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Teenage infertility

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Under what circumstances or in what kind of situation would a teenage girl become aware that she probably won't be able to have children, and for what reason?
#1 - February 20, 2012, 12:09 PM
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You'll probably want to do more authoritative medical research, but I had a friend who discovered as a teen that she had two uteruses and they didn't think she could bear children.  And on ONE DAY AT A TIME, Valerie Bertinelli's character found out she couldn't have children.  IT was weepy-sad.

Maybe lack of menstruation or unusual menstruation could be a clue.
#2 - February 20, 2012, 12:17 PM
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***TMI Warning***

I have a personal story that might help with your research.

I was aware from a young age it would be hard for me to have kids. I was having irregular periods, going months (sometimes more than a year) at a time without a period, and then when I did it could be anything from mere spotting for a few days to a very heavy flow for weeks at a time. I think I was 17-18 when I first wondered if something was wrong (after talking with some girl friends I realized I wasn't normal, lol) and went to a gynecologist and had bloodwork done, in addition to my annual exam.

I was told then that my hormones were just evening out, that I could go on a birth control pill if I wanted to regulate things (I didn't particularly--let's face it, not having a period is kinda a plus), and if I wasn't worried about having kids any time soon (I wasn't) not to worry. I was told to come back in my early 20s if things were still a problem.

Well, I did. Same problem. Around 21ish I was told basically all the same things. Except this time it was, if you aren't worried about having kids right now and you don't want to take the pill, just come back in a few years if you're concerned.

Fast forward several years. At 26 I was still having the same problem. They did more bloodwork and an ultrasound to see if I had PCOS (Polycystic Ovarian Sydrome), which is incurable. Everything came back in normal ranges except I had slightly high blood sugar and slightly elevated testosterone and androgen hormones, I think. I was told to lose weight, eat healthier, and work out more. I was also prescribed Metformin, just in case, to help with the blood sugar. This was a bad move, as two years later it kept me from getting private insurance under suspicion of PCOS or Type II diabetes (Metformin is a drug for diabetics, but it has been shown to help in some instances with fertility). The horrible thing was I only took the drug for about 2 weeks and hated it so I quit.

Now I'm married and struggling with infertility at 31, so it's back to the doctor with me next month to check things out and to get things started.

That's the long story. The short story is, I knew by around 16 I'd have problems getting pregnant easily. Of course, back then it was just a suspicion. 15 years later, that suspicion has been definitely confirmed.
#3 - February 20, 2012, 12:23 PM
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If you have a growth hormone issue, you might possibly have difficulty--I haven't heard a doctor say that you 100% won't be able to have children, but that might be because they don't want to sound discouraging. But if you are already on growth hormone to survive, and they try to let you go through puberty on your own and it doesn't work and they have to give you hormones artificially--well, that might do it. The one person I know in this situation has not tried having children yet--but I know it's a possibility.
#4 - February 20, 2012, 12:29 PM

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Thanks for the ideas, Anne Marie. I do plan on doing medical research once I've got a better idea of what my character's situation is. She does have irregular periods, maybe I'll do a google search with "irregular periods," "infertility," and "teenager girl" and see what turns up.

Thank you for sharing that story, andregirl. It's helpful. Good luck with everything!
#5 - February 20, 2012, 12:33 PM
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Endometriosis could do it. I had that and knew as early as 13, and it often leads to infertility. I was told to get pregnant quickly. ;)
The teenager could have an ovary removed (that happened to my aunt because she had a cyst on it) and it made fertility an issue. She could go through chemo...
#6 - February 20, 2012, 01:04 PM
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Robin, I was just going to post about endometriosis! My cousin had it, and it did create fertility issues, as she was told it could. She ended up never being able to conceive (but has two wonderful adopted daughters!).
#7 - February 20, 2012, 01:06 PM

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She does have irregular periods, maybe I'll do a google search with "irregular periods," "infertility," and "teenager girl" and see what turns up.

