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What is Wrong with Our Fertility?
My blood silently boiled back towards the end of 2019, when I consulted on a 43-year-old woman with a BMI of 48 who smoked, did drugs, had uncontrolled diabetes… and was 32 weeks gestation. How did she get pregnant and I can’t?!
“I just don’t understand why so many of you young women are having trouble getting pregnant! My friends and I, none of us had difficulty having kids. I just don’t understand it,” is what my mother said as I was talking to her after my third embryo transfer. The first one didn’t take at all, despite the 80% chance of success I was quoted by our previous fertility doctor, a guy who had helped several people I know get pregnant. “It has to work, I thought. I went in for more testing, and my medication regimen was adjusted accordingly. With the second transfer, I got a faint second line on the home pregnancy test, which was encouraging at first, any second line, no matter how faint means that something is trying to grow. The line faded over the next couple days, and by the time I went to have my beta hCG blood work drawn, it came back as zero; I had had a chemical pregnancy. The embryo implants but fails to progress and spontaneously aborts. That one hit me real hard. Seeing those two lines disappear caused a sadness I was not expecting. Mustangman and I cried over that loss. I took a break from all the stress and hormone injections for a couple of months, and in the meantime joined an IVF support group on Facebook for women in Ohio. Boy, did I learn a lot! Besides being introduced to the clinic I just switched to, I found hundreds of women struggling to get pregnant. Like buying a new car, suddenly you start noticing all the other people that drive the same car. I began hearing about fertility struggles from the nurses that take care of my patients. It seemed that the list of couples I knew having difficulty with getting pregnant was growing exponentially. I thought about my own friends, many requiring assistance with medication or procedures in order to conceive. And while infertility is as old as the Bible, my mother’s query rang in my ears: why are so many young women having trouble?
Those of you who know my age might be tempted to place the blame at my advanced age of 36. Pishposh. My mother had me just before she turned 36. Lots of women have children in their mid 30’s- early 40’s. But it’s not just age-related; I see many women in their 20’s having trouble as well. A nurse I work within the OR followed me out from the break room yesterday saying “so I heard you might be pregnant?” This led to a discussion about IVF and fertility in general. I found out she and her husband have been trying for a year with no success. When I asked her age, I found out she’s 28. That is prime baby-making age right there! So what is going on? In addition to PCOS, the most common diagnosis the women on the IVF board give is “unexplained infertility.” And it’s not just the women that are suffering. Men are also taking a hit in their fertility. Scientific America posted an article saying that men’s sperm counts have dropped by 50% over the past 40 years. Another article I read said that men today have 1/3 the sperm count their grandfathers did. Male factor is also a common cause of fertility problems. But that doesn’t explain the whole picture.
So what is it? What has changed since my mother and grandmothers were popping out kids at will it seems? Are our lives so much more stressful that the cortisol is messing with our hormones? Is it because women are working outside the home more? Is it the drugs and alcohol? More sexual partners? Or is it more basic- our food and water? I tend to think it’s the latter. Another article in Scientific America reports studies have shown the amount of estrogen in the water- a result of urine from women on birth control pills- can wreak havoc on the reproductive functions of aquatic and human life. In her book, It Starts With The Egg, Rebecca Fett discusses the various environmental exposures that contribute to poor fertility; the soaps, lotions, cosmetics, and cleaning products we use have been shown to hinder pregnancy. Our soy and carb-heavy diet doesn’t help either. This is why my fertility doctor heavily advocates for keto, and ideally carnivore keto. Carnivore keto is a bridge too far for me, but I have noticed how much better I feel when I don’t eat carbs or sugar.
I’m don’t know what the answer is. But something is happening. While all of my IV drug users with endocarditis cry to me about how much they need to quit drugs so they can be a mom to their X number of children, I cannot stay pregnant for the life of me (PS: they never get sober, and eventually die from their drug use). And I recognize that getting what you want isn’t the result of having a good job or being a good person- God isn’t a rewards vending machine. But it does seem that the people who struggle the most to get pregnant are those that really want children and are willing to sacrifice mightily for it. If one were conspiratorially minded, one might come to the conclusion that that is the point…
With my third embryo transfer, things felt different. I wasn’t blindly hopeful like I was with the first, or as rage-y and negative as I was with the second. I was apathetic, really. But that glimmer of hope that came with that second line on the home pregnancy test and the message from my clinic that yes, my hCG was low but positive, faded when my repeat blood work this morning showed my hCG levels had dropped. I stop all medications and wait. An exploratory laparotomy is the next step. In the meantime, I’ll just keep operating on my patients during the day and playing fetch with my cat in the evening. Come one, how can a fetch playing cat not cheer you up?
