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Thinking about your own children having children of their own may be something that you can push aside for now. If you are even luckier, you may never even have to face the issue of your child having fertility problems in their adulthood. However, there are certain conditions that may be discovered at birth or later during childhood in both boys and girls that make it obvious that, if they become interested in parenthood, they will have to consider alternatives. Certain medical fertility conditions that may develop during infancy or childhood and their treatment may also carry a risk of subsequent infertility, if there is damage to the sex organs or the body's ability to make certain hormones. For assistance on this subject, feel free to call our office or email us for confidential help. Call: (708) 383-0808 or email: GRAC@magicfoundation to directly contact a parent of an affected child.
Talking with a child
When talking about such conditions, a child should never be told that he or she will not be able to become a father or mother. Such discussions should be gauged to the age and level of understanding of the child or adolescent. If appropriate, it may be reassuring to point out that parents of adopted children or children born using assisted reproductive techniques (ART) or are loved and become just as precious to their parents as children born the most common way.
Overview
Discussions can include the many options for parenthood including adoption, and assisted fertility techniques including donated egg or sperm. If a female has a well-developed uterus but ovaries that can not produce eggs, she may be able to be pregnant, except with a donated egg, which has been fertilized (in vitro fertilization, IVF) and placed in the uterus at the proper time. If a male has a low sperm count, medication may increase it. If necessary, sperm injection techniques may be used in an attempt to fertilize eggs. Among women who have ovaries that do not spontaneously ovulate, hormones can be used to stimulate ovulation.
Ovary or testes failure
When there has been a complete failure of development of the testes or ovaries, this means that sperm or eggs will not be produced. In these instances, if parenthood is chosen, donation of eggs or sperm will have to occur. Examples of medical conditions in which this would occur include most kids with Turner syndrome and other forms of ovarian dysgenesis (impaired development) and boys with complete failure of testicular development or loss of all testicular tissue.
In some situations, ovulation or sperm production may occur to a limited degree for a limited time during or just after puberty. Retrieval of eggs or sperm for freezing for use in the future may be advocated by some and can be considered. However, in such instances, the success of assisted fertility is uncommon. Further, if a person has one of the conditions that involve loss or mutations of chromosomes, the risk of passing these to offspring must be considered.
Lack of ovulation or inadequate sperm production
Another variation is the situation mentioned above, in which medication ran be given in an attempt to stimulate ovulation or sperm production. This usually is tried when production of various hormones is inadequate or not synchronized. In these situations, spontaneous pubertal development may never be completed without treatment. In these instances, hormones are first given to stimulate complete physical maturity. When physical development is complete, the individual is also capable of adult sexual function. Such people are physically normal adults with normal sexual function and it is not apparent that infertility may be a issue. However, such people may require hormonal replacement therapy to maintain their mature status.
The unique therapies used to stimulate sperm production is expensive, may involve injections and should be reserved for the time leading to the actual time when pregnancy will be attempted. Likewise, medication to stimulate ovulation should be given only when endeavoring to achieve pregnancy.
Other reproductive developmental problems
There are also conditions in which the ovaries can produce eggs or the testes sperm, but the rest of reproductive apparatus is not completely formed. Among males, this may involve inadequate development of the ducts or glands to provide for maturation and transport of sperm. A potential fertility assisted technique in this condition involves surgery or retrieval of sperm from within the testes and intracytoplasmic sperm injection (ICSI) into the egg. While success has been reported, it only occurs a small percentage of the time. Among females, the uterus may not be sufficiently formed to support a pregnancy. If the uterus is fully developed but the tubes connecting the ovaries with the uterus are incomplete, or the vaginal-uterus connection is defective, there is a potential for fertility using an implantation of fertilized egg(s) into the uterus.
Summary
The ovaries and testes have two functions – producing eggs or sperm, plus sex hormones. While fertility requires normal hormone levels and sexual function, normal sexual function can be anticipated after hormone replacement if necessary, even if fertility is a problem. Sex hormones stimulate puberty and maintain individuals as sexually mature individuals. Both males and females with failure of sperm or egg production, who have normal genital development and adequate hormone stimulation, can anticipate normal sexual function.
Contributing Medical Specialist
Peter A. Lee, M.D. Ph.D.
Hershey, Pennsylvania
If you need help, or want to speak to a parent of a child with a GRAC condition contact us at (708) 383-0808 or here online.
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Remember, MAGIC is made up of parents of affected children. If you need to speak to someone about your child, feel free to call us (9-4 Central time) or email us anytime! |
