GRSJ224/infertility

The Stigma Attached to Infertility

Overview

A stigma is a mark of disgrace associated with a particular circumstance, quality, or person. It has to do with discriminating against a person based on perceivable social characteristics that distinguish them from other members of a society, such as health. This is a reality for many people dealing with infertility. In humans, infertility is the inability to become pregnant or fully carry out a pregnancy. It affects between 60 million and 168 million people worldwide. In a recent Canadian study, infertility is estimated to affect almost 16% or 1 in 6 couples. Still, many women feel alone when trying to emotionally cope with the inability to carry a child. There are many causes of infertility, which can be due to the male or female. Although, the reality is that it is not the man or the woman’s fault and finding the root cause to why someone is infertile is hard to do. Luckily, there are other steps a couple can take to have a baby as the number of treatment options and assisted reproductive technologies have been increasing in recent years. For example, IVF (in vitro fertilization) and surrogacy. Even though there are many factors that come with seeking these options, such as cost, a study found that stigma was a frequent reason for not seeking treatment than was cost. Sadly, women who could benefit from seeking these treatments don’t, due to stigma. One way to reduce the stigma attached to infertility is to encourage and educate people to avoid stigma and empower couples who are facing difficulties conceiving.

As if those suffering with fertility problems didn’t have enough on their plates, they often have to contend with a stigma that comes attached to their condition.

Myths

According to a study done by BMC Public Health, it was found that a lot of people have very little knowledge about infertility.This lack of knowledge can explain why there is such a strong stigma attached to infertility in our society. It is important to know the facts behind common myths to better understand infertility and reduce the stigma.

"It’s easy for women to get pregnant"

This isn’t true as not all women are able to get pregnant and it isn’t their fault. Certain health conditions and factors, such as age, can affect a woman's ability to conceive. A healthy 30-year-old woman has about a 20 percent chance of getting pregnant each month with her chances dropping to about 5 percent a month by the time she turns 40. Infertility can affect women of any age, and from any background.

"Only women can have infertility problems"

It is commonly believed that infertility is the women's problem, but this is not the case.  Statistics show that in the United States, 35% of all infertility cases treated are due to a female problem, and 35% in males as well. It was also found that 20% of the cases were due to a problem with in both partners, and 10% to unknown causes. This suggests that both partners need to be tested when a couple is having trouble conceiving. Fertility also declines with age in both men and women, but it is true that the effects of age are much greater in women. Even though science and statistics show that women are not always the reason for problems with infertility, much of the stigma persists today.  

"Healthy people don't have fertility problems"

While it's true that maintaining a healthy lifestyle can improve fertility, even the healthiest people can have fertility issues and this alone will not fix these them. Many people are unable to conceive due to genetic factors such as an inherited chromosome abnormality or a single-gene defect passed from parent to child.  Fertility problems do not mean that you haven’t lived a healthy life, it simply means you need help.

"If you cannot afford costly procedures, such as in vitro fertilization (IVF), you shouldn't seek treatment"

Sometimes high costs are an unpleasant reality of fertility medicine but this doesn’t mean a person shouldn’t seek treatment.  It is possible a simple blood test could be used to diagnose your issue and it is also possible that you may only need a minor medical procedure to fix it. Some people give up before even knowing what is wrong. IVF is the most extreme option but it is not the most common. It is important for people to explore all their options before giving up due to the cost.

"IVF always results in multiple babies"

During an IVF session, doctors normally implant multiple embryos because it leads to greater odds of one being successful. IVF is a delicate process and only about a quarter of IVF procedures produce even a single pregnancy. Although the process can increase the odds of having multiple babies only about 10% of IVF cycles end in twins or triplets.

"Infertile couples will never be happy or fulfilled"

Not being able to carry a pregnancy to full term or have a child naturally can psychologically affect people, but that doesn’t mean they will be forever unhappy. Over time, people are able to move on. This can mean letting go of the initial dream of having a baby or deciding to adopt. Sadly, this is a common misconception and does not help those affected. Either way, most people do find other ways to be happy or fulfilled.

Negative pregnancy test

Common causes for Infertility

Causes in Women

A women's age (the ability to conceive starts to fall around the age of 32 years), smoking, alcohol consumption, weight, a lack of folic acid, iron, zinc, and vitamin B-12 and mental stress are all factors that can affect fertility. There are also medical conditions that can affect a women's fertility such as ovulation disorders or problems in the uterus or fallopian tubes.

Causes in Men

Common causes in men are similar to those women although age is a difference as male fertility doesn't start till fall till much later. Problems regarding semen and low sperm count can occur naturally or by cause of antidepressants. This is a common reason for infertility in men.

Treatment Options

The stigma and myths attached to infertility can allow people struggling to feel ashamed and not want to seek treatment. With reproductive technology constantly improving, it is important for people to not be ashamed to seek treatment or search for other options. After a couple has been trying for a while without being successful, it is important is to see a doctor. Your doctor will ask questions regarding things you've tried and come up with the best options. Treatment will depend on many factors, including age, how long the infertility has lasted, personal preferences, and their general state of health.Sometimes a doctor may suggest something as simple as lifestyle changes. Other times more serious options may be necessary.

These other options include:

Fertility Drugs

Women may need to inject drugs made of human hormones (gonadotropins) to stimulate egg growth and ovulation which would create a better chance for an embryo to grow in the uterus. Fertility drugs can sometimes be used in combination with medical procedures to result in the best possible outcome.

