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This blog addresses various emotional aspects of experiencing infertility. It is written by a clinical psychologist who specializes in infertility counseling. Thank you for reading, and best of luck with your journey!

Thursday, April 21, 2011

Are some types of infertility evolutionarily advantageous?

I read a really fascinating article in the most recent issue of Fertility and Sterility, which can be found here. The article, by Azziz, Dumesic, and Goodarzi, discusses the ancient existence of polycystic ovarian syndrome. The authors investigated how a disorder, which causes subfertility or infertility, could still persist at a relatively high level in modern times--theoretically, wouldn't it have been "bred out" of the species? It appears that increasing rates of obesity in Western cultures has not caused an increase in the rates of PCOS, so it is unlikely that change in diet has increased the prevalence of PCOS in moden times. The authors offered an intriguing explanation--that for much of human history, having PCOS has actually been advantageously adaptive, meaning that women with PCOS were more likely to survive and pass on their genetic material to the next generation.

It seems likely that PCOS actually had several adaptive advantages. In hunter-gatherer societies, food was often scarce. Women with PCOS, because of their insulin resistance, use food resources more efficiently. Their capacity to store food energy is greater, and they expend fewer calories, making them better able to survive times of starvation.

Further, because PCOS frequently causes subfertility rather than total infertility, women with PCOS had fewer children spaced farther apart in time. This was advantageous in a number of ways. With no or limited birth control, women often spent much of their life pregnant or giving birth. Even in the recent past, childbirth was extremely dangerous for women and was the top cause of female death. Thus, limiting the number of childbirths increased a women's likelihood of survival. In addition, by having fewer children, women with PCOS were more able to secure their children's survival--they more easily garner sufficient resources for them. Furthermore, children were more likely to survive if they were being raised by their biological mother, so the fact that women with PCOS had longer lifespans further enhanced their children's survival rates. In sum, it seems that for most of human history, having PCOS was actually a blessing, not a curse.

I think that looking at PCOS from the evolutionary perspective in this article has some valuable psychological implications. Most importantly, I think it is useful for anyone who is currently struggling with PCOS to realize that the disorder actually has some very important adaptive advantages. This will help them have more positive and less conflicted feelings about their bodies. Too often in infertility treatment, we end up feeling as if our bodies are vexing or failing us. Realizing that our bodies are actually trying to help us, although admittedly in a frustrating way, can be a reparative experience.

Looking at PCOS from an evolutionary perspective also made me wonder if there are other infertility diagnoses that have some of the same survival advantages. For example, could premature ovarian failure similarly enhance a woman's, and her offspring, chances of survival? When dealing with infertility, it is very easy to forget that for many men and women, both throughout history and in the present-day world, fertility has actually made their lives incredibly difficult. Perhaps the grass isn't always greener on the other side of the fence after all.

4 comments:

  1. would be interested to know your thoughts on chromosomal translocations. I have wondered if, in some weird way, this could be part of how we evolve, through mutating our chromosomes (we used to have an extra set, didn't we, until it merged with another one?)
    I'm guessing not, but it might be a topic worth kicking around

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  2. very interesting post, Lisa..
    by the way congrats on being featured on the fertility blogs :)
    wishing you all the best
    Heather

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  3. How i got a cure for PCOS (polycystic ovary syndrome).

    I actually promised myself that i will do this because i never in life thought i would be cured of PCOS because my gynecologist told me there was no cure and because of this i could not take in and get pregnant. I had PCOS (polycystic ovary syndrome) for 7 years and this was a big pain to me and my husband due to the downcast we felt for not having a child. I experienced irregular periods or no periods at all sometimes, heavy periods, i gained weight (fat). I seeked a cure from one doctor to the other used androgen, clomiphene, metformin and even traveled to different states to see other doctors to no avail. My husband got to know about Dr. ALeta via a testimony he read on the internet on how a woman got a cure and he contacted her with the contact she left. I got the herbal medication and used it for the speculated 3 months that was all i have a son who is just 8 months old. Do not give up just contact her on (aletedwin@gmail.com) on how to get the herbal medication. Thanks and i wish you get cured soon too.

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