Infertility is known as a condition that affects the reproductive system of both biological sexes (females and males), due to failure to conceive for over a year of unprotected sexual intercourse.
Infertility can affect people from any ethnic background, but is more likely to happen with women of colour. Around 10-15% couples of the reproductive age (16-44 years) are predicted to be infertile and 1 in 7 couples find it difficult to get pregnant.
Causes of infertility
The causes of infertility can range from lifestyle, diet and geographical location.
The causes can vary due to physical conditions in men, such as hormonal disorders, genetic disorders, and testicular dysfunction.
Women need their reproductive system like ovaries, fallopian tubes and uterus fully functioning in order to have a child. Therefore, if problems arise, it can cause infertility or complications that lead to miscarriage. Endometriosis is a condition is leading to growing infertility in women. It is described as a chronic condition where cells from the womb are found in other parts of the female body, affecting 1.5 million females in the UK. Polycystic ovary syndrome (PCOS) is also another painful condition that causes infertility in women.
Another cause, especially for women, is age. Women’s fertility may start to deflate around their mid-30s and can be really difficult for some women to get pregnant around their mid-40s. So, for career-driven women who do not attempt to conceive before their mid-30s, they are more likely to experience difficulties.
Other unconventional but now commonly recognised causes are environmental factors, for example certain chemicals and toxins from industrial areas which can affect the sperm count in males and fertility in women.
Effect on mental health
Infertility has a lasting impact on mental health Infertility itself or complications like miscarriages may cause psychological and personal distress, with 60% having experienced higher anxiety and depression than people who are fertile. Distress includes feelings of frustration, depression, anxiety, guilt and worthlessness.
Infertility can affect both men and women. However, women are disproportionately affected. This can be for cultural reasons.For example, in most parts of Northern Africa, Middle East and other parts of Asia the woman is perceived to be at fault for not conceiving. Because of this, many male fertility issues may go undiagnosed and untreated . Also, the. norm in some communities is to encourage a married couple to conceive straight away to show they are fertile. This can increase mental health issues like depression and anxiety when trying to live up to those expectations.
In some circumstances, treatments for infertility have been reported to give symptoms of anxiety and depression. This is common where a couple successfully conceive from treatment, but then experience a miscarriage. Here, the likelihood of the woman developing post-traumatic stress disorder (PTSD) is high.
Furthermore, couples can lose hope and struggle with frustration because of uncertainty of the treatments.
Around 90% of infertility complications can be treated with medical treatments involving prescriptions for hormones, surgery of the reproductive organs, in vitro fertilisation (IVF), intrauterine insemination (IUI) or artificial insemination (AI).
The NHS provides free IVF, however availability is based upon eligibility of women under the age of 42. Due to the availability measures in place for free IVF and the private facilities being very expensive in the UK, people turn to other countries in Eastern Europe or Asia for affordable IVF, IUI or AI.
Women trying to get pregnant are encouraged to keep track of their menstrual and ovulation period, because having sexual intercourse at a certain point of the ovulation cycle can increase the chance of getting pregnant.
Importance of highlighting this issue
By highlighting this issue, it can motivate both sexes to get medical check-ups early to prevent any fertility problems down the line. It can also lower the social stigma of ‘blaming the women’ for infertility.
Adequate and appropriate educational policies surrounding sexual health and reproduction must be encouraged and initiated in countries where such stigmas are prevalent. By raising awareness through education or campaigns, these stigmas can be erased and an opportunity for support networks for people going through a similar situation can be created.
In summary, infertility and going through infertility treatments can impact the mental health of both sexes. It is important that access to mental health professionals is provided along with the treatments to address the mental health issues and help couples through decision-making.
Infertility can be draining and going through treatment can increase the mental health issues identified. The social judgement and pressure of fulfilment doesn't help either. However, with appropriate treatment and mental health support, feelings of anxiety and depression can be reduced and a higher chance of successful pregnancy can be achieved.
There are many organisations that help couples and individuals deal with infertility, from offering mental health support and the best option to go forward. The options range from the medical treatments pointed out above, surrogacy when a woman’s body may not be suitable for conceiving, and adoption. The NHS and the Association of Fertility Patient Organisations, which includes the Fertility Network UK, Surrogacy UK, Endometriosis UK and Verity, provide support for the conditions that cause infertility.
Infertility overall is a big issue that affects many people. It can be a life-changing occurrence and can diminish one’s hope of fulfilment, given that many women feel like their purpose is to conceive and birth a new life. But it also gives rise to misconceptions in society that all women have the desire to become mothers. This social stigma can affect those women who have chosen not to have children. Sufficient access to medical treatment, mental health professionals and education will empower individuals to make an informed choice about their lives, whether that includes having children or not.
Rupinder Kaur Brar