Infertility

Infertility is not a situation that most people take lightly. It is generally fraught with anxiety and not a little shame. My great-grandmother Leta had two children with her first husband Ralph. She was still under 30 when she divorced him and married Albert Mohr. He was under 40 and had no children. And they didn’t have any. I don’t know why. Nor did she have any children with any of her subsequent husbands, at least two of whom she married during what we would call her “child-bearing years.” And we know that she was quite a sexual being.

So I am considering that perhaps after having two children she could have no others. According to several web sites, there are quite a number of reasons that a woman may become infertile, some far more complicated than others.

Chlamydia, for example, is a sexually transmitted infection that is also the most frequent cause of fallopian tube damage or blockage—75% actually.

Pelvic Inflammatory Disease (PID) is the most common cause of infertility worldwide. It's a bacterial infection of the pelvis or one or more of the reproductive organs—ovaries, fallopian tubes, cervix or uterus. Sometimes PID spreads to the appendix or to the entire pelvic area. The bacteria stems from the same bacteria that cause sexually transmitted diseases or may develop from bacteria that reach the reproductive organs through abortion, hysterectomy, childbirth, sexual intercourse, use of an intrauterine (IUD) contraceptive device or a ruptured appendix.

Lifestyle habits that may contribute to a woman’s infertility are: 1) heavy use of alcohol, tobacco or drugs; 2) starvation diets or anorexia; or 3) stress. A woman may also be infertile as the result of hormonal deficiencies, problems in the reproductive organs and some illnesses. While many of these are treatable, others are not.

These include the following:

Polycystic ovary syndrome (PCO) is a disease in which the ovaries produce high amounts of male hormones, especially testosterone. Instead of producing eggs, the follicles form fluid-filled cysts that eventually cover the ovaries. This syndrome is dangerous for a number of other reasons, such as an increase in diabetes, cancer and heart disease. Physical effects include excessive facial hair, thinning hair, acne, depression, unexplained weight gain, irregular or no periods and/or high insulin or cholesterol readings.

Endometriosis refers to a condition in which sections of the uterine lining implant in the vagina, ovaries, fallopian tubes or pelvis, form cysts that grow with each menstrual cycle, and may eventually turn into blisters and scars which block the passage of the egg.

Decreased production of any one of the five hormones that regulate a woman's reproductive cycle may result in infertility.

Adrenal or thyroid deficiencies may cause hormonal and ovarian problems, and some women produce excess amounts of prolactin, a hormone that normally stimulates the production of breast milk and simultaneously prevents ovulation.

Women may develop antibodies or immune cells that attack the man's sperm, mistaking it for a toxic invader.

In a luteal phase defect, a woman's corpus luteum (the mound of yellow tissue produced from the egg follicle) may fail to produce enough progesterone to thicken the uterine lining. Then the fertilized egg may be unable to implant.

Fibroids, (or benign growths) may form in the uterus near the fallopian tubes or cervix. As a result, the sperm or fertilized egg cannot reach the uterus or implant there. This is very common in women over age 30.

A variety of uterine problems may also cause infertility. These include:  1) endometritis (an abnormal swelling of the uterine lining that makes it difficult for the fertilized egg to implant); 2) scar tissue left after abdominal surgery that affects the movement of the ovaries, fallopian tubes, and uterus; 3) frequent abortions that weaken the cervix or by leaving scar tissue that obstructs the uterus; 4) weak, infrequent or abnormal contractions in the uterus that fail to push the sperm up to the fallopian tubes; 5) poor quality cervical mucous; 6) certain diseases, such as diabetes, kidney disease or high blood pressure, or ectopic pregnancy and some urinary tract infections; 7) medications such as hormones, antibiotics, antidepressants, and pain killers (although these are temporary); and 8) premature menopause (often from excessive exercise or anorexia).

Of course, my great-grandmother could just have been very good about not getting pregnant after her two children. As I do not know the exact reason or reasons, the novel, at least as far as I can tell right now, will require I make one or more.