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– Today it is easier to admit that you are depressed than to say: “I am infertile”. This is absurd. Infertility will not be cured by a gynecologist suggesting “take it easy” or uncle – good advice saying “hurry up, time is running out”. It is a disease that we must talk about aloud, not in a whisper, says Dr. Maja Polikowska-Herman, a psychiatrist.
Zuzanna Opolska, Medonet: Doctor, in July the Central Statistical Office informed us about a new tendency – an increase in the number of births …
Dr Maja Polikowska – Herman: And experts reported that the positive changes in the statistics may be influenced by the “Family 500 plus” program and the improving situation on the labor market. Only the 500 plus project officially started in April, and I haven’t heard about three-month pregnancies yet. This program is sure to pay off, but not yet. The change was due to the achievements of the pro-family policy in recent years: extension of leave for parents in 2013 and IVF funding. Let’s not forget that the whole process of diagnosis and treatment before IVF takes a minimum of a year, plus a 9-month pregnancy and we are in 2016. But the data from the Central Statistical Office is a piece of the puzzle … If we look at the birth rate statistics from 1946 to 2013, we’ll see that the period of birth depression has lasted since the 90s, and the total fertility rate is below 2, ie the optimal value. Unfortunately, we are in a demographic bottom and we will stay there for a long time.
And the rest of Europe?
The problem affects almost everyone, according to the Eurostat report, for the first time in the history of the EU we are dealing with a negative birth rate! Only Ireland, France, Sweden and the United Kingdom are on the positive side, mainly due to emigrants. From the standpoint of evolution, they are genetically the best individuals, strong and emotionally intelligent. They adapt to environmental conditions and fight for the survival of the species, i.e. the transfer of genes. Ireland and Great Britain are full of our countrymen in reproductive age and Polish children are born there.
Let’s go back to the Poles who stayed – do not want to or cannot be parents?
The number of women who do not want to have children has remained stable for years. What changes and can be a problem is the age limit when we decide to have the first child. From the medical point of view, after the age of 35, the risk of complications increases, but more and more gynecologists are pushing the limit by the age of forty. We women are at a disadvantage – we are born with a certain number of eggs, and men produce sperm throughout their lives. After the age of 35, so-called anovulatory cycles occur much more often, during which there is no ovulation and therefore no fertilization. In addition, the quality of the eggs produced by the ovaries is much worse. And the greater the risk of chromosomal defects, the greater the risk of miscarriage. After the age of 40, it is about 40 percent, and after 45 – 50 percent. To all my patients who want to have children, but not yet, I advise what Joanna Krupa did. Freezing the eggs is a great idea. It is true that in Poland it can be done only for oncological indications, but in many European Union countries it is not a problem at all. The more so because, as Professor Bartosz Łoza says, “we live unbearably long” and we have much more time for motherhood.
How many people struggle with infertility?
In the world, 18 percent couples of childbearing age, and in Europe 15 percent. But officially it is said that the problem of infertility is underestimated. In Poland, about 1,5 million couples require treatment. Today, if partners do not have children, it should be assumed that this is not a conscious choice. I sensitize everyone to sensitivity and use good advice carefully. I have patients who struggle with infertility. And as far as the question: do you have children? – stiffens, the next one: why don’t you try? – knocks you off your feet. Like “uncle good advice” who at Sunday lunch says “if you can’t do it, I’ll show you.” If the problem of infertility lies on the male side, it is even more taboo. Men who cannot achieve “reproductive success” feel castrated and withdraw into themselves.
Recently, the problem of male infertility is growing …
The causes of infertility are evenly distributed, in 35 percent. depend on a woman, 35 percent. from a man, and both of them are responsible for the rest, or we have a situation where the cause cannot be found medically, i.e. “Idiopathic infertility”. We know, however, that today’s sperm parameters were treated as a disorder and pathology just 15 years ago. It was certainly influenced by the hygiene of life, or in fact the lack of it. Long-term stress, poor nutrition, stimulants and stimulants do not contribute to good sperm condition. So are lap laptops and heated car seats.
The “Fertile Gadki” campaign from September 2016 showed that every third Pole cannot calculate her fertile days, and 44 percent cannot calculate her fertile days. men do not know that they begin a few days before ovulation. We also do not know where the vagina and the vas deferens are …
The procreation program proposed by the present government pays attention to the education of both specialists and the general public. Unfortunately, the first standards of infertility treatment in Poland appeared in 2011, and the first government program in 2013! So we are very late. Besides, the problem affects the whole of Europe, there are no holistic fertility treatment programs in any country. On the one hand, it is worth focusing on prevention, and on the other hand, educating Poles how they can improve the quality of sperm or eggs. Diets correlated with the cause of infertility are playing an increasingly important role. Being overweight, just as underweight, makes it impossible to become parents, and 1000 kcal diets that absolutely eliminate sugar and fat are deadly for sex hormones. Another issue is psychological help for couples, of which there is definitely not enough. There are no psychiatrists in infertility treatment centers. Just because women don’t talk about depression doesn’t mean they don’t have it. Conversely, patients fear that their poor mental state will postpone subsequent gynecological procedures or disqualify them from further infertility treatment. And untreated depression may affect the effects of infertility therapy. A few years ago, I conducted a study with the support of the “Our Stork” association on emotional disorders related to the inability to get pregnant. Couples’ problems are mainly related to anxiety, depression and the way of functioning. Partners fall out of their psychosocial roles and develop a social phobia. Often, couples trying for a baby avoid public places because they are unable to compensate for the sight of pregnant women and children playing. I often hear from my patients that when they find out that their friend is pregnant, they are unable to function for a week or two.
