Author: Viola Kajendrakumar
Do other women go through their daily responsibilities and wish they could sit down and have an open conversation about more “taboo” science matters? That’s how I feel about women’s reproductive health. We, as a society, have come so far in encouraging the conversation, but there is still confusion and discomfort for women of all backgrounds. Away from my research laboratory technician duties, I am passionate about having that conversation based on solid scientific facts for those who are navigating and discovering their reproductive health. Women should pay as much attention to their reproductive health as they would for cardiovascular health. Please note that I am in no way a doctor of any sort. I only speak on my own research, observations, and experiences at my job. I have to surround myself with the clinical and research side of reproductive health for my job. Always remember to do your research and consult with medical professionals before taking any steps in your journey. My goal with this piece is to simply demystify and further encourage the fertility conversation.
Fertility and the modern woman
Historically speaking, in Canada, the average age of first pregnancy has changed over the years. Between the 1940s to 1960s, the average age for first pregnancy was between 24-26 years old. In our modern time, the average age of first pregnancy is about 30 years old. In planning for children, there is always a chance of experiencing infertility. Infertility occurs in 4 out of 10 women and 3 out of 10 men and can come from conditions like endometriosis and hormonal imbalances. But one significant consideration is age. Age affects fertility; it will decrease for women after the age of 35. 91% of women can get pregnant by the age of 30; the rate drops to 77% by age 35 and 53% by age 40.
There are medical options for women to consider. At fertility clinics, there are options of having a donor egg or sperm given to a potential parent, or parents can use their own eggs and sperm to produce a baby using technologies like in-vitro fertilization (IVF) or Intra-cytoplasmic sperm injection (ICSI).
At the Fertility Clinic
IVF is the process where the egg is fertilized outside the body with sperm in hopes of pregnancy, a 2-5-week process per cycle. ICSI is also a method of egg fertilization where sperm is injected into the egg with a thin needle (refer to the image above). This procedure is done when sperm quality or count is poor. Undergoing fertility treatment will include consultations, bloodwork, medication, ultrasounds, and more. The preparation continues until the big day, the Ovum Pick-Up (OPU). The OPU is where eggs and sperm are retrieved in hopes of creating a healthy developing embryo. It involves observing the embryo under specific dishes to watch for development every day for 5-7 days. After the OPU, there are additional optional procedures, like pre-genetic screening, to determine various traits of the embryo. For example, pre-genetic testing aneuploidy (PGT-A) checks if there are the correct number of chromosomes. An incorrect number of chromosomes can lead to implantation failure and miscarriage. Embryologists and andrologists work hard towards giving the patient the best embryo possible. From there, the embryo is transferred back into the female patient or surrogate, and a pregnancy test is needed about two weeks after the embryo transfer.
Financial and emotional support
Working in a fertility clinic, I see individuals from all walks of life, hoping to have a child. Going through with IVF, ICSI, or other treatment options can be stressful and expensive, but it doesn’t mean that fertility clinics don’t have resources available to help patients. Fertility clinics may have counselors to support and guide people through this process. Counselors may also set up support groups so patients and non-patients alike can meet and discuss their thoughts and feelings about their fertility journey.
Fertility clinics may also have financial aid options for those who need it, and some governments may have plans set out as well. In Ontario, Canada, there are financial guidelines for the coverage of treatment costs, depending on the treatment, age, and number of cycles. In the United States, the government does not help with the cost of IVF. Sixteen states like New York, Ohio, Texas, Delaware, and Hawaii have passed laws that would require insurers to have an offer for coverage or have coverage of infertility related diagnosis or treatment. California and Texas are the two states that will require insurance companies to offer infertility treatment coverage. Each country has different laws, insurance coverage, support groups, and additional services when it comes to infertility treatment.
Success stories do exist at fertility clinics. Every day, I see the pictures of doctors holding the babies of patients they treated, a constant reminder to prospective patients and staff that this really does work. It is easy to get caught up with figures and numbers when you do research, but when I see the pictures of those babies, it re-energizes my purpose and my passion for communicating about this topic. To bring things back to perspective, the first step is to do your research and consult with medical professionals to know your options. Doctors will do everything they can to help you accomplish your goals and dreams. Remember to be patient and understanding with yourself too. Sometimes, some things are out of your control, and you are doing the absolute best you can. With that, I say good luck to those who are beginning their fertility journey or in the middle of that journey, as you read this. Take care, and stay healthy.