Considering infertility Rels 300 / Nurs 330 5 November 2014 300/330 - appleby1 ( /a/artificial_insemination.asp ).

Considering infertility

Rels 300 / Nurs 3305 November 2014

300/330 - appleby 1

(http://www.cartoonstock.com/directory/a/artificial_insemination.asp )

InfertilityAffects approximately 1 out of every 8

(some say 6) couples in CanadaMedically defined as inability to conceive

after one year of unprotected intercourseIncidence is lower for women between

the ages of 18 and 29, and greater for women between 30 and 44

May be broadened to include people who desire to have children, but who are not in stable heterosexual relationships – e.g., single persons, lesbian women or couples, gay males or couples

300/330 - appleby 2

Medical causes of infertility

Sexually transmitted infectionsSmoking (both women and men)Delayed childbearingExposure to harmful agents

◦Workplace and environmental toxic substances

Alcohol and substance useWeight (obesity and malnourishment),

eating disorders, exercise, stressMedical interventionsEndometriosis

300/330 - appleby 3

Specific Reproductive Causes of Infertility

FEMALE FACTORS: Blocked fallopian tubes Irregular or absent ovulation Endometriosis Cervical irregularities, e.g.,

hostile cervical mucus Uterine fibroids or polyps Hormonal imbalances Early menopause Age (+ 35) STI history Cancer treatments (chemo,

radiation, surgery)

300/330 - appleby 4

Male factors in infertilityLow sperm counts,

or no spermLow motility rates /

low rate of movement

Abnormal morphology of sperm / physical abnormalities

STI historyHormonal

imbalancesCancer treatments:

chemo, radiation or surgery

300/330 - appleby 5

Male or female factors?30% of infertile couples are

infertile due to male causes40% are infertile due to female

causes20% are infertile due to a mix of

male and female factors10% - no specific cause of

infertility can be found

300/330 - appleby 6

Responding to Infertility

Adoption

Do you have an adopted child in your family?

What was the process for adopting this child?

How is this child treated in your family?

How does this child feel about being adopted?

What are the best things about adoption?

Are there any down-sides to adoption?

300/330 - appleby 7

Why not adoption?

What reasons do individuals or couples have for rejecting adoption as a solution to their infertility?

Personal reasons?Social reasons?Biological reasons?Genetic reasons?Additional considerations?

300/330 - appleby 8

Is infertility a medical condition?There are medical

conditions that contribute to infertility

There are reproductive technologies that correct, overcome or circumvent the medical condition

However, many reproductive technologies result in babies for infertile persons or couples without addressing the cause of infertility

300/330 - appleby 9

How is success measured? Success in overcoming the medical condition

of infertility is measured by the provision of a child

With a series of interventions that become increasingly technological, male and female infertility factors are largely circumvented, rather than corrected

Reproductive services arose within and are aligned with research agenda designed to ultimately create human life outside of the human body

Minimal primary research is being done on the medical condition of infertility

300/330 - appleby 10

Social dimensions of infertility

Why do individuals and couples desire to have children?

Divine commandment to “be fruitful and multiply” To provide a future for a religious, racial or cultural

community To ensure a genetic heritage for future generations As evidence of mature and responsible adult status To demonstrate or strengthen a couple’s love To satisfy a deep hunger or longing for a baby

300/330 - appleby 11

(5:23) https://www.indiegogo.com/projects/on-infertile-ground--

5 1 in 6 couples face infertility. Most suffer in

silence,too ashamed to tell friends and family.

http://www.youtube.com/watch?v=8JfK_4u80nY

300/330 - appleby 12

“Motherhood and Infertility: Viewing Motherhood through the Lens of Infertility” by Miriam Ulrich & Ann Weatherall (Feminism Psychology August 2000 [10:3] 323-336)

“Reasons for wanting children included motherhood as ‘natural instinct’, as ‘a stage in the development of a relationship’ and as ‘social expectation’. These were used to construct motherhood as physical, psychological and social completeness and fulfilment for women. Consequently, infertility was experienced as guilt, inadequacy and failure, reinforced by the language used to describe infertility.”

300/330 - appleby 13

Reproductive rightso Do

individuals/couples have a right to reproduce?

o Is this a universal human right, like the right to life?

300/330 - appleby 14

Reproductive rights

A person’s or couple’s inability to become pregnant should be understood as:

300/330 - appleby 15

Yes, the right to reproduce is a universal human right, because…

No, the right to reproduce is not a universal human right, because…

http://www.bbc.com/news/health-29485996; 4 October 2014 

First womb-transplant baby bornBy James Gallagher Health editor, BBC News

“A woman in Sweden has given birth to a baby boy using a transplanted womb, in a medical first, doctors report.” IVF to produce 11 embryos, which

were frozen Uterus donated by a friend in her

60s Drugs used to suppress the immune

system 1 year after transplant, doctors

transferred one of the frozen embryos to the woman’s womb

Due to toxicity of immunosuppressant drugs, uterus will later be removed

300/330 - appleby 16

The baby will "give hope" to those wanting children,say the transplant team

http://www.sciencedaily.com/releases/2014/10/141007092110.htm

World's first child born after uterus transplantationOctober 7, 2014; University of Gothenburg

“The uterus transplantation research project at the University of Gothenburg [in Sweden] started in 1999.” 9 women have received uterine transplants from live

donors – mostly family members, some friends 7 successful, 2 not successful Other women still trying for successful pregnancy and

birth

What would cause a woman not to have a uterus?

Why would some women choose this experimental treatment instead of adopting or using a surrogate mother?

300/330 - appleby 17