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Blame Nature: It's Hard to Get Pregnant!
a blog by Gina Paoletti-Falcone, RN, BSN, July 1, 2010
One of the things I enjoy most about being an infertility nurse is being the tour guide through the mysterious world of reproduction. Sex education has focused on practicing “safe sex,” both to avoid unwanted pregnancy and sexually transmitted disease. But there's never been much emphasis on “how to make a baby.”
Most people assume that if they have unprotected sex, egg and sperm will get together and make a baby. So by the time you get to a fertility specialist there’s a lot of disappointment and confusion and you really need some information!
It's reassuring to realize that, as a species, human beings reproduce very inefficiently. We were not meant to conceive every time that egg and sperm are in the same place at the same time. So what do you think the chances are if you have sex at just the right time?
You may be surprised to hear that at age 30, a healthy woman has about a 20% chance of conceiving each month and by 40 her chances drop to about 5% each month.
It’s reassuring to know that in the 21 years that I’ve worked as a fertility nurse, we've discovered new information about human reproduction, developed tests that provide more information, drugs that are easier to use and laboratory techniques that have made it possible for more patients to have babies, one way or another.
One dramatic example is treating men who have no sperm in their semen sample, none, zero, nada.
In 1989 we would repeat the semen analysis, finding no sperm a second time and then have the donor sperm conversation. Today we know that some azoospermic men (no sperm in the semen) actually make sperm, but not in great enough numbers to get into their seminal fluid or have some obstruction along the way that prevents them from making it into the semen.
Urologists can now surgically extract sperm from testicular tissue (I know it sounds painful, but anesthesia is a wonderful thing!) and embryologists can wade through that tissue under the microscope and find sperm. These sperm can be “injected” into an individual egg after an IVF egg retrieval in a process called ICSI (intracytoplasmic sperm injection), allowing these men to be the biological fathers of their children.
So I hope that each of my blogs is an informative tour of one of the many topics that you might be worried or wondering about. I hope you find reassurance in my explanation and, with that, reassurance that if you hang on to the hope, you won’t be stuck here in my world forever. You will move on to bigger and better things.