To head off all of the "just adopt" comments, I've included a link at the bottom explaining exactly why adoption is so difficult. I won't engage in this off-topic discussion here.
We discuss fertility here a lot and it's usually unproductive and often anecdotal. I thought I'd share an issue I've wanted to highlight for some time.
I met my husband when we were 27 and 30 and we married at 29 and 32. Children were a nonnegotiable but we wanted to enjoy a year or two as a married couple, before trying. We hadn't lived together while we were dating and knew that the whole "husband and wife" thing would take some adjusting. We wanted to own a home before we started a family. My husband had left oil, at my request, hoping to move up with the city. We had a lot of things we wanted to do together, things that would be more fun and easier without kids. We didn't want to wait long, but since I was only 29, we did plan to wait for a year and a half to two years.
I ran this plan by my gynecologist, asking if I should revise. She assured me that she thought I'd be fine, since I had no indicators of fertility troubles. I asked about the miscarriage I had in my teenage marriage and she told me that that just meant I could get pregnant. I shouldn't worry... and so I didn't. For the next year and a half, my husband and I took an Alaskan cruise for our honeymoon, canoed on the Buffalo River, bought a house, took trips to Colorado Springs and Fort Worth, went to parties with friends, and improved our home. We had a blast, but knew that time was precious, so just before Christmas of 2018, I had my IUD removed and we decided to see what happened.
By April, we were aiming for those few days a month. By June, I was using ovulation strips. By September, I was starting to worry, but my doctor insisted it was probably fine and I should just stop trying. Y'all, I cannot stress enough how glad I am that I ignored this terrible advice. My husband and I were both over 30 and we didn't want to waste any more time. We wanted a family, so we wanted answers. If those answers reaffirmed, medically, that nothing was wrong, great. We scheduled a semen analysis and had to wait until January.
On February 13, 2020, my husband came home with the news that he had barely over 1 million sperm and the average is 40 million. Our only option was IVF. He didn't even have enough for an IUI (artificial insemination), unless we wanted to use donor sperm, something neither of us wanted and which didn't offer great chances with a 10-15% success rate (IVF was more like 60% in our case). We were devastated... and then a pandemic hit.
I'll end the story there. If you'd like to read the rest, I do write a blog and opened a page specifically for my infertility journey. It's not uplifting, since I wasn't sure how things would end, but it does have a happy ending and I hope someone out there finds comfort in that. I've posted a link.
My husband and I were lucky, I suppose. Our first IVF cycle was an utter failure, but we tried again immediately and marked the one year anniversary of our first cycle with one month old twins. We also have six frozen embryos and hope for more children. The cost? $30,000, to date. More transfers will cost more money, as will keeping our embryos frozen.
My husband's fertility issues had nothing to do with age or lifestyle. His hormone production was great and he should have had ideal sperm... but he didn't, due to a genetic anomaly that couldn't be fixed or explained. Of the 1 in 8 (or 15%) of couples who will suffer from infertility, in 1/3 of all cases, the male is to blame, 1/3 the female, and 1/3 both. Yet, medical professionals still tend to hold the woman responsible by default. Our doctor told us verbatim that there was no point doing a semen analysis, because "90% of the time it's the woman," which as I've cited, isn't even true. While testing a man's fertility is relatively simple, it's largely ignored and women are often expected to undergo expensive and invasive tests first. We weren't the exception. We just refused. When we found out that my husband's sperm count was so low, however, there were no options... and for some reason, this isn't being widely studied, despite the statistics. My husband would have loved to try some form of treatment, but none existed.
Another consideration for men's fertility (which fortunately did not affect us), is the impact of paternal age on fetal development. While women have grown up hearing about their biological clock for centuries, people are only just beginning to discuss the repercussions of men fathering children later. According to the Mayo Clinic, in couples where the man is over 40, there is a higher risk for pregnancy loss, rare birth defects, autism, schizophrenia, and lukemia. I'm not saying these risks are greater than for older women, but they do exist and should be considered.
What I'm getting at here and maybe my tl/dr is that a woman's fertility is not the only factor in planning for a family. I was relatively young and had been assured that my age was a non-issue by multiple health care professionals... and they were right. I was plenty fertile. I didn't have any cysts or polyps and my AMH results (the test that tells you how many eggs you have left), were great for my age. I had no fertility problems, at all, while my husband would likely never be able to get me pregnant. It was devastating to learn we'd have to go through IVF and, letting the pandemic pass or even lessen wasn't really an option for us, which was due to our age.
I wouldn't change the decisions I've made. My days are filled with diapers, tantrums, giggles, and tiny matching clothes. My girls were absolutely worth it and my marriage is stronger for the struggle, even if I'm not. I'm not so sure that my marriage would have fared as well, had we taken on fertility treatments sooner and we'd have missed a lot, just the two of us. It all worked out and my husband and I are deliriously happy... but if we'd done things a little differently, that might not have been the case. If we'd drawn out our dating phase or our engagement or had waited even a couple more years before trying for children, because I was still young, it might have been too late, even though my doctor gave me the green light to do so.
I don't say any of this to scare women, but to warn those who aren't worried about their own fertility, for whatever reasons, that theirs isn't the only factor. Maybe you have a May/December thing going on and you feel like you have all the time in the world at 26, when he's 39. Maybe you're like me and your maternal grandmother had your mom at 38 and to your knowledge, fertility troubles don't run in your family. Maybe you're just super healthy and on the right course with your fiancé and you just aren't worried, because you're only 28. I did my homework in regards to my fertility and literally no one suggested that my husband might have trouble conceiving or that there wasn't some pill he could take to fix the problem, so I'm telling you.
Male factor infertility is a problem in 2/3 of cases and there isn't always a solution. Take this information with a grain of salt if you want, but all the focus we put on women's fertility leaves a blind spot for both women and men. It's awful that something so directly involved in men's health isn't a higher priority. It's awful that women are blamed for something that is the fault of both sexes. For me and my husband, it would have been awful to live a life without children. I'd also advise anyone starting fertility treatments to insist on a semen analysis before spending a dime on the much pricier tests for women. Male infertility is rarely visible. My husband is quite stocky, has a full beard, a decent sex drive, and is just all man. We could have wasted a lot of time and thousands of dollars just treating me.
My infertility blog: https://belleofinfertility.wordpress.com/
Some men's fertility resources:
Why we don't all just adopt: https://belleofthelibrary.com/2021/03/22/why-we-dont-all-just-adopt/