Female age affects fertility, but doesn’t rule out pregnancy

Age and fertility

In the last couple of days, two news stories have appeared that, at first glance, might seem to contradict one another.

One warns women of age 35 and over not to stop taking contraception, with the Family Planning Association launching its “Conceivable?” campaign that reminds women to remain vigilant.

The other cites fertility doctors who suggest that age is still the most critical factor in whether couples can conceive, despite the wealth of new reproductive techniques emerging each year.

Contraception until menopause

The abortion rate for women aged 40-44 is now the same as for under-16s — four per 1,000 women — in England and Wales.

This suggests there is a real issue with women who believe that, past 35, they have next to no chance of becoming pregnant.

There are many reasons why some women opt for an abortion – including birth abnormalities in the baby, which are more common when the mothers are older.

But FPA says its anecdotal evidence suggests some of the abortions are because women wrongly assumed they could not get pregnant because they were too old.

The FPA’s chief executive, Julie Bentley, said, “Whilst the message about fertility declining with age is an important one, it is often overplayed, alongside disproportionate messaging about unplanned teenage pregnancies.

“It sends an inaccurate message to women and society that only the young fall pregnant and is leading older women to believe their fertility has gone long before it actually has.”

The advice for older women who don’t wish to fall pregnant is simple: continue taking contraception until after the menopause.

Fertility anxiety

Fertility doctors suggest that there are no more people needing fertility treatment than a decade ago.

What’s changed is the anxiety levels surrounding having a family.

Fertility clinics are full of patients who have delayed starting a family and believe that assisted reproductive treatments such as IVF offer them a guaranteed insurance policy of becoming parents.

Unfortunately, these expectations may not be realised, and a quick glance at the latest HFEA national data in the UK shows that only 24% of all IVF cycles resulted in a birth. This drops to 12% for women aged 40-42, and a heart breaking 3% for women age 43-44.

These cold statistics hide an emotional rollercoaster of stress, anxiety and often enormous financial strain.

They do, however, very effectively demonstrate the huge impact of female age on the chance of conceiving.

Unfair?

It does seem unfair, and you can bet there are plenty of women experiencing the “wrong” thing.

There will be those who fall pregnant unexpectedly who are aghast at the prospect, while others desperate for a family watch the years tick by without children coming.

It proves that there are no hard and fast rules when it comes to fertility.

Fertility treatments aren’t guaranteed, and while age plays a factor it’s not conclusive.

Via and Via

Study: Infertility negatively affects self-esteem

With results that probably won’t surprise any couple experiencing fertility issues, a new study suggests that infertility seriously affects positive self-esteem.

“Flawed”

In a national survey carried out in the United States, seven out of ten women said that infertility made them feel flawed, while half of all men said they felt inadequate.

Sharing

Six out of ten couples said that they try to hide their fertility troubles from family and friends, while a third admitted their ability to confide in others has decreased since they began trying to get pregnant.

Over half said that it was easier to tell people that they weren’t planning to have children rather than to share the struggles they faced.

Disbelief and Delay

Disbelief is also a common issue, for despite one in eight couples of childbearing age do struggle with fertility problems, two-thirds of those surveyed said that they never thought they’d have difficulty in conceiving.

Over half of the couples said they wish they had started trying sooner, with a staggering nine out of ten respondents already seeking fertility treatment saying this.

Advice

Relationships with family and friends can also suffer, with six out of ten couples admitting to becoming tired of people asking them how the process is going or offering suggestions on how to conceive.

Unsolicited advice — such as being told to “relax”, get more exercise, sleep or a different diet — aggravated many couples.

Intimacy & Sex

Infertility issues seemed to affect intimacy in different ways, though more couples (58%) said it had brought them closer together than hurt (36%). Having said that, men suggested time arguing had increased, while both sexes said stress and tension had increased.

Added to this, 55% said that fertility issues had made sex a physically and emotionally anxious time, while a similar number (53%) said fun and spontaneity had gone, and four out of ten said they felt sexually unattractive.

