Infertility diagnosis is usually established according to the amount of time that a couple has been trying to conceive as well as a woman’s age. According to those parameters, a couple is considered to be infertile if they have not conceived after a twelve month period of unprotected intercourse and the woman is under the age of thirty four. If a woman is older than thirty four, a couple is considered infertile if they have not conceived after six months of unprotected intercourse. Time and age are important parameters in establishing a diagnosis of infertility.
There is a prevailing belief that incidence of infertility in the United Sates is becoming greater. There has been extensive media coverage of infertility treatments, which leads more people to seek help. Moreover, there are many more doctors trained to treat infertility which usually results in more couples who receive advice and treatment. All this has lead, in the opinion of researchers at the National Center for Health Statistics, to a widespread, but erroneous perception of an infertility epidemic.
According to Susan Faludi, author of the book Backlash: The Undeclared War on American Women, the establishment of infertility diagnosis after one year of unprotected intercourse is a recent development inspired by “infertility specialists” marketing their high tech treatments. Faludi notes that:
“The one-year cutoff is widely challenged by demographers who point out that it takes young newly weds a mean time of eight months to conceive. In fact, only 16 to 21 percent of couples who are defined as infertile under the one-year definition actually prove to be, a congressional study found. Time is the greatest, and certainly the cheapest, cure for infertility. In a British longitudinal survey of more than seventeen thousand women, one of the largest fertility studies ever conducted, 91 percent of the women eventually became pregnant after thirty-nine months.”
How did medical professionals determine woman’s age parameters for infertility diagnosis? Does woman’s fertility really significantly decline ones she turns thirty? In 1982, the New England Journal of Medicine reported that woman’s chances of conceiving after the age of thirty drop by forty percent. Virtually every study up until then had found that fertility didn’t truly start declining until women reached at least their late thirties or even early forties. Three years later, in 1985, the U.S. National Center for Health Statistics unveiled the latest results of its nationwide fertility survey of eight thousand women. It found that American women between thirty and thirty-four faced only 13.6 percent, not 40 percent, chance of being infertile. Women in this age group had a mere 3 percent higher risk of infertility than women in their early twenties.
The concept of the ever deteriorating women’s biological clock was dramatically reinforced by spreading the findings of a New England Journal study through TV media and newspaper articles. This created “infertility epidemic” has produced significant panic among women who decided to postpone childbearing in order to pursue education, economic development or other goals in life.
I believe that establishing infertility diagnosis based on woman’s age while all other laboratory tests are normal has a negative effect on woman’s self esteem, stress levels and overall trust that her body is capable of conceiving and having a healthy pregnancy and birth. These types of “infertility” patients are a daily occurrence at my acupuncture practice. Educated and hard working women come to my practice feeling defeated and depressed after they hear the infertility verdicts from their doctors. In my clinical experience, it is not unusual to see women having irregular cycles or more premenstrual tension after they are told that they are infertile. According to Dr Christiane Northrup, author of the book Women’s Bodies Women’s Wisdom, beliefs are physical. Dr Northrup says, “A thought held long enough and repeated enough becomes a belief. The belief then becomes biology. Beliefs are energetic forces that create the physical basis for our individual lives and our health. If we don’t work through our emotional distress, we set ourselves up for physical distress because of the biochemical effect that suppressed emotions have on our immune and endocrine systems.”
Is it possible that we are rushing the diagnosis and thus premature treatment of infertility? Is our culture too focused on “instant gratification” even when it comes to making babies? In my opinion, it is important to find middle ground when it comes to diagnosing and treating infertility. For example, if a couple has not conceived within the time parameter that has been defined by medial doctors, it is important to proceed with baseline diagnostic tests like sperm analysis, female hormonal testing and hysterosalpingogram (an x-ray test that examines uterine cavity and fallopian tubes). If there is a severe sperm abnormality or a blockage of the fallopian tubes, then a couple should proceed to assisted reproductive technology treatments like IVF. If the baseline diagnostic tests are normal, it is important to look at other factors that may be causing fertility problems like diet and lifestyle choices.
Sloane, E. (1985). Biology of Women. A Wiley medical publication. New York: Wiley. Pg 462
Faludi, S. (1991). Backlash: The undeclared war against American women. New York: Crown. pg.42