info@fertilitymatters.ca

What Is Infertility

What is infertility?
Women and infertility
Men and infertility
Improving Fertility
Getting medical help
Fertility Treatments
Finding a clinic
Coping with stress

What is infertility?

Infertility can be defined as:

the inability to conceive after having regular unprotected sex, after one year for women who are under 35 years old and after 6 months for women over 35 years old.
the inability to contribute biologically to a conception or
the inability to carry a pregnancy to a live birth

Did you know?

Roughly 16% (or 1 in 6) couples in Canada experience infertility. This number has doubled since the 1980s.

Causes of infertility

Infertility is both a male and a female concern. It can be the result of a female factor, a male factor, or a combination of both.

30% of the time, the cause is in men
40% of the time, the cause is in women
20% of the time, the cause is a mix of both male and female factors
10% of the time, no explanation can be determined for the cause

Source: Government of Canada
healthycanadians.gc.ca

Infertility in women can be the result of several factors. Problems with the reproductive system, the reproductive organs or the reproductive processes are all reasons why a woman may have difficulty conceiving or maintaining a pregnancy to a live birth.

Causes may include:

age – fertility decreases significantly after age 35
problems producing eggs – an irregular or absent period or menstrual cycle may be indicators
history of sexually transmitted infection (STI) – for example, Chlamydia, can cause blockages in the fallopian tubes
problems in the uterus – fibroids or polyps
problems with the fallopian tubes – missing tubes or blockages
endometriosis – the buildup of tissue around the reproductive organs
hormonal imbalances
early menopause – before age 40

Causes of infertility in both men and women may include:

past treatments for cancer – chemotherapy, radiation, and/or surgery
some chronic illnesses (like diabetes), as well as their treatments
tobacco and alcohol use
being under weight or over weight

Did you know?

91% of women can get pregnant at age 30

77% by age 35

53% by age 40

Source: Government of Canada
healthycanadians.gc.ca

Male infertility is the cause of almost half of couples seeking help for starting their families.

Causes may include:

poor sperm quality – their rate of movement and shape
low sperm count, or lack of sperm
a history of sexually transmitted infection (STI), like Chlamydia
hormonal imbalances

Other causes of infertility in both men and women may include:

past treatments for cancer (like chemotherapy, radiation, and/or surgery)
some chronic illnesses (like diabetes), as well as their treatments
tobacco and alcohol use
being under weight or over weight

Source: Government of Canada
healthycanadians.gc.ca

No matter if you have been diagnosed with infertility or are just looking to increase your chances of getting pregnant, there are several things you can do to improve the chances that you will be able to conceive on your own.

For women, begin trying to have children before the age of 35.
Eat a healthy diet.
Get regular exercise.
Do not smoke.
Drink fewer alcoholic beverages.
Be proactive and learn ways to help you deal with stress.
Alternative therapies, such as yoga and massage, can help to increase the chances of getting pregnant by helping to reduce your stress.

If you are experiencing difficulties conceiving, the following are considerations:

better timing of sexual intercourse

ensuring that hormone levels are in balance. Consult your physician for treatment if hormones are imbalanced.

surgery may be required to repair reproductive organs

Source: Government of Canada
healthycanadians.gc.ca

Women

When you should see your doctor:

if you are 35 or younger and have not become pregnant after one year of regular unprotected sex
if you are older than 35 and have not become pregnant after six months of regular unprotected sex

You should seek medical advice sooner if you:

have severe pain during your periods (menstruation) or while you are having sex – these may be signs of endometriosis
have no periods or have irregular periods – this may point to problems with ovulation
had surgery in your abdomen or uterus in the past
had more than one miscarriage
have a history of a sexually transmitted infection (STI)
had cancer treatment in the past
have a family history of early menopause – before age 40

Men

You should see your doctor if you:

have had surgery on your testicles or an injury to your testicles in the past
have premature ejaculation or lack of erections
have a history of a sexually transmitted infection (STI)
had cancer treatment in the past

What to expect from your doctor

Your doctor will likely give you a physical examination and ask several questions to:

check your general health
find out more about what you are doing to try to conceive
identify any parts of your lifestyle that may be having an impact on fertility such as, smoking, alcohol and drug use, being obese, or being exposed to harmful chemicals

Some common diagnostic tests for both women and men include:

screening for sexually transmitted infections (STI)
blood tests to check hormone levels

Tests for women only may include:

an ultrasound exam of your pelvic region
an x-ray dye test to find any blockage in your fallopian tubes
a sonohysterogram, that can help to find fibroids, polyps, or endometriosis in your uterus

Tests for men only may include:

sperm and/or semen analysis
genetic testing (if there is reason to suspect a genetic cause)

Source: Government of Canada
healthycanadians.gc.ca

Depending on your diagnosis or the results from your specialized tests, your doctor may recommend fertility treatments, also called assisted human reproduction (AHR) or assisted reproductive therapy (ART). ART uses medical procedures to assist with getting pregnant.

Fertility treatments can include:

Ovulation-inducing drugs: These fertility drugs are used to stimulate the follicles in the ovaries to produce multiple eggs in one cycle.
Intrauterine Insemination (IUI): During an IUI procedure, a small tube carries sperm directly in to the uterus, through the vagina.
In Vitro Fertilization: In vitro fertilization (IVF), the manipulation of both sperm and eggs outside the body to help with fertilization. In some cases, a procedure called intracytoplasmic sperm injection (ICSI) is used to inject a single sperm in to a single egg to assist fertilization.

Procedures like IVF and embryo transfer usually take place in a fertility clinic or hospital where staff have specialized training.

