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It might be helpful for Macchan and Sho-kun to consider not only their present selves but also their near future selves when making choices.

First, an egg is needed to become pregnant.Part4However, the cells that will become eggs are all produced before birth, and they do not increase after birth. In the ovaries, many egg-forming cells are called out in preparation for ovulation, and one of them is selected, matures, and is released. As you get older, the number of eggs decreases. Also, the eggs themselves age, and chromosomal and genetic abnormalities become more likely. As a result, fertilization becomes more difficult, and even if pregnancy occurs, miscarriages become more frequent.

The ideal time for pregnancy is when hormone levels are balanced, there are few problems with the uterus and ovaries, and the body, mind, ovarian function, and egg cells (the precursors of eggs) are healthy. This period is generally said to be between the ages of 25 and 35.

I used to think that the probability of getting pregnant was the same at any age when you were menstruating.

I often hear about "infertility" and "infertility treatment" in the news and newspapers, but what exactly does "infertility" mean?

If you want to get pregnant and have unprotected sex, it's generally said that you can conceive within six months to a year. So there's no need to rush from the start. Generally, "infertility is defined as not getting pregnant after one year of unprotected sex." However, if a woman has irregular periods and doesn't ovulate, or has conditions like endometriosis, it's expected that she may have difficulty getting pregnant. In such cases, even if the definition mentioned earlier isn't met, it's a good idea to consider the possibility of infertility and consult a doctor. Also, as both men and women get older, it becomes more difficult to conceive, so considering the possibility that delaying treatment may reduce the chances of success, it's sometimes better to see a doctor sooner rather than waiting a certain period. As you can see, circumstances vary greatly from couple to couple, so if you're having trouble getting pregnant or want to have children, it's a good idea to consult an obstetrician/gynecologist.

Is it okay if it's only women?

Since infertility can have causes on both the female and male sides, it's best to go with your partner.

Pregnancy is rare and precious, so it's important to take care of your body on a regular basis. As a first step, you should track your menstrual cycle and basal body temperature.Part2It would be good to be able to understand that.

Basal body temperature can reveal whether or not ovulation is occurring, the length of the menstrual cycle, and the length of the high-temperature phase, making it useful for medical diagnosis.

Okay, okay. What happens when you go to the obstetrician/gynecologist for a consultation?

Infertility testing for women typically begins with checking basal body temperature charts, performing gynecological examinations and ultrasounds, and testing for female hormone secretion. Hysterosalpingography (HSG) may also be used. For men, semen analysis is performed, and a urological examination is conducted as needed.

So it's about understanding the current state of reproductive function in both women and men, huh?

If a specific disease is diagnosed during the examination, treatment for that disease will be provided, and then infertility treatment will be carried out as needed. If no specific cause of infertility is found, treatments that are less burdensome on the body and closer to natural conception are often started first. These are called general infertility treatments, namely the timing method and artificial insemination. The timing method involves instructing the couple to have intercourse in accordance with the timing of ovulation, while artificial insemination involves injecting prepared and concentrated sperm into the uterus with a syringe in accordance with the timing of ovulation. With this method, even if the man's sperm count is low, a certain number of sperm can be delivered to the uterus. A small amount of ovulation-inducing drug may also be used in combination.

I've heard of the timing method.

When conventional infertility treatments fail to result in pregnancy, that's when assisted reproductive technology (ART) comes into play. Since ART has advanced so much these days, I'll talk about that as well.

Is assisted reproductive technology the same as in vitro fertilization, which I often hear about?

Yes, in vitro fertilization is included. Assisted reproductive technology involves handling eggs and sperm, or embryos, outside the body for treatment. When performed, various steps are necessary, such as egg retrieval, sperm retrieval, in vitro fertilization (intracytoplasmic sperm injection), embryo culture, and embryo transfer. Furthermore, in the case of frozen embryo transfer, embryo cryopreservation is also necessary.

Wow, so many different words suddenly came up!

In vitro fertilization and embryo transfer (IVF) literally means fertilizing eggs and sperm outside the body. It's a treatment where eggs collected from the ovaries are fertilized and developed outside the body with sperm, and then returned to the uterus. Then, the fertilized eggs are frozen and stored, thawed at the appropriate time, and returned to the uterus in the frozen-thawed embryo transfer method. For people with very low sperm counts, a method of injecting sperm into the egg is used in combination. This is called intracytoplasmic sperm injection (ICSI).

During egg retrieval, do they take one egg each cycle and try to fertilize it?

Not necessarily. As preparation for in vitro fertilization, hormones are used to stimulate the follicles and develop multiple eggs. Then, multiple eggs are retrieved at that time, so the egg retrieval process doesn't have to be done every time. The fertilized eggs are cultured until they are ready for transfer. In principle, only one fertilized egg is transferred, and the rest can be cryopreserved.
Preparations are underway to make many infertility treatments covered by insurance starting in fiscal year 2022. It's worth keeping an eye on the latest information.

For treatments with many steps, do you schedule the dates for tests and treatments to coincide with your menstrual cycle?

If you are working, you will need to coordinate your schedule with your infertility treatments.
Furthermore, tests and hormone injections are scheduled to ensure that eggs are successfully retrieved on the egg retrieval day, so hormone replacement and treatment schedules may affect work, as well as overall health.
The desire to become pregnant is a personal freedom and right, but communication with family, friends, and colleagues during fertility treatment and pregnancy cannot be ignored. It is important for everyone involved, both those directly affected and those around them, to take it personally and support each other for the sake of everyone's reproductive health and rights.

Sometimes the media reports on older mothers having children, but everyone is different, and I am me.

When spending time with a partner, it's important to communicate with them and share your thoughts and feelings.
Writing down what kind of life you want to live and what kind of career you aspire to, or talking about it with someone, can help clarify your own desires. Just because you talk about it doesn't mean you have to make it happen. People's hopes and thoughts change over time.

I never imagined that Sho-kun would become my partner either.

I never thought I'd be able to open a coffee shop either.

I guess it's important to think about your own hopes and also to leave things to chance.
My workplace is hosting an online presentation of role models (Knit a Network!Researcher Roundtable) There is that, but I learned that everyone has different life events and career paths, and I realized that there isn't just one way to live life.

Everyone has their own background, current situation, and hopes.
When I opened my coffee shop and when I quit my job, I received help from many people. I realized that to achieve my goals, I needed the understanding and cooperation of others. And I also learned that sometimes I need to be the one to help others.

Since starting the coffee shop, and listening to various stories from Macchan, Sho-kun, and others, I've truly come to realize that there are so many diverse lives, lifestyles, and ways of thinking.

It's me who, through talking with Professor Ebi and Ms. Kani, has gained new knowledge and insights into reproductive health/rights, and my previously vague career and life plans have begun to take shape.

I wonder if this has been of any help to Macchan and Sho-kun in planning their future lives?

Yes!