Thank you for sharing that story, andregirl. It's helpful. Good luck with everything!
Thank you. :)

Oh, another way she could know is if she had a tubal pregnancy that had complications and needed to be removed to save her life. That happened to someone I knew once.
#8 - February 20, 2012, 01:21 PM
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My first thought was also endometriosis. It may or may not mean irreversible infertility. I don't know if advice today has changed, but since having periods over many years increases the scarring, having your kids as early in life as you can is a help. Hormonal imbalances that can be evened out by medication are also a possibility if you want something non-tragic/reversible.

I also know someone who had extreme fibroid tumors already as a young woman. So extensive that she would miscarry her pregnancies because growth of the placenta was stymied by lack of enough healthy uterine lining.  

The following are admittedly horrendous stories, but both are true.

A friend of mine has a cousin who went to the doctor at age 16 b/c she'd never had a period. Turned out she had no, and I mean NO, female organs except for ovaries, which was why her puberty seemed normal in every other way. This poor girl had to undergo plastic surgery before she could even have a sexual relationship. It all had a happy ending: she married a widower with children, so there was her family.

The second event is that a 16-year-old girl had "female cancer" -- don't know precisely what kind, and needed a complete hysterectomy.
#9 - February 20, 2012, 01:22 PM
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My first thought was also PCOS. (Andregirl, my BFF has it, and has had three successful pregnancies!) My second thought was that some cancer treatments (like for leukemia, maybe?) can damage the ovaries/eggs. But that might be getting into way more complications than you want in your story.
#10 - February 20, 2012, 01:32 PM

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Thanks everyone!
Here's some relevant information that may be helpful.
The character is 16, has irregular periods, but is otherwise healthy (cancer is definitely not in the storyline, but thanks for the input). She is thin, not skinny - just average (weight is not the cause of her infertility). I need the discovery of her infertility to happen at the end of the story, brought to her attention by an episode of extreme abdominal pain and possible passing out. Also, she was put on birth control right around the time she began menstruating, but stopped after a year or so (don't know if that is relevant)
#11 - February 20, 2012, 01:41 PM
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That sounds like PCOS to me - some kind of growth on an ovary can cause extreme pain and irregular periods. The ovary could end up needing to be taken...
#12 - February 20, 2012, 02:00 PM
Robin

Untreated chlamydia can cause infertility, if that fits into her storyline.

I also had a friend who discovered as a teen that she had PCOS and was told that she would "never have children without medical assistance." She was not overweight as a teen, although my impression is that being thin was never effortless for her.She later did have children (twins) with medical assistance -- and I know others with PCOS who have successfully had children. I don't know whether your story requires incurable infertility or not.

In any case, if you want to go with the PCOS angle, I could ask my friend if she'd be willing to email you and discuss. She's pretty open about the whole thing, and now that she has 2 kids the painful part of it is behind her, so I think she might be happy to talk to you.
#13 - February 20, 2012, 02:05 PM

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My one niece was very thin and did not have a period for a long time, I moved before they finally diagnosed her at 18, mostly she didn't care until she became 17 and realized she was very different from everyone else.

I on the other hand had endometriosis and by the time I was twenty had it so bad, I knew I would never have children although it was suggested that if I tried to get pregnant it might ease the problem.  I was not in a relation at the time and wonder if the doctor thought I should just go out and wave someone down that I thought looked like a good candidate.  "YO, you want to make me preggers?"  Never happened.
#14 - February 20, 2012, 02:25 PM
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If she has an ectopic pregnancy (google it) and it ruptures, then they often have to remove the ovary and fallopian tube to save her life. (Or the fallopian tube is simply destroyed from the rupture anyway.) Granted, you get two ovaries to start with, but if there were some complication...dunno. It would make it 50% harder, at least. (This is something that could easily have happened before the book, without a lot of "teen-pregnancy" drama in her history....I think ectopics can believably rupture before the person realizes they are pregnant?)
She could also be a carrier for a genetic disease she doesn't want to pass on - for instance, she could have a family member who has/had Huntington's disease, so then she gets tested and learns she has the gene. That's a common one for this kind of scenario.
#15 - February 20, 2012, 02:33 PM

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I had a sister that had irreversible early onset menopause due to low body fat and intense exercising.  She was at the time a marathon runner....logging 10 to 15 miles daily. It was very sad.   Body fat regulates hormone production especially those which trigger ovulation. 
Chemotherapy also affects egg production.  That too might influence fertility....in a teenager? I'd research it.
#16 - February 20, 2012, 03:29 PM

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Ovarian cysts that burst was my first thought.
#17 - February 20, 2012, 05:35 PM
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Ovarian cysts that burst was my first thought.

