Always, Katie: Listen Up! Don't Let the Fear of "1-in-8" Steal Your Hope (NIAW 2017)

Thursday, April 27, 2017

Listen Up! Don't Let the Fear of "1-in-8" Steal Your Hope (NIAW 2017)

Resolve's theme for National Infertility Awareness Week (NIAW) this year is "Listen Up!" What a great time to be able to share something that has been on my heart regarding infertility for the past several months :-)

1 in 8 (the rate of infertility in the US) is SCARY! It's a flippin' SCARY number! It's 12.5%!  I get that! 

But guys, gals, please. Don't let it terrify you. Don't let that fear rule your life. It's not as scary as it sounds. Stick with me...

Infertility is defined as not achieving pregnancy within one year of unprotected sex (or within six months for couples when the woman is older than 35). This is what is true of 1 in 8 couples. (Not 1 in 8 INDIVIDUALS, which is a common misconception I hear/read. 1 in 8 does not mean that your risk as a couple is 1 in 4!!) 

Now. I have seen so many presumably-healthy friends stressing and worrying when they haven't gotten pregnant within a couple months of throwing away their birth control pills.

My theory is that we've done a pretty great job of raising awareness of infertility and of the psychological effects of long fertility struggles and invasive treatment, and we've done a great job getting the "1 in 8" statistic out there.

What we maybe haven't done a great job of raising awareness for is how common it is for those diagnosed with infertility to get pregnant WITHOUT using invasive, expensive artificial reproductive technologies (ARTs) - procedures like IVF. We haven't spread hope as well as we've spread fear.

Some of these 1 in 8 couples get pregnant with another month or two of trying, some learn to track their cycles and have strategic sex (not the most romantic, but hey!), some discover hormonal imbalances that are easily corrected with pills (polycystic ovary syndrome and thyroid disorders are two common diagnoses like this), some need to lose a blocked or damaged tube, or clear out endometriosis surgically. Sure, surgery is invasive, but often it's an effective, one-time fix and is usually covered by insurance, whereas ARTs are rarely covered. 

Of the 12.5% of couples who are not pregnant within 12 months (or six, for "older" women), 85-90% of them WILL get pregnant using strategic sex, drug therapy, and/or surgery. (ASRM)

So now we're down to 1.25% to 1.875% of the general population who cannot conceive without ARTs. That's already a lot less scary than 12.5%, right!? Just wait!

According to Dr. Roberta Corona of Barbados Fertility Centre, about 36-39% of couples who do three rounds of IUI are successful. Now, that doesn't include couples like us who go straight to IVF without trying IUIs, so the math starts getting a little bit squishy here :-)

We'll take the 1.875% (since it's higher), and use a middle ground on the 36-39%, so divide by three. We're down to 0.625% of the general population that needs to do IVF. But even for those of us who do IVF, for women my age, with my diagnoses, the likelihood of getting pregnant on your first transfer (like we did), is around 50% nationally. (It's higher at BFC. Just sayin'.)

One of my friends who DID have to go through IVF tells this story:

"After a little under a year of trying to get pregnant, I met with my OB/GYN to see what options there were for preliminary infertility testing to try to ease some of my anxiety. Within the first couple of tests done, we were officially diagnosed as having infertility issues. This diagnosis came about mid-March. By early May I decided to look into IVF/IUI options. I was connected with others who suggested a fertility center to me, so I consulted the center to see the odds of IUI working in our case. Upon sending some of our test results, we were told we would have the best chance at success by moving straight to IVF and skipping IUI all together. We decided to move forward with this suggestion. We had to get a few more tests done, and sort out our protocol but by July we had begun the medications and monitoring appointments. We completed our first round of IVF in August, and found out we were pregnant with twins before the end of that month. Within 6 months time, we received our infertility diagnosis, found a fertility center we wanted to use, completed IVF, and got news we would be having twins. [Katie's note: her twins were BORN a smidge over a year from diagnosis - even going the "full intervention" route doesn't mean it'll be years and years and many attempts!] We are extremely fortunate things went so smoothly for us, and infertility was one of the most stressful things we have ever had to face, but also the most rewarding!"

So now we've established that the "horror story" of "I spent years and years and thousands and thousands of dollars, took hundreds of painful injections, and went through hormonal hell doing multiple rounds of IVF" does not happen to 12.5% of couples, but to about 0.3125% - and many of THESE will get pregnant after another IVF cycle. If you've been trying to conceive for a few months and are getting nervous, PLEASE take comfort in this! (This is not to diminish the difficulty and stress of other treatments, not at all. It's hard at any level, and I felt better on IVF drugs than I did on Clomid!)

I am not a doctor, or a researcher, or even really all that great at math (despite miraculously finishing calculus), so all of this is a casual estimation. Not medical advice, etc! It does totally add up to 100, though, so I'm pretty pumped about that.

Why am I so passionate about this? Infertility stole a lot from me, and I don't want to see it NEEDLESSLY steal these things from more people than it has to. It stole spontaneity... it stole the surprise of a positive pregnancy test... it stole my chance to plan a cute surprise announcement for my husband... it stole my ability to blissfully *assume* all was well with my pregnancy... it even mostly stole my ability to keep my pregnancy under wraps until we were comfortable telling the world (although my public blog is also largely to blame for that, lol). If you have a chance to keep those things, don't WILLINGLY hand them over to a fear that - honestly - doesn't have a very high chance of being realized.

Please, please. Don't let the fear of 1 in 8 ruin your hope, your joy, your spontaneity. YES, keep the one-year or six-month timelines in the back of your mind, YES, see a doctor if you know you have a condition that could cause problems, YES, be mindful of your cycle and any changes you notice. But PLEASE, don't be afraid and don't lose hope, and while you remember these things, also remember Matthew 6:34 - "So do not worry about tomorrow; it will have enough worries of its own. There is no need to add to the troubles each day brings" (Good News Translation).

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