Fayola KJ Fraser
Infertility refers to “a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular attempts,” the World Health Organization (WHO) says.
A universal assumption is that infertility is related exclusively to issues in the female reproductive system, but fertility problems “occur in people of all genders and can have many causes,” according to Planned Parenthood.
Dr Catherine Minto-Bain, a fertility specialist, consultant obstetrician and gynaecologist, and medical director of the Trinidad and Tobago IVF & Fertility Centre (TTIVF), describes infertility simply as “not getting pregnant when you want to be.”
Her expertise dictates that if a couple has been trying for at least a year to conceive without success, they should begin to consider their options at that year mark. Infertility Awareness Week is celebrated every year during the last full week of April (April 21–27), and it accounts for the largest public awareness campaign to raise the profile of infertility.
This year’s theme, “Leave Your Mark”, is a call for testimony and sharing, to demystify and reduce the taboo surrounding infertility. Infertility, according to the WHO, affects one in six people worldwide. While many people feel isolated in the struggle to conceive, Dr Minto-Bain’s message is that “you’re not alone.” Debunking the taboo surrounding fertility also requires an overhaul of the narrative and the biggest misconception, that “it’s always the women’s fault.” In T&T, based on research from TTIVF, male infertility is the cause of at least half of conception struggles. Moreover, fertility is also not consistent throughout one’s life, Minto-Bain indicates, as people have the misconception that if they have had a baby before, they can easily have one again. However, “secondary infertility” can occur after having a child.
Why does infertility occur?
Dr Minto-Bain identifies “four building blocks in baby-making.”
• Firstly, when men have a low sperm count, abnormal sperm shape, or low sperm motility (poor swimming), this can lead to infertility.
• Another common cause of infertility is the inadequate genetic health of the woman’s eggs, or the eggs not being released as they should be.
• In some cases, the woman’s fallopian tubes may be blocked or damaged, meaning that the sperm cannot meet the egg as it is supposed to.
• Lastly, if the woman’s womb is not in a healthy condition, or she has issues with diabetes, thyroid, or other medical conditions, this will make conception significantly more difficult.
Key lifestyle changes
For couples struggling with conceiving, some key lifestyle changes can be adopted during the process. Dr Minto-Bain sees many women who believe that expensive supplements and treatments are the key to resolving infertility issues but suggests that most of these have not been proven to change or improve egg quality.
She recommends that women should focus on preparing the body for pregnancy by taking folic acid, ensuring that their weight is in a healthy range, checking for diabetes, and doing a full medical. The advice for men is different, as unlike women, who are born with all their eggs for a lifetime, men are making sperm consistently.
“What men eat and expose themselves to is very important,” she says, indicating that adopting an exercise regimen and a healthy diet consisting of the right amount of fruits, vegetables, and whole grains, and cutting out trans fats and pesticide-ridden food is key. To produce healthier sperm, she also suggested that men should not smoke cigarettes or cigars, sleep well, minimise alcohol, and take vitamin CoQ10 to improve sperm motility.
Most importantly, however, couples who are downtrodden about conception should not wait until it is too late to go to a fertility clinic. Minto-Bain said that oftentimes, people go to an assortment of doctors to do various tests, but instead, both partners should be assessed by a fertility doctor who can rule out tests that are not needed, reducing time and effort wasted otherwise.
At the TTIVF, they listen and gather information, “as we are the detectives, putting the puzzle together and coming up with options.” Minto-Bain insisted that fertility doctors are the right point of first contact, as she has seen many other doctors speak in absolutes about couples’ infertility who have gone on to get pregnant thereafter.
For women who may not be sure about their desire to have children or may not have a partner to have children with at the time, there is the option of egg-freezing. Although Dr Minto-Bain “doesn’t think it is for everyone,” she considers it a good option that works well for certain women, especially those with conditions such as endometriosis.
However, she suggested that women who are even considering egg freezing should do it well before their 30s to attempt to capture the best quality eggs and increase the likelihood of successful conception in the future. Prolonged infertility and mental health disorders There is a clear link between prolonged infertility and mental health disorders. According to the National Center for Biotechnology Information, “women with infertility report elevated levels of anxiety and depression,” as it is often a silent struggle not shared with family or friends.
Many women can account for a relative or friend asking prying questions about when or whether they will have a child, and as women, we are taught to grin and bear it or laugh it off. Minto-Bain and TTIVF’s mission is to demystify and decode the struggles of infertility and create a community for women and men to feel less isolated.
Their event, “Conceiving Hope’’ will seek to “empower men and women struggling to conceive with the knowledge they need to travel their path to parenthood with hope and confidence and create a safe space for people to interface with each other and the highly qualified experts.”
Doing the important work of raising awareness, building communities, and fuelling hope continues to be at the core of TTIVF’s mission: to support all families here in T&T. Conceiving Hope: Your Journey to Parenthood is a free, one-day-only event by TTIVF at the Hilton Trinidad on May 25 from 9 am-3.30 pm. Visit www.trinidadivf.com for information and registration.