A Journey Through Infertility
pudding.cool
pudding.cool
Let's set aside that there are deeper sociological reasons on why young people start with kids later in life. We are not giving enough weight to all of the pollutants that we are exposed to in society, and how they affect our bodies, health and lives.
I heard Dr. Shanna Swan talk recently about the effects of hormone disrupting chemicals on (male) infertility. It's dire stuff really.
She was on the podcast promoting a recent Netflix documentary called The Plastic Detox in which they intervene in couple's lifestyles to reduce the amount of plastics and the hormone disrupting chemicals (bisphenols, phthalates, etc) they are exposed to. I highly recommend it.
There's over 70 different hormones in the human body regulating all kinds of biological functions. Fertility is only one aspect but think about the adverse effects these chemicals might be having on body weight, our sleep cycle, blood pressure, stress, libido, etc. We are prescribed drugs for related ailments at record rates. Maybe we should take a step back and treat less and prevent more.
When talking about hormone disruption, I think people over-focus on how that affects the ability to have kids. But that overlooks how hormones can change behaviors and desires. I don’t see anyone rebutting the fact that testosterone levels in prime-age men have dropped by half compared to the 1960s. Yet nobody seems to be talking about that as a probable cause in the drop in fertility rates. Even if these men are technically able to have kids if they want. Is it possible that the drop in testosterone levels means that men are less interested in having kids, and perhaps less able to persuade women into doing so?
Have you talked to her about what the problem is? It doesn’t sound like you have. In which case, that almost certainly is at least part of the problem
Seriously: she is really good at evading conversations like that. I have done all I could imagine to get her to actually talk about kids and our non existing intimate relationship. She always either gets angry or silent or changes the topic. Without knowing anything about me, some people are always inclined to believe something is wrong with me, not her. That’s so utterly unfair. I always treated her like a princess, work out and try to be healthy and look good, share all chores and take care of the house. Really if something is wrong with me she has never told me. Like I said I have no idea what to do.
It's not like fertility rates just started dropping in the 1960s. TFR in the US 200 years ago was over 7. Wealth and fertility are anti-correlated almost universally, at least at the population level.
Why did people centuries or millennia ago have so many children? Partly economic reasons: they can work your farm, and they can support you when you're old. Partly because sex is great and children are a frequent result of it.
The economic reasons fade as wealth grows, and the connection between sex and having children gets decoupled by technology. That leaves innate desire, which just doesn't seem to be that strong. We don't need to posit some recent drop in innate desire to explain the drop in fertility rates. The historical behavior we see fits just fine with innate desire being constant, and just not that high.
It varies from person to person; some of that variation is social/cultural influences, some is life experiences/circumstances, some is just randomness-but very likely it has a genetic component.
If certain alleles predispose one to be more likely to desire to have children, then in a society with strong social pressure to have children and limited availability of contraception, the selective pressure in favour of those alleles is going to be limited; in a society where social pressure to have children is low and contraception is readily available, those alleles will significantly increase the odds of having children, likely resulting in their frequency increasing over time, and maybe even (in the very long-run) a rebound in TFR
There are a lot of variables that are hard to control for.
Many of my friends have gone through IVF and still I was surprised by some weird parts of the story.
For example: "I was stabbed with 932 needles" and when you tap you find out "because I wanted to improve my odds, I went to 31 acupuncture appointments, where 687 needles pierced my underbelly, legs and head".
It is clearly established that acupuncture is placebo, but beyond whether this placebo might actually improve the odds (highly disputed), it is an elective alternative procedure with unclear benefit, not part of a standard IVF journey.
I understand the story is a very personal one, but it would be good to remember it isn't necessarily representative of most people's experience.
Personally I’m not a fan of acupuncture and I suspect any nervous system benefits from acupuncture would be far outweighed from those of regular exercise. But maybe for people with chronic pain or other issues it could be useful.
When each cycle costs about 30k USD, a lot of women with low amh, egg quality or ovarian reserve would try anything to help tweak the odds!
Source: my wife, every YouTube video was with something new which "totally" change your odds. Pinky promise.
God, how I hate those people.
And always this sentence: I know someone who this worked with! You can always find someone where something "worked". Started smoking? Bet you find someone where it worked.. started drinking alcohol? Bet you find someone where it worked... Etc.
Mfer.
Excuse my English
As someone who is a bit squeamish around needles, I don't know if I could have done what she did.
This very much depends on the patient history (age, cause of infertility, …) and the clinic. Live births per intended retrieval can vary from 10%-60% conditional on the above.
Placebo or not, anything which reduces the stress of the mother-to-be can be extremely helpful.
- first, implement a nationwide social freezing program, where women in their 20s are offered to freeze their eggs at a young age for free. Such a large-scale program would probably also improve the tech and might make egg collection less intrusive.
- combined with this program, let the women who freeze their eggs opt-in into an egg donation program, where some of their eggs can be used by women with fertility problems
But as with many things fertility, seems that modern states simply do not have the capacity to seriously try anything. Who knows why that is.
But Israel's advantage seems to be partly cultural and I don't see any time-limited elected government willing to expend that much effort to change their nation's culture.
Now you're suggesting every young and healthy woman should get these injections and have eggs scraped out of her ovaries?
This honestly feels so backwards. Create a broken society and then fix it in post with med tech.
My wife regularly observes that this hell of a journey looks more taxing on me than her. Which is probably true.
This process is hard on the fathers-to-be as well. We do exist, we want to have kids, we are heartbroken each time as well. We also have to be careful not to hurt our wives' feelings when expressing our grief and sorrow.
