A Primer on Infertility/Pregnancy Loss

by William Cutrer, M.D., and Sandra Glahn, Ph.D.

Every year on a Sunday in May, pastors ask mothers to stand. In some churches all the mothers will receive a flower. Restaurants will offer bargain meals to families honoring Mom. On Mother’s Day we honor the sacrifices our mothers have made and continue to make—and well we should. But for millions of couples, Mother’s Day is “M-Day,” the most dreaded holiday of the year. For these couples—the ones experiencing fertility problems—this day serves as a reminder of what they long to have but which eludes their grasp. A child.

When it comes to infertility, a lot of myths get passed around. Maybe you’ve heard some of them.

Myth: Infertility and sterility are the same thing.

Fact: Infertility is not sterility. Infertility is the inability to conceive after one year of unprotected intercourse and/or the inability to carry a pregnancy to term (600,000 women miscarry in the U.S. each year). Secondary infertility is when couples who have had one child (or more) are unable to conceive or carry to term again.

Myth: Infertility is rare.

Fact: Infertility is quite common. Approximately one in six couples of childbearing age experience fertility problems.

Myth: Infertility is a woman’s problem.

Fact: Infertility is shared about equally between the genders. About 30 percent of infertility problems are due to female factors, 30 are due to male factors, and 35 percent are a combination of both. The other five percent remains unexplained.

Myth: All the people in the Bible who were infertile were women.

Fact: We have to be careful to avoid viewing the Bible as an exhaustive textbook on infertility. While, the scriptures describe a number of couples who had difficulty conceiving, the stories are not about the process of infertility per se. And women are not the only infertile people. The levirate marriage laws (Deut.25:5,6) suggest male fertility problems. In addition, Ruth was married for ten years to her first husband without children. After he died, she went on to marry Boaz and give birth to Obed, King David’s grandfather. This would suggest that her initial inability to conceive was due to male factor infertility.

Myth: Infertility is caused by the inability to relax.

Fact: Infertility is not caused by the failure to relax. Ninety-five percent of the time it is due to a diagnosable medical cause. About sixty percent of all couples who seek treatment will eventually have a biological child. The percentage is much lower for couples who do not pursue medical treatment. Common causes in the female are ovulation or hormonal problems, endometriosis, anti-sperm or anti-embryo antibodies, blockage which prevents gametes from meeting, and/or structural or functional problems with the uterus or cervix. In men, it is caused by poor sperm penetration or maturation, hormonal problems, and/or blockages of the male reproductive tract.

Myth: Infertility is not any more common than it used to be; it’s just that we’re talking about it more.

Fact: The number of couples diagnosed with fertility problems is on the rise. Delayed childbearing and sexually transmitted disease are partially responsible. Environmental factors may also play a role.

Myth: Just adopt—then you’ll get pregnant.

Fact: Adoption is not a cure for infertility. Five percent of couples who end treatment and adopt end up getting pregnant. Five percent of couples who end treatment and choose not to adopt end up getting pregnant.

Myth: Couples going through infertility are having fun trying to have a baby.

Fact: Fifty-six percent of couples experiencing infertility report a decrease in the frequency of their sexual relationship. Both women (59%) and men (42%) report a decrease in sexual satisfaction, and infertile couples overall report having five times the sexual difficulties of fertile couples.

Myth: Real Christians are against any assisted reproductive technologies.

Fact: Godly people, should they choose to use assisted reproductive technologies, must do so in a way that honors the dignity of life, even at the one-celled stage.

Proverbs 30:16 says, “There are three things that are never satisfied, four that never say, ‘Enough!’: the grave, the barren womb, land, which is never satisfied with water, and fire, which never says, ‘Enough!’” Couples are often encouraged to learn from this that the deep desire of humans to have children is part of the way God has structured the world. Their stress is a normal response to an abnormal situation.

Do you know a couple struggling with fertility problems? Say a prayer for them as they face the daily heartbreak that accompanies such a loss.