Infertility, Fertility, and Subfertility

 This is a more personal post that I sometimes write, but which will serve for an introduction into a planned short series of posts on this subject.

NB, while I will try to stick to neutral terms, many of my sources do not, so apologies if I appear to flip between gendered and neutral terminology. 

Infertility affects men, women, and those who identify as both or neither. Infertility doesn't care if you are married, single; old, young; gay, straight; poly or monogamous; what race, colour, nationality or heritage a person has. It doesn't care about any of those, or anything else. It doesn't discriminate, and neither should we. 

Definitions

Fertility

Fertility is defined as "the quality of being fertile, productiveness", and while it can refer to non gestational matters, such as the imagination, it is usually used to refer to the ability to conceive children or young of any species.

Infertility

Infertility is technically the absolute opposite of Fertility, as can be seen by the quotes below:

"...infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex." ~ CDC, USA

"a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse." ~ World Health Organization

"Infertility is when a couple cannot get pregnant (conceive) despite having regular unprotected sex." ~ NHS, UK

"Infertility is the inability of a person, animal or plant to reproduce by natural means." ~ Wikipedia

According to the WHO, there are three types of Infertility:

Disability - whereby infertility is caused by external factors, such as maternal sepsis or unsafe abortions. This is thought to predominantly affect developing countries.

Primary - the inability to carry a pregnancy to a live birth, ever

Secondary - when a person has had one (or more) live births, but is unable to conceive or to carry to live birth any subsequent pregnancies.

Subfertility

Subfertility is an underused term, in my opinion. Its definition is as follows: "Subfertility generally describes any form of reduced fertility with prolonged time of unwanted non-conception." ~ Gnoth et al.

Subfertility as a definition can be seen to hold a position on the continuum in between the absolutes of Fertility and Infertility. If fertility is the presence of the ability to reproduce, and Infertility the absence of that ability, Subfertility is the state whereby a person who can't reproduce may be helped.

It is notable, to me, that our local NHS clinic, is known as a subfertility clinic, rather than an infertility clinic. I like this, because for me it implies that their place is to assist people in moving towards Fertility, not in moving them Out of Infertility. 

I find that I dislike "Infertile" as a diagnosis as it feels fixed, insurmountable, and immutable. If you are infertile, then you have reached an absolute, a state which is unchangeable. Subfertile feels like a medical professional is acknowledging that you need assistance to achieve "Fertility", but that there is the potential to get there. You might need medication, assistive reproductive techniques (IUI, IVF), donor gametes, or a gestational carrier, but you have the potential to achieve "fertility"...

A Series?

So, I mentioned I plan to make this a set of posts. I don't plan to write and/or post them in any particular order, or without any other subjects else covered in between, but here is a rough list of my intentions:

1. How to get pregnant and when to be concerned
   Like many people, my Sex Ed at school focused on NOT being pregnant, and in many ways overemphasised the risks of sexual activities as MIGHT became WILL. This is intended to give a brief balance to that and then to state when you should go talk to a doctor.
2. Miscarriage - facts and support. 1 in 4 pregnancies don't make it to live birth, but we still don't talk about it. Miscarrying is horrid, but not something to be ashamed of.
3. Assisted Reproductive Techniques 1 - IUI
4. Assisted Reproductive Techniques 2 - IVF and related ICSI, IMSI, and IVM
5. Donor gametes, DNA, and genetics
6. Gestational Carriers & Surrogacy - you are still the parent
7. "Bingo!" - why saying "Think Positive" or "Just Adopt" will likely make the hearer want to poke you in the eye
8. Other ways to make a family

Needless to say, a lot of this will be UK focused, as that's where the plurality of my information comes from, but I plan to include wider international information where possible.

The intention behind this loose series is to provide a place to share thoughts and information with friends and relatives dealing with various aspects of this whole shitshow.