Social support benefits subfertile couples

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Merewyn Hines knew early in life she wanted to be a mom, with or without Mr. Right. So by the time she was 30, the Port Coquitlam project manager had started researching fertility methods, reading about single motherhood, and even putting aside money for a baby fund. Taking concrete steps toward conception was the easy part, though.

“When I was 25, I decided if I wasn’t in a strong, meaningful relationship by 35 I would have a child on my own,” Hines says in a phone interview. “I started planning. You always hope you’re the person who gets pregnant the first time you try, but it didn’t quite work out that way.”

Hines is now thrilled to be in her second trimester. However, it took her four years and much heartache to get here. A friend who offered to be a sperm donor changed his mind. She needed treatment for endometriosis. Intrauterine insemination didn’t work. In vitro fertilization (IVF) resulted in two pregnancies, but she later miscarried. She finally decided to give it one more chance, and it worked.

Becoming pregnant through any number of procedures available today can take a physical toll as well as a financial one. (Hines estimates she spent about $60,000 on numerous attempts.) It’s the emotional impact, however, that can be especially overwhelming. Hines says that what helped her most was being open about her desire to conceive and her struggles along the way. The first time she went through IVF, she told few people about it. The second time, she reached out for support.

“When I miscarried the first time, it was the lowest point in my life,” she says. “I basically went into a severe depressive state.…The second time, I got home from the hospital after a D and C [dilation and curettage] and wrote a Facebook post about all I’d been going through and was overwhelmed by the outpouring of support from friends and family. They got me through it.

“If you have a miscarriage, the first thing you do is blame yourself, and if you’re not talking to anyone, it’s horrible,” she says. “A lot of people keep it private, not just a miscarriage but also the fact that they’re trying [to get pregnant]. But when I told people what I was going through, so many people told me about their own experiences. Just knowing people are there no matter what happens made such a difference.”

Although many people opt to keep quiet about their quest to become pregnant, there’s less stigma surrounding fertility treatments in general, says Dr. Al Yuzpe, cofounder and codirector of Vancouver’s Olive Fertility Centre. In fact, he says, the word infertile is on the way out.

“The majority of couples are not infertile, they are subfertile or have reduced fertility,” Yuzpe says in a phone interview. “Infertility implies a very negative connotation, and the reality is being subfertile means not getting pregnant as easily as they’d like or should.”

Yuzpe, a reproductive endocrinologist who has worked in the fertility field for more than 40 years, says that reduced fertility affects one in six couples. Of identifiable causes, the most common are advanced maternal age, excess weight or obesity in females, lack of ovulation, and tubal disease.

“The chance of a woman conceiving at age 30 is around 20 percent; at 40 it’s eight percent, at 42 it’s around five percent,” Yuzpe explains. “We know without any doubt that increased maternal age has a negative impact on fertility. Women are led to believe that it really isn’t an issue when they read People magazine and see older women having children, but [they] don’t always get correct information, and many of those [celebrity] women are using egg donors. A lot of misinformation is promulgated on the Internet.”

Those myths include the one about bicycle-riding having a negative effect on a man’s sperm. However, taking steroids for the purpose of bodybuilding is a sure-fire way to shut down sperm production.

“The other thing we don’t think about that often, but that’s more of a problem now, is women’s weight,” he adds. “Once women have a body-mass index of over 35, their pregnancy rates begin to drop and their miscarriage rate goes up.”

There are many treatments for those facing reduced fertility, with IVF being the most important advancement in the field, according to Yuzpe: “It bypasses or corrects most of the steps in the fertility process that haven’t occurred normally.”

Sometimes treatment is as simple as counselling a couple on the frequency and timing of intercourse. Then there are new technologies that are enhancing existing fertility treatments.

One that’s in use at Olive and that Yuzpe is especially excited about is a system called EmbryoScope. It uses time-lapse photography and a series of algorithms to measure embryo development, which helps doctors select the best fertilized egg to use in IVF to maximize chances of success.

Yuzpe emphasizes that there’s much hope for people having trouble conceiving,

“The majority of patients, especially those under 37 or 38, will be able to achieve a pregnancy on their own or with intervention, as long as there is not an irreversible cause that can’t be treated,” he says. “Medicine can do so much more than 20, 30, or 40 years ago."

A free public talk on fertility with Dr. Al Yuzpe, Dr. Victor Chow, and Lorne Brown, doctor of traditional Chinese medicine, takes place on May 26 at the Surrey City Centre Library from 6:30 p.m. to 8 p.m., and on May 28 at UBC Robson Square from 7 p.m. to 8:30 p.m.

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