When the child is waiting

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One in six Canadian couples experience infertility problems. From April 24 to 30, Canadian Infertility Awareness Week sheds light on this hitherto taboo disease.

For many, conceiving a child is a relatively simple project. For others, the journey is littered with traps. In Canada, fertility problems are on the rise. In the 1980s, the proportion of Canadian couples having difficulty conceiving a child was estimated at 5.4%. Today, the data suggests that it is almost 16%, or one in six pairs. If this increase can be explained by several reasons, public choice will play a big role.

Age is a determining factor, especially in women. Thus, the decision of an increasing number of couples to postpone the birth of children to a later date directly affects fertility problems. “We see a lot of stories in the media about women over 40 having children, so we think we have a lifetime to start a family,” says Katherine Peloken, a professor in the Department of Psychology at the University of Montreal. But the reality is that when a woman approaches forty, her chances of conceiving are reduced by 50%.

UdeM Director of Pathology and Cell Biology Greg FitzHarris is interested in exactly this situation. He is studying the links between female aging and egg deterioration in order to find solutions that would allow women to become pregnant. “I am interested in the issue of the woman’s age and infertility, as this is an increasingly common factor in the clinic. Currently in the lab, we use female mice between six and eight weeks old to represent teenage girls, and then 18-month-old mice to represent women in their forties. When we examine an old mouse, we find the same problems as an old woman,” he explains.

Both also agree to say that some other components may interfere with the difficulty of conceiving a child. Illnesses, hormonal imbalances, and problems with egg or sperm production can be linked to various factors that humans are implicitly linked to, such as weight and smoking.

Complicated clinical path

In couples who come to a fertility clinic, this process is experienced differently, both physically and psychologically, depending on whether they are a man or a woman. “Women will report much more psychological distress than men. Regardless of who is affected by infertility in a couple, most medical procedures are performed on the woman’s body. Medicines, injections, hormones that can affect mood, in addition to the discomfort from interventions and all the appointments in the clinic … These inconveniences will be experienced first of all by a woman, ”says Katherine Peloken.

The psychologist notes that men also find this process difficult, but it is difficult to quantify everything, since most research on infertility is done from a female perspective. “A man will feel uncomfortable when giving a sperm sample, since the room where he will have to perform is not necessarily suitable for this. There is also pressure and anxiety about performance, in addition to the feeling that you are not always involved in the process. They will suffer more than their partner because they realize that it is their partner who is being treated. Then there is a feeling of helplessness,” she notes.

Although approximately 20% of fertility clinic clients are same-sex couples or single women, these individuals do not necessarily face the same realities as heterosexual couples. “For them, the course is different in that it is not necessarily tinged with failure,” the professor says. It’s more of a choice. For example, a lesbian couple who wants to have a child knows from the first day that they will have to go through this process, while for a heterosexual couple suffering from medical infertility, going to the clinic comes as a surprise. . So it’s a shock for him.”

Disturbed sex life

In 2021, a study she participated in examined the impact of infertility on the sexuality of couples who experienced it. The process in a fertility clinic has also been shown to affect the desire and pleasure that would otherwise be experienced during sex. “Couples with fertility problems have a history of unsuccessful sex,” she explains. Over time, sexuality becomes mechanical. It is subject to the menstrual cycle and is no longer driven by desire.

She notes that even when the clinical process is completed or the couple successfully conceives, negative effects can persist: “Sometimes there can be long-term consequences for the couple’s sex life as there is desensitization to normal sexual stimuli. . Desire signals are eradicated. Sexuality is associated with childbearing or is a reminder of past failures.

The specialist notes, however, that some couples become stronger and more united after this test, as evidenced by another study of her published in 2020. “Yes, these were the biggest challenges of their lives, but the partners feel like they brought them closer. There are couples who are really good at the basics, whose partners are able to support each other and meet each other’s needs. Adversity will bring them together,” she notes.

IVF, the magic solution?

The evolution of medical knowledge and technology now allows infertile couples to be offered more options such as in vitro fertilization (IVF).. DD However, Pelokin reminds us that this is not as easy as it seems: “People have the idea that they can have children for a long time, and the impression that they can go and have a baby in a test tube, but this is not always the case. knows what a journey to fertility is like.”

Greg FitzHarris also warns against guaranteeing the success of in vitro fertilization. “Only a certain number of sperm and eggs can turn into a child. In an oocyte, if the egg does not have the correct number of chromosomes, there is nothing the clinic can do to change this. Even fertile humans are relatively infertile compared to other mammals,” he says. While he and his team work to find solutions to improve egg quality in aging women, he would advise not to wait for problems for those who are able to conceive a child naturally. “Our goal is to pinpoint exactly what is wrong and develop the right strategies to fix it. Yes, in the long term, we would like to improve egg quality for older women and those who have difficulty conceiving. However, I don’t want to give the impression that our work will allow all women to wait until the age of forty to have children and, if they are unable to, go for IVF. It would be an unnecessary risk,” he said.

However, a professor in the Department of Obstetrics and Gynecology at UdeM notes that egg donation may be an option for older women: “If we study the data of patients in their 40s undergoing IVF, we will see, on average, that few of them become pregnant. But if those same patients receive eggs from a younger donor, their chances of conception increase dramatically. The same sperm is used, the older woman carries the baby, but the younger egg dramatically increases the chances of success. This means that age is very important when we talk about fertility.”

taboo topic

Although the World Health Organization officially recognized infertility as a disease in 2009, the topic is still little discussed. “Infertility affects a part of a person’s personality,” notes Katherine Peloken. So when someone is having difficulty conceiving, there can be many emotional experiences that can be experienced, such as guilt, shame, feelings of inferiority, or the feeling that the body cannot do what it normally should. There are also some people around you who don’t necessarily understand what it means to not be able to have a baby when you want to. And sometimes the comments may lack sensitivity.” She invites people suffering from fertility problems to set their own limits and encourages those around them to ask key stakeholders questions about what behaviors should be supported. “It is important to listen and not give advice,” she adds.

It would be particularly important for a psychologist to inform the public about fertility and what it entails. “You have to stop idealizing motherhood at any age, thinking that when a woman is ready, it will be easy. It may not be. Unfortunately, we do not get enough information about reproductive capacity. Pretty early we are taught about protection and contraception, but very little is said about the biological clock, which is not eternal. It’s important to think about it,” she concludes.

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