Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
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
Off topic a bit, but if you’ve read anything about modern human trafficking, particularly sex trafficking, it is most definitely used as a control. It’s barbaric.
I’ve also heard that. I think women tend to be higher users of IV drugs because they are more emotionally driven and looking for ways of coping with the pain of life.
I listened to the audiobook of Sebastian Junger’s Tribe and he recounts some fascinating data of how contrary to expectations rates of depression, suicide, and mental illness all went down during the Blitz in wartime London. This corresponds to the fact that for decades afterwards Londoners would wax nostalgic about that era.
His theory is that during times of war or natural disaster we revert back to the innate tribal behaviors of our ancestors, that Londoners huddled together in the air-raid shelters actually got to know their neighbors, felt like they were “all in this together,” and in short felt like they belonged to a tribe. Contrast that with the life of a lonely twenty-something living in a big city far from where he was born and raised, far from family and childhood friends, meeting strangers in bars and “friends” online. While he may not have to worry about finding enough to eat or the Luftwaffe dropping bombs on him every night, he’s more likely to feel anxious and depressed because we’re hardwired to feel that way whenever we are separated from our tribe.
Well I’m pretty sure that psychologists are pretty darn confident that women have higher rates of neurotism.
Sorry to hear this, VC and Mustangman.
I’ve experienced the flip-side of this: no problem getting pregnant; needed medical assistance to stay pregnant. I lost three first trimester pregnancies that I know of. Ended up having my two girls at 36 and 40. And both of them have congenital diseases, so we’ve paid a pretty steep price in suffering.
The physical/psychological factors are many, I suspect. But, I’ll recommend a book I just finished to deal with the spiritual element, which is possibly the most difficult of all when we suffer: The Way of Trust and Love: A Retreat Guided by St. Therese of Lisieux, by Fr. Jacques Philippe. I won’t say it’s an emotionally easy read — I’ve cried more over the last two weeks than I have in the last decade. But, he gives solid advice on giving it over to God and learning the right questions to ask and the purposeful reframing of the experience of suffering to grow in the spiritual life.
Whatever happens, keep the faith.
Oh, and I never used the Pill, so there’s that data point.
How changed is the chemical structure over the generation?
So many of our drugs are synthetic chemistry now, rather than natural. I don’t know about the history and make-up of the birth control pill (or other medicines), but it makes me wonder.
Another source could be the full scope of feminine products we use from tampons to make-up, lotion and shampoo. These are laden with plastics, fragrances, stabilizers, synthetic colors, and other things. At your age, you’ve been bathing in a chemical soup your entire life.
As someone who’s wife has suffered two miscarriages. We know how you feel. It’s heartbreaking and does challenge one’s faith. Trust God. He knows what’s best. Wishing you all the very best. You’ll be in my prayers.
I don’t know why some women are having a harder time getting pregnant. I have seen this in my friends, too, and they were not older either. One in particular was in her twenties, and they ultimately adopted.
Whatever the reasons, I’m sorry.
For some it is easy to get pregnant, and impossible to stay pregnant after about 8 weeks.
Henry C: OK. That could be true. But is there some study out there that says liver cleanses work? These theories seem plausible but I’d like a bit more evidence for the hypotheses.
Henry. I have had a condition called Candida Albicans. You know all those commercials about toe nail fungus, feminine yeast infections and such? Those people have Candida. It is a overgrowth of a natural yeast in the body due to improper diet and over use of medicinal drugs which can infect the gut, the lungs and the brain. Most doctors won’t diagnose it because the elite medical community knows a huge cause is the over proscription of pharmaceutical drugs. Millions have the condition and don’t know it. It kinds feels like the flu. You just feel like crap or kinda in a fog that you can ‘t shake. Severe cases can lead to Epstein Barre which then can lead to cancer.
To cleanse my body I use liver cleanses every few months. Does it work? You betcha. I have to have them. And don’t give me the same ol’ same ol “where are the studies” nonsense. This is just another case where there will never be a study on liver cleanses because liver cleanses work and they are cheap and because such a study in the end would indict our over use of drugs which Big Pharma won’t allow. Also Gallstone surgery which Liver cleanses relieve is really big business. Over 60,000 cases a year, most of which would have been unnecessary.
Sidenote. If you are going to do one for the first time, it is best to drink pulpy Apple juice for two weeks before hand. Pulpy apple juice softens the gallstones which inhabit and gum up the liver by the thousands and helps you pass them. Gallstones are simply crystallized cholesterol which has sharp edges and can be harmful if they are too big when passed. One will usually pass hundreds of gallstones in their first liver cleanse. Also if you do liver cleanses you likely will never have a gall stone problem after that because after the first couple of cleanses your stones will get smaller and smaller to the point they will be mostly just sand.
So what’s your liver cleanse regimen?
There was an interesting study a few years ago about that. That problem only seems to be in Western Nations. Asia/Africa/Latin America men don’t have the same problem. I can’t remember why the studies authors thought that was.
A big one I have heard a lot of OBGYN’s think but for some reason it really has not been studied is STDs. STD might be playing havoc with. HPV really has not been study to see how much its causing the issue especially since there are different strains of it. They say possible 80% of the population will get it at some time in their life. Again I am talking about the population in General not your case.
However I have had a lot of friends who have had miracle Babies. So there is still hope. I don’t know how many cases I have heard first hand stories about were the doctors said they could not have kids. Then somehow the women conceives. Heck I had one friend who had all sorts of issues. Then suddenly in her late thirties has like three kids (three pregnancies) very close together.
