Hesperian Health Guides

When you are not able to get pregnant (infertility)

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HealthWiki > A Health Handbook for Women with Disabilities > Chapter 4: Understanding your body > When you are not able to get pregnant (infertility)

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Disability does not cause infertility. Some women with disabilities will be infertile, but no more so than women who are not disabled. If a woman with a disability is infertile, it is usually not because of her disability.

What is infertility?

We say a couple—a man and a woman—is infertile if they cannot get pregnant after having sex together a few times a month for a year, without using a family planning method. A couple may also have a fertility problem if they have had 3 or more miscarriages (lost pregnancies).

A man or woman who has already had a child can also become infertile. A problem can develop after the last child was born. Sometimes the problem is not the man’s or the woman’s alone but a combination of the two. And sometimes both partners seem to be healthy and no doctor or test can find out what is causing the problem.

What causes infertility?

Infertility in a woman

a woman's reproductive parts, with scarring in the tube that keeps the egg from being fertilized.
blocked tube

The main causes of infertility in a woman are:

  1. Scarring in the tubes or inside the womb. Scarring, or thickened rough skin, in the tube can prevent the egg from moving through the tube, or the sperm from reaching the egg. Scarring in the womb can prevent the fertilized egg from attaching to the wall of the womb. Sometimes a woman gets scarring but does not know it because she does not feel ill. But years later she learns she is infertile. Scarring can be caused by:
    • an infection from an untreated STI that travels up into the womb or tubes (pelvic inflammatory disease or PID), or from tuberculosis (TB) in the pelvis.
    • unsafe abortion or problems in childbirth that caused damage or infection in the womb.
    • unclean conditions when an intrauterine device (IUD)—a small device implanted inside the womb to prevent pregnancy—was put in, which caused an infection.
    • problems from an operation on the vagina, womb, tubes, or ovaries.
  2. WWD Ch4 Page 82-1.png
    Ovary does not
    produce an egg.

  3. Problems with ovulation. If an infertile woman's monthly bleedings are less than 21 days apart, or more than 35 days apart, she may not produce eggs. This can be caused by her body not making enough hormones, or not making them at the right time. Sometimes this happens as a woman gets older and is close to the end of her cycle of monthly bleeding (menopause). Some women do not produce eggs if they gain or lose weight very quickly, or if they are too fat or too thin, or if they become ill.

  4. She has growths (fibroids)
    in her womb.
    a woman's reproductive parts, showing growths in the womb.

    Fibroids are tumors that do not cause
    cancer, but they can cause a miscarriage.

Infertility in a man

The main causes of infertility in a man are:

  1. He does not produce enough sperm.
  2. His testicles do not make healthy sperm. This can happen if he wears tight clothing that press his testicles close to his body, or if he works in a hot area, such as near boilers, furnaces, or engines—especially if he drives for many hours without a break. This can also happen if he sits all day, or sits for a long time in a hot bath before having sex.
  3. He cannot ejaculate because he has scars in his tubes from a sexually transmitted infection (STI), or he has a spinal cord injury.

Infertility in both men and women

a worker spraying a chemical on plants.

In both men or women, infertility can be caused by:

  1. Illnesses such as mumps, diabetes, tuberculosis, and malaria.
  2. Drinking alcohol, smoking or chewing tobacco, or using drugs.
  3. Malnutrition, too much stress, overwork, or exposure to some chemicals.

Creating a family through adoption

Some women with disabilities choose to create families through adoption. A woman may do this because she or her partner are infertile, or she has a health problem that prevents her from giving birth. Or she may decide to adopt a child simply because she believes it is a good way to become a mother and to make a family.

How I became a mother

When I was growing up, like most young girls in the US, I had a dream of finding a partner and having a family. But unlike most other young girls, I didn't believe it would come true. I use a wheelchair to get around, and I had no role models of women who used wheelchairs as parents. I had never been encouraged to think it would be possible for me to have my own family.

When I first met my husband, I was sure he was the right partner for me. He shared my secret dream of making a family through adoption. I knew there were many children who had lost their first family and were waiting for a "forever family." I knew in my heart we could be that family for the right child.

At first, my parents felt it would be unfair to my husband to "burden him with all the child care." They didn't think I could care for a child. Although I was nervous, I knew I had figured out how to do many things that others had said I would never do. I took care of our house, had my own job, and had cared for friends' children in the past. I knew my husband and I could do this!

We had to try several adoption agencies until we found one that supported our plan to become parents. We realized we couldn't change people's prejudices, so if an adoption agency felt our plan would not work, we just went to another agency. After we found a supportive agency, we showed them how well I could parent, rather than what I couldn't do.

Finally we were matched with a child who met our hopes and dreams. She was a wheelchair user, just like me. We were worried that the judge who had to legally approve the adoption might say no because of my disability. But he saw we were a great match and approved our adoption.

I feel honored to guide my daughter through her growing years, and to help her become the lovely and competent person she is now.
-Karen Braitmayer