues.

When is it time to give up on IVF?

Couples continue to get pregnant with IVF put 8 cycles.
When is it time to stop IVF: Princeton IVF blog

Any couple who has gone through IVF knows what a rough and wild ride it can be, both physically and emotionally. For that reason, many couples give up on IVF early on, perhaps too early.

Why do women drop out of IVF treatment?

The reasons why women quite IVF are usually financial, when their insurance coverage or access to funds to pay for treatment run out, or emotional, when the thought of going through another cycle and the prospect of all the drugs, office visits and prospect of disappointment becomes overwhelming.

But, what happens to couples who persist and continue to go through IVF treatment cycles?

Fertility doctors in Bristol in the UK, sought to answer that question and what they found was encouraging. In their program, 1/3 of patients conceived on the first IVF cycle. In the next 3 cycles (1-4) the pregnancy rate was about 20% per cycle. While the rates were lower in cycles 5 and 6, they were not zero. Pregnancies continue to happen.

After 6 cycles of IVF, the cumulative pregnancy rate was 68%. In women between 40 and 42, there were successful pregnancies through the 9th cycle.

We've failed a few cycles of IVF. Should we give up?

Only you and your partner can answer that question. IVF tends to be more successful on the first round, but successful pregnancies do continue to happen with repeated attempts, sometimes even when it seems futile.

 

Ready to give up after IVF? It's not time to give up.

Many couples with unsuccessful IVFs get pregnant on their own
Upto a third of couples who failed to get pregnant with IVF may get pregnant on their own.

IVF treatment can be incredibly stressful, even when it is successful. Imagine how difficult IVF can be when it is not? That is likely why so many couples give up after an unsuccessful IVF cycle.

According to reasearchers in the UK, almost a third of couples who are not successful at IVF and stop treatment will conceive on their own, although that might take up to 2 years.

Surprisingly, many of the couples who did conceive this way were not as thrilled as one might expect. Some couples have moved on in their life situations, and others were felt that maybe they never needed IVF in the first place.

Can having a miscarriage increase your chances of having a baby?

Miscarriage after IVF may mean a better chance for future baby

An unsuccessful IVF cycle can be downright devastating to couples going through fertility treatments, particularly when the cycle results in a miscarriage. Between the guilt, the disappointment and the "if I only had's," many couples leave the experience totally devastated.  But are those concerns really warranted?

Probably not.

Fertility specialists have known for years that women who miscarry, are actually more likely to have a baby, even though most patients are a understandably somewhat skeptical about this.

To look further into this fertility specialists at the University of Aberdeen in Scotland looked at well over 100,000 IVF treatment cycles performed between 1999 and 2008. They were particularly interested in women who had a first cycle at that was unsuccessful, whether that was there was a miscarriage or no pregnancy at all. What they found was not surprising considering what we already know.

Women who had miscarried had a higher 49% chance of livebirth in the subsequent IVF cycle as compared to only a 30.1% chance had the first cycle not resulted in a pregnancy.

So, what does this all mean? 

  • Don't be in a rush to give up. Lots of women conceive on subsequent cycles.
  • Having a miscarriage from IVF, and likely from other treatments, means you are more likely to have a baby, not less likely.

Here are 12 things to avoid telling your friend with infertility:

12 Things not to say to your friend with infertility: Princeton IVF blog
Dealing with friends who have infertility.

Infertility affects 1/8 couples, so chances are you either are having trouble getting pregnancy, had trouble in the past, or you know someone who currently is having difficulty. On this Infertility Awareness Week, here are some tips to be just a little more sensitive.

You should avoid saying these 12 things to your friend or colleague with infertility: 

1. Just relax.

Yes, stress does play a role infertility and stress reduction techniques can help couples conceive, but infertility is a medical diagnosis and seeing a fertility doctor can discover real problems that require treatment.

2. Minimize the problem.

Regardless of how you view it, research shows that the inability to get pregnant is one of the great stressors in life, up there with losing a job and being diagnosed with cancer. 

3. Worse things could happen.

Chances are your friend does not see it that way. 

4. Maybe you were not meant to be parents. 

Don't go there. Many couples with infertility see their condition as a divine punishment rather than what it is, a treatable medical disease. This will only reinforce their self doubt.

5. Why are you not doing IVF?  

IVF is the most effective treatment out there for infertility, but it is not for everyone. It can be expensive, invasive, stressful and conflict with some people's religious values. 

6. Just adopt. 

Adoption is always a reasonable option, but most couples take time to get there, and still others do not want children if they cannot have their own genetic children. 

7. You're young. There's still plenty of time.  

Younger women usually have an easier time getting pregnant, so if things aren't working, it's time to figure out why.  Yes, the chances for success are higher in younger women, but there are no guarantees.

8. Gossip.

Infertility is private. You wouldn't want someone talking about your medical problems to others.   

9. Crude remarks. 

Fertility problems deal with the most sensitive and personal parts of our lives. Don't assume your friend will find humor in it.

10. Complain about your own pregnancy. 

No matter miserable your pregnancy may be, your friend sees pregnancy as the greatest blessing she ever could hope for. Seeing other pregnant women is one of the most difficult challenges for women facing infertility.

11. Minimize their concerns because they already have a child. 

For many couples, a family is not complete with only one child, and it is just as common for couples to seek out help for child number two as for the first. Doctors refer to this as secondary infertility.

12. Ask whose fault it is.

Infertility is a couples thing. While oftentimes, it is one of the partners who has the problem, it takes two to have a baby. Sometimes even when it is a male issue, the female partner must go through most of the treatment. Assigning blame, is counterproductive and can cause considerable strain i a relationship. Don't add to it.

adapted from Resolve.org.