Tuesday, May 22, 2012

Infertility Awareness Week

Image source: Infertility Awareness Association of Canada

It is Infertility Awareness Week in Canada.

This likely means nothing to you unless you have facing infertility yourself, or know someone who has.  Chances are you may fall into this category and not even know it.  Why?  Because 1-in-6 Canadians deal with infertility at some point in their lives.

Unfortunately, there is still a great deal of stigma around infertility so many couples keep their struggles a secret.  This means that infertility is still poorly understood, and many people suffer in silence.

Dealing with infertility is extremely challenging for individuals who want to have a child or more children.  Here are some facts about the emotional implications of infertility.

First of all, men and women react to, and experience, infertility in different ways:


  • Experience significantly less distress unless cause is male-factor infertility;
  • Those facing male-factor often experience guilt, shame, loss of self-esteem, anger, and isolation;
  • Men may feel even more stigma than women because it is associated with sexual dysfunction;
  • Often cope with denial, repression, distancing and avoidance; 
  • Often keep diagnosis secret.


  • About half of women who have faced infertility describe it as the most upsetting event they have ever experienced;
  • Up to one-third of women dealing with infertility may be at risk clinically-relevant mental health problems;
  • Infertile women are twice as likely to be depressed as their fertile counterparts;
  • Infertility is also associated with tension, hostility, anxiety, self-blame, suicidal ideation and social stigma.

I have mentioned before that stress does not 'cause' infertility and some of you have reacted with scepticism, but here is an explanation.  Very extreme physical or psychological stress can disrupt the endocrine system, causing hormone imbalances that may affect ovulation.  But there are many, many, many unrelated causes of infertility, and telling a couple having difficulty getting pregnant to "just relax" is going to make them want to push you into a paper shredder.  Unless they have a diagnosis, and they have told you what it is, you have NO IDEA what may be responsible for their infertility.  In addition, there is no evidence that being anxious about getting pregnant causes infertility.  In fact, in terms of distress, depression has been linked more closely with infertility and poorer fertility treatment outcomes than stress and anxiety.

There are a growing number of treatment options available for people facing infertility, but most of them are extremely expensive, and are not always covered under extended health insurance plans.  Common procedures include:
  • Cycle monitoring;
  •  IUI;
  • Ovulation induction;
  • Sperm aspiration;
  • IVF/ICSI; 
  • Assisted hatching;
  • Blastocyst transfer;
  • Egg freezing/embryo 
They also do not guarantee pregnancy or live births.  The success rates go down with age and are generally under 25% for women over 40 using their own eggs.  

There are also 3rd-party family building strategies, which are often tricky to arrange (particularly in Canada where it is illegal to pay for surrogacy, donated eggs or sperm, above reimbursement of incurred costs to surrogates and donors), expensive, and involve ethical issues, emotional issues and legal negotiations.

I hope that we can expand public awareness around the issue of infertility and the emotional, legal and financial challenges it creates for individuals struggling to get pregnant.

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