Infertility: The Physical Self

we introduced the idea of a holistic approach to fertility. We briefly looked at the prevalence of fertility issues in Irish society and some of the impacts of infertility for individuals who experience it. This month I will give an overview of physical barriers to fertility and some of the investigations available to diagnose such obstacles.  Also, we will reflect on the importance of caring for your body whilst undergoing any of the treatments mentioned.

Usually the first place to start when we have a health issue is to consult a medical professional. In recent years there have been huge medical advances in Assisted Human Reproduction (AHR) and there are some hi tech fertility clinics across Ireland that are offering a range of tests and treatments to assist with couples or individuals that wish to have a child. The first port of call for a couple who have actively been trying to conceive for more than 12 months is usually the G.P., who will after running some basic blood tests then refer the couple to a specialist clinic.

I am not a medical specialist in fertility but I can outline some of the physical issues that may contribute to a delay in or an inability to conceive naturally. They are as follows:

Female Infertility:

- Age: Women are born with a finite number of eggs. Therefore as a woman ages, the number and quality of her eggs decreases. The chances of conceiving naturally decrease by 3% to 5% per year after the age of 30. This reduction in fertility is to a greater extent after the age of 40. A blood test that measures Anti-Mullerian Hormone (AMH) in a woman’s body can reflect the egg supply remaining or her ‘ovarian reserve’. Normally a woman will produce one egg per menstrual cycle. Medications can be prescribed to increase the number of eggs released by the ovaries each month in order to increase the likelihood of creating a healthy egg.

- Damage to fallopian tubes- The fallopian tubes are the route from the ovaries to the uterus for a woman’s eggs. If there is damage to the fallopian tubes this may prevent contact between the egg and the sperm. This damage can be caused by pelvic infections, endometriosis or pelvic surgeries due to scar formation.  A surgical investigation called a Laparoscopy can often detect damage to fallopian tubes by inserting a slim line telescope into the abdominal cavity and examining the uterus, tubes and ovaries.

- Hormonal causes-Hormones play a vital role in a woman’s ovulation (release of an egg) and the thickening of the endometrium (lining of the uterus). If there is an imbalance or problem with these hormones conception will not occur.  A range of blood tests can be carried out on specific days of a woman’s menstrual cycle in order to determine hormonal levels and hormone medications can be prescribed in order to balance these levels if necessary.

- Cervical causes-some woman may have a cervical condition in which the sperm cannot pass through the cervical canal. This problem can be treated with intrauterine inseminations.

- Uterine causes-The presence of polyps and fibroids can cause an obstruction to the conception process.  A pelvic exam or ultrasound can be used to diagnose any uterine causes of infertility.

- Immunology- Failure of the embryo to become implanted in the womb can be due to an issue with the immune system.  Blood tests can be carried out to measure levels of certain cells that may be impacting on implantation such as Natural Killer (NK) cells. Elevated NK cells can be treated by administering an intralipid infusion prior to ovulation in order to regulate the immune system, therefore allowing implantation to occur.

- Unexplained Infertility- Approximately 20% of couples will be unable to determine the cause of infertility using the current available methods of investigation. This is often after years of trying to conceive and can be a devastating blow that is difficult to accept. This is particularly where I feel it is important to explore other aspects of Self that may contribute to infertility.

Male Infertility:

- Sperm Quality- The most common issue regarding male fertility is the production and quality of sperm. In order for a male to impregnate a partner he must create sperm, similarly to the female, hormones play a vital role in this production. At least one testicle must be functioning in order for the sperm to be produced; it is then transported through delicate tubes and mixed with semen.   There needs to be enough sperm in the semen (sperm count) and it must also be functional and able to move (mobility).  Sperm count and mobility can be tested easily through semen analysis, which is a laboratory assessment of mans ejaculated semen sample.

These are some of the investigations one might expect to begin once referred to a fertility clinic. A doctor will usually meet with you and your partner to go over your previous medical history in order to determine where to start.

There can be a great sense of relief in handing over the issue to a trained professional, in particular if this has been something you and your partner have held onto in confidence for a long period of time. Many couples continue to try to conceive without any medical interventions and like everything there are pros and cons to this. For some, medical investigations and treatments can provide simple answers and solutions to their issue. But for others the on-going procedures, financial strain and continuous disappointments become overwhelming and create added stress and pressure. Infertility treatment is not cheap and unfortunately in Ireland there is little to support couples with this aspect of treatment. Most health insurance policies do not cover fertility treatment; therefore tax relief on medical expenses is the extent of financial relief.

Physical interventions obviously also have an impact on one’s body. As with any medication there are side effects and implications with all of these treatments and medications. It is important in relation to medical interventions that you listen to your body and take breaks or look after it when needed.

Holistic treatments, like acupuncture, massage and reflexology can really complement medical treatment if carried out by a therapist who specialises in fertility support. These treatments can increase the natural production of hormones, release stress and help to identify barriers to conception by paying attention to the body. If you see an acupuncturist regularly they may also be able to identify reoccurring patterns in a womans menstrual cycle.

So the Physical Self plays a massive role in understanding barriers to fertility for both men and women.  It is however only one aspect of Self and I look forward to exploring the Emotional Self in next month’s article.
Source : tv3

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