TRYING FOR A BABY

Q:My husband and I have been trying to have a baby for a while now. Friends and family have stopped asking, but I see the questions in their eyes… Whenever I bring up the word ‘infertility’ my husband shuts down the conversation. I don’t know what my next step should be, as I feel we need help.

A:Saskia, Andrew and Paul say: One in six couples is diagnosed with infertility. Infertility does not discriminate between race, religion, location or gender. It is, in fact, recognised as a disease. Infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive. If you are over the age of 35, the time of trying to conceive is reduced to six months. There are two types of infertility: primary infertility, where a couple has never had a baby before, and secondary infertility, where a couple is unable to conceive after they have already had a child. Many couples wait too long until they access fertility treatment. The success rate of fertility treatment is linked to the woman’s age, and in some cases delaying treatment by 6-12 months can make a significant difference in the outcome of therapy. An early evaluation of a couple with fertility problems will provide important information to guide the couple as to how urgently treatment is warranted, and which types of treatment will be relevant to them. Understanding the cause of a couple’s infertility will equip them with knowledge to make an informed decision going forward. Choosing the correct reproductive medicine specialist is very important to avoid wasting time and money, and having a positive experience during treatment. Do not be falsely reassured by friends or inexperienced doctors telling you to “just wait, relax and it will happen by itself”. There are usually physical or biological factors which cause infertility, and medical treatment will be beneficial to you. Couples should also know about the legal ramifications surrounding assisted reproductive treatment. One of the most important things to address is the issue of embryo disposition and gamete disposition – particularly in the event of death, divorce, separation, incapacitation, withdrawal from treatment by a partner, passing of time, or reaching the age limit of 55 years old. In short, you need to consider what happens to the frozen embryos or gametes if something happens to you or your partner, and make sure that your wishes are legally declared. Ask about an “embryo disposition agreement” or a “gamete disposition declaration”. Think of it as an ante-nuptial contract for assisted reproductive treatment. When it comes to the donation of eggs, sperm and embryo, donors who do not sign an agreement run the risk of obtaining parental responsibilities and rights. The parties also run the risk of having a very complicated situation arise, for example, when the donor is known and sees the child regularly, but there is no formal agreement regulating their respective rights and responsibilities. An anonymous donor who does not sign an agreement may also run the risk of obtaining parental responsibilities and rights. There needs to be a clear written confirmation of the parties’ intention and agreement, so it is advisable to consult with an attorney that is well versed in fertility law and associated parental rights in order to properly explain what the law is surrounding artificial fertilisation. It’s hard to be diagnosed with infertility, when all you want is to start a family with the person you love. The IFAASA encourages people to share their stories of infertility. Have a look at the Facebook page to see that you are not alone. Sharing also helps to break the stigma surrounding infertility and to educate those who are still unaware that it is in fact a recognised disease and not something to be ashamed of.