percent infertility rate, and African American women recording a 10.5 percent rate of infertility. These differences may be due to socioeconomic factors, such as poverty, poor nutrition, or lack of physician care, rather than strictly racial issues.
High-tech treatments and infertility
If you’re already frantically reading your insurance booklet and shaking the piggy bank in hopes of finding a few spare thousand dollars to pay for high-tech infertility treatments, you may take comfort in the following statistic: Only around 3 percent of infertile couples end up doing high-tech treatment like in vitro fertilization to get pregnant (You can find everything you need to know about IVF in Chapters 15 to 18.)
But IVF has been a boon to those seeking to conceive. Since the first IVF baby (Louise Brown in 1978 in England), over 6 million babies have been born through IVF. That number is expected to explode to 200 million by the end of this century. Considering Dr. John Rinehart’s look back to the early days of success, IVF has come a long way: “In the early days of IVF, success was so rare that we would buy a bottle of champagne for each woman who delivered a baby. Today, it would take a vineyard to supply that much champagne.”
Shaking Down the Family Tree
It may seem silly to look to your family tree for signs of infertility that could be inherited; after all, you’re here, so how could your parents have had fertility issues?
Putting together a family birth history
Most of us don’t ask our parents about their road to parenthood until we’re trying to become parents ourselves. But you may be surprised to find out that it took your parents a number of years to have you or your siblings. It’s also possible that people in your family tree may be adopted or the product of artificial insemination, issues that often weren’t discussed a few decades ago.
While family lines that are completely infertile tend to die out in a generation (for obvious reasons), some families may be subfertile, with less than average sperm counts or ovulation issues, and still manage to have a child or two.
Finding out important information
Researching your family history can provide valuable information. For example, you may discover family genetic tendencies that could cause problems on your own reproductive road. Or you may find out that everyone in your family took six months to get pregnant, a fact that may put your mind at ease, particularly around month number five of trying without success.
Before trying to get pregnant, you’ll want to know whether any diseases occur more than once on your family tree. If so, the disease may be caused by a dominant gene that you could pass on if you carry it, even if your partner doesn’t carry it. Some examples of this can be BRCA 1 and 2 (commonly known as the breast cancer gene, but it can affect men as well with increased predilection toward prostate cancer), muscular dystrophy, Huntington’s disease, and more. Depending on how open your family is, finding out this information can be difficult. Many families don’t discuss anything related to pregnancy, especially not problems getting pregnant, pregnancy losses, or genetic defects. Just a few generations ago, parents of children with genetic abnormalities were encouraged to put them in a home and tell the relatives the baby had been stillborn.
If your family tree does hold a genetic problem or a birth defect that shows up more than once, you’ll probably want to have genetic testing done. A gene map, which can be done from a blood test, will show whether you carry abnormal genes that could cause problems for your child.
Sometimes the only thing you find out from family records is nonspecific, such as “all the Smith boys died young.” Try and pin down why they all died young: Did they have hemophilia or muscular dystrophy, or did they all fall out of the same apple tree?
Checking the stats of your race
Even if you’re not aware of genetic illnesses in your family, certain populations tend toward specific issues. For example, while sickle cell anemia occurs in 1 of 8 African Americans, cystic fibrosis can be found in 1 of 26 Caucasians and at an even higher percentage among Ashkenazi Jews. Other diseases such as Tay-Sachs and Gaucher are also prevalent among the Jewish population.
Many OB/GYNs suggest screening for the most likely diseases based on your heritage. It doesn’t hurt to get this done before you become pregnant. While many genetic diseases are recessive, meaning that both parents must carry the gene in order for the baby to develop the disease, should you turn up to be a carrier, your partner can be tested right away. If both you and your partner are carriers, each child from your union holds a 25 percent chance of inheriting both genes and thus the disease. Fifty percent of your children will be carriers of the disease and 25 percent will not have or carry the disease.
THE GOOD NEWS ABOUT INHERITED DISEASES
When it comes to inherited diseases, you have options your grandmother and mother never did. You can receive pre-pregnancy genetic counseling or have early pregnancy testing of the fetus for abnormalities. Your grandmother, who may have had children well into her 40s, was more likely to have a baby born with chromosomal abnormalities. Such problems are more common in women over 35, and there was no way to test for them during pregnancy in earlier generations. Your mother may have been afraid to have more than one child if she knew there was a family history of cystic fibrosis or muscular dystrophy. The problem that your aunt had during pregnancy from an inherited bleeding disorder is now a condition that can be diagnosed and treated during pregnancy, increasing your chances of having a healthy, full-term baby. Rh factors may have caused fetal death just two generations ago, but they can now be easily prevented by an injection of RhoGAM, which prevents the growing fetus from having its blood cells attacked in utero.
Remember, these are all statistical numbers. Some families where both parents carry a recessive gene disorder have multiple children in a row who have the disease, despite the 25 percent odds per child. Other families don’t. Statistics are based on large numbers of people and the likelihood of any one event occurring. You and your family may or may not fall into the statistical pattern. (We talk a lot more about what your genes do later on in Chapter 3.)
Seeing What Causes Infertility
Infertility has many causes, and figuring out which applies to you may be very simple — or very difficult. Although women used to bear the brunt of blame for infertility, the truth is that
