Structuring Scholarly Papers http://writingcenter.unc.edu/faculty-resources/classroom-handouts/revision-checklist/ScreenShot2022-05-09at11.56.37

Reference

Zielinski, R., Ackerson, K., & Low, L. K. (2015). Planned home birth: benefits, risks, and opportunities. International journal of women's health, 7, 361.

Infertility

James Goggans

Trident University

Instructor: Dr. Maria Luque

MHS504 Scholarly Writing in the Health Sciences

8 May 2022

Infertility

Infertility is a serious public health issue that affects men and women. An infertile person cannot have children; for a man, one cannot have a successful erection and ejaculation, and for women, one is considered infertile if one cannot get pregnant after having unprotected sex for 12 months with a man. Infertility is a relevant public health issue that affects individuals and families. According to the CDC, about 19% of heterosexual women aged 15 to 19 are considered infertile (Sadecki et al., 2022). The report further shows that more than 9% of men in the US are infertile. As a serious healthcare issue, efforts have been made to address it. For example, the National Public Health Action Plan developed a plan that helps detect, manage, and treat infertility. National and local governments have also allocated resources to research and treatment. However, the problem has not been fully resolved, and individuals and families struggle with the challenges associated with infertility.

Causes of Infertility

Several causes have been documented for infertility in men and women. According to Gipson et al. (2020), there are pathogenic variants that cause infertility in females. Studies show that infertile women have two homozygous. All the oocytes carrying PV are surrounded by a thin ZP which does not allow sperm-binding, rendering a female infertile. The loss of PV function leads to an abnormal and structural dysfunction of the ZP, making women unable to conceive.

Researchers have also linked female infertility to problems with the uterus, such as fibroids, polyps, and adhesions inside the uterus cavity. Some females also have a problem with the fallopian tubes, especially those resulting from gonorrhea or chlamydia. Females who also experience problematic ovulations are likely to be infertile, as they cannot release eggs regularly. Ovulation problems may arise from substance abuse, eating disorders, thyroid conditions, or pituitary tumors. Lastly, women may have issues with the quality and number of eggs. When the supply of eggs runs out before menopause, a woman cannot get pregnant. Similarly, some eggs have the wrong number of chromosomes and cannot successfully grow into a healthy fetus.

Many factors increase women's risk of infertility. Age, lifestyle choices, genetic traits, and health conditions make some women at a higher risk than others of being infertile. Older women, for example, are more vulnerable to infertility than younger women. As women age, the overall number of eggs reduces, there are increased chances of developing healthcare issues, and more eggs have an abnormal number of chromosomes. Other factors such as endometriosis, cysts, tumors, smoking, heavy drinking, structural problems, low body fat count, and being overweight or underweight also increase being infertile.

Surprisingly, the nature of a woman's work is reportedly significant in increasing the chances of infertility. For example, female surgeons are more likely to be infertile compared to women in other occupations (Rangel et al., 2021). The study argues that the high risk of female surgeons results from delayed training, which makes most of them start a family when they are older. The complex nature of their work also makes them vulnerable to infertility, especially those who work more than 12 hours a week are likely to be infertile. When these women get pregnant, they are likely to develop complications and cannot carry the pregnancy to term. Some lose the baby through miscarriage or give birth to babies with defects. Demographically, infertile women are likely to be educated, using barrier contraception, non-smokers, and married.

These risk factors affect men too. According to research, men may be infertile due to genetic defects and health problems such as diabetes and infections, including chlamydia, mumps, HIV, or gonorrhea. These factors lead to abnormal sperm production, which hinders egg fertilization. A man may also have a low sperm count or reduced quality of sperm which cannot successfully fertilize an egg (Schlegel et al., 2021). Enlarged veins in the testes(varicocele) also affect the quality of sperm, making a man infertile. In some cases, these risk factors cause blockages; hence one will be unable to deliver the sperm.

Effects of Infertility

Infertility is associated with severe health effects for affected individuals. According to research, women who experience infertility at any point in their lives are likely to develop cardiovascular issues later. Growing evidence shows that increased cardiovascular diseases are associated with female infertility that arises from conditions such as obesity, ovarian disease, endometriosis, and thyroid dysfunction (Gleason et al., 2019). Further studies reveal that infertile women have atherogenic lipid profiles and high hs-CRP levels, which increases vulnerability to cardiovascular issues. Based on these findings, infertility goes beyond the daily challenges and has long-term effects.