The survey interviewed 585 people in relationships where conception had been an issue for two or more years. Full results are available at the Plan For Some Day web site.

I can certainly vouch for a lot of the results in this survey. What has been your experience?

Photo by mrhayata

Men and Miscarriage: How to cope and how to support

Miscarriage is a tragedy, however statistically common it is and at whatever stage of pregnancy it happens.

It is of course natural and right that any woman who has experienced a miscarriage should be given all the medical help and emotional and physical support and comfort possible.

It’s also important to consider that the male partner / husband is also very likely to be grieving the loss of an unborn child, and also needs support and the space to come to terms with his own emotions.

This article draws together some helpful advice for men on how to cope with miscarriage and how best to support their partner/wife, based on resources from around the web and from personal experience.

I hope it helps you. If you have any thing to add, please feel free to leave a comment at the end of the article.

How “should” you be feeling?

Some articles on this subject, such as Men and Miscarriage: How Men Handle Miscarriage, suggest that men emotionally “move on” quicker than women, but the fact is that everyone is different.

You may find that you don’t react much when you first find out about the miscarriage, and that emotions — ranging from deep sorrow to anger to frustration to feelings of helplessness — come on weeks or even months later.

There’s no right or wrong answer. This is grief, and you have to deal with it in your own way. Typical feelings men experience after miscarriage is a useful primer for both men and women on this.

Communication is Key

No matter how you or your partner may be feeling, reacting and coping with the miscarriage, it is vital that you don’t stop communicating with one another.

The fact is that you are the only two people who know exactly what you’re going through, and though it can be helpful for one or both of you to talk to friends, family or counsellors, you can also be each other’s strength.

The fact is that communication is key to creating and maintaining strong relationships, but particularly during stressful, highly emotional situations like coping with miscarriage.

Grieve alone, and grieve together. Tell your partner how you are feeling and allow her to tell you the same — and acknowledge and empathise with her.

Is It My Fault?

Attributing blame to one or other partner after a miscarriage is extremely unhealthy and should be avoided.

There may be a medical reason which increases the likelihood of a miscarriage, but unfortunately pregnancy loss (particularly early, such as in the first three months) is also considered fairly “normal”.

Laboratory research shows that it is possible for abnormalities to cause a pregnancy to fail — often had the pregnancy gone to full term the baby may well have had a disability anyway so it can sometimes be seen as nature’s way of disallowing unhealthy foetuses to live.

That’s all very clinical, though.

If you and your partner have experienced several miscarriages, it is definitely worth consulting your doctor and having tests to establish whether anything is wrong, and whether some forms of medication may help during pregnancy.

In any case, in the general run of things it’s not really anyone’s “fault”, and even if there is a medical condition it’s often something that can be sorted out.

How can I best support my partner?

The article Miscarriage: how men can deal with it offers advice for supporting your partner after a miscarriage:

1. Understand that she will be upset and you can’t fix the problem. You need to be supportive, understanding and appreciate that there will be a grieving process which will take time.
2. Understand that even if it’s very early stage pregnancy she will feel like she has lost a baby, even if you don’t. Saying things like “don’t worry it was only the size of a tic-tac” isn’t going to be much help.
3. Give her lots of support. She needs to know that you love her.
4. It’s important to re-enforce that it’s not her fault. It’s quite possible she may try and blame herself for something she did or didn’t do but it’s highly unlikely the loss had anything to do with her actions. I could write a whole article just on this point but from listening to many men talk about miscarriage, almost all said that their partners felt like she was to blame.
5. Encourage her to talk to her female friends and family who have had children. It’s very likely some will have been through the experience and will be able to offer support and advice.
6. Understand that a pregnant woman is a sea of hormones and those hormones are still running wild after the loss. Know the signs of depression and seek medical advice if you feel she isn’t coping well after a week or two.
7. As guys we like to try and fix problems but sometimes you just need to provide a shoulder to cry on and an ear to talk to. Don’t take it personally or get frustrated that you can’t make her forget about it.
8. Spend as much time with her as you can and remain positive about having kids. Having one miscarriage isn’t necessarily a sign that you will have more so focus on staying healthy and having another go when the time is right.