I’ve heard that same concern voiced regarding STDs.
Hopefully I’ll have some answers after my surgery in a couple weeks. That’s really cool about your friend. What a blessing.
To use a hopefully-CoC-compliant expression, “bollocks.”
Just for starters, there’s a huge difference between short-term and long-term relaxation.
She was married 17 or 18 years. I think trying to have kids for most of it before her first pregnancy. Yay is was a God thing.
So I will say I do think the mental/emotional aspect of fertility is just as important as the physiological problems. Stress does inhibit fertility, and being anxious about conceiving makes things worse. It is very difficult, however, to figure out how to be positive and relaxed when all you’ve known is disappointment. I’ve always been a pretty pessimistic person- how can you work in healthcare and not get ground down by what you see?- so it’s hard for me to do the touchy feely things like vision boards and meditation that are supposed to help with that aspect of fertility. I dare say, many of my fellow type A personality ladies are in the same boat.
This was posted on another thread by someone, back in April, and I made a copy of it for future reference. It may bear repeating here:
And then of course there’s this:
Therefore Sarah laughed within herself, saying, After I am waxed old shall I have pleasure, my lord being old also? And the LORD said unto Abraham, Wherefore did Sarah laugh, saying, Shall I of a surety bear a child, which am old? Is any thing too hard for the LORD?
God acts according to his own timing.
I think @amyschley would sympathize with this. I do too, actually. My mother would have been perfectly happy for me to never have gotten married or have kids. All of the stereotypical “when are you going to get married and have babies?” guilt tripping that happens in most cultures was completely absent for me growing up. I was pushed to always maintain a good career that would be able to support myself. My mother has always been extremely proud of the fact that I’m a cardiothoracic surgery NP and I assist with open heart surgery. But there has been zero asking when I’m going to have kids. My mother actually sounded surprised when I told her how upset I was at my first two failed transfers. She said “I had no idea children were something you really wanted.”
I don’t think God is a vending machine dispensing babies, nor is he the great puppeteer pulling the strings of who gets pregnant and who doesn’t. That would imply that God meant for all of the terrible people that abuse and neglect their children to be fertile while he purposefully withholds children from those of us that would be good parents. That’s an awful slipper slope to go down. As @amyschley has stated before: God promises everlasting life and salvation, not the American Dream.
I’m sad if your mother doesn’t believe that bringing you into the world was the best thing she ever did.
And that bringing children into the world isn’t the best thing YOU could ever do.
Sorry, had to remove a double-negative.
She regrets quitting her job to be a stay at home mom, and she’s seen how bad things have turned out for some of her friends/acquaintances that stopped working and ended up in a world of hurt when their husbands had affairs and left them after 20-30 some years of marriage.
Those are sad situations too, but having children is still the best and most important thing that PEOPLE do, both men and women. In the long term, nothing else really matters without them.
In a global sense, yes, that is true. On a personal level, our purpose on this earth is more than just to have children. I’ve always said that if I never get to have children, I will be ok in the long run knowing that I spent my life doing something really meaningful.
When God promises that my husband will be the father of many nations, I’ll believe that Sarah overcoming her barrenness says anything about my chances.
Not to pick on you specifically, but I absolutely hate when she is trotted out as some kind of example. Unless God has specifically told someone that she will have children, no woman is promised that. And He hasn’t made any promises about conception since, oh, Hannah if you’re Jewish or Elizabeth if you’re Christian.
Don’t lie about what God is going to do. God has His own timing, yes, but “never” may well be the timing He has in mind. Saying otherwise is the kind of Therapeutic Moralistic Dieism that is the antithesis of real Christianity that drives people away from the Church.
I’m barren. My body is unable to do the one thing it is designed to do. There is no magical thinking I can do to change that. Prayer will only be effective if God chooses to make it effective, and He is under no obligation to do so.
Sometimes, there are no storybook endings of miracle babies — just people who try to move on from the hole in their hearts.
Okay … replace rape victim with Holocaust inmate, or war zone resident, or refugee. They manage to get pregnant too, oftentimes after being raped as well.
As I noted in a similar piece I wrote for Ricochet a couple years ago, modern society has this illusion of being able to perfectly manage conception. It shows up in our language: “birth control” and “choose life.” Those are things that can’t be done, though. One can prevent ovulation; one can keep the egg and sperm separated; one can combine the egg and sperm into a zygote; one can kill a fetus. One cannot make a zygote implant or ensure that a fetus lives long enough to be born.
I’m reminded of an exchange in “Jurassic Park”:
Dr. Sattler: It’s still an illusion.
John Hammond: When we have control…
Dr. Sattler: You never had control! That’s the illusion.
It’s only when confronted with the ugly reality of barrenness that anyone seems to recognize that you can have all the unprotected and carefully timed sex or create all the IVF embryos you want, but you still aren’t in control. That your feeling of control over your fertility was only an illusion.
One of the cases where we really, really agree.
At 22, I was not expecting to get pregnant. In fact, I was doing things not to get pregnant. Y’know, except not doing the exact thing that makes women pregnant. Now I’m 40. I’m in a position to get pregnant. I have a nice, settled life. I have a wonderful husband. My daughter is amazing and though less excited about being a sibling, it still excited about the idea that it might happen.
And then circumstances are such that even though everything else might be right, the timing just can’t get sorted out. So I might still be fertile (might) and getting pregnant would most likely fix a lot of my health issues and help my team figure them out, but I still might not be able to get everything together in enough time for it to happen (if it even can still).
Regardless of reasons for infertility, it sucks. And secondary infertility also really, really sucks.