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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
Reading through the post and the comments, I haven’t seen too much in the way of statistics. For example, what is the fertility rate among women who have never taken the pill compared to previous decades?
I have read that male sperm count is down in the United States.
A few things make sense to me. Artificial birth control probably is a major factor. A factor influencing the reduced sperm account could indeed be the proliferation of “men without chests.” I’ve read that there is less interest in sex among millennials, though I doubt that that lack of interest includes religious married couples, unless they are taking the pill.
There was some speculation regarding other environmental factors, but logically the strongest factor to me, is years of ingesting hormones to keep from getting pregnant.
A lot of that could be fear of being “cancelled” because of some accidental slight.
Having children is the American Dream for you? I’m only quoting Scripture to emphasize that God is in control, and He’s the giver and bringer of all life. I’m sorry if it came off any other way.
BMI of 48.
I had to search to find a chart that went out that far.
A 5 foot 6 inch tall woman who weighs 290 is the one who is getting all the action?
I love that that’s where your mind went. That’s amazing. No, this woman was much bigger than that. I think she was closer to 400 lbs. Some guys like ’em that way. I could tell stories that would make your eye twitch about people coming to the hospital with the complications of their sex lives.
God is the giver and bringer of life in the sense that he created us with ability to create life ourselves. I don’t think He’s sitting up in heaven saying “you get a child…eh, you don’t get a child.”
You are going to have so many stories to tell at your next Ricochet Meetup.
What a fascinating story. Why doesn’t the Logos of the universe just not care about you, or me or anyone?
I can easily imagine an indifferent universe. With a Logos or otherwise.
Why is that belief that no one cares about you so hard to understand for people of more traditional beliefs?
P.S. Sorry to distract from your main post but that is the way of all great Ricochet posts.
God not being a puppeteer and not caring are two different things.
So sorry to hear about all of this. I was on the infertility roller coaster from 2016-2018. It’s really just the worst, and it’s so hard to pick up the pieces and keep going when you don’t have success. We finally succeeded with our third IVF embryo transfer. My sister also had success with IVF (second transfer). Both of us are healthy, in our early to mid thirties and were labeled as “unexplained infertility”.
Not to place blame, but I agree that often the expectations of success are set way too high at the clinics. I was shocked when my first transfer didn’t work. I was also totally blindsighted by a chemical pregnancy on transfer #2. Seeing a positive that turns into a negative after more bloodwork was definitely the low point in 2 years of a lot of lows:-(
The thing you realize after having a chemical pregnancy (I’ve had two) is that the initial positive pregnancy test means nothing- it’s staying pregnant that matters. Did they ever do a hysteroscopy/laparoscopy on you or do ERA testing?
Totally agree. And my chemical was my first pregnancy/positive EVER, so I of course was in blissful ignorance for 2 days until that second blood test.
Interesting you ask about hysteroscopy and ERA. I did both between transfer #2 and #3 (the successful one). Who really knows in the end, but I attribute my successful pregnancy to one or both of those procedures. The ERA in particular – I ended up with abnormal results using the standard transfer window (apparently 25% of the time, results are abnormal). Once my doctor adjusted my transfer window accordingly = full term (fraternal twin!) pregnancy. We transferred 2 embryos that time, and both stuck.
I did the ERA after my first failed FET, and I was pre-receptive so they adjusted my progesterone dose by 12 hours. How to come a call with the second transfer, and then switched clinics. When we did the consult with our new clinic, and I told them about the results of my ERA, they were like “that’s cute.” They put zero stock in the ERA. We did a three day fresh transfer with the two embryos we got from my retrieval. Again, another chemical. We’ll see what the hysto/lap shows.
I don’t want to argue with you, and I hope that’s not what I’m doing here. This is just from Scriptural perspective and you can have your own, and certainly you are free to discount what I say. But God makes the baby even in the womb. “For it was you who created my inward parts; you knit me together in my mother’s womb.” And Scriptures say: “And Adam knew Eve his wife; and she conceived, and bare Cain, and said, I have gotten a man from the LORD.” (Of course translations vary.)