My male friends are unsympathetic

Sometimes it may seem that your male friends aren’t particularly sympathetic to how you’re feeling.

We could put some of this down to the stereotypical guy who doesn’t like to share or show emotions much, or it could just be that you haven’t told them how you’re feeling.

Don’t forget that every man is in a different situation. Single guys may well not understand, married-with-kids guys may well have experience of miscarriage but find it difficult to come alongside you unsolicited.

How do you cope with the sarcastic or seemingly unhelpful comments? I guess it depends on how much it bothers you.

If you can just brush off the “oh well, you don’t really want kids yet” or “you can have my kids” comments (and their many derivatives) then fine — remember that your partner is probably your main confidant and strength anyway.

If not, you need to politely explain that some of their comments aren’t helpful, that you’re happy to talk about the situation with them (if indeed you are) but that the jokes, however well-meaning (bloke diversionary tactics) aren’t helping you.

Don’t let anyone try to cajole you into “moving on” – your grief takes as long as it takes.

What about “trying again” after miscarriage?

At some time after a miscarriage you will both be ready to try to conceive again.

It is really important not to rush things, and to try to understand how each other is feeling.

Conceiving after miscarriage is a really useful article looking at the subject from both female and male perspectives.

Resources

Here are some useful resources and interesting articles for further reading around this subject:

• Men and Miscarriage: How Men Handle Miscarriage
• How men cope with miscarriage: John Itsagwede explains how he and his wife dealt with the pain of losing three babies
• Miscarriage coping guide for men
• Typical feelings men experience after miscarriage
• Conceiving After Miscarriage
• Men and Miscarriage
• Miscarriage: How men can deal with it
• Men and miscarriage: Information on support groups
• Helping Men Get Through A Miscarriage
• What Are Men’s Reactions To A Miscarriage?

Empty Arms: Beautiful video shares the anguish of infertility

Empty Arms is a beautiful video created by Susan Robinson. In a simple way using music, images and words it tries to share some of the pain that couples with fertility issues face every day.

It’s a poignant video, not judgmental or accusatory, but of encouragement to friends and family to stand alongside and simply love.

Not fully understanding, not always having words, not trying to problem solve … these are all things that are just fine. Being there as a shoulder to cry on, a friendly face, someone who says “I’ll stand by you and support you as you journey through this” – that’s what’s really needed.

Take a look at TearsAndHope.com to play the video.

Octuplet birth physician was “criminally negligent”, says fertility expert

Everyone seems to have an opinion on Nadya Suleman, the 33-year-old who now mothers fourteen children.

One of the latest to weigh in is medical director of Georgia Reproductive Specialists, Dr Mark Perloe.

He believes that the physician who treated Suleman is guilty of “criminal negligence” because American Society for Reproductive Medicine guidelines were breached when six embryos were implanted.

Generally only one to two embryos should be transferred via IVF to women under age 35, to a maximum of five for women over 40.

“Transferring six embryos was outside any existing standard,” he said, claiming that his company would not have considered IVF treatment on Suleman at all, due to her back problems and number of existing children.

“There are safe, proven methods for successful single births that significantly reduce the chances of having multiple births,” he said.

I’m sure Perloe isn’t hoping to gain any exposure for his own company from lashing out at another one of his profession, so I won’t link to his web site.

Babies aren’t bad for marriage, but starting a family won’t save a couple

Having a baby won’t save a bad marriage.

In fact, some couples report reduced satisfaction in the relationship with their partner after starting a family.

That may sound depressing, even fatalistic, but the truth is that parents who plan a family and collaborate with parenting are much less likely to experience this dip. It’s even likely to lead to a happier marriage and better-adjusted children.

Thinking about it for a moment it may seem obvious, but I’m sure there are still plenty of couples teetering along their precarious relationship path that believe that having a child together will improve their marriage.

