Naa Jaane Kyun Hota Hai Yeh Zindagi Ke Saath

Becoming pregnant might seem easy for a lot of women but for others it may not be so simple. Young girls spend all their life saying that we’ll have kids in the future so when it doesn’t happen, you often wonder ‘Why Me’? The fact that young girls typically spend so many years trying not to get pregnant makes it a much bigger shock when they find out that it’s not happening. You wouldn’t know if you can make babies or not until you try for one. Not being able to have a baby can be, to a large extent, a very silent thing with no signs or symptoms of any underlying condition.

Infertility is a growing concern these days and it is important to detect the causes so as to be able to treat it. Not having children these days can be by choice as well as by circumstances. About 80% of women who don’t have children are childless by circumstances and not by choice.

Why can she have a Baby?

Before discussing a possible factor that can cause female infertility, it is important to know the factors needed for a pregnancy to occur naturally.

• A good quality egg

• A good quality sperm

• Healthy and functional Fallopian tube for the egg and sperm to meet

• A healthy uterus to house the embryo

• Ability to have sexual intercourse; and of course

• Good physical and mental health

Why can’t I have a Baby?

The act of becoming a mother is based on certain biological factors and every woman needs to meet those biological factors to have a baby. Humans aren’t that fertile to begin with. The chance for a young couple getting pregnant in one month of regular intercourse is only about 25%. The problems which may lead to infertility may be the ones which you were born with, ones which are caused by ageing and some that can’t be figured out.

Direct causes of female reproductive problems may be related to each organ within the reproductive system viz. the ovary / uterus / Fallopian tube / cervix / vagina. On the other hands the fault may lie at the brain (hypothalamus pituitary) that controls the female reproductive organs.

Too Many Eggs but still no baby : PCOS link to Infertility!!!

PCOS is the most common cause of infertility in women. PCOS is basically a condition of hormonal imbalance leading to infrequent, if not persistent, anovulation (failure to release egg). PCOS is a condition wherein women have too many eggs in their ovaries but none of them reaches maturation to get released from the ovary. Release of an egg (ovulation) is mandatory for a pregnancy to happen. However, PCOS is not the worst thing in the world to have – it is better for a woman to have too many eggs than too few.

The Ticking Biological Clock : Age and Infertility

Let’s get it crisp and clear – Infertility Management, to a large extent, is Time Management. Female age is not only one of the biggest factors for female infertility but also one of the most important factors which determine the success of fertility treatment. Women are only ‘warehouses’ of eggs and not ‘producers’ meaning that as a woman ages, the number and the quality of their eggs decreases. Every menstrual cycle, many eggs are recruited from the woman’s ovaries but only a few reach maturation and are released. This means that there is a large wastage of eggs every menstrual cycle which leads to steady depletion of eggs over the years.

The rate of depletion varies from woman to woman and the numerical age of the woman may not always correspond to the age of her ovaries. There are quite a few younger women who have reduced fertility due to their compromised ovarian reserve. A woman at the age of 30 has approx. 20% chance per month of conceiving but only a 5 % chance when she is 40.

Still an Enigma : Endometriosis and Infertility

Endometriosis is one of those words that many of us have heard, but may not quite know what it means. Endometriosis is a condition when the tissue that normally lines the inside of a woman’s uterus grows outside of it.

Endometriosis not only actually impacts the ovary affecting both the quality and quantity of eggs but also leads to scarring and distortion, which also affects the Fallopian tubes and the fertilization capability of the eggs.

Apart from the anatomical distortion that endometriosis may cause, it may also lead to release of certain chemicals and immunological factors which also may contribute to infertility.

The Transport Trouble : Tubal Factors and Infertility

The Fallopian tube plays the role of a transporter of eggs and sperms. It is also the place where the female egg and the sperm meet to achieve fertilisation. Blockage of tube on both the sides makes natural conception impossible.

Infection, injury, scarring because of PID, endometriosis or surgical procedures like termination of pregnancy may affect the tubes. It may block the path of the egg from the Fallopian tube to the uterus as well as the transition of the sperm to the uterus causing difficulty in fertilisation.

The Woes of the Womb : Uterus and Infertility

The womb houses the embryo and is the place where ultimately the embryo will grow into a fully developed baby. Problems in the womb can be there from the birth or may develop later on spontaneously or because of certain infections and/or procedures.In some cases, the uterus may be absent from birth or in some cases may be double from birth.

In some cases, a growth known as fibroid may distort the womb and may prevent implantation of a fertilised egg. Uterus can get damaged in the form of sticking together of the womb lines – this condition is known as Asherman’s syndrome. Asherman’s syndrome may result from tuberculosis infection or following some surgical procedures. This may deny access to the sperms from reaching eggs leading to Infertility.

To Sum Up

Although from the outside, having a baby may look easy; in reality it can be much more complex. Reproduction is as much complex as it is to assemble the tiny parts in a computer for it to work; and it is no more than a miracle when everything gets assembled properly and leads to the formation of a baby. But then that’s only under the best of conditions and lately the best of conditions have been found to be hard to come by.

