There are lots of F words and for many, fertility is one of them. It’s an uncomfortable subject that many women and men have to deal with. But why is talking about fertility and infertility treatment so hard and, frankly, taboo for the majority of us?
Dr. Shahin Ghadir, Fertility Expert, Reproductive Endocrinologist, and co-founder of Southern California Reproductive Center, tells me it’s because “[fertility] goes down to the root of you as a human being. No one wants to feel subnormal. And because it’s a topic that hasn’t been talked about for generations in the past.”
Tamika Simpson, MPH, PMH-C, IBCLC is a Perinatal Mental Health specialist with Ovia Health. She thinks part of the reason why talking about fertility is so uncomfortable is because of the way our society approaches sex in general.
“If we are talking about fertility, we are also talking about sex, and that has been taboo for a long time,” she explains. “But with infertility, not only are we talking about sex, we would now be talking about a problem related to the reproductive organs, which is not something that people in Western culture are generally comfortable being open about.”
No matter the reason, these conversations can be hard – but there are ways to make them easier. So, if you’re trying to conceive, or plan to try in the future and you’re anxious about bringing it up with your partner, read on.
Surprise — OBGYNs are a big part of the problem
While most would assume their OBGYN would at the very least mention fertility during annual exams, it’s not the norm. As a result, women are often left in the dark about their fertility and options for infertility treatment. What many women don’t realize is that the first step to learning about your fertility is a simple blood test that can often be covered by insurance.
While asking your OBGYN is a place to start, Dr. Ghadir tells me it’s not the best place to start. He recommends going to a fertility specialist in addition to your regular doctor.
“I think that the knowledge that a general OBGYN brings to the table is completely different than what a board-certified fertility specialist can bring to the table,” he says. That’s because narrowing down a specific problem can take quite a bit of testing, which isn’t offered by most OBGYNs.
And you don’t have to limit yourself to a referral from your OBGYN (although it’s a good first step). “I think asking your OBGYN for their recommendations is going to open the doors to only who your OBGYN knows. I think in this day and age, people should ask their OBGYN and also should do their own research.”
You can find a directory of board-certified fertility specialists from the American Society For Reproductive Medicine. Yelp and Google Reviews are other avenues for trying to find the right fertility specialist.
When to start talking about infertility treatment
Many of us know that fertility decreases after the age of 35. However, age isn’t the only thing that impacts our fertility. “If someone has irregular periods and is not ovulating regularly, there’s really no reason to wait to see a fertility specialist,” says Dr. Ghadir.
If you’re under the age of 35 and you’ve been trying to conceive for a year, Dr. Ghadir also suggests seeing a fertility specialist. And if you’re over 35 and have been trying for more than six months, don’t let another month go by — book that appointment.
Women with some preexisting conditions should also see a fertility specialist. “A history of STDs could have affected your fallopian tubes, or if you have known endometriosis, significant pain with your menstrual cycle, [or other] signals of endometriosis and polycystic ovary syndrome,” says Dr. Ghadir.
Remember, if you’re having trouble conceiving at any age, the problem might not be your fertility at all. Rather, it can be an issue with your partner, who should also go for testing.
“Many things can cause male infertility, but one of the major factors is if he was born with a testicle that wasn’t descended,” says Dr. Ghadir.
“Being proactive and knowing information can help everyone in the long run. And it takes two people to make this happen,” he points out. “There’s no blame involved, even if it’s one person’s issue more than the other.”
How to talk with your partner about infertility
Both professionals suggest tackling this problem as a couple. Keep in mind that some doctors are still only allowing patients in office due to Covid, so ask first. Even if they aren’t physically permitted to be in the room, calling them or using FaceTime are other options. This allows your partner to hear the information firsthand as well as ask their own questions.
Professional guidance is the best way to steer the conversation in a positive direction. “Visit a healthcare provider together. Don’t try to diagnose yourself, but talk with a healthcare provider about your concerns and see what your options are,” says Simpson. “Knowing what the options are can help guide this conversation and allow you to make informed decisions that seem like a good fit for you and your partner.”