The fun and excitement of starting a family is incomparable. As a couple, it is natural to anticipate starting a family as a joyful time and the beginning an exciting next chapter in life. Pregnancy is often anticipated as a special time, involving positive experiences such as surprising close friends and family members with pregnancy news, shopping for the baby, or having a baby shower. But when you are fertility challenged, pregnancy may seem fragile and precarious.
If you are struggling to conceive, what you should do is to ask questions about infertility and seek answers around the subject even as you are striving to overcome it. It is important that you are aware that infertility is not failure. It is not your fault or your spouse’s fault and it may not prevent you from having a family.
One thing you should not do is to ask whose fault it is or to accuse your partner of being responsible for your having trouble conceiving. While infertility is often like a forbidden topic for women, sperm issues are often even more shameful and secretive. But it should be openly discussed between you and beyond if and when necessary. Being able to reproducesexually is at the core of many people’s view of their femininity or masculinity.
A significant number of married women in Nigeria are infertile, and thus having difficulty trying to conceive, but while infertility is common among women, men too are part of the infertility problem. Infertility affects men and women alike, married and single.
Being infertile could make you feel depressed because you think life is being very unkind to you for being unable to perform a basic biological act, however, it is not unusual for your man to have a hard time accepting a low sperm count. But do you know that your man is just as likely to be infertile as you? About 40 percent of cases are attributed to men, 40 percent to women, and 20 percent to both men and women. It is not surprising that as a woman you would naturally want to seek treatment first, and if it is established that the cause of the problem doesn’t lie with you, it is not unusual to have to drag your spouse with you to the Gynecologist.
Several men visit fertility specialists on their own and it is not unusual for a man to have a tough time imagining that he could be the cause of his wife’s inability to conceive. Denial is common among men, more than among women, but a man often feels responsible that he’s done something harmful to himself and that the problem could be beyond control. Don’t be surprised to discover that your man is embarrassed, scared, and sceptical that he has a problem, given that he may be feeling so healthy.
This is where knowledge helps. Even in the best of circumstances, the odds of conceiving a child aren’t great. A typical ejaculate contains 100-300 million sperm, of which only about 15 percent (15-45 million) are healthy enough to fertilize an egg. Of these, only very few sperm survive ejaculation and the toxicity of the vaginal environment to reach the egg and become serious contenders for conception. But when sperm counts fall below normal, the chances of conception plummet. More than 90 percent of male infertility, in fact, is caused by low sperm counts, poor sperm quality, or both.
You and your spouse should be aware of this vital sperm information, so I will explain further. If your man has sperm count below 15 million /ml, he is considered to have low sperm count. But even if he has a normal number of sperms, at least 4 percent must be normal in structure (morphology) and have an oval head and a long tail, to promote conception.
Sperm heads that are rounded, pinpointed, or crooked are signs of impaired sperm formation that can make it difficult for the cells to reach the egg. Do you and your spouse know that it is important that sperm move quickly and straight forward because they have to swim through layers of cells around the egg before they can penetrate the egg itself? You need to know such crucial information.
If you are struggling with infertility, you probably have other layers and types of grief that can be associated with your fertility challenges. Your struggles can make it difficult to celebrate, enjoy, and actively participate in the pregnancies and parenthood journeys of close friends and family members. When others share pregnancy news or talk about pregnancy or parenthood, feelings of resentment, jealousy, anger, or loss may be triggered. Such feelings may be experienced as “out of character” and in contradiction to how those involved want to feel or how they think they “should” be able to respond.
Even common, everyday gatherings can be challenging if the majority of others in attendance are either expectant or current parents and the focus of the conversation gravitates to pregnancy or parenthood. For a person struggling with infertility, such conversations are not only typically painful, but they may also prompt feelings of self-consciousness or being left out, because you may not feel they have anything to contribute to the conversation or that they can’t relate. This can lead to withdrawal from family and friends. Social withdrawal may also be prompted by a desire to avoid insensitive comments, judgment, lack of understanding and empathy, or unsolicited advice.
Infertility may be beyond your first encounter with a significant health issue or physical limitation. It can be difficult to accept and adjust to the idea that, in spite of overall good health and a healthy diet and lifestyle, your fertility is on the decline. This may require a re-working of your sense of self.
As a man, being diagnosed with a male factor issue could make you feel “less of a man” because virility is so closely associated with masculinity in our culture. Similarly, when female factor issues are diagnosed, you, the woman, may tend to struggle with feelings of inadequacy, defectiveness, or a sense of not being a “true woman” because fertility and womanhood have traditionally been so strongly linked.
If you are struggling with a fertility challenge, you may be struggling with the loss of control over such an important life goal. This may be one of the first challenges that you haven’t been able to resolve by working harder or working smarter. Itcan be challenging to your sense of identity as a capable and successful person and can also lead to a sense of learned helplessness, if all your efforts seem to repeatedly have no impact on the outcome. Not having a sense of when you might finally be pregnant or successful in having a baby can make it quite difficult to make major life decisions about things such as pursuing additional training or education, seeking work promotions or opportunities, exploring career changes, moving to a new area, buying a home, or making life decisions.
The bottom line in all this is that you should not let this challenge paralyze you or leave you stuck to one spot and unable to move forward in life. Having a better understanding of the nature and complexity of the various secondary losses associated with infertility may make it easier to cope and also to make others more supportive and empathic towards you.
MD/CEO Nordica Fertility Centre