Women And Infertility

I was watching General Hospital and one of the characters received the news that she could not have children.  Any child she carried would not be carried to full term.  She would lose the baby.  What heartbreaking news.  It hurts to see women who want to be mothers and who would be great mothers unable to have children while those who are unfit have children.  It doesn’t seem fair.  Lulu, the character wondered why this happened to her since there was no family history of infertility.  Before that she blamed herself for her condition because she had had an abortion when she was a teenager.

I have often wondered why are some women unable to have children or carry them to full term?  There was a time when I was afraid that I would not be able to have children.  In biblical times barren women were looked down upon by other women.  Sarah was despised by her servant Hagar because she was able to conceive while her mistress couldn’t (Genesis 16:4).  Hannah was tormented by Peninnah, her husband’s other wife and rival because the LORD had closed her womb.  She made Hannah’s life a living hell until God blessed Hannah with children.  Rachel rejoiced when she conceived her first child, saying, “God has taken away my reproach” (Genesis 30:23).

In developing countries women face ostracisim and see their infertility as a failing or a curse.  Newsweek ran a story in 2008 about women around the world who are coping with infertility.  One woman was uable to conceive for the first 13 years of her marriage.  She said that people would ask a woman her name—and then, “How many children do you have?” When the woman answered “none”, they don’t know what they can talk to you about.”

It must be so difficult for a woman to be surrounded by family members and friends who have children of their own or to see mothers where ever you go with their children and know that she would never have that experience.  It’s ironic. There are women who can have children but choose not to and there are women who would like to be mothers but are unable to have children.

What causes infertility in women?  Women’s Health Government has a fact sheet which answers these and other questions about infertility.

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

• A woman’s body must release an egg from one of her ovaries (ovulation).
• The egg must go through a fallopian tube toward the uterus (womb).
• A man’s sperm must join with (fertilize) the egg along the way.
• The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

Infertility among women is common.  According to  the Centers for Disease Control and Prevention (CDC) about 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

• Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
• Physical problems with the uterus
• Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

What increases a woman’s risk of infertility?

Many things can change a woman’s ability to have a baby. These include:

• Age
• Smoking
• Excess alcohol use
• Stress
• Poor diet
• Athletic training
• Being overweight or underweight
• Sexually transmitted infections (STIs)
• Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency

Check out the Women’s Health Government fact sheet to find out how age can affect a woman’s ability to have a child; how long a woman should try to get pregnant before consulting a doctor; how a doctor determines if a woman and her partner have fertility problems and treatments.  They also offer more information (links) on infertility that may help you or someone you know who may be having difficulty getting pregnant.

Glen Meade Center for Women’s Health outlines the ways in which women can be tested for infertility:

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
• Checking morning body temperature to determine if ovaries are releasing eggs
• Hysterosalpingography (a radiologic assessment of the uterus and fallopian tubes)
• Pelvic ultrasound
• Laparoscopy (inspection of pelvic region)
• Luteinizing hormone uterine test (ovulation prediction)
• Thyroid function tests

There is hope for women experiencing infertility.  Glen Meade offers the following treatment options depending on the cause of the infertility:

• Education and counseling
• Fertility treatments, such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
• Medications that treat infections and clotting disorders
• Medications that help women grow and release eggs from the ovaries

Notes to Women wants to reach out to women facing infertily by encouraging them to read articles from women who are coping with it such as this one.  We hope that the tips for living with infertility will be helpful to you and give you some comfort.

Sources:   http://womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm; http://www.glenmeadehealth.com/ms_infertility.html; http://www.thedailybeast.com/newsweek/2008/09/14/what-it-means-to-be-a-woman.html

Smoking and Women

A long time ago I took one drag on a cigarette and vowed never to touch another one again.  It made me cough and I felt terrible.  My sister used to smoke but then she stopped.  I have a cousin who used to smoke and her lips looked black.  I used to work with a woman who smoked while she was pregnant.  I have to admit that although I don’t like seeing anyone smoke because it’s not good for your health, I dislike seeing women smoke even more. 

In the movies they make it look glamourous.  Bette Davis looked sophisticated with a cigarette in her hand in Now Voyager.  It seemed so romantic when Paul Henreid lit both cigarettes and give her one. 

Smoking is anything but romantic or glamourous.  It is dangerous for your health.  Sadly, despite the many warnings that cigarettes can cause cancer and increase our risk of heart disease, approximately 23 million women in the US (23 percent of the female population) still smoke cigarettes. Smoking is the most preventable cause of death in this country, yet more than 140,000 women die each year from smoking related causes. The highest rate of smoking (27 percent) occurs among women between twenty-five and forty-four (http://womenshealth.about.com/cs/azhealthtopics/a/smokingeffects.htm).

