Overcoming Infertility

A Compassionate Resource for Getting Pregnant

An Excerpt

By Robert Jansen, M.D.

When it comes to fertility, how do we separate normal from abnormal? We're used to seeing what's normal spread across a wide range of possibilities. In nature there is the large with the small, the tall with the short, the high with the low. The normal and the abnormal blend, often with no clear separation between them. Attributes that have disadvantages in one context have advantages in others. In practice we loosely call something "abnormal" if our encounters with it are outside what we expect.

And what can a young couple embarking on a family expect? We need to get a bit closer to just what the chance of getting pregnant is each month – or what the chance of conceiving is in one menstrual or ovarian cycle. We can call this statistic monthly fertility. Nature gives normal monthly fertility a wide range.

The French demographer, Henri Leridon, has studied records from rural European societies from 100 years ago, when there was little or no effective contraception (except for breastfeeding). He calculated that the average normal chance of getting pregnant for a young couple living in the French countryside and embarking on a family was 20 percent per month. The normal range of this statistic, he found, was from about 7 percent per month to about 45 percent per month (more on what we mean by "normal range" later). Arithmetic shows that the expected time such normal couples take to achieve a pregnancy was thus in the range of two to 18 months.

But society has changed since the careful parish records of country England and rural France were put together in the 1800s. We now see couples starting their families at a much older age -- in their thirties instead of their twenties or teen years. We also have the effects of the environment on fertility, particularly the social effects of sexually transmitted disease and the effects of environmental pollutants, which are responsible it seems for a long-term trend downwards in sperm counts (discussed in chapter 9).

Want to see more?

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• The Facts to Relax: Coping With the Stress of Infertility
• Truth Be Told: Uncovering Common Infertility Myths
• Talk about it!