Published in General
I am sorry this is happening. I too have wondered at the chemicals we all house these days.
Prayers.
Should I get out the General Ripper clip about fluoridation?
God bless you and MustangMan in your quest.
I’m sorry to read this. My wife and I have dealt with infertility too and it’s rough. We too wonder why it’s so tough for people to get pregnant. The last time we were at the fertility doctor there was a young couple in the waiting room and I thought “ you’re too young to be here”.
There are so many toxic chemicals in everything that disrupt our endocrine system. And yes, our food and water are compromised.
Even the fertility drugs are a kind of disrupter, that’s their purpose.
Be still and seek G-d. He will light your path.
Ps, good to hear from you, all be it a topic of frustration, disappointment and sadness.
Prayers, VC.
I am so sorry to hear this.
You stress about getting pregnant. She doesn’t.
In any situation, “Relax” is the sort of advice that is never wanted or heeded. Telling someone that stress itself is a problem is unlikely to make the person stop stressing.
It is nevertheless considerable. I have personally known half-a-dozen mothers who only successfully gave birth after they gave up hope and so stopped stressing about it. Were their pregnancies due to lack of stress or due to God’s own timing? I don’t know.
There probably are many other factors. Modern women disrupt their natural hormonal system for decades with the pill. That must have effects. Modern men are discouraged from being masculine, perhaps resulting in less testosterone.
A couple I know is set to have their second surprise baby after many unsuccessful years. Like you, they were deeply hurt and discouraged by those years without a child. But even the sharpest pain becomes forgettable when relief and joy finally arrive.
Perhaps the Lord is waiting on the prayers of others and not just your own. Ditch the IVF. Trust in God. We will keep bugging him on your behalf.
https://www.theguardian.com/environment/2010/apr/21/toxic-stew-chemicals-fish-eggs
It’s not the link I was looking for but I remember my microbiology lecturer in college talking about what the contraceptive pill was doing to fish. This is from around the same time period.
One of ours like to do that too. I was stretched out on the couch the other evening and he dropped one of his mice on my leg and just waited patiently for me to notice. I tossed it, he gleefully galloped after, and 5 minutes later repeated the exercise. Hard not to feel at least a little cheered at those games.
There are much greater and more stressful conditions in our living conditions environment today than existed before. That’s my opinion from observation since I have no technical expertise. Both men and women have moved away from what may be thought of as natural conditions to lifestyles that are mostly possible because of our technologically advanced state. Most live now in artificial or man(human)made conditions rather than natural. This may cause an unnatural stress level for both sexes generally even adulterating changes in our food, water, air and other ingestible products.
The estrogen factor is huge and (largely for political reasons) ignored and understudied (unless you’re Alex Jones, obsessing about gay frogs – but he doesn’t do the studies any favors at all). Increasingly it’s not the only factor in the water supply – what about all the opiates, the meth, and heaven knows whatever else we’re flushing down all the time? Water treatment plants can only screen for so much, and only remove so much, and various endocrine disruptors and other hormones need only be present in nearly undetectable amounts before they start to cause weird cascade effects. I’ve often wondered if the various hormone tests in the water are ever compared water supplies for more isolated people and areas and the deep well water they use, which is often still relatively untouched compared to city water – there might some answers there, especially when one thinks of the Amish, for whom children still abound.
I don’t think their lifestyle, male versus female, has changed as much as the bulk of society either. Do they appear to be as stressed as the rest of us?
VC, I am so sorry to hear you and Mustangman are going through this. I’ve been there. Never did get pregnant. Sounds like you’ve got plenty of resources, but you know you can always e-mail or PM me if you need to. Prayers. It is a very emotional time.
As they generally eschew cell phones and social media, I’m guessing that their stress levels are considerably lower just on principle.
My wife and I knew a couple that despaired of their infertility and finally gave up. They took a trip to Ireland to see if they could adopt a baby with the help of the church. That stopped two months later when they found out she was pregnant.
How about “Age” ? Modern women wait much longer to have their first child, and fertility declines with age. Average age of first pregnancy these days is nearing 30, if I am not mistaken. Best fertility is in your twenties.
” Another article in Scientific America reports studies have shown the amount of estrogen in the water”
Based on what I’ve read, the amount of estrogen from this source is pretty minor…a much greater amount comes from agricultural runoff.
