The topic of fertility is something that many people know exists yet surprisingly seem to know very little about. One study involved the use of a questionnaire comprised of basic questions on fertility that was distributed to over 12,000 women. The majority of these women scored less than 50% on the questionnaire and only 1% were able to answer all of the questions correctly. (Scott, 2004) With this in mind it's not surprising that questions and frustrations come to mind when couples are unsuccessful in their attempts to procreate.
There are several causes of infertility. Some applicable to both men and women while others are gender specific but the majority of which have viable treatment options available. First, infertility can be age related. In our Western culture, current trends lead many couples to wait until they're more established before starting a family. From a career and financial planning stand point this makes a great deal of sense. However this may not always be wise from a biological perspective. Even if couples maintain a healthy diet and active life style, they may discover they are unable to conceive.
In fact, one in seven women will discover that they are infertile if they have not had children by the age of 30. (Scott, 2004) Men are also affected by age and research shows that the majority of males 50 and older experience degradation in sperm quality, libido, and testosterone levels. (Scott) Regardless of their age, men with low sperm counts, immobile sperm, or whose bodies contain antibodies that destroy their sperm may discover they're infertile. (Santrock, 2019) In women, infertility can result when ovulation problems occur or fallopian tubes become blocked. Further, some women may experience antisperm secretions or a condition known as endometriosis where tissue builds up in the uterus. In most cases, treatment is available and may include prescription drugs, estrogen therapy, acid or alkaline douching, hormones, and in some cases surgery. (Santrock)
If surgery is required, there are three treatment options. The first and most common in the U.S. is In vitro Fertilization (IVF) which involves fertilizing eggs by combining sperm and eggs in a laboratory dish, then transferring any resulting embryos into the woman's uterus. The second surgical option is Gamete intrafallopian transfer (GIFT) where eggs and sperm are inserted directly into a woman's fallopian tube. Last, couples trying to conceive have the option of undergoing a Zygote intrafallopian transfer (ZIFT) which involves fertilizing eggs in the laboratory then transferring any resulting zygotes to a fallopian tube. (Santrock, 2019)
Success rates, after being normalized across age groups, show that IVF results in 31% live births, GIFT yields 24.5%, and ZIFT 29.2%. (Santrock) In addition to the obvious benefit of increasing the chance of conception, these procedures are not without certain risks. One such risk is the increased chance of multiple births. One study conducted in Massachusetts found that multiple births in women age 35 and older more than doubled from 1989 to 1996. (Cohen, 1999) However these multiple births in older woman are often accompanied by low birth weights, very low birth weights, and infant mortality. For example, statistics for babies born with low birth weights to women under age 35, show only slight deviations in the number of infant birth weights and mortality figures from 1989 to 1996 whereas low birth weight baby rates increased between 27% and 30% for multiple births involving women 35 years of age and older. (Cohen)
A more traditional alternative to the problem of infertility is adoption. The concept of adoption is nothing new. In fact, the first official U.S. law for adoption was passed in 1851 with the Adoption of Children Act. (Herman, 2005) Despite adoptions popularity, there are still pros and cons associated with it. First, adoption involves a social and legal process. It takes time to screen perspective parents and for adopted children and their new parents to acclimate into a homogenous family unit. (Santrock, 2019) Second, adopted children and adolescents many times have additional challenges associated with psychological and school-related problems (increased delinquency, school achievement, substance abuse, and physical health) compared to their nonadopted counterparts.
However, despite these challenges, often adopted children are more outgoing and exhibit many prosocial behaviors such as showing support of others, being generous, humane, and benevolent. (Santrock) In addition, the negative sides of adoption can be further diminished if the child is adopted early in their lives. Studies show that children adopted under the age of 10 seem to have the least amount of problems and children adopted under the age of 6 months have no lasting side effects from their earlier experience. (Santrock) Further, research does indicate that children do fare better through adoption if biological parents could not provide adequate child care for their children. (Santrock) Last, it's important to keep in mind that the laws concerning adoption have changed substantially over recent years so it's difficult to know the impact this new legislation will have on continuing efforts to diminish the psychological and adjustment problems associated with adoption. (Santrock)