It's National Infertility Awareness Month

April may represent many different causes and observances including National Donate Life Month, Grilled Cheese Month and National Poetry Month, but it also represents a less-discussed cause—infertility awareness.

“People are ignorant to what it truly is and think you can just get over it—just like anything else that’s devastating in your life, you can’t,” said Maria Small, who has been battling infertility for more than three years. “No one speaks about it, no one talks about. Maybe that’s why I’m so vocal about it–because I know so many people can't be and I want to be their voice.”

Getting to this point wasn’t easy for Maria. After years of heartbreaking failed infertility treatments, she and her husband Chris have decided to pursue adoption (learn more about their journey and see video in tomorrow's story). Besides the support of her husband and her family, Small credits her RESOLVE support group for getting her through tough times.

RESOLVE: the National Infertility Association, established in 1974, is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.

While April is National Infertility Awareness Month, RESOLVE has coordinated this week, April 24 to 30, as National Infertility Awareness Week. An Advocacy Day will be held on May 5.

According to RESOLVE, “Infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages and the woman is under 35 years of age. If the woman is over 35 years old, it is diagnosed after six months of unprotected, well-timed intercourse.”

Dr. Pasquale Patrizio, the director of the Yale Fertility Center, specializes in helping infertile couples try to conceive. He emphasizes age as being the biggest factor in the ability to get pregnant, saying the “prime time to have a baby is between 25 and 30.”

However, Patrizio acknowledges that age range does not necessarily work with many couples’ lifestyles. He stresses the importance of planning for the future with emphasis on the advances in technology.

“It’s now possible to freeze eggs,” said Patrizio. “Before it was the inevitable passing of time, now there are technologies that can help women preserve their future fertility and postpone their plan of a pregnancy with success. These options were not there before.”

There are, though, many couples who are ready to have a baby who are unable to conceive. Patrizio recommends that couples who have been trying to conceive without success for a year should seek medical advice with an expert in reproductive medicine, though that timeframe shortens to six months if the woman is 35 or older.

When a couple comes to Yale Fertility Center, the first step is a full evaluation of the couple, starting with semen analysis and ruling out issues with ovulation and the fallopian tubes.

“I stress the word ‘couple’ because infertility is not a problem with the single, it’s a problem with the couple,” said Patrizio. “Once you rule out the two major parts, the investigation goes into more depth to try to understand other possible reasons and there are many reasons.”

Once those issues are ruled out or treated, couples move on to different ways of trying to conceive including medications, intrauterine insemination (IUI) or in vitro fertilization (IVF).

In addition to working with the couples on conceiving, Patrizio notes an equally important part of the treatment is psychological. Yale Fertility Center has a social worker on the premises to help with these issues.  

“The strength of the couple is really tried and this can be a very draining process, mentally speaking,” said Patrizio. “When we see there is help that is needed, we provide that help.”

Kerry Stewart realized the benefit to seeking help firsthand. She and her husband Eben have been married for 14 years and began their journey with infertility a decade ago. The Stewarts went through it all–from years of trying to failed IVFs and miscarriages; adoption matches that fell through to one that happened overnight in July 2008 to give them a son; and finally, an embryo frozen for seven years giving her the chance to be pregnant and an adorable little girl who was born last November (learn more about their journey and see video in tomorrow's story). 

“We’ve got a strong marriage,” said Stewart. “We made a point of it bringing us together, not tearing us apart. We took turns falling apart and we both have needed some anxiety/depression medication and therapy and have sought the help that we needed.”

If, after all of those steps, a couple has not been able to conceive, a thorough examination of the process is performed that looks at what happened, the body’s response, the quality of the eggs and the embryos, the uterus and other factors.

“All these need to be reexamined and we do more testing because you may be affected by some rare condition,” said Patrizio. “Before proposing a tentative treatment plan—which includes asurrogate, egg donation or adoption—we need to make sure we have exhausted all the possibilities. It’s not that unusual that the third cycle, even without changing anything, may be a success. Egg donation and surrogacy are not covered by insurance and, besides being expensive, they’re also totally different from a reproductive plan a couple may have in mind. They need some time to adjust to that. We need to be really sure that that’s in the best interest of that particular couple.”

Fast Facts About Infertility

• Infertility affects 7.3 million people in the U.S. This figure represents 12 percent of women of childbearing age, or 1 in 8 couples. (2002 National Survey of Family Growth)
• Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or is unexplained.  (http://www.asrm.org/)
• A couple ages 29 to 33 with a normal functioning reproductive system has only a 20 to 25 percent chance of conceiving in any given month (National Women’s Health Resource Center). After six months of trying, 60 percent of couples will conceive without medical assistance. (Infertility As A Covered Benefit, William M. Mercer, 1997)
• Approximately 44 percent of women with infertility have sought medical assistance. Of those who seek medical intervention, approximately 65 percent give birth. (Infertility As A Covered Benefit, William M. Mercer, 1997)
• Approximately 85 to 90 percent of infertility cases are treated with drug therapy or surgical procedures. Fewer than 3 percent need advanced reproductive technologies like in vitro fertilization (IVF). (http://www.asrm.org/)
• Fifteen states have passed laws requiring that insurance policies cover some level of infertility treatment: Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. (For more on this visit the insurance coverage section of resolve.org.) 

For the complete list of fast facts and more information, click here.

Next up, Maria Small and Kerry Stewart share their journeys toward having a family.