Infertility
Introduction
John T. Bruchalski, MD, FACOG has recntly written a pamphlet on this question entitled Hope for Married Couples Who Want to Have a Child. It has been published by the Secretariat of Pro-Life Activities of the United States Conference of Catholic Bishops and is available on their website in both English and Español as well.
What does it mean to be infertile?
Technically, infertility is defined as no pregnancy achieved in one year of random intercourse in the absence of contraceptives. Therefore infertility is really the unfulfilled desire to have a child—infertility is not a disease. Instead, it can be the result of any of a number of different diseases or abnormalities in either the male or female spouse, and is often a combination of factors on both sides. Healthy conception of a child is an intricate and precisely integrated process—if there is a condition that consistently prevents any necessary step from occurring, the couple is said to be infertile.
You are not alone!
The current incidence of infertility in the population has risen over the past several decades and today is 1 in 7 or about 15%. So for every 100 couples, 15 of them will not have achieved a pregnancy at the end of one year. The increased rate is due to several factors, such as delayed marriages, later childbearing for various reasons, environmental pollutants, and epidemic sexually transmitted disease to name a few.
Factors that may contribute to infertility
Infertility is a term properly applied to a couple, not just to a woman—about 40% of infertile couples have a condition that is male-related. Having said that, are there some symptoms or signs that might specifically alert a woman to a potential problem with conceiving a child? The answer is yes. Conditions that may contribute to infertility in the woman:
- Nutritional deficiencies*
- Hormonal imbalance. For couples using Natural Fmily Planning (NFP) or any form of fertility awareness, a postovulatory phase (or luteal phase) of less than 9-10 days is one sign of hormonal imbalance.
- Absent or infrequent menstrual cycles due to polycystic ovarian syndrome (PCOS), a low BMI (low body fat) seen in anorexia or extreme athletes, or high BMI (high body fat) seen in obesity.
- Variable or irregular menstrual cycles, signaling subtle ovarian dysfunction.
- Endometriosis, which may include symptoms of:
- very painful periods (dysmenorrhea)
- chronic pelvic pain
- painful intercourse (dyspareunia)
- History of sexually transmitted disease (gonorrhea, pelvic inflammatory disease), causing scarring in the reproductive tract.
The doctors will first seek to meticulously and thoroughly identify lifestyle, environmental, and medical factors. Ovulation patterns can be evaluated by NFP charting, comprehensive hormonal testing either through blood or saliva, mid-cycle ultrasound, and sometimes an endometrial biopsy (a biopsy of the uterine lining timed to tell if the hormones are having their desired effect). Each test tells a part of the story, and taken together, they give an overall view of the normality of the ovulatory process.
To look at the woman's internal organs, two tests are needed. The first, an HSG, or hysterosalpingogram, is used to take a picture of the internal structure of the uterus and fallopian tubes. It can diagnose such things as fibroids, polyps, and blocked tubes. The second, a diagnostic laparoscopy, is a minor surgery in which a long scope is placed in through the belly button into the abdomen and used to visualize directly all the pelvic and abdominal organs and detect any scar tissue, endometriosis, or other abnormalities.
Our restorative approach to treatment
Treatment is chosen depending on the problem or problems identified. Sometimes improving one's diet, weight loss or gain to reach a healthy weight, or simply identifying the optimum fertile time, can be an effective low-cost and low-risk means of achieving a pregnancy.
Infertility is a difficult and frustrating obstacle for couples with the desire to raise a family, but there are sound, holistic options. From an ethical point of view, any treatment or procedure that is directed toward correction of a defect in the reproductive system of the male or female is valid, as is anything that promotes or makes sexual intercourse more effective in achieving its final goal. The doctors at Tepeyac will not, however, counsel procedures in which conception is achieved in the absence of loving sexual intercourse between spouses, such as IVF (in vitro fertilization). We do not recommend IVF, as the children created by the process are too often treated like commodities to be frozen, manipulated, or discarded.
Tepeyac takes the responsibility to uphold the dignity of women, children, and families very seriously. The doctors work with couples to:
- Evaluate the couple carefully and thoroughly, including adequate instruction so the couple understands their fertility;
- Use all available medical and surgical treatments, including NAPRO technology, to correct those elements amenable to treatment;
- Allow the wondrous collaboration between the couple and the Creator to take place as designed;
- Finally, respect and assist the mystery and dignity of the human family and human person.
If you need help in this important area of your life, we would prefer that you (and your husband, if possible) take a class in fertility awareness (www.nova.ccli.org) so that you can understand your own fertility and be sure that you are doing all that you can yourself to improve it. Then, it would be most beneficial that you chart your signs of fertility (cervical mucus and basal body temperature) for three months before making an appointment to see us. Again, if you have any questions, please contact our staff at (703) 273-9440 x 118.
*For more on the impact of nutrition on fertility, we recommend Fertility Cycles and Nutrition (2001) by Marilyn Shannon