STAY POSITIVE DURING INFERTILITY JOURNEY

MARJIE DUCEY

World-Herald Staff Writer

The World Health Organization’s latest report on infertility wasn’t good news for those trying to get pregnant.

One in six people will experience infertility in their lifetime, a jump from one in eight, according to the WHO report.

That’s an increase from 12 to 17%, said Melissa Mathes, an OB-GYN at Nebraska Medicine. There is no particular data for Nebraska but it likely applies, she said.

She recommends that Nebraska women trying to get pregnant seek help if they are younger than 35 and have been trying for a year or if they are older than 35 and have had no success after six months.

“It is important that a person or couple talks to their provider about their medical history, the medications they’re taking, their history of STDs, the regularity of their menstrual cycles,” Mathes said. “All of that will be taken into account.”

There’s likely multiple causes for increased infertility. One is the older age at which some couples are trying to conceive. There are also environmental factors, including possible agricultural exposures to pesticides and fertilizers as well as certain plastics.

“The problem is not getting better, it’s getting worse,” she said. “It’s important we continue to research causes to allow for prevention and more focused treatments for infertility.”

When Mathes meets with a patient or couple trying to conceive, she does a basic workup that evaluates if the woman is ovulating on a regular monthly basis, if the sperm are normal and moving appropriately and if there are healthy, open fallopian tubes that allow the egg to meet sperm.

“That’s the very initial basic workup,” she said. “We then proceed with testing and treatment from there.”

For some, it’s a simple solution. Sometimes medication will be used help the ovaries release an egg. For others, it’s more complicated and in vitro fertilization (IVF) may become the best treatment.

That involves meeting with one of the six reproductive endocrinology and infertility physicians in the state, all located in Omaha.

It usually takes a month or two to get an appointment, Mathes said. If living in the western half of the state, check if telemedicine services allow for consultations to occur remotely.

The process can soar in cost to tens of thousands of dollars depending on insurance coverage and treatment, Mathes said.

“It’s important to start to advocate for the furthering of health care coverage for infertility workup and treatment,” Mathes said. “Most people will pay out of pocket. That’s a huge disparity and limits options for people who want to proceed with treatment but are unable to afford the treatment.”

There are no guarantees. Science is great, Mathes said, but there is still a lot that doctors don’t know.

However, there are things people can do to help the process.

That includes eating a balanced diet. Patients should stop smoking or using illicit drugs like marijuana, which impact the function of the fallopian tubes and sperm.

Mathes encourages her patients to stay active and limit caffeine to 200 milligrams a day. Couples should also limit alcohol. She also recommends starting a prenatal vitamin one to three months before attempting to conceive.

“When trying to conceive, I encourage my patients to have intercourse at least every other day the six days prior to ovulation,” Mathes said. “That is the peak fertile window.” marjie.ducey@owh.com, 402-444-1034, twitter.com/mduceyowh

Mathes said 80 to 90% of couples will conceive in the first 12 months of trying.

For that other 10 to 20%, it’s a stressful and emotional process. Infertility doesn’t discriminate, impacting men and women of all ages, races, educational levels and geographic locations.

It’s important to not look past the mental health toll of infertility, Mathes said. She tries to focus on the fact that the majority of people will be successful. She encourages patients to not allow outside comments and comparisons to impact them.

“I think trying to remain as positive as possible through the process is important,” she said.