What is infertility?

Infertility is defined as an inability to conceive after one year of trying, or an inability to carry pregnancies to a live birth. The problem is common and includes people experiencing secondary infertility after one or more natural children. Approximately, one in six couples in New Zealand experience infertility. One in eight couples require some form of medical assistance to achieve a pregnancy.

Of these approximately 35% of infertility is a problem solely of the female, and another 35% is a problem solely with the male. In about 25% of cases, there is a problem found in both members of the couple. Only about 3.5% of infertility is unexplained once a thorough evaluation of both partners has been conducted

Can infertility be treated?

Over the past 20 years, there have been significant advances in treatment for infertile couples. New methods of medical treatment can result in successful pregnancies for over 50% of infertile couples. Certain treatments, such as the articifical starting of ovulation, respond with an even greater chance of success. To achieve the best opportunity for evaluation and treatment, a couple should find a doctor with special interest and expertise in the area of infertility, and with whom they feel confident and capable of communicating their questions, concerns and feelings.

In New Zealand there are currently clinics based in Auckland - Auckland Fertility Clinic, Fertility Plus, Artemis (North Shore) and Fertility Associates. In Hamilton - Fertility Associates; Wellington - Fertility Associates and Capital Coast Health; Christchurch - The New Zealand Centre of Reproductive Medicine; and Dunedin - Otago Fertility Service, Health Care Otago and the University of Otago Medical School

The evaluation and treatment of infertility requires a great commitment of time, energy, money and resources by all concerned.

Emotions

Infertility is not merely a physical condition, it is an emotional and social condition as well, carrying with it intense feelings which need careful support from physicians, nurses, counsellors and technicians involved. Treatments can take many months to complete and do involve tests for both males and females. This period of waiting, investigations and treatments can prove stressful.

Common feelings such as anger and frustration, loss of control, isolation from friends and family, depression and grief may seem overwhelming to the couple who are denied a child they so earnestly wish to conceive and parent. Infertility is experienced as an on-going grief, a grief in which many couples feel alone and isolated.

At some point during infertility treatment, or investigation, a person may be experience this as a state of crisis. This crisis, in turn, may lead to further isolation and despair. This may place strain on relationships as well. They may feel alone and not have anyone to talk to who understands the experience of infertility. Infertility is a crisis of the deepest kind. It threatens every aspect of a person's life - one's sense of self, one's dreams for the future, one's relationship with others. Few crises are as challenging and overwhelming.

In talking about this grief reaction and the crisis that people go through Sue Saunders, the author of recently published book Infertility: A guide for New Zealander - Information, Feelings, Choice, Action describes infertility as a series of losses.

'The loss of dreams and hopes; the loss of power and control of your life; the loss of autonomy as medical professionals become more involved in your life; the loss of body image and competent functioning; the loss of perceived status in the eyes of others; the loss of security and stability within life and the important loss of self-esteem. All these losses need to be acknowledged and worked through to resolve the grief that accompanies infertility.'

Several couples are quoted in the book, including a male who wrote in his journal:

'For 12 months I have been on an involuntary emotional rollercoaster. My life was picked up and smashed on the ground, what I had expected and taken for granted was thrown away. Forever since, I have been trying to put back together what remains....It has taken me a long time going through my emotions to realise what I can do....Just as the branches on a tree are strengthened by a strong wind, so should life's hard knocks enrich and strengthen our lives. Don't let infertility break you.'

The things he found helpful was to control the stress by yelling, crying, running and gardening. The others things he found useful were getting counselling and meeting others in the same situation.

We agree one of the greatest ways to deal with infertility is to be informed and talk about it. This is not always easy or comfortable. A couple may find friends and family who are supportive or find it helpful to see a counsellor to talk through your feelings and options. If couples want to talk to someone else who has been through what they are going through and understands, they can contact the local infertility society. The society also welcome general inquiries for information from health professionals or the general community

Original material supplied by Fertility NZ. Edited by everybody.