> There were the 7 a.m. doctor’s appointments before work; the dozens of days working from home in order to take all my medications; and the many times I reshuffled my travel plans.
Yes I mean just wait until you have kids. It's gonna get tougher.
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I didn't realize IVF was such a brutal process. 932 needles sounds like insanity, not to mention everything else. I'll carry a lot more compassion for those going through IVF going forward, and a lot more excitement for those able to concieve naturally.
That said, 245 is still a big number. 79 blood samples and 166 hormone injections.
https://www.imf.org/en/publications/fandd/issues/series/anal...
https://www.ssa.gov/policy/docs/ssb/v66n4/v66n4p37.html
https://www.newsweek.com/americas-population-time-bomb-18987...
IVF is also no longer something that's only for older women. Younger couples from both sexes are starting to need it.
https://tulipivf.com/news/detail/397
https://thehill.com/opinion/healthcare/4727738-people-need-i...
A click-bait article I read mentioned that Israel's culture is more child-rearing friendly than others, like the United States, where kid-friendly gathering places are not encouraged.
the article at https://www.taubcenter.org.il/en/research/why-are-there-so-m... mentions several possible reasons for the increased fertility, at least compared to OECD countries - Israel's birth rate is similar to its neighbours, Egypt and Syria, according to the article.
My partner and I are currently going through a surrogacy process, and it's been a brutal multi year project that has had numerous setbacks. At this point we are just white knuckling our way forward.
I'm glad we as a society have these options available for those that need them, but man is it hard going through these processes.
It feels like this site is almost erasing the father from the IVF process.
Dont have any kids. They reduce your freedom. I need to emphasize this.
To be fair, once I stopped having freedom, we went hard obviously.
If you already have 1, might as well go wild.
What I find most incredible about it is the number of women who experienced immensely painful procedures while conscious multiple times, and went back again and again, in order to have a child. And few of them, if any, regret it.
It is simultaneously one of the most impressive feats of modern science, and one of the most unfair burdens put on any section of the populace, that they were able to, and had to.
- Capability. Many couples are perfectly capable of carrying a pregnancy, they’re just having trouble conceiving.
- Cost. Surrogacy in a lot of countries is very expensive compared to IVF. Where I live in the UK, IVF is free on the NHS, or ~£8,000-£10,000 a round privately. Surrogacy can be £20,000 to £100,000 (or more), depending on the arrangement.
- Legal issues. In the UK, for example, the surrogate mother is the legal mother of the child at birth.
- Availability. Finding a surrogate can be very hard, especially in countries where commercial surrogacy is illegal. People go use surrogates abroad instead, which has its own range of issues (read up on orphaned surrogate kids in Ukraine).
- Ethical barriers. Using a surrogate involves issues of bodily autonomy. You can’t stop your surrogate smoking or drinking while pregnant, for example.
- Emotional barriers. Emotionally, motherhood starts at conception. Most mothers do not want to skip those 9 months of bonding they have with their baby prior to it being born.
In short, adoption is incredibly expensive, stressful, and not a sure thing.
Doesn't this seem extremely selfish?
The fewer mothers there are, the more children each mother will have to give birth to.
If one in two women decide to become mothers, then each mother needs to have four children. If one in four become mothers, then it means each mother needs to give birth to eight children.
Since you are depending on those children to work for you during retirement, you're essentially leeching off other people's children.
No wonder mothers no longer think they are sacrificing themselves for their children, but rather for a capitalist machine that requires more bodies.
Your hope is deeply dysfunctional.
You also talk about selfishness but at same time are implying that you want children to work so that you can have your cushy retirement. Our society should just stick together in solidarity; to paint this as “leeching” is also capitalist propaganda.
IVF and IUI (and now, IVM) treatment cycles are largely handled by private clinics that receive funding from provincial governments and, by extension, federal. Even with first-class health insurance, from employers, and government grants (paid to the doctors) there are out-of-pocket costs (ex., vitamins, supplements, missed work time, medications, genetic testing, sperm washing...). In our case, after multiple years, our health insurance coverage has dried-up (~30,000 CAD) and our lifetime grant eligibility for IVF (one treatment cycle) has finished. We could have easily exhausted our financial resources, (ex., investments, pensions, re-mortgage, lines-of-credit...), but with less chance to conceive daily, it's a race of diminishing biology. The opportunity to conceive a healthy child has been erased by time.
This added to the emotional and social costs of not being able to have a child. In my field, I find colleagues to be judgmental of working adults without children. As if having a child of your own gives you this magical insight into working with children that childless adults do not posses. I've started answered the question: "Do you have kids?" by saying, "Not by my own choice." This hopefully communicates that I've tried, but at a certain point a decision had to be made about whether to continue.
My spouse has taken all of the physical toll of the treatments. The male's job is to provide a sample, see their doctor, and sign the paperwork. By contrast, my wife has had early morning or lunchtime appointments (in an effort to not miss work) 3-4 times per week during certain monitoring or pre-proceedure periods. She has been subjected to blood testing, hormone therapy, daily injections, invasive ultrasounds, bruising, repeated pharmacy trips. All this in addition to phone-calls to remind staff at our clinic what the doctor recommended or asking the clinic reception for confirmation of a certain prescription or guideline. Of course, she undertook all of these responsibilities while internalizing the trauma of our familial reality.
My partner is strong, resilient, and beautiful. I owe her more grace and more appreciation than I can ever give.
My daily reminder to myself is to remember that my partner are I are already a family. Our commitment to one another has not changed. Although our lives may look differently then we may have imagined, it will not be any less meaningful.
Of course, each person and couple is different and the reasoning behind the difficulty of a successful implantation will differ.