Motherhood is the only fuel that will make you do the impossible! Hoping that you bring the best piece of art into the world!

Fertility lies may seem to be a scare mongering phrase but it is sadly an accurate one; without a doubt. With quite a few celebrities flaunting a baby bump at 40’s, gossip magazines selling the lie that 40’s was the new 30’s and big companies offering perks to their employees for freezing their future, fertility has moved from being a natural choice to being an experimental one. Advances in reproductive technologies blending with the feminist principles make couples/individuals feel that parenthood can be completely planned according to their own timetable! But Biology can’t bend according to your plans and science cannot make miracles. It’s time we get more realistic and not hold on to fantasies when it comes to fertility.

Here’s throwing some light on the 5 lies that some of you believe to be true but unfortunately are not-

Lie - 1

In the pink of my health; I can get pregnant anytime I want!

Haven’t we heard of the famous Salman Rushdie’s ex-wife and model Padma Lakshmi’s fight with endometriosis? A beautiful woman suffering from a condition which has fertility implication and almost incapacitated her!

Having a fantastic figure or for that matter a six pack abs does not always indicate that you’re fertile. There’s no dearth of cases wherein some of the prettiest women have tubal block and some macho men have no sperm in their semen. It definitely is good to be in optimal physical health but a good physique of physical health is not synonymous with good fertility health. Maintaining a good lifestyle, not smoking/drinking and not doing drugs definitely improves your chances of conception, but does not guarantee fertility. Without a proper fertility check, it is impossible to know you can father/mother a baby or not.

Lie - 2

I already have a baby, a sibling can come along anytime

Most people think that if you’ve one child you can have other easily – a big misconception. Not being able to have a subsequent child is, in medical terms, referred to as Secondary Infertility. The trouble with secondary infertility is not only that you want a baby badly but also that your previous baby wants a sibling badly and that can be a big heartache.

Secondary Infertility can be because you have either waited too long to have a second one because of which you’ve run out of your eggs or you’ve developed a medical condition which is compromising your fertility. Secondary Infertility cases have almost doubled in last 2 decades and account for almost 30% - 40% of infertility cases.

Lie - 3

I need not worry about having a baby; I’ve my eggs frozen

With the Silicon Valley companies offering new benefit to women in the form of egg freezing; egg-freezing became more of a ‘social’ choice than a medical choice. Egg freezing as a concept was introduced mainly for young individuals who needed to undergo cancer treatment, which would compromise their fertility. From there on egg freezing is being now used for the purpose of circumventing reproductive ageing in healthy women. The debate of social freezing Vs medical freezing may continue for a long time. It is important for a woman to know that egg freezing still lacks medical evidence and has potential health as well as emotional risks. Currently there is insufficient information to advocate egg freezing; so far only 2 – 12% of thawed eggs have led to a live birth. Consider Social Egg freezing as a hope, not a promise; a Gamble, not a Guarantee

Lie - 4

My career is in full swing. Right now is not a time to have a baby

Fortunately or unfortunately women have to face their biological clock some day or the other. The time when your career is in full swing is the time that you’re at the peak of your fertility health. Delaying your baby plan though may seem to the most legitimate thing at that point of time but may not always be the right thing. Lot of times working women professional assume that they already know how they want their future chalked out to be; and sometimes being childless can also seem acceptable. But remember; things change, people change, feelings change and so do priorities. By the time you reset your priorities, time could have flown by in terms of fertility and you may find yourself left with very limited fertility options or sometimes may be none at all.

Lie - 5

Even if I find it difficult to get pregnant, IVF can surely help me.

IVF has become more accessible to everyone in recent years. But the biggest myth related to IVF is that it always works. Everyone who uses it is successful and has a baby. Though it would be great for all individuals and couples who are trying to get pregnant to be successful, unfortunately there is no fertility treatment including IVF that works for everybody. Lot of women these days start planning for a baby in their mid 30’s or late 30’s and think that even if they can’t conceive naturally, IVF will help them sail through. It is important for women to understand that if you do not have good quality eggs left, resorting to IVF cannot change it. Also with increasing age, there is an increase in other fertility related issues such as PID, endometriosis etc., which can compromise fertility. Not only women, even men who have low sperm count keep on delaying definitive treatment thinking that if nothing works, IVF / ICSI will come to their rescue; which is far from the truth.

Summary

We all have ideas about how our life – career – family should play out. But when it comes to creating a family, things may not turn out to be the way we want. When it comes to fertility decision making, lot of us take help from internet. Surfing can be a fabulous place for information and connection but at the same time a dangerous place filled with obsession and misinformation. It’s all important a thing to erase the lies regarding creating a family so as to help you for better fertility decision making.

Parenthood is the only fuel that will make you do the impossible! Hoping that you bring the best piece of art into the world!