Other studies also show that the consequences of infertility go beyond the pursuit of family building. Infertile women are at risk of cancer and maternal morbidity and have increased vulnerability to other chronic diseases. A recent study shows that infertile patients are more likely to develop diabetes, renal disease, liver disease, heart disease, cerebrovascular disease, and others (Murugappan et al., 2021). Other studies indicate that infertility is not a disease; instead, it is a symptom of an underlying disease that may be detected later in the life of an infertile man or woman.

Infertile women experience distressing life experiences. According to Alamin et al. (2020), identity crisis is a significant contributor to distress in the lives of infertile men and women. Women and men who feel that society can only accept them if they have children undergo emotional and psychological torture. The challenges get worse when men and women cannot get treated successfully, s they suffer loss and grief. A significant number of women and men have gotten into depression after they find it challenging to live with the fact that they cannot have children.

Infertile men and women experience psychological and social stigma. Infertile women have reportedly experienced higher levels of emotional abuse and stress in the US compared to other developed countries(Ozturk et al., 2021). Infertile women are also less likely to report emotional and physical violence, which increases their vulnerability to stigma. In some cases, infertile men and women are abandoned by their partners, who fail to endure the stigma and abuse from society and close family/friends.

Reports also indicate that infertility is a silent struggle, as infertile men and women often find it hard to share their distress with second or third parties. Despite the high prevalence of infertility, infertile women do not share their stories with family and friends, which increases their psychological vulnerability. The inability to give birth cause feelings of shame, anxiety, and low self-esteem and contributes to poor life quality.

Infertility Treatment

Stakeholders have channeled resources and manpower into treating infertility. Current treatment options include medications and embryo implantation with assisted reproductive technology. Some treatment options are tailored for men, others for women, and both genders can use some. In most cases, however, infertility is treated with conventional therapies, including surgery or medication. In some cases, these options turn out to be unsuccessful, and affected individuals and families resort to sperm donation or surrogacy.

As much as several treatment options are available, research shows that a significant population of men and women do not seek help to address infertility. According to research, only half of US women seek medical services in an attempt to address infertility( Greil et al., 2020). This means that majority of them will live with the problem as they continue to face emotional, physical, and psychological challenges. The same case applies to men; very few men are willing to seek help and treat infertility. According to research, 99% of male infertility cases can be addressed with a combination of medical and lifestyle techniques. However, the barriers to treatment make infertility an unresolved problem.

Studies that seek to understand the barriers to infertility treatment reveal significant issues that, when addressed, can enhance access to treatment. One of the main factors that come ut is the nature of the treatment, which may be scary for the target people. Treatment approaches such as laparoscopy are revealed to be quite painful, and people may fear going for that. Negative thinking and perceptions are also significant barriers to treatment. For example, some individuals believe that there is no treatment for infertility, as most approaches fail. The fear of wasting resources for an uncertain attempt shuns people away. For other couples, associating treatment with increased chances of high-risk pregnancies scare them away.

Men's experiences are also affected by societal perceptions about infertility, the cost of treatment, and insufficient knowledge about the treatment process. Research shows that most men are unwilling to live with the reality that they have infertility issues, hence lacking the confidence to walk up to a clinic or hospital to seek help. For some, financial constraints become a challenge, and they choose to accept infertility as a natural occurrence that they live with forever. Some men are scared of having conversations with healthcare providers as they reveal important information to aid in the treatment process. Lastly, just like women, some men believe that infertility treatment cannot be successful, hence no need to waste time and resources.

There are safety concerns regarding infertility treatment for men and women. For example, TRIP13 mutant is believed to address fertility issues in women. However, it is associated with human diseases, and the safety of the patient should be considered first (Gipson et al., 2020). Multiple birth defects and Neurological sequelae have also been observed in children conceived by IVF and ICSI. The health concerns associated with infertility treatment challenge the ethical responsibility of the practice of medicine. Therefore, safety factors must be considered before administering any infertility treatment option.

Evidence also shows that partner support directly impacts infertility treatment outcomes. According to research, men and women who get support from their partners alleviate the burden of infertility-related stress. Couples should support each other, and partners should be involved throughout the treatment process to enhance treatment outcomes. Family and social support are also linked to significant treatment outcomes. Health care professionals should explore the social networks available to infertile patients and encourage people to seek positive support from partners and family members. Partner coping patterns must also be assessed to determine the partner's ability to cope with the treatment processes and infertility experience.

Infertility treatment remains controversial in reproductive medicine, as researchers continue to link infertility treatment with negative outcomes. Research shows that some infertility treatment options lead to serious health effects that require additional help. For example, patients who undergo assisted reproductive treatment are at a high risk of experiencing psychiatric issues. Therefore, it is important to acknowledge and recognize the issues before assisting these patients in coping with the diagnosis and treatment of infertility.