I have believed that something was biochemically off kilter with the human reproductive system as a whole since my children were born. My oldest is forty, and that’s how long I’ve been concerned about this. For me, it was the rate of C-sections that I thought was crazy high. I’ve had three C-sections, and many of my friends ended up having a C-section or two also. In the decades before my kids were born, the C-section rate was very low, in the range of 3 to 5 percent of all births. Then for some reason, the years my kids were born, the rate went to 20 percent. It was so noticeable that women started blaming the obstetricians, which never worked for me. I have never known any doctor who would perform an unnecessary surgery or women who wanted to control the timing of the birth of their babies. The explanations about the increase in C-sections were just ridiculous. Some women blamed the fetal monitors–that’s called blaming the messenger. :-)
That was the beginning of my interest. Then came along the early (11 years old for many children) menstruation that started forty years ago, and on the other end, later menopause. Higher rates of cancers in the reproductive system as well. We saw a spike in breast cancer on Cape Cod thirty-five years ago that still has not been explained.
The last observation for me was the infertility rate, which thirty years ago, should have been at its historic normal rate of 3 percent but was up to 10 percent.
Something is different out there in our biochemical environment. Whatever it was, it started pretty dramatically forty years ago. The carbon-based petroleum products we come into contact with every second of every day–basically, plastics–that began to proliferate after World War II would fit the timing. Also, the use of so many vaccines would too. There are almost endless possibilities. But “the pill” seems to be the most obvious place to start. It’s a powerful drug.
I don’t know the empirical facts about this, beyond the general observation that infertility problems increase with age.
Best fertility is probably in the teens. We don’t seem to think about this.
But I know a lot of women in their 20’s that are struggling too. I don’t think it’s mostly age related.
Indeed – it seems very odd. I know several couples in their 20s who have had rather a lot of trouble.
As to the stress argument- I don’t think it’s that. You cannot tell me that we are more stressed now than our parents and grandparents were during the World Wars and the Great Depression.
We had certain reasons why we went straight to IVF. We didn’t go through months of trying naturally and getting frustrated at not conceiving. I was super optimistic after my first transfer. How could I not be with an 80% quoted success rate? I don’t think it’s solely stress.
We tried for many years and finally headed down the infertility route. We went in with the understanding that either of us could call the whole thing off for any reason at any time. We never got very far through the frankly dehumanizing process…just to several months of awful injectible drugs.
One night I had a dream that I went to heaven and there were lots of little babies standing there, saying “We’ve been waiting for you!” That’s when I called it off. We later adopted our son.
I will never forget the look of tired desperation on the faces of people in the waiting room of the infertility practice.
We’ve thought about adoption, but nowadays women with unwanted pregnancies either keep the baby and raise it in a miserable situation or they get an abortion. I’m also not willing to adopt drug addicted babies or babies of other ethnicities as I’ve had too many friends adopted that are not of the same ethnicity as their adoptive parents and the sense of being unwanted is profound for them because it’s so glaring.
It’s also wrong, as can be shown from this syllogism:
You have to relax to get pregnant.
Raped women get pregnant.
Therefore rape must be relaxing.
I have also heard of that happening. It’s the same principle as “once you stop looking the right guy is just going to show up.” Yes, those things happen, but there are also a lot of really great people that never meet someone to marry or never get pregnant even years after “giving up.” And I don’t think God is the great vending machine in the sky waiting to give me a baby when I become sufficiently relaxed. I was very relaxed during this past transfer, and did get a positive pregnancy test. It just failed to progress.
As another barren woman, my thoughts on why I have so many sisters:
Fertility peaks at 25 and steadily declines until 35 when it dives off a cliff. When the average woman doesn’t marry until 26, she is already losing fertility by the time she is trying to get pregnant.
Deliberate hormonal manipulation. I increasingly believe that hormonal birth control has long term effects on the body that persist after stopping consumption. Since the average age at first sexual experience is 16, most women have been on the hormones for a decade or more before attempting to get pregnant.
Unintentional hormone manipulation. Between the hormones in our food, our water, and all the plastics we encounter, we are bombarded with hormones. Then there are chemicals that affect our hormones; I recently found out that the class of antidepressant I take has a little known side effect of raising prolactin levels. High prolactin levels are associated with polycystic ovarian syndrome and infertility — I’ve been on this for years and neither the psychiatrists nor the reproductive endocrinologists have ever mentioned that this could be an issue.
Male lack of fitness/ obesity. Brown fat in the core (what causes the apple shape) generates estrogen which causes problems for sperm. Moreover, testosterone levels increase with physical fitness, so a sedentary lifestyle reduces that needed hormone.
Not really. Rape is a sudden stress. Prolonged stress obviously affects various systems of the body differently. It’s like the difference between choking on thick smoke on a particular day and smoking cigarettes for decades.
As I said and we all know, many women get pregnant after giving up on having a baby. Maybe it’s just rolling the dice for the nth time. Or maybe something changes when a woman enjoys sex without fretful regard of its potential outcome. I don’t know.
But if it was prolonged stress, wouldn’t our grandmothers have suffered as they lived through years of the uncertainty of war and economic depression?