On the one hand, they feel terribly guilty of being jealous, and on the other hand, they can’t help but be. Infertility patients go through the same stages in the same way and talk about them the same way. They have their own language – their sentences sound like “copy and paste”. This is amazing. I do not know a couple who, even successful, went through the infertility treatment unscathed. Sex on command kills passion, frustration, mutual grievances and accusations appear. Unfortunately, the standard saying of gynecologists: “chill out” – nothing will …
We still stigmatize the infertile?
Nothing has changed, in society the infertile are considered less valuable. I remember the controversial campaign from 2015 “I managed to buy an apartment and renovate my house. But I didn’t have time to become a mother. I regret”. Firstly, such a message is built on a feeling of guilt, and secondly, it stigmatizes. Women perceive their own femininity through the prism of having a child – this is a cognitive bias. A child does not determine femininity and does not affect the value of partners. This is an added value to the relationship. We need a different campaign. One who says infertility is a disease, you don’t have to be ashamed, you have to be treated. Today, more people will admit to being depressed than having problems conceiving. We are reaping the harvest of infertility, which is not a catchy topic that pharmaceutical companies cannot earn so much. Together with my team, I organize workshops – my original aid program for couples trying for a child. We mainly focus on de-stigmatizing patients struggling with infertility. We help them find themselves in this problem, we confront and try to show them the real emotions they feel, to which they cannot even admit to themselves, let alone talk to someone else. Conversation is what saves and helps. We teach you to talk anew, to talk real, also in pairs. Infertile patients fall into the trap of hiding a problem they are ashamed of. We have to learn that this is no shame. The message: yes we have a problem with infertility, it will automatically cut all comments like “the clock is ticking” or “you are not getting younger”.
Only infertility separates us from a demographic jump?
I do not have good news. We have a second problem – mechanical in nature, research shows that we have stopped having sex.
We prefer the Internet?
The number of people addicted to pornography on the Internet is growing and, according to some experts, this is the main reason. I remember the “future sex” scene in “Demolition Man.” Sylvester Stallone wanted to make love and Sandra Bullock handed him the headphones. I thought we would never live in a world where virtual reality would dominate our lives. Unfortunately, director Marco Brambilla turned out to be a prophet. This is confirmed by research.
The analysis carried out on students between 9th and 12th grade, assessing risky sexual behavior, showed a decrease in sexual activity (defined as intercourse in the last three months) in all groups. Another statistic from August 2016, conducted on almost 27 people, compared sexual activity to the age of 18 of the representatives of the X, Y, Z generations. It is dramatically, 6 percent were left without sexual partners. people born after 1960, but among those born in the 70-80-90’s – 16 are people who have never had intercourse! Still, I wouldn’t demonize the Internet at all. The fact that we run away to the virtual world is the result of what is happening to us. And we clearly have a global problem with emotional disorders. According to the World Health Organization, 350 million people worldwide are treated for depression, and burnout already affects students and high school students. If we live too fast, too hard and too intensely, we burn ourselves at the start. We don’t enjoy sex anymore, because we don’t enjoy life. We can cure infertility, but if we don’t put our emotions in order, the children won’t be, and we’ll end up on the list of endangered species.
What is our future?
As always, I will answer that it is good. Japanese scientists are keeping an eye on the pulse. From the tail cells of the mice, they obtained egg cells, and from them offspring. This achievement could be used to treat some types of infertility in the future. In a similar way, it is possible to produce an egg from male skin cells, and in the long run, children who have two genetic fathers. Previous attempts, however, were unsuccessful – the eggs from the skin of male mice quickly died. This is one scenario … Another scenario is a bit simpler and less controversial. It is important to remember that “if we are to run through life, it is only together.” But this “together today” should change a bit. We need to learn to live in a world with easy one-click access to everything (news, photos, videos, books) and not be fooled by the feeling that while everything is easy, it is easy with emotions. Access to ourselves, to what we really feel and how we really think is not at hand. We hide our real self in the subconscious with various defense mechanisms. And that gets us in trouble a lot. This causes that we have difficulties in relationships, the wave of emotional disturbances and the number of other civilization diseases are growing. Working on yourself and your emotions is difficult, but definitely worth every effort.