1. Considering infertility Rels 300 / Nurs 330 5 November 2014 300/330 - appleby1 (http://www.cartoonstock.com/directory /a/artificial_insemination.asp )http://www.cartoonstock.com/directory /a/artificial_insemination.asp

2. Infertility Affects approximately 1 out of every 8 (some say 6) couples in Canada Medically defined as inability to conceive after one year of unprotected intercourse Incidence is lower for women between the ages of 18 and 29, and greater for women between 30 and 44 May be broadened to include people who desire to have children, but who are not in stable heterosexual relationships – e.g., single persons, lesbian women or couples, gay males or couples 300/330 - appleby2

3. Medical causes of infertility Sexually transmitted infections Smoking (both women and men) Delayed childbearing Exposure to harmful agents ◦ Workplace and environmental toxic substances Alcohol and substance use Weight (obesity and malnourishment), eating disorders, exercise, stress Medical interventions Endometriosis 300/330 - appleby3

4. Specific Reproductive Causes of Infertility FEMALE FACTORS:  Blocked fallopian tubes  Irregular or absent ovulation  Endometriosis  Cervical irregularities, e.g., hostile cervical mucus  Uterine fibroids or polyps  Hormonal imbalances  Early menopause  Age (+ 35)  STI history  Cancer treatments (chemo, radiation, surgery) 300/330 - appleby4

5. Male factors in infertility Low sperm counts, or no sperm Low motility rates / low rate of movement Abnormal morphology of sperm / physical abnormalities STI history Hormonal imbalances Cancer treatments: chemo, radiation or surgery 300/330 - appleby5

6. Male or female factors? 30% of infertile couples are infertile due to male causes 40% are infertile due to female causes 20% are infertile due to a mix of male and female factors 10% - no specific cause of infertility can be found 300/330 - appleby6

7. Responding to Infertility Adoption Do you have an adopted child in your family? What was the process for adopting this child? How is this child treated in your family? How does this child feel about being adopted? What are the best things about adoption? Are there any down-sides to adoption? 300/330 - appleby7

8. Why not adoption? What reasons do individuals or couples have for rejecting adoption as a solution to their infertility? Personal reasons? Social reasons? Biological reasons? Genetic reasons? Additional considerations? 300/330 - appleby8

9. Is infertility a medical condition? There are medical conditions that contribute to infertility There are reproductive technologies that correct, overcome or circumvent the medical condition However, many reproductive technologies result in babies for infertile persons or couples without addressing the cause of infertility 300/330 - appleby9

10. How is success measured?  Success in overcoming the medical condition of infertility is measured by the provision of a child  With a series of interventions that become increasingly technological, male and female infertility factors are largely circumvented, rather than corrected  Reproductive services arose within and are aligned with research agenda designed to ultimately create human life outside of the human body  Minimal primary research is being done on the medical condition of infertility 300/330 - appleby10

11. Social dimensions of infertility Why do individuals and couples desire to have children? Divine commandment to “be fruitful and multiply” To provide a future for a religious, racial or cultural community To ensure a genetic heritage for future generations As evidence of mature and responsible adult status To demonstrate or strengthen a couple’s love To satisfy a deep hunger or longing for a baby 300/330 - appleby11

12. 1 in 6 couples face infertility. Most suffer in silence, too ashamed to tell friends and family. (5:23) https://www.indiegogo.com/projects/on-infertile-ground--5 1 in 6 couples face infertility. Most suffer in silence, too ashamed to tell friends and family. http://www.youtube.com/watch?v=8JfK_4u80nYhttps://www.indiegogo.com/projects/on-infertile-ground--5 http://www.youtube.com/watch?v=8JfK_4u80nY 300/330 - appleby12

13. “Motherhood and Infertility: Viewing Motherhood through the Lens of Infertility” by Miriam Ulrich & Ann Weatherall (Feminism Psychology August 2000 [10:3] 323-336) “Reasons for wanting children included motherhood as ‘natural instinct’, as ‘a stage in the development of a relationship’ and as ‘social expectation’. These were used to construct motherhood as physical, psychological and social completeness and fulfilment for women. Consequently, infertility was experienced as guilt, inadequacy and failure, reinforced by the language used to describe infertility.” 300/330 - appleby13

14. Reproductive rights o Do individuals/couples have a right to reproduce? o Is this a universal human right, like the right to life? 300/330 - appleby14

15. Reproductive rights A person’s or couple’s inability to become pregnant should be understood as:  300/330 - appleby15 Yes, the right to reproduce is a universal human right, because… No, the right to reproduce is not a universal human right, because…            

16. http://www.bbc.com/news/health-29485996http://www.bbc.com/news/health-29485996; 4 October 2014 First womb-transplant baby born By James Gallagher Health editor, BBC News “A woman in Sweden has given birth to a baby boy using a transplanted womb, in a medical first, doctors report.” IVF to produce 11 embryos, which were frozen Uterus donated by a friend in her 60s Drugs used to suppress the immune system 1 year after transplant, doctors transferred one of the frozen embryos to the woman’s womb Due to toxicity of immunosuppressant drugs, uterus will later be removed 300/330 - appleby16 The baby will "give hope" to those wanting children, say the transplant team

17. http://www.sciencedaily.com/releases/2014/10/141007092110.htm http://www.sciencedaily.com/releases/2014/10/141007092110.htm World's first child born after uterus transplantation October 7, 2014; University of Gothenburg “The uterus transplantation research project at the University of Gothenburg [in Sweden] started in 1999.” 9 women have received uterine transplants from live donors – mostly family members, some friends 7 successful, 2 not successful Other women still trying for successful pregnancy and birth What would cause a woman not to have a uterus? Why would some women choose this experimental treatment instead of adopting or using a surrogate mother? 300/330 - appleby17