The most common side effects of smoking are:

Pulmonary and Respiratory Disorders:  Smoking increases your risk of developing a condition called chronic obstructive pulmonary disease. The lung damage that occurs from pulmonary disease is not often reversible. However, if you do quit smoking your lung function will not decline further, and you may notice an improvement in coughing and breathing.

Cardiovascular disease:  Cigarette smoking is a leading cause of cardiovascular disease in the United States. Women who smoke more than double their risk of developing cardiovascular disease. Immediately stopping smoking can result in instant improvement in your cardiovascular function and a reduced risk of heat disease. After smoking cessation has continued for at least a year, your risk of developing cardiovascular disease drops by 50 percent. Your risk continues to decline the more years you remain smoke free. Some studies suggest the heart attack risk for smoker’s drops to that of nonsmokers after two years of cessation.

Cancer:  Cigarette smoking contributes to developing several different kinds of cancer, including cervical cancer, lung cancer, cancer of the esophagus, mouth, bladder and pancreas. Smoking cessation can improve your survival rate and reduce your risk of developing severe cancers resulting from smoking.

Osteoporosis:  Smoking contributes to bone loss, thus increases a woman’s risk for developing osteoporosis. 10 years after smoking cessation a woman’s excess risk for osteoporosis declines significantly.

Breast Cancer:  Women who smoke are more at risk for breast cancer. In fact, the risk of developing fatal forms of breast cancer is 75 percent higher for women who smoke than those that do not. The number of cigarettes a woman smokes per day can affect their breast cancer survival rate.

Vulvar Cancer: Women who smoke are also 48 percent more likely to develop a rare form of vulvar cancer.

Smoking may also contribute to many other diseases and problems. It is especially dangerous to pregnant women. Babies exposed to smoking mothers are often born with birth defects and low birth weights. Mothers who smoke are also more at risk for miscarriage, premature rupture of the membranes and placenta previa. Babies born to mothers that smoke often experience withdrawal symptoms during the first week of life. Over time smoking also contribute to skin wrinkling and may even reduce your sexual ability. Quitting smoking improves all of these conditions immediately (http://www.womenshealthcaretopics.com/smoking_and_women.htm).

Women are more at risk for certain problems related to smoking than men are. Women who use oral contraceptives or other hormonal forms of birth control are especially at risk for developing serious side effects. Women using hormones who smoke increase their risk of developing life threatening blood clots and strokes.

Women who smoke typically have reduced fertility. Studies suggest that women who smoke are 3.4 times more likely to experience problems conceiving than those who do not. This may be because of a decreased ovulatory response. In some women the egg had trouble implanting when the mother smokes.

Smoking also affects women’s normal cyclical changes, including those that occur during menopause and menstruation. Women who start smoking during their teen years are more at risk for developing early menopause than women who do not smoke. Smokers may also experience more menstrual problems including abnormal bleeding or amenorrhea than women who don’t smoke. This may be because smoking often lowers levels of estrogens in the body (http://www.womenshealthcaretopics.com/smoking_and_women.htm).

Now that we know the risks of smoking, let’s look at some tips that will help women to quit.  I came across an article on How to Quit Cold Turkey written by a woman who used to smoke.  Note these tips are only for women who wish to quit smoking cold turkey.   There are three things you will need:   

• A willingness to Quit
• Some gum
• A team of Support

Read more: How to quit Smoking Cold Turkey! | eHow.com http://www.ehow.com/how_2353369_quit-smoking-cold-turkey.html#ixzz1F84jTm6G

Other steps to quit smoking are:

Step 1

Think about the positive health changes that will take place after you stop smoking.

Step 2

Make improvements in your appearance part of your plan. Aim for a sweeter smelling and better looking you.

Step 3

Get rid of all your cigarettes and put a healthy snack in your mouth instead of a cigarette when you get the urge to smoke. Also replace smoking with an activity you enjoy engaging in or can benefit from to help you quit.

Step 4

Talk to your doctor about taking medicine to help you stop smoking. Ask him if you are healthy enough to use the patch, nasal spray, inhaler, gum or lozenges, and find out which of these products he thinks is best for you.  Read more: http://www.livestrong.com/article/178278-how-women-can-quit-smoking/#ixzz1F868POZ5

I have a friend who used to smoke.  She quit because she read in her Bible, “Or do you not know that your body is the temple of the Holy Spirit who is in you, whom you have from God, and you are not your own?” (1 Corinthians 6:19).  She looks much better since she quit. 

If you are a woman who smokes,  quitting may be the hardest thing for you to do but it will be the best thing in the long run.  You will feel better–more energetic and able to climb a flight of stairs without feeling winded.  And you will have a clear mind.  Plan to quit today.  You can do it!