It is not you or science that creates life or a baby, at least not exclusively. God is directly involved in everything each of us do and want. Maybe He doesn’t want to give you a child. Maybe not yet. But I have known miracle babies. One woman had one ovary, one third of a uterus, and had her tubes tied. And her husband used a condom. And yet she had an unexpected but welcome baby. She actually calls him her “miracle baby”.
Miracles sometimes do happen. But it is the Lord who creates life. And he acts, or waits, in His own time, in his own wisdom. And ultimately He is in charge.
That’s all I meant to say.
PS: My wife and I are childless, too. And she laughs when I say You could be another Sarai.
And let me say, please, that I wish that we had had children. And in our later years especially, I think about it more and more. We recently, a few years ago, came close to adopting a child from a family friend, who was pregnant and her husband spent 38 weeks arguing with her that she could not keep this child, so she was going to give it to us. Being older we were excited and apprehensive. And we began preparing for the boy’s birth. The baby died at 38 or 39 weeks gestation. We cried a little bit. And the mother cried for months. And the husband cried a little bit.
Oddly, this is at least the second couple I have known that went through this experience, of the husband demanding an abortion or whatever, and the child dying immediately prior to birth, the mother being devastated, and the husband then getting upset at the death, and in one case the husband getting outraged at God (and he was an atheist).
We never went through IVF; we said that if it was the Lord’s will we would have a child, if not, then not. The answer was Not. So I know a little bit of what you may be going through. And I hope that you do have children. But it is not entirely your call. It certainly wasn’t ours.
[Fixed it.]
It’s nice that she can laugh at you. I’d probably slap my husband into next week for deliberately triggering my greatest psychological and spiritual pain.
Yes, anything can happen with the grace of God. To take a lesson from Sarah, though, whether it happens or not is based on God’s will, not the woman’s belief that it will. So telling women that it will if they just have faith is making a promise on God’s behalf that He will likely choose not to honor. More than that, it is dangerously close to pagan thinking that if I do something for God, He’ll do something for me. It doesn’t work that way. As noted in the intro, morbidly obese diabetic drug users who’ve probably never spoken the Lord’s name not in vain get pregnant; what faith did they have to deserve a child?
“God still loves you and will remember you in your pain” is a comfort; “Relax and have faith in God’s timing” rubs salt in the wound by making barrenness the woman’s fault.
May I recommend reading this blog and this post in particular?
https://heremembersthebarren.com/2014/05/08/this-just-in/
That is absolutely heartbreaking all around.
Well, that’s not unusual.
Atheists often say they don’t believe in God, but usually believe in God enough to have strong enough feelings to be actively against him and not just indifferent.
I’ve got a spare teenaged boy or two… the rest I’ll keep, thanks.
The easy prevalence of pornography is also a two-fold factor (and not just for men anymore, but increasingly for women).
On the one hand, why risk going out and trying to woo a mate when it’s so risky? Easier to just stay in and fantasize.
On the other hand, to be to the point, frequent masturbation (by both sexes) dulls the drive still further to even want to go out with someone – the nerves are deadened by overstimulation that is potentially far far more intense and than actual intercourse. You see the same effects with drug users, where other activities that might provide the same high (or low) take too much work and lack the immediacy or intensity that the drug can provide.
Frankly, video games and Netflix binging have similar effects.
As I often hear expressed, “So, tell me about this God you don’t believe in…” and the reply is so often something like Zeus, or that person’s own father.. “Funny, I don’t believe in that god either.”
The More control we develop over the world, the more the pain we seem to feel when we run into things we cannot control.
https://www.youtube.com/watch?v=03bOrvlAyeQ
I believe God, that he is just, and merciful. And long-suffering. And even gracious to us all. I can see that in my own life. And I believe that we will see that in full one day.
The husband is clearly the fiend! (I know, just a typo, but “fiend” fit the husband pretty well…)
I know! I need to hear all of them.
Well, will you look at that. Let’s call it a typo. : ∫
A Freudian typo?
It does seem that way, doesn’t it.