Infertility in history

FERTILITY HAS BEEN ONE OF THE MOST IMPORTANT TOPICS SINCE THE BEGINNING OF HUMAN HISTORY.

In an ancient times, infertility was always attributed to the woman. In some civilizations, infertility was even a legal ground for divorce. Today, the situation is fortunately different. Reproductive medicine is advancing at a tremendous speed and many couples who would have had to give up hope in the past can now have a child.

Infertlity in a long history

Writings and stories about infertility stretch back to the medical texts of ancient Egypt, Greece and beyond. The entire Judaeo-Christian tradition begins with the story of Sarah and Abraham’s desperate desire for a child. In Icelandic sagas, Indian epic narrativesand ancient Greek plays, we find stories of childlessness, miraculous births and adoptions that cross national boundaries.

In centuries past, couples sought all kinds of remedies for childlessness. They prayed and went on pilgrimages. In medieval England, men and women took remedies containing the sexual organs of animals in the belief that this would stimulate their reproductive organs. In 18th-century Europe, childless women were encouraged to “take the waters” in spa towns to ease their nerves and prevent spasms of the womb. More recently, in the mid-20th century, doctors who believed that female infertility was a psychosomatic condition recommended adoption as a “cure”. They argued that becoming a mother to an adopted child made women relax and increased their chances of conception.

It seems infertility has been stigmatised in many different historical contexts. Noble women in medieval Japan were disdained if their marriages remained childless. In 16th-century England, childless women suffered because motherhood was perceived as the most important marker of femininity. And in 19th-century France, many doctors linked childlessness to abortion, venereal disease, or promiscuity.

Despite this historical evidence, many people persist in thinking about infertility as a product of the modern age. One reason is that IVF itself has made infertility socially visible to an extent unparalleled in earlier decades.

The causes of infertility are multiple and far from being solely on the woman's side. Men suffer from fertility problems too and there is increasing public debate on male infertility. But looking back over a longer time frame shows that for most of history, women have been blamed for childlessness. In some ways this has not changed since 1978, when firt "test tube" baby, Luise Brown, was born. Because IVF is a technology that intervenes on women’s bodies, it also reinforces the focus on how women’s reproductive systems might “fail”.

Miracle of life

Infertility remains an immediate and painful problem for many people today. Every year, an estimated 50m couples worldwide were infertile. We will never know how many people suffered from infertility in past generations – the numbers were never counted, but all indications are that rates are on the rise.

In modern western society we are taught in school how to avoid conception in every way possible way. Then, at some point, a turning point comes and our efforts are completely reversed. However, what we mostly didn't take away from school is that conception is actually a big coincidence and almost a small miracle. Instead of the most suitable contraceptive method, we look for the best advice and tips on how to get pregnant. After all, conceiving a child is not as easy as it might seem. There are some couples among us who don't have to make any effort and succeed on the first try. But these are the exception.

Pregnancy is actually a miracle. In fact, the probability that a well-timed sexual encounter between a healthy couple will result in pregnancy is at most 25%. That a woman can get pregnant at any time is a long-ago debunked myth. In fact, an egg has the ability to be fertilized a maximum of 24 hours after its release, i.e. after ovulation. Sperm are also not immortal, surviving only about three days in the fallopian tubes. The fertile period can therefore be considered to be a maximum of five days a month, rather less. The probability of conception decreases rapidly with age. No wonder, then, that infertility afflicts up to 20% of couples.

Assisted reproduction

A technology once perceived as equivalent to a miracle has come to be seen almost as a cure-all for fertility problems. The arrival of assisted reproduction brought infertility as an issue into the public domain – and led people to believe it was a modern problem that could be solved. But there are other reasons, apart from IVF, why infertility feels like a late 20th-century phenomenon. It was part of a series of changes, which began nearly 20 years earlier, that altered the way women thought about their own bodies.

Infertility treatment is very challenging and stressful, but proffesional help is very accessible. Many fertility clinics over the world offer the latest treatment methods. However It is adviced not to leave the help of professionals as a last resort. Many couples put off getting medical help as the very last option. As with trying to get pregnant spontaneously, age plays a major role in assisted reproduction. Treatment should therefore not be postponed.

The basis of assisted reproduction is ovarian stimulation, the aim of which is to obtain as many high-quality eggs as possible. It is with age that the quality and number of eggs decreases, and by the age of forty ovarian reserve is vanishing. Although men are slightly better off in this respect, it cannot be said that their reproductive cells are not affected by ageing. They can still produce sperm, but as they get older, more and more genetic defects appear causing impossible to fertilize egg.

You're not alone.

Pregnancy problems are due to the female factor in one third of cases, men are responsible for the other third and the last third is a combination of both factors. Lack of awareness can lead to feelings of disappointment, failure and loneliness. It is therefore good that infertility and its treatment are no longer taboo. And also - infertility is not an exception. There is no reason to be ashamed to seek help from fertility specialists.

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