Pregnancy At 40 and Older – The Risks

I got pregnant when I was forty and had our son when I was forty-one.  It was a textbook pregnancy.  There were no complications.  I didn’t have to have an epidural and the actual delivery took under fifteen minutes.  The contractions although they were bad, they didn’t last long.  I have heard some horror stories of women being in labor for more than 24 hours.  I couldn’t imagine going through that.

In a couple of months our son will be celebrating his third birthday.  Wow.  Where did the time go?  It seemed like only the other day I was holding him in my arms for the first time.  The pregnancy was an experience I feel truly blessed to have had.  At the time, though, I didn’t want to go through another one.  I didn’t feel mentally or physically or even emotionally up to it.  Before I had my son, I had always planned that when I got married, I would love to have twins–a boy and a girl.  That of course didn’t happen.  God blessed us with a son.  And we have decided that we wouldn’t have more children because of my age.  I am heading toward my mid-forties.  We worry about the risks and are not willing to take them.

I have been adamant about not having a second child but I would have a couple women push me to consider it.  There is one in particular who works in the office cafeteria.  Every time I see her, she manages to bring the conversation around to me having another baby.  I try to change the topic but she is persistent.  I try to tell her that at my age I should not even be considering this but she brushes that excuse aside.  She seems to believe that age is not a factor.  Once when she broached the subject, I had a moment of insanity when I actually wanted to get pregnant again.  Of course when I spoke to my fiance, he snapped me right back to reality.

There are times when I entertain the thought and imagine what the baby would look like.  I like the idea of having a little girl who will look like her Daddy.  But then, I think about the risks.

What are the risks?  Are they worth taking?  I decided to find out via the Internet. 

With today’s medical technology, prenatal care, and well educated doctors women have the best chances ever to become pregnant and have successful pregnancies after age 40. However, the risks are there and women in this age range should be aware of them.

One risk many women over the age of 40 are most concerned with is genetic disorders. As a woman ages her entire body does as well, including her eggs. Many times Down Syndrome results from an older woman’s egg simply not dividing like it might have when the woman was younger. Of course, if you are age 40 or more and you want to have a child you should not let the slightly higher risk of genetic disorders or birth defects scare you. A woman who becomes pregnant at age 35 has a risk of 1 in 365 of having a baby with Down’s Syndrome. That risk increases to 1 in 100 with a woman 40 years of age and approximately to 1 in 40 for women 45 years of age. Any woman who becomes pregnant has a risk of about 3% to have a child with a birth defect. This percentage more than doubles for women over 40, but still the 6-8% risk is still relatively low.

These statistics seem pretty scary to women who are 40 years old or older but want to have a baby. However, the statistics are just that and while one out of ever 100 babies has Down’s Syndrome there are 99 other babies that are perfect. The best thing to do is visit your doctor before you become pregnant. Your doctor will advise you of your risks and give you a plan to help reduce risks. This includes eating healthy, exercising, treating any current diseases or disorders, and simply being as healthy as possible before pregnancy begins. At that point you will be better prepared to have a baby, your pregnancy will go smoother, and you will more than likely have a perfectly healthy baby.

There are tests that can be performed early in the pregnancy to see if your baby has a higher chance of having a genetic disorder or birth defect as well. As long as you work with your doctor and have prenatal care you will more than likely have a healthy baby at age 40 or older (http://www.amazingpregnancy.com/pregnancy-articles/543.html). 

I had these tests done and everything was perfect.  There were no concerns.  For the first five months of my pregnancy I was mindful of having a miscarriage.  I learned that not only is it more difficult to conceive after 40, but that the miscarriage rate increases with both maternal and paternal age, says Michelle Collins, a certified nurse midwife and an assistant professor of nursing at Vanderbilt University School of Nursing, Nashville. One woman said that she had her first child at 39 but at 43 she was having problems conceiving and had three miscarriages in one year.   (http://www.pregnancytoday.com/articles/healthy-safe-pregnancy/pregnancy-after-40-6175/). 

If you are forty or older and are considering having a baby, talk to your doctor first.  Learn what your risks are and if you are willing to take them.  If after talking to your doctor, you decide you want to go through with it, then start taking the prenatal vitamins, Folic Acid supplements and doing the necessary things.  One person commented, if it is God’s will for you to have a child, it will happen.  He let it happen with two women who were pushing way past 40–Sarah and Elizabeth and they both had healthy baby boys and back  then they didn’t have the medical technology we have today.  If I believed that God wanted to bless us with another child, I would go through with another pregnancy, trusting that everything will turn out just fine. 

If you are a 40 or 40+ year old woman and are serious about getting pregnant again, don’t wait any longer.  Consult your doctor and do what you need to do.  I wish that all goes well for you and your baby.