Very unlikely.

A New York Times article by Tara Parker-Pope quotes from the most recent studies that point to the time bind facing new parents and the burden on women resulting from increased household work as factors in reducing marital bliss. She holds out hope to her readers by reporting the finding from a 50-year longitudinal study of Mills College women that couples are likely to reconnect once their children leave home.

For parents of young children, that’s a very long time to wait. And it’s not good news for the children either, because children are more likely to have social, emotional, and academic problems when their parents’ marriage is in distress.

Many of these findings on marital distress in the early childrearing years are based on the uncritical use of averages. More in-depth examination reveals that the averages hide considerable variation. Detailed interviews with 96 couples, followed for 6 years after their first babies were born, revealed four different pathways that couples take in deciding to become pregnant and carry the pregnancy to term:

• First are couples who agree about when to begin trying to become pregnant (about half of the sample).
• Then there are the couples who “find themselves pregnant” and decide to “accept fate” and go ahead (about 15%).
• Another set of couples (about 20% of the sample) are still ambivalent when they reach the 7th month of pregnancy.
• Finally, for some couples who are at serious loggerheads about the decision, one spouse agrees to become a parent only because the other threatens to go it alone (about 10%).

The average decline in marital satisfaction was almost completely accounted for by couples who

1. slid into having a baby without planning
2. were still ambivalent about becoming parents in late pregnancy, or
3. disagreed about having a baby but went ahead and conceived without resolving their difference.

About half the planners showed increased marital satisfaction or maintenance of their initially positive level in measurements taken when their babies were about 18 months old. All the couples where one partner had given in (usually the man) were either separated or divorced by the time their first child entered kindergarten.

The study concludes that it’s very unwise to rush into parenthood before both partners are ready. Partners need to start by having a discussion or a series of discussions – by making a decision. If both partners can express both sides of their feelings, it is less likely that one partner will carry all the ambivalence for the couple.

When both partners feel they are part of this major family decision, they are more likely to be able to meet the challenges of balancing the needs of both partners in terms of work and family. All this bodes well for their developing relationship with each other and with their child – and ultimately for their child’s sense of security and well-being.

www.contemporaryfamilies.org/

Women not confident about contraception, put other worries before unwanted pregnancy

Four in five women are concerned about the current method of contraception used for birth control, yet two in five have stayed with their chosen method for five or more years.

That’s according to a new survey carried out in the US by Schering-Plough, which also found that well over half of women using a hormonal contraceptive had increased stress levels when having sex if they’ve not used their birth control product correctly.

Women using birth control say they worry more about their own or their partner’s satisfaction (29%) and body image (24%) than pregnancy (10%) or contracting a sexually-transmitted disease (8%).

Of women aged 18 to 34 who currently use birth control, four in five use contraception primarily to prevent pregnancy. However, 93 percent of women aged 18 to 34 (both on and off birth control) do not know that half of unintended pregnancies in the United States occur with couples that used some method of birth control.

Sixty-two percent of women indicated they discuss birth control with a potential partner. Women of all ages who currently use, or have previously used hormonal contraceptives, reported that a physician’s recommendation was among the top five attributes that are most important to them in choosing a birth control method.

Nearly a quarter of 18-34 year-old women said that a daily method of birth control would be most convenient for them, though 46 percent of women in the same age group who currently use a hormonal contraceptive have more difficulty remembering to use their current method correctly when their daily routine is interrupted.

“The findings from this survey signal that while we may be living at a time when women have many contraceptive options and are empowered to make their own informed decisions, many are either dissatisfied with or have concerns about their method,” says clinical professor of obstetrics and gynecology at Yale University School of Medicine, Dr. Minkin. “Overall, this is a wake-up call for women to evaluate how happy they really are with their current method and recognise that they don’t have to settle for the status quo when it comes to birth control options.”

Soya products could significantly lower sperm count, study suggests

Men who eat a diet containing even modest amounts of soya products could be adversely affecting their sperm count, according to a recent medical study by scientists in the United States.

