Infertility! The dreaded malady has almost no match in terms of its ability to cause stress, disrupt relationship between husband and wife, high rates of depression, inability to concentrate at work and estrangement from family and friends. For those unfortunate enough to have to face this condition, it seems to be the worst thing that can happen! Typically, the most common problems faced are the damage to the relationships with friends and relatives who have children.
As people in similar age groups move on and have families, the infertile couple finds life getting harder with every baby shower, birthday party or those occasions where families get together. In many areas of the country, it is common practice to exclude childless women from religious functions involving babies. The second problem is more intimate and concerns the relationship between the wife and husband when lovemaking gets turned into a medical procedure and that too an unsuccessful one!
In this scenario of doom and gloom there is a ray of sunshine in terms of the medical advances in the field of assisted reproductive techniques (commonly abbreviated as ARTs). Terms such as artificial insemination, donor eggs, sperm donor and in-vitro fertilization are even beginning to show up in the popular press. These techniques represent a tremendous advance and can help a number of couples facing infertility. The field has advanced to such an extent and the techniques are used so commonly that many governments are faced with the task of updating the laws and regulations on such basic issues as definitions of parents!
A recent case in the UK highlights this problem. It concerned a couple that had their fertilized embryos frozen and stored. Unfortunately, the couple separated and a few years later the woman wanted to use those embryos to have a baby. The husband objected and claimed that he had as much right over the use of the embryos as his ex-wife. When last heard, the courts had ruled in favour of the husband though the case is likely to go all the way to the European courts and many other cases are likely to come up.
Going back to the start of this section where we mentioned the stressfulness of infertility. For those undergoing the high-tech reproductive procedures, the problem gets worse. These procedures themselves are very stressful. Numerous tests, weeks of painful hormone injections and hormone suppressors, daily sonograms, constant worry over details like number of follicles, their size and location and the emotional roller coaster of whether the day’s news is good or bad.
The dramatic changes in hormone levels caused by the injections also affect the mood and mental state. At the end of all this, the actual procedure and then the wait to find out if things have worked out. Unfortunately, the success rates are very low and many times the whole cycle has to start all over again. The maximum success rate for such an IVF cycle is something like 10 per cent to 15 per cent. It is interesting to note that we do not know the success rate for natural pregnancy.
The body may have a number of natural attempts that fail but they are not measured. An intrusive, time-consuming and painful procedure like IVF, however, does not have high success rates. Patients go through it, as they do not have any other options. Another fact to note is that such procedures and the associated medications are horrendously expensive. A typical IVF cycle costs approximately Rs 80,0005 and it is not uncommon to have five or six attempts.
The previous discussions should be enough to convince anyone that the assisted reproductive techniques are stressful and they may contribute to the problem of infertility. A number of researchers have examined this problem to determine if the stress from the procedure causes low success rates. There are some indications that increased stress during the procedure leads to lower success rates. A caveat is in order here. These studies are not very rigorous and the answers should not be taken as definitive till more rigorous and comprehensive studies are done. The chief problem is that these studies were carried out in women undergoing some assisted reproductive procedure.
Their infertility ensures that they are stressed (whether the stress is exacerbated by the procedure or not) and they are likely to have low success rates. Having said that it is still important to note that stress does disrupt the reproductive system and can reduce the chance for preg-nancy. It may be obvious, but some of the stress management techniques discussed in later chapters should be employed by such couples to improve their chances of success. Just my two bits worth, it would be a nice advance in medical science, if the techniques improved to such an extent that they eliminated the stress and dramatically improved the rate of success.