This was also my thought when you said extreme abdominal pain. Good luck! : )
#18 - February 20, 2012, 05:56 PM

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My initial thought was to go with an STD like pelvic inflammatory disease (PID) or something along those lines, but I didn't want the story to end on a preachy note. i.e., if you have multiple partners you are going to get an STD and ruin your future life...  But I've got some good ideas from all of your suggestions! Thanks again!

#19 - February 21, 2012, 07:08 AM
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My initial thought was to go with an STD like pelvic inflammatory disease (PID) or something along those lines, but I didn't want the story to end on a preachy note. i.e., if you have multiple partners you are going to get an STD

You don't need multiple partners to end up with an STD, esp chlamydia, any more than you need multiples to end up pregnant. One time is all it takes. One of my close friends in high school had only been w one guy, & she was mortified to find that she had an STD.  (Twelve years later, she had two kids and reasonably fine preg & deliveries.)

I was 16 when I was told that I couldn't have kids  bc of a combination of severe scarring from rape & the STD he left behind that I only learned of when I developed a PID.  It influenced my decisions for college (goal: teach so I could have summers off, plan to adopt), my dating choices, everything.  One of my kids was a bio-baby, but pregnancy was not easy (surgery, bedrest, miscarriages). Delivery was harsh bc of the scar tissue, & it was only a particularly fab OB who agreed to my choice not do a c-section unless the baby was at risk.

So either unfaithful boyfriends or a Bad Thing are options as well for learning of infertility early on.
#20 - February 21, 2012, 03:09 PM

Wow, Melissa. I don't even know what to say. But :hug
#21 - February 21, 2012, 08:34 PM
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Wow, Melissa. I don't even know what to say.

No need to say anything! It's just another example.  Sometimes sh!t happens.  More girls will face infertility bc of boy's actions (infidelity or rape) than genetic anomaly.  Cysts and endo might be probable, but endo is not as typical for teens as it is in women.  I think maybe when a lot of us were teens, the doctors might have been more willing to say "infertile," but I think a lot of Gyns are more cautious these days. 
#22 - February 22, 2012, 09:55 AM

I had a friend in high school who ignored the symptoms of her STD until it got so bad one of her fallopian tubes ruptured and the other was scarred beyond repair. That would definitely cover the abdominal pain. Her parents rushed her to the ER thinking appendicitis. And you don't need multiple partners - she had one; he'd had many.

#23 - February 22, 2012, 04:38 PM

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Melissa, thank you for sharing your story. When I said "multiple partners" what I really meant was unprotected intercourse with multiple partners. I worry it might sound like I am trying to send a message to my readers that isn't the point of the story.

In any event, I think an ovarian cyst or PCOS is a good possibility for the story. I was also thinking that my MC may have been born with only one ovary, I'm just not sure where the extreme abdominal pain is coming from, which I now have to research.
#24 - February 24, 2012, 06:47 AM
« Last Edit: February 24, 2012, 06:51 AM by Michelle J. »
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My sister-in-law had a ruptured appendix that scarred and damaged her reproductive organs. It made it very hard for her to conceive, although she eventually did. Perhaps in your story, the damage could be worse so that the character could not have children. It certainly caused abdominal pain.
#25 - February 24, 2012, 07:29 AM
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Being extremely underweight can cause really irregular periods.

My sister had kidney and general urinary tract issues in her teens (constant urinary tract infections). In exploring reasons for the UTI's, her doctor uncovered possible reproductive issues.
#26 - February 24, 2012, 08:42 AM

My mother was seventeen when she became pregnant with me & after she had me that she had blocked fallopian tubes. It made her infertile & she was told she was lucky to have pregnant at all.
#27 - March 02, 2012, 12:39 PM

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