Even small amounts of soya products, now frequently used in the Western world as meat and dairy substitutes, as well as popularly used in Eastern cuisines, lowered the sperm count, and those with the highest intake of soya-based food had almost half the level of active sperm in their semen.

Scientists believe that isoflavones, a compound found in soya, mimics the female sex hormone oestrogen, which could therefore explain the reduction in sperm levels.

Soya products which can cause this affect include tofu, tempeh, soy sausages, bacon, burgers and mince, soy milk, cheese, yoghurt, ice cream, and soya-based roasted nuts, drinks, powders, and energy bars.

However, it’s not a cut-and-dried case, because researchers also believe that obesity plays a major factor in determining sperm count. That is probably why Asian men, who will often have a diet rich in soya products, are still fertile – obesity is much less of a problem in Asian countries, whereas in the US and other Western countries it is a serious, and increasing, issue.

(Via Yahoo! News)

NHS launches pregnancy advice web site

The UK’s National Health Service has just launched a new web site where expectant mothers can go to get authoritative advice and information on all aspects of pregnancy and childbirth.

“Whether you’re planning to have a baby, are already pregnant, or your new baby has just arrived, our new interactive pregnancy planner is for you,” the site opens.

It’s the perfect way to find out all you need to have a healthy and happy pregnancy and to make sure you get the care that’s right for you. It contains over 250 pages of NHS accredited information, including pictures, videos and planning tools. You’ll also find all the facts you need to choose the best maternity services in your area.

The NHS is no stranger to offering medical advice online, and already runs the NHS Direct health information web site.

The site offers help on pre-pregnancy, pregnancy and labour, parent and baby advice, and general pregnancy information.

Pregnancy can be a huge mystery, and with the Internet’s myriad of information – some accurate and some wholly misleading – on the subject, it’s good to know that a trusted medical organisation is providing comprehensive coverage.

NHS Pregnancy web site (via Web User)

Vets may be at higher risk of miscarriage

An Australian study suggests that female vets over-exposed to anaesthetics, X-rays and pesticides used could be at an increased risk of a miscarriage during pregnancy.

The concern is for those working in smaller practices where “scavenging” equipment used to suck away waste gases, such as nitrous oxide, may not be used.

Nitrous oxide inhalation can lead to an increased risk of miscarriage.

The risk to women exposed to these gases for at least one hour per week rose by around 250%, based on a research questionnaire carried out among 2,800 vets.

Those who carried out more than five X-rays per week had an 82% increased risk, and those who used pesticides had an 88% increased risk.

“We hope that our research will make vets aware of the need to fully protect themselves whilst they are working, especially if they planning to have a baby,” said lead researcher Dr Adeleh Shirangi.

(Via BBC News)

Study Shows New Therapy Opens Blocked Fallopian Tubes, Returns Fertility Without Surgery

A study published in “Alternative Therapies In Health and Medicine” (Feb, 2008) reports that blocked fallopian tubes can be opened without surgery, enabling infertile women to become pregnant naturally.

Authors of the study “Treating Fallopian Tube Occlusion with a Manual Pelvic Physical Therapy,” became curious after a pilot study published in “Fertility and Sterility” (9/06) showed the treatment returned fertility in women with blocked and swollen tubes.

Read more

Caffeine during pregnancy increases miscarriage risk, study suggests

A new study by the Kaiser Permanente Division of Research suggests that a high intake of caffeine during pregnancy may lead to an increased risk of miscarriage, regardless of its source.

While previous research showed a link between caffeine consumption and miscarriage, this is the first study to thoroughly control for morning sickness, which typically causes many women to avoid caffeine, explained De-Kun Li, MD, Ph.D., an investigator with the Kaiser Permanente Division of Research and lead investigator of the study. “This study strengthens the association between caffeine and miscarriage risk because it removes speculation that the association was due to reduced caffeine intake by healthy pregnant women,” Li said.

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