Recently, I wrote a post about the hilarious and exasperating journey of parenting small children. But for seven harrowing years of infertility, my wife Mary and I would have given anything to have children, no matter how hard it was.
Here are ten words I would use to describe how infertility feels:
We saw couple after couple get pregnant before us, our best friends included. When they told us, we high-fived them, then we went home, and hardly knew what to say to each other. We felt lost, sad, and even lonelier than before. We were excited for them; we were just very sad for us.
It's okay to go home and cry your eyes out when your friends get pregnant.
Everybody wants to give you advice, and some people say incredibly stupid things. My favorite: "You just need to stop trying so hard!" Some people want to know every excruciating detail of what you're doing to get pregnant. Suddenly, your most private details are the subject of casual conversation. Once people know you're trying, people want to know how it's going, if you've done artificial insemination, if you'd consider IVF, and how it felt in that small white room with the gross leather chair and the bad magazines.
It's okay to avoid the question, smile, and change the subject. Keep as many things private as you can (except to a few trusted friends).
3. On Hold
We were always checking the calendar, wondering if we should plan that vacation, or that work trip, because what if we're pregnant? Then we stopped doing that, because we would have never lived if we would have scheduled everything around a "what if."
It's okay to miss a month or two; you have to live your life. This is hard, but over the long haul, it will create more stress if you feel so trapped that you can't plan anything. We even found that it's good to take a month off now and then.
For women, there are so many things entering your body (probes, needles, drugs) and so many people measuring your progress. Even sex, at the mercy of a calendar or a temperature reading, can feel invasive. The loss of control can almost merge into a loss of self. But, it feels like once you've started down this road, there's no stopping until you get pregnant.
It's okay to say what you need, and it's okay to shore up your boundaries in whatever ways you can.
During one of the first visits where I was given the small cup and ceremoniously ushered into the small room, I actually ran into some people from my church afterwards. Of course they had their baby with them. I had a small cup that contained very personal contents with me. They asked, "What are you doing here?" I mean, what do you say?
It's okay to laugh at yourself sometimes. And when someone catches you with your cup in your hand, that's all you can do.
Unfair is the password that gets you into the infertility club. Mary tells a story of a friend asking her if she was angry with God. "No!" she blurted. "I'm angry at pregnant women!" She knew this was irrational, but she also knew that it was good for her soul to be honest in safe places. You actually may be angry with God, and you may need to find some safe places to be honest about that.
It's okay to express the darkness, even the stuff you're terribly embarrassed about, because it's good for your soul. But in the right places, with people who can handle it.
Even though it seems like a stressed out couple is less likely to get pregnant, the American Society for Reproductive Medicine finds that there is no proof stress causes infertility. Besides, trying hard to "not be so stressed about it" never worked for us. It also didn't help to "just stop trying." Everybody has a friend who was infertile for 73 years, and the day they stopped trying, they got pregnant. That never happened with us.
It's okay to be stressed. Don't stress about your stress. Trying hard not to be stressed is silly.
The cycle of hope and despair with infertility can take you out. I remember getting so excited when Mary was two days late, and just knowing that this time, it's going to happen! Then, a few days or hours later, when she told me she got "it," I would plunge into despair. The alternative is to temper your hope so that your despair doesn't get so low. After about a hundred months of experiencing this cycle, we found that the best route is to keep hoping, and if it doesn't happen, keep crying. It's too hard to pretend that you're not excited and that you're not depressed. Be excited. Be depressed.
It's okay to hope, and it's okay to cry. Keep hoping and keep crying.
This was not how it was supposed to be. This was not what you dreamed it would be. And you don't know how it will end.
It's okay if you don't know how to wrap your mind around your emotions. Be gentle with yourself for not totally having control of how you feel from moment to moment.
Every time you have to go through another kind of treatment, you ask yourself: Is it worth it? Do I really want it that bad? And then in the very next breath, you are taken out by the sheer magnitude of how much you want a baby.
It's okay to want and not want. That's normal.
If you're struggling with infertility, it can be such a dark time. You have to be out loud with each other about what you need, and every journey will be different. You have to give yourselves permission to do this journey in whatever way makes the most sense for you.
My blessing for you as you struggle: May God give you what you need, when you need it, over and over and over again.
1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
2. Regular menstrual cycles are a sign of regular ovulation. Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
3. Basal temperature charting does not predict ovulation. An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection. About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.
5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40's with fertility treatment are using donated eggs from younger women.
7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.
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