Discovering infertility means for many couples going through an emotional duel, in which feelings such as sadness, loneliness, frustration, guilt and even envy have a place.
In Spain, about a million couples are affected by fertility problems and women have their first child later than in any other European country, with the exception of Italy.
Thus, the average maternity age in our country is 31 years (31.2), almost two years later than the European average. But in addition, about 40% are mothers for the first time over 35 years old and the age group that has grown the most is over 40 years old, according to the National Institute of Statistics.
For all these reasons and on the occasion of World Fertility Day "it is important to remember that, after the age of 35, the fertility of women drops very significantly," says Antonio Urries, president of the Spanish Association of Fertility Biology. Human Reproduction (ASEBIR)
For this reason, every June 4, the World Health Organization draws attention to the causes of infertility, which can affect both men and women for very different reasons, but whose greatest risk factor is the age of the woman, which limits the chances of achieving a pregnancy both naturally and with assisted reproduction treatment.
In this sense, the president of ASEBIR recalls that "from a biological point of view, the ideal way to achieve a healthy pregnancy at the desired time is to match the age of maternity with the most fertile time for women, which is between 20 and 30 years old.
However, personal, economic and social circumstances have caused a delay in the age of childbearing and, therefore, an increase in fertility problems.
As a consequence, assisted reproduction treatments have registered an increase of 28% in the last five years, according to the National Registry of Activity of Assisted Reproduction Centers in Spain; the country that has the most assisted reproduction clinics in all of Europe, according to the 2020 Study of the ESHRE (European Society of Human Reproduction and Embryology).
Programming fertility: the option to freeze healthy eggs
As the body ages, both the number of oocytes in the ovaries and their ability to be fertilized and give rise to a healthy embryo decrease.
In this context, ASEBIR recommends that women consider their reproductive project from a young age and that, if they decide to delay the moment of becoming a mother for the first time, they can consider preserving fertility to increase the chances of future reproductive success.
Twenty years ago, less than 3% of women in Spain were mothers aged 40 or over. This number has multiplied by three, being more than 10.2%, without counting the many who try at this age and do not succeed.
The ovarian reserve curve begins to decline at the age of 25 and the approximately 250,000 oocytes that women have during puberty are gradually lost, so that by the age of 37, around 90% have disappeared and they only have about 25,000.
Thus, naturally, while at age 30, women have approximately a 20% chance of pregnancy; at age 40, the chances are reduced to 5% and practically disappear at age 45.
However, the use of assisted reproduction techniques is not infallible either, and the success rate by age after fertility treatment with one’s own oocytes decreases substantially when performed with women over 35 years of age.
"At 35 years of age or less, when we carry out an embryo transfer, we have a success rate of 42.5%, a success rate that decreases to 20.8% in women over 40 years of age," concludes the president of ASEBIR.
infertility
Assisted reproduction/EFE/Merck
When you discover infertility
Infertility also entails going through an emotional duel in which feelings such as anger, envy, guilt, frustration…
On the other hand, the couple’s relationship can be affected, producing moments of estrangement or discomfort if there is no tolerance for differences of opinion, communication is not fluid or one of the members of the couple does not receive enough emotional support.
Social and family relationships may also be disrupted due in part to the need for
couple to avoid painful situations such as being with families with children or pregnant women and the lack of empathy they perceive from the environment.
This is what the researchers Sara Rujas Bracamonte and Mercedes Martínez Marcos point out in an article published in the Spanish Journal of Public Health.
In their research, they allude to different studies that show how infertility produces a psychological crisis that can affect different areas of life.
Infertility can damage self-esteem, and both women and men can
feel hostility towards their bodies, perceiving them as "inadequate" and incapable of granting a son or daughter to their partners.
From an emotional point of view, it means losses for each member of the couple: loss of the possibility of achieving a pregnancy, loss of genetic continuity, loss of control over their lives.
These losses do not affect men and women in the same way, due to the fact that biologically men do not get pregnant and to the social pressure exerted on women.
In the study carried out by the aforementioned researchers, it is concluded that receiving the diagnosis causes a mourning linked to multiple losses.
And they are the loss of the life project normalized by society and the loss of natural reproductive capacity, the most pronounced by women.
And one of the most difficult aspects for women with infertility to cope with is the difficulty
of living permanently with feelings of envy and frustration when they discover the pregnancy of other women or when they are in the presence of the children of other couples, feelings that can favor processes of isolation).
“Our work also shows that women often also suffer isolation from the “fertile world” (family members and friends who are pregnant or have recently become mothers) due to a lack of empathy, these results are in line with what reflected in other studies”, refer Sara Rujas Bracamonte, from the Nursing Department of the Faculty of Medicine of the Autonomous University of Madrid, and Mercedes Martínez Marcos, from the Puerta de Hierro-Segovia de Arana Health Research Institute (IDIPHISA).