Unsuccessful treatment efforts have also been attributed to a lack of a holistic approach to infertility. According to Gipson et al. (2020), failure to view fertility holistically has hampered the efforts to address infertility. Today, the world is witnessing adverse and novel health challenges and impeded economic development, which may significantly contribute to infertility. The efforts to treat infertility will be more successful if linked to health, economic, and social factors.

Summary and Conclusion

Infertility is a significant health issue that affects a significant population. Infertility is linked to various causes, including genes, age, health conditions, structural factors, ovulation problems, and many others. Men and women who are unable to have children undergo physical, emotional, and psychological distress in society. Health-wise, infertile people are likely to develop chronic diseases later. Researchers indicate that most infertile people have an underlying condition through infertility. Patients battling infertility are vulnerable to heart diseases, diabetes, cancer, and other chronic conditions. Apart from health effects, infertile men and women experience distress, primarily associated with a lack of acceptance. Infertile men and women are emotionally abused, stigmatized, and even abandoned by their loved ones. There are several treatment options, including medications and technology-assisted reproductive processes. However, the treatment options are associated with health and birth effects and a lack of certainty. There are also barriers to treatment, including negative perceptions, social and cultural factors, and the nature of the treatment.

Conclusion and Recommendations

It is clear that as much as there are several treatment options, infertility remains a challenging issue. Several steps must be taken to enhance treatment and avail information to enhance acceptance in society. There is a need to invest more in research to develop safer ways of preventing and treating infertility. It is also important to address barriers to treatment through education and offering social support. The myths associated with infertility treatment, such as risky pregnancies, must be done away with by availing of educative materials that will help people to embrace infertility. Healthcare professionals and other stakeholders should also focus on encouraging social support from partners and extended family members to enhance treatment outcomes by alleviating the stress and burden associated with infertility.

In general society, access to the correct information is important to ensure people accept and embrace their loved ones who are infertile instead of stigmatizing or abandoning them. It is also important to have clear reporting procedures for verbal or physical abuse among infertile men and women. Relaxation techniques have also been shown to reduce negative emotions, hence recommended to reduce anxiety among infertile men and women.

References

Alamin, S., Allahyari, T., Ghorbani, B., Sadeghitabar, A., & Karami, M. T. (2020). Failure in identity building as the main challenge of infertility: a qualitative study. Journal of reproduction & infertility, 21(1), 49.

Gleason, J. L., Shenassa, E. D., & Thomas, M. E. (2019). Self-reported infertility, metabolic dysfunction, and cardiovascular events: a cross-sectional analysis among US women. Fertility and sterility, 111(1), 138-146.

Gipson, J. D., Bornstein, M. J., & Hindin, M. J. (2020). Infertility: a continually neglected component of sexual and reproductive health and rights. Bulletin of the World Health Organization, 98(7), 505.

Gipson, J. D., Bornstein, M. J., & Hindin, M. J. (2020). Infertility: a continually neglected component of sexual and reproductive health and rights. Bulletin of the World Health Organization, 98(7), 505.

Greil, A. L., Slauson-Blevins, K. S., Lowry, M. H., & McQuillan, J. (2020). Concerns about treatment for infertility in a probability-based sample of US women. Journal of reproductive and infant psychology, 38(1), 16-24.

Murugappan, G., Li, S., Alvero, R. J., Luke, B., & Eisenberg, M. L. (2021). Association between infertility and all-cause mortality: analysis of US claims data. American Journal of Obstetrics and Gynecology, 225(1), 57-e1.

Öztürk, R., Bloom, T. L., Li, Y., & Bullock, L. F. (2021). Stress, stigma, violent experiences, and social support of us infertile women. Journal of reproductive and infant psychology, 39(2), 205-217.

Rangel, E. L., Castillo-Angeles, M., Easter, S. R., Atkinson, R. B., Gosain, A., Hu, Y. Y., … & Kim, E. (2021). Incidence of infertility and pregnancy complications in US female surgeons. JAMA Surgery, 156(10), 905-915.

Sadecki, E., Weaver, A., Zhao, Y., Stewart, E. A., & Ainsworth, A. J. (2022). Fertility trends and comparisons in a historical cohort of US women with primary infertility. Reproductive health, 19(1), 1-11.

Schlegel, P. N., Sigman, M., Collura, B., De Jonge, C. J., Eisenberg, M. L., Lamb, D. J., … & Zini, A. (2021). Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. The Journal of Urology, 205(1), 36-43.