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Most people who adopt infants, are infertile or believe themselves to be infertile. The infertility may be correctable by modern and often expensive techniques, may be a more serious problem requiring surgery, may be incurable or may be of undetermined causes, in which case the situation is called "unexplained infertility."

Despite dramatic newspaper stories about a skyrocketing infertility rate, experts at the National Center for Health Statistics say the infertility rate is about the same as it was years ago. The reason infertility is highlighted today is primarily because of large numbers of "Baby Boomer" couples who delayed childbearing until their late twenties or their thirties and now have decided to start a family. (Fertility declines with age. For more information, see FERTILITY RATES.)

There are probably also a greater percentage of individuals seeking treatment, aware of a variety of fertility treatments available today that were unknown a decade ago.

Couples who have been unable to conceive after one year should see a fertility specialist because many causes of infertility can be treated today. They should also contact a support group, such as RESOLVE INC., a national organization, which can provide practical information and emotional support.

Author Sharon Covington says dealing with infertility can be difficult because the medical community is sometimes unsympathetic, not realizing that patients feel their body is inadequate or has betrayed them.

Patricia Conway and Deborah Valentine wrote about the lack of sympathy given to infertile couples by their friends and family. Infertile men are advised to eat oysters or relax. Some friends are nonsupportive because they are uncomfortable around the infertile couple-they may be afraid or embarrassed to discuss their own pregnancies. Thus, the couple may be deprived of the opportunity to talk about their infertility and feel they should suppress their feelings.

Because of this lack of support, many infertile couples find great comfort and empathy in support groups (also known as "mutual aid groups"), whose members not only understand the problem but also provide information about REPRODUCTIVE TECHNOLOGIES and adoption.

The infertile couple may have attempted to achieve a pregnancy for years, even as long as a decade or more, before finally deciding what they really want is to be parents and then being able to give up the idea of a pregnancy and a biological child.

If the desire for a genetic link is not a paramount concern, infertile couples may turn to adoption agencies at this point. Unfortunately, they often find, to their dismay, the waiting period for an infant is likely to be a matter of at least two to three years and perhaps even longer.

They may be urged to adopt a child with SPECIAL NEEDS and may opt to do so. Some couples turn to INTERNATIONAL ADOPTION, successfully adopting their child from another country. Others may turn to INDEPENDENT ADOPTION. And still others will locate an adoption agency willing to work with them.

Hopefully, the social worker who counsels the adoptive couple will have a basic understanding of the pain of infertility; unfortunately, some social workers believe this pain should be completely resolved before the couple seeks to adopt.

Author Patricia Johnston describes this problem in her book An Adoptor's Advocate. According to Johnston, the social worker may presume that the adopting couple should have put the pain of their infertility behind them forever, completely having resolved all issues. Yet the scars from the pain of awareness of infertility do not dissolve overnight with the decision to adopt a child, and infertile couples who choose to adopt need to realize feelings of anxiety over infertility may never disappear altogether. Still, anguish over an inability to reproduce may fade away as the happy adoptive couple sees their child for the first time and lives a normal family life.

Later on, perhaps in adolescence when a child's sexuality and probable fertility becomes apparent, the parent may again mourn over his or her own infertility.

Author Christine Adamec, in her book Is Adoption For You? The Information You Need to Make the Right Choice, says that the following emotions are common to infertile couples:

Denial: "The doctor must have made a mistake. Someone mixed up the lab results. Something else happened."

Anger at Infertility in General: "Adoption agencies report that many adopting couples are very angry, not only about the unfairness of their infertility, but also about the many requirements they must undergo as prospective adoptive parents. They really hate the idea that they must prove their worthiness while people they perceive as incompetent parents can bear child after child, with no one asking them for references, no one making them undergo a physical examination or talking with a social worker or taking classes."

Shock and Powerlessness: "Infertile people often feel that they have been thwarted by their own bodies. They may also feel cheated."

Feelings of Inadequacy: "Some women say that they feel they are defective and maybe don't even deserve a child. They may feel unfeminine and unattractive. Men may feel inadequate, in the sense both of having a defective body and of not being able to give their wives what they want most." People may say such things as "He's shooting blanks!" compounding feelings of inadequacy.

Adamec says infertile women may feel angry and upset when they see pregnant women and become angry and distraught when their menstrual period comes yet again.

Occupational Status and Success at Adopting or a Live Birth

In one unusual study that compared the success of infertile couples at becoming pregnant or adopting, Canadian researchers found a significant link to their occupation and socioeconomic status. Specifically, they found a link between occupations that are considered in the higher echelons and success at becoming a parent. They did not find a link between income and success at becoming a parent.

The researchers studied 1,567 couples who consulted with physicians at 11 teaching hospitals in Canada. All had been infertile for more than one year. Six% of the couples adopted a child and professionals had a higher success rate at adoption than nonprofessionals. Researchers found the probability of adopting dropped if the infertility had lasted longer than three years.

Researchers also found that adoption was 1.64 times more likely when the male partner was a professional and 1.49 more likely when the female partner was in a professional occupation. (Professionals included people in management, science, social science, religion, teaching, health and the arts, as opposed to individuals employed in service or industrial careers or who were unemployed.)

Said the researchers, "Partnerships in the higher occupational strata were more likely to achieve livebirth or adoption and less likely to become lost to follow-up. The effect of occupation was similar with respect to both pregnancy and livebirth; also, in repeated analyses using different occupational variables, the upper stratum of the occupation range was consistently associated with pregnancy and livebirth, and the association is independent of treatment."

Even when expensive treatments were taken into account, such as in vitro fertilization, this did not change the findings.

Although they could not identify the factors that caused the higher success rates professionals enjoyed at becoming parents through adoption or live birth, researchers speculated that individuals at higher socioeconomic levels may be less likely to smoke and more likely to be healthy. They said, "it is possible that a better socioeconomic status conveys an effect on fertile health that is consistent with the effects of social class on mortality and morbidity."

Christine Adamec, Is Adoption For You? The Information You Need to Make the Right Choice (New York: John Wiley & Sons, 1998).

John Collins, M.D., et al., "Occupation and the Follow-up of Infertile Couples" Fertility and Sterility, 60, no. 3 (September 1993): 477- .

Patricia Conway and Deborah Valentine, "Reproductive Losses and Grieving" in Infertility and Adoption: A Guide for Social Work Practice (New York: Haworth Press, 1988).

Sharon N. Covington, "Psychosocial Evaluation of the Infertile Couple: Implications for Social Work Practice," in Infertility and Adoption: A Guide for Social Work Practice (New York: Haworth Press, 1988).

Robert R. Franklin, M.D., and Dorothy K. Brockman, In Pursuit of Fertility: A Consultation with a Specialist (New York: Henry Holt, 1990).

Patricia Irwin Johnston, An Adoptor's Advocate (Indianapolis: Perspective Press, 1984).

Judith Schaffer and Christina Lindstrom, How to Raise an Adopted Child (New York: Crown, 1989).

Stephanie E. Siegel, Ph.D, Parenting Your Adopted Child: A Complete and Loving Guide (New York: Prentice Hall Press, 1989).

Find more information on infertility

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