The fertility rate has been declining in both developed (one in six couples is infertile) and developing countries (one in four couples is infertile). People who try on treatment options take on average seven years and €30k+ to have a baby. In clinical interviews, infertile patients often state that something so fundamental and natural [getting pregnant or impregnating] does not happen to them.

This article has two intentions. First, inform and comfort those who are struggling and feel out of place for not conceiving as easily as others. Second, provide some insights for those who aren’t aware of the reality of those trying to conceive.

Here are a few statements you may have already heard, and what science says about them:

“Just Have Sex More Regularly.”

First, not everyone trying to conceive has that option. Some are single, some are in a homosexual relationship, some are undergoing treatments that render unprotected sex impossible (e.g., chemotherapy), some live subjected to hazardous environmental factors (e.g., exposure to phthalates), and some do not have access to quality information about their reproductive health. Second, even if none of these were present, the psychological and emotional struggle timed sex has on most people is harsh. The National Institute for Health and Care Excellence (NICE) indicated it as a source of distress to couples.

ADVICE: Sex does not always equal a baby. If you are struggling to conceive after trying for over six months, ask for help. You may contact your GP, a clinic, or an online service like Enhanced Fertility.

“But You’re A Man, This Shouldn’t Concern You.”

As we have written in a previous article, men suffer from infertility too. Fertility-related concerns regard them and are definitely valid to have. Aside from that, even if the malefactor is not at fault, men have parenthood dreams too, whether alone or in a couple. Research shows that there are unfortunately gender inequalities in fertility literacy and help-seeking behaviors, men being on the low end of both. This can happen for many reasons, but the focus here is on how to revert this trend. Including men in the information made available helps a lot, i.e., informing them about their reproductive health, what can affect it, and how they can prevent issues and preserve their fertility. Plus, displaying clear and concrete information in the form of numbers and images also helps get the point across.

ADVICE: Look for information that includes you in it. Scientific articles from creditable sources are available and are often the best choice to read. You can look at the following references as a start, starting from least to most complex: (1), (2), and (3)

“Just Do IVF!”

Despite more and more people turning to IVF (in-vitro fertilization), it is not a miracle. It is a common misconception that IVF will ensure a pregnancy. The success rates of live birth vary at 39% per embryo transfer for patients under 34 years and 6% per embryo transfer for patients over 43 years. However, these figures change not just with female age, but egg and sperm quality, uterine receptivity, hormonal balance, preservation and storage methods used for the eggs, sperm or embryo, etc. According to the Victorian Assisted Reproductive Treatment Authority (VARTA), women up to 30 years have a 43% chance to conceive and deliver after one stimulated cycle and 65% after three stimulated cycles; women 42 years old and up have their chances down to 6% after one and 11% after three stimulated cycles. Using donor eggs, sperm, or embryo, or trying surrogacy are all valid options to explore. Nevertheless, this shows how assisted reproduction techniques have their limits

ADVICE: Research your options and go to your consultation prepared with a list of questions. An individual assessment of the case is necessary before recommending IVF or any other treatment, therefore bring a report of your fertility risk factors (use the Fertility Risk Detection Tool).

“Oh Don’t Worry, You’re Still Young…”

Fertility risk factors, like STIs and alcohol, start young, and unforeseen events, like cancer, can happen at any age. Young people are aware that some lifestyle choices impact fertility but disregard the impact they truly have, which may lead them not to behave to best when it comes to reproductive health. So, it’s never too soon to be knowledgeable about your health. Furthermore, age has a big impact on fertility health. Female and male fertility and success rates for IVF decrease with age. Unfortunately, most people tend to overestimate the age limit for childbearing. Most women look for help when they are already 38 years old and when fertility health is already in decline. Women’s fertility takes a dive at 35 years of age, and men’s at 45. You should also take into account that some conditions hinder your fertility before you hit a critical age, for example, hormonal dysfunctions and genetic conditions.

ADVICE: Age matters. The sooner you are aware of this, the sooner you plan your future or at least (re)assess what you want out of life. Think about where you are and where you want to be now, in five years, and in ten years. If you aren’t ready to become a parent, consider fertility preservation options.

“Take This And You’ll Get Pregnant Right Away!”

Receiving advice is normally a caring act. However, fertility patients often report how invasive some comments are and how insensitive they sound. For example, hearing “I know what you need”, is frequently not true. Even if you know someone who believes they have a magical potion to cure you, consult a certified healthcare professional. Bombarding people like that makes them feel overwhelmed and like they aren’t doing enough, which is not helpful.

ADVICE: Giving light-hearted advice does not help. Supporting the other person includes listening, validating feelings, comforting, and assisting in the decision-making process, but it does not mean pushing, pressuring insisting, and invading personal space. Not everyone will understand or respect where you are coming from. State your boundaries, search for common ground, and don’t settle for less than you deserve. Remember that not everyone is going through what you are, it’s easy not to understand where you are coming from. Hopefully giving the other person some insight into your reality helps.

“Stop Reading All That! The Computer Isn’t Going To Help You.”

Researching often means regaining control over the situation and making sure everything that can help the situation is being done.
ADVICE: Don’t mock people for doing long hours of research and obsessing over it. If anything, help the other person look for quality information (here are some criteria to help you filter information: (1) the information should be referenced, (2) the references should be from scientific journals or written by experts in the field, and (3) the website should be from a reputable source) and keep their research under 90 minutes per day.

People struggling to conceive often consider access to online communities beneficial due to their component of social support, reduced sense of isolation, and empowerment. However, there are several disadvantages to these support groups, like spreading misinformation (e.g., specific coital techniques or eating pineapple improves fertility) and inspiring negative comparisons (“I don’t deserve to feel like this because others have it worse”).

ADVICE: Support groups are useful, but you do not have to join an online or face-to-face support group. And you can leave one after you join. Despite that, talking to someone who understands can help. That someone can be your partner, a friend, a family member, basically anyone you trust. Talking to a mental healthcare professional can help you open up and work through your journey.

Yes, not everyone conceives easily. Infertility does not pick individuals; it can happen to anyone. In this article, we have reviewed common stressors people struggling to conceive go through due to a lack of awareness of the general population about reproductive health. If you are struggling to conceive and have found yourself on the receiving end of any of the stressors described, we would like to empower you and say that you are not alone. If you have perpetuated some of these stressors, we hope to have helped you understand what some people go through and be better equipped to support them.

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