In order to ensure you are well-informed about your fertility treatment options, it is important for you to know what questions you should be asking your doctor or fertility specialist.

What kind of treatments do you recommend for my situation?
What are the known risks of the planned procedures for me, for my spouse or partner, for a donor (if this applies), and for any children born as a result?
What is the full cost? Is any of it covered by my province’s health care plan, employee benefits, or private health insurance plan?
Taking into consideration my age, diagnosis, and treatment, what are my chances of becoming pregnant?
If this procedure does not work, what would you suggest next?

Source: Government of Canada
healthycanadians.gc.ca

In Canada, there are over 40 fertility clinics. Not all clinics provide a full range of fertility treatments. To ensure you are choosing the right clinic for you, speak with your doctor or health care professional. Here are some things to consider when choosing your fertility clinic:

Choose a clinic that makes you feel at ease and that is suited to your needs.
Ask questions to make sure you understand and are comfortable with the procedures being offered.
Find out about the options available, their risks and advantages, as well as their success rates.
Ask for a step-by-step breakdown of the process you choose, and the time and costs involved.
You may also want to get counselling to help you make decisions.

It is important to be as informed as possible before starting treatment. Some questions to ask your health care providers include:

Which medical procedures are recommended for me, given my situation?
What are the risks of these procedures for me, my partner (if applicable), a third-party donor (if applicable), and any children born as a result?
What is the full cost of these procedures?
Is any of this cost covered by my provincial health care plan, my employee benefits, or my private health insurance plan?
If this procedure does not work, what would be the next step?

You can find a list of these clinics here:
https://www.cfas.ca

Source: Government of Canada
healthycanadians.gc.ca

Being diagnosed with infertility and the process of going through fertility treatments can be an emotional roller-coaster. There are many feelings that one can experience when going through this journey. The physical, mental and emotional stresses that can accompany fertility treatments are normal. It is important to be aware that these stresses are a part of the journey and to understand how you can manage your stress.

Causes of stress

Infertility and the fertility treatment process are very complex. As a result, there are many reasons that you may feel stress. A few of those reasons may include:

Sense of loss

You may feel a “loss of control” in planning your family. You may also feel you have lost your hopes and dreams for the future, privacy, self-esteem/sense of self, intimacy with your partner, and autonomy over family building.

Social issues

Social stress can be one of the hardest things to manage. Other people may not know or understand what you are going through. You may not want to share your experiences with family or friends. Comments and questions, no matter how well meaning, can at times feel intrusive and insensitive. Because others may not understand or appreciate the challenges you are experiencing, you may feel socially isolated and awkward around family and friends.

Treatment stress

Medical treatment for infertility means you must hand over a very private and personal matter to health care professionals. Also, many women have emotional side-effects when taking hormone-type drugs.

Disruptions to everyday life

Getting fertility treatments may become all-consuming and disrupt your normal routines, work hours, and lifestyle. The financial costs may also cause you stress since treatments are often expensive and may not be fully covered under provincial or private health insurance. If you live some distance from the nearest clinic, you may have extra travel costs too.

Tough decisions

Many of the decisions you need to make when getting treatments are complex and hard. Some examples include:

You and your spouse or partner might not agree about which treatments to try, how many times to try, or when to stop treatment.
If you get in vitro fertilization (IVF) treatments, single embryo transfer is often advised, and you may be asked what to do with embryos that remain.
You may need to consider other ways to build your family, like using donated sperm or eggs, surrogacy, or adoption.

Managing Stress

In order to help you manage the stress you may experience as a result of your infertility diagnosis or fertility treatment, here are several things for you to consider:

Coping with yourself

Recognizing and paying attention to your own needs is very important. On top of “emotional roller coaster” feelings, the physical side effects from treatment may really affect you physically, mentally, and emotionally. It is important that you continue to eat well, get enough rest, and plan to do other activities. Moderate physical exercise can also help relieve stress.

With your spouse or partner

Although fertility treatments affect both women and men, women report higher levels of physical and emotional stress. This process can also be very stressful on a couple’s relationship. You and your spouse or partner may not always react the same way or cope with stress in the same way. It is important to talk and stay connected with one another. But it is equally important not to allow the issue to consume your lives. A good strategy is to schedule activities together that allow you to focus on something other than your situation, to give you a diversion from the stress.

In social situations

It can be a challenge to cope with things like baby showers, family gatherings, or even work, where questions may come up about your plans for having children. It is really your decision how much to tell others, depending on how open you are with your family, friends, and colleagues. Sharing some information can help to reduce social pressures, gain support, and sensitize others to comments that might be upsetting or unhelpful. Infertility and experiences with treatment are actually more common than you may think. Sharing your situation may inspire people you would not have expected to tell you their stories and give you helpful information.

Becoming informed

Learning as much as you can about your treatment can help you regain some sense of control and make informed decisions. It is important to ask lots of questions so that you can actively participate in your care. You may want to get a second opinion from another healthcare provider. For more information, there are also books, websites, online forums, and support groups.

Getting help

Talking to a counselling professional who specializes in infertility issues and fertility treatment (like a psychologist or a social worker) can be very helpful. These people can help you explore different coping strategies, consider the pros and cons of different family-building options, find information and support, and manage stress. Your treatment centre may have a counsellor on staff or be able to refer you to a resource in your community. Patient organizations may also be able to help you find counselling resources.

If you would like to receive information on counselling professionals in your area or for support groups in your area, or online, please contact Fertility Matters Canada. FMC can help you to locate a support system that is right for you.
FMC Phone: 1-800-263-2929
FMC Email: info@fertilitymatters.ca

Source: Government of Canada
healthycanadians.gc.ca