Joy. Excitement. Wonder. Morning Sickness. Big belly. Swollen ankles. Strange food cravings. Baby showers. Concern about whether or not you’ll be a good mother. Visits to the doctor. A lot of visits to the doctor. While pregnancy can be stressful and sometimes overwhelming, moms know that those nine months are worth it when you can take that newborn into your arms.

However, just trying to get pregnant can be frustrating and discouraging for many couples who have difficulty conceiving. “Many of my patients… once we discuss infertility, I liken their emotions to that of someone grieving the loss of a loved one,” says Dr. Gloria Richard-Davis, a nationally-recognized specialist in infertility and reproductive endocrinology, and Professor of Obstetrics and Gynecology at the University of Arkansas Medical Sciences (UAMS). She is also the co-author of “Planning Parenthood: Strategies for Success in Fertility Assistance, Adoption, and Surrogacy.”

“Are you aware of Elizabeth Kubler-Ross’ five stages of grief? There’s shock, anger denial…I’ll have patients tell me they haven’t been trying even though they’ve been having sex and not using contraception,” she says.

The Centers for Disease Control and Prevention defines infertility as not becoming pregnant after one year of unprotected sex. Dr. Richard-Davis says that window of time narrows to six months for women over 35. As many as 10 to 15 percent of all couples in the United States struggle with infertility, according to the Mayo Clinic.

And this isn’t just a woman’s problem, either. For many couples there is more than one factor. Men play a much bigger role than is widely known. “40 percent of all cases involve a male factor. That is why it’s important to examine both partners in order to find all the factors that are contributing to the inability to get pregnant,” Dr. Richard-Davis says.

Another big factor? A woman’s age. “Women are waiting later to get pregnant, but as you get older, you risk not having enough eggs, or other health issues that can cause infertility.” And when couples have gone through extensive testing and results are normal, the infertility is simply known as “unexplained.”

“A lot of couples think it must be because of stress that they can’t get pregnant, but that is not what we consider a direct cause. What is interesting, however, is there was a study done, and it showed that patients in stress reduction courses had 50 percent more pregnancy that those not taking the stress reduction courses.”

Miscarriage and coping

Miscarriage is always traumatic, and it’s even more difficult for couples who struggle with infertility. Dr. Richard-Davis says it’s important that women are allowed to grieve the loss of the pregnancy. “If a woman is showing and experiences a miscarriage, people expect and allow her to go through the grieving process, but that isn’t so for a woman who may not be showing. She doesn’t get the same level of support.”

Dr. Richard-Davis strongly encourages her patients to seek counseling if they have recurrent pregnancy loss, which is defined as three or more consecutive miscarriages.

‘You can get pregnant’

“I tell my couples, ‘you can get pregnant, but it’s up to you to determine how far you want to go with your treatment to do so,” Dr. Richard-Davis says. “For some women, it may be as simple as regulating her monthly cycle with a pill. For others, if male factor is involved we may have to inseminate sperm into the uterus.”

In vitro fertilization (IVF) is most effective if there is low sperm count or if both fallopian tubes are blocked. This involves fertilizing the egg outside of the woman’s body. Each couple is unique, and becoming pregnant after a treatment depends on many things, especially your age and quality of embryos. If a couple needs donor eggs, sperm or embryos to become pregnant, Dr. Richard-Davis adds that counseling is strongly encouraged before the process begins.

Fertility treatments, depending on the needs of the patients, can cost into the tens of thousands of dollars. It’s important to review your health insurance plan to determine whether or not your insurance covers the cost. For many of Dr. Richard-Davis’ patients, their health insurance plans do not cover the doctor-prescribed treatments. That is significant out-of-pocket expense that some couples decide to forgo.

“Some patients weigh the cost of IVF against the cost of adopting and choose to adopt early on. Cost is definitely a factor,” Dr. Richard-Davis says.

Adoption as an option

Many families choose to adopt, regardless of their ability to have biological children. Both couples and single parents can choose adoption through many private services that offer both local and international adoption, or through Arkansas’ public adoption agency, Arkansas Department of Human Services Division of Children and Family Services. Photos of local boys, girls and sibling groups in need of forever homes populate the website. The website also provides information about the steps that families can take to adopt a child; for additional inquiries or questions on how you can start the adoption process, contact the DHS/DCFS Adoption Services Unit at 682-8462.

Read more about one family's path to adoption here:
Making a Case for Adoption and the Gladney Center

What increases infertility risk?

  • Age
  • Irregular periods
  • Sexually transmitted diseases (STDs)
  • Excessive alcohol use
  • Smoking
  • Extreme weight gain or loss

Source: Centers for Disease Control and Prevention