Medical Procedures

If the medical treatments mentioned above fail, the doctor may then suggest assisted reproductive technology (ART) techniques, such as IVF. There is a negative stigma surrounding ART. Some believe that a child conceived through intrauterine insemination (IUI) or in vitro fertilization (IVF) is not equal to a naturally conceived child, as if being born through artificial insemination makes a child less of a miracle.

Surgery:

Surgery may be done to unblock fallopian tubes, retrieve eggs or sperm to be used in fertility treatments, or reverse sterilization surgery.

Intrauterine insemination (IUI):

During this procedure, a thin tube carries sperm directly into a woman's uterus through the vagina. Fertility drugs are normally taken to help her ovaries produce one or more egg. This procedure can be done with sperm from a partner or a donor.

In vitro fertilization (IVF):

IVF has been proven useful in overcoming a good number of infertility conditions, such as blocked or damaged tubes and unexplained infertility. The process involves a number of steps that allow fertilization outside a woman's body. First, the woman is given fertility drugs which allow the ovaries to produce one or more eggs. The woman will then have surgery to remove the eggs from her body. The eggs are then fertilized with sperm in a dish to produce one or more embryos. Lastly, an embryo is transferred to the woman's uterus through a thin tube to achieve a pregnancy.

Surrogacy:

Surrogacy is an arrangement where a woman agrees to become pregnant and give birth to a child for another person or couple, who will ultimately become the parent(s) of the newborn. People may seek a surrogacy arrangement when pregnancy is medically impossible, when pregnancy risks present an unacceptable danger to the mother's health, or when a man alone or a male couple wishes to have a child.

Social Effects

Aside from the emotional challenges and the stress infertility can add to a relationship, there is also the social stigma that comes along with it. For many couples, infertility and the treatments cause a serious pressure on interpersonal relationships, personal distress, and reduced self-esteem.  People tend to hide their infertility struggles as they continue to fulfill daily obligations, carrying the secret burden of a life crisis. People inadvertently maintain a false belief that they are alone in their struggle. This is merely because of the stigma and the fact that we don’t talk about infertility like we should. Social support can be a critical component of how a person adjusts to the unexpected stress of infertility.  It is important because people (especially women) tend to disclose their infertility to others.

Around the World

Infertility is experienced as a stressful situation by individuals and couples all around the world. In many countries, fertility is looked at as something to be respected. If someone is labeled infertile, it is like a stamp of shame.

In countries, especially poorer areas where women are expected to be married off and have children, those who do not have children often suffer from stigmatization. Most infertile people on the globe live in developing countries and having children in these settings is often the only way for women to enhance their status in the community. These women are often uneducated, so their main identity comes from being moms. Women face a burden even if the cause is their male partners or husbands. At the Harvard Chan School of Public Health, Dr. Mahmoud Fathalla observed that the social burden of infertility does indeed fall on women. Dr. Fathalla also found that when a couple is unable to produce, the man may divorce his wife or take another wife if they live in a culture that permits polygamy. Dr. David Adamson, president of the American Society for Reproductive Medicine and a board member of the International Federation of Fertility Societies stated that it is extremely difficult for people in the United States to deal with infertility, and that it's even more devastating to people when you go to other cultures.

In Kenya, the culture believes that a woman should have at least one biological child to be deemed socially acceptable. A women by the name of Mamta Jhunjhun Wala, living in Mumbai still remembers the stigma of being unable to bear children for the first 13 years of her marriage. She decided to seek treatment at Mumbai's Malpani Infertility Clinic, and was finally able to conceive a daughter and twin boys. Wala stated that she started a support group to help give other infertile couples the help she wishes she had because there was nobody to support her when she needed it .

In a recent study, it was found that African American women wait twice as long as white women to see a doctor for infertility, and are less likely to seek treatment. African American Women are also twice as likely to suffer from infertility due to higher rates of uterine fibroids. This is not well known because the stereotype behind a infertile women is typically a white women. In other countries gossip is a large factor that allows the stigma to grow and can make a woman feel ashamed for not being able to have a biological child naturally. Around the world, people of all cultures, especially women suffer from the stigma attached to infertility.

Advocates

Advocating is very important in order to get your point across and improve our society. It is especially helpful when dealing with a topic that is not well understood or visible. Infertility is both of these things since their are many misunderstandings about it and you cannot all if someone is infertile by looking at them. With infertility have a lot of stigma attached to it, advocating can come a long way.

Michelle Obama, known for her advocacy for women and girls around the world, shared in a recent interview with ABC’s Robin Roberts, a story of the miscarriage that led her to seek treatment for infertility. The former first lady surprisingly revealed that she underwent IVF in order to conceive her two daughters. In the interview, Obama stated that during the time of her miscarriage she felt like she failed. This was because she didn’t know how common miscarriages were and we don’t talk about them among  society. This is a common feeling among people in our society who struggle with infertility issues. Obama also stated that one of the worst things women do to each other is not sharing the truths about our bodies and how they work. Michelle Obama is a good example to society as she reminds us that this is an important issue to discuss and it is not something women or even men should be ashamed of. By showing others that they are not alone and talking about infertility, the stigma attached to it can easily be reduced and eventually disappear.