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Dealing with fertility issues can cause a stream of difficult emotions. And one woman on Reddit is questioning whether she’s in the wrong for not being “overjoyed” by a friend’s pregnancy announcement in the wake of her own fertility struggles. Many commenters were quick to reassure her. But there’s more to unpack here. The Redditor explains she has suffered two miscarriages, with the most recent one in January 2025……Continue reading…
By : Anna Halkidis
Source: Parents
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Critics:
The most common causes of female infertility are hormonal in nature, including low estrogen, imbalanced GnRH secretion, PCOS, and aging, which generally manifests in sparse or absent menstrual periods leading up to menopause. As women age, the number of ovarian follicles and oocytes (eggs) decline, leading to a reduced ovarian reserve. Some women undergo primary ovarian insufficiency (also known as premature menopause) or the loss of ovarian function before age 40, leading to infertility.
85% of infertile couples have an identifiable cause, and 15% is designated unexplained infertility. Of the 85% of identified infertility, 25% is due to disordered ovulation (of which 70% of the cases are due to polycystic ovarian syndrome). Tubal infertility (structural issues with the fallopian tubes) is responsible for 11–67% of infertility in women of childbearing age, with the large range in prevalence due to different populations studied.
Endometriosis, the presence of endometrial tissue (which normally lines the uterus) outside of the uterus, accounts for 25–40% of female infertility. Women who are fertile experience a period of fertility before and during ovulation, and are infertile for the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. The consequences of infertility are manifold and can include societal repercussions and personal suffering.
Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available. Medical coverage and affordability barriers exist. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood. One of the main challenges in assessing the distress levels in women with infertility is the accuracy of self-report measures.
It is possible that women “fake good” to appear mentally healthier than they are. It is also possible that women feel a sense of hopefulness/increased optimism before initiating infertility treatment, which is when most assessments of distress are collected. Some early studies concluded that infertile women did not report any significant differences in symptoms of anxiety and depression compared to fertile women. The further into treatment a patient goes, the more often they display symptoms of depression and anxiety.
Patients with one treatment failure had significantly higher levels of anxiety, and patients with two failures experienced more depression when compared with those without a history of treatment. However, it has also been shown that the more depressed the infertile woman, the less likely she is to start infertility treatment and the more likely she is to drop out after only one cycle. Researchers have also shown that, despite a good prognosis and having the finances available to pay for treatment, discontinuation is most often due to psychological reasons.
Fertility does not seem to increase when the women takes antioxidants to reduce the oxidative stress brought by the situation. Infertility may have psychological effects. Parenthood is one of the major transitions in adult life for both men and women. The stress of the non-fulfilment of a wish for a child has been associated with emotional consequences such as anger, depression, anxiety, marital problems, and feelings of worthlessness. Partners may become more anxious to conceive, increasing sexual dysfunction.
Marital discord often develops, especially when they are under pressure to make medical decisions. Women trying to conceive often have depression rates similar to those of women who have heart disease or cancer. Emotional stress and marital difficulties are greater in couples where the infertility lies with the man. Male and female partners respond differently to infertility problems. In general, women show higher depression levels than their male partners when dealing with infertility.
A possible explanation may be that women feel more responsible and guilty than men during the process of trying to conceive. On the other hand, infertile men experience psychosomatic distress. Mutations to the NR5A1 gene encoding steroidogenic factor 1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility, where the cause is unknown. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants in fertile control men.
Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia. Small supernumerary marker chromosomes are abnormal extra chromosomes; they are three times more likely to occur in infertile individuals and account for 0.125% of all infertility cases. See Infertility associated with small supernumerary marker chromosomes and Genetics of infertility#Small supernumerary marker chromosomes and infertility.
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