Infertility

When I was first started writing this blog, I thought I’d cover both infertility and miscarriage in one swoop. However, as I began to research more, and talk to people, I realized that there’s so much to talk about for both subjects, that they both deserve their own blog. As a result, even though the two are often tied, I have decided to cover them separately.

Last week, I shared my thoughts on the pressures women feel to have children. This week, I want to talk about those that are among us that want more than anything to have children, but struggle to have it happen. These are the women that try whatever they can to have children, but either struggle to get or stay pregnant. A few weeks ago, I asked for ideas for this blog, and very quickly, this topic was suggested. It got me to thinking. The more I thought about it, in fact, the more I realized that so many women in my circle have been affected in some way.  It made me start thinking about how we have an entire population of people that are dealing with something so traumatic, and so private, that we may be friends with someone and not even know that they are going through it. Their stories are important. Their stories shape who they are and their families. Their stories could very well be our stories. Infertility and miscarriage don’t discriminate. When I truly started thinking about it, I started ticking off the women that I knew for a fact had suffered a loss, or had difficultly in having children. I was surprised at how long the list actually was.

Think of your own circle of friends. Think of the beautiful faces, the smiles, the person that they are. Now realize that among those faces, there are women that you know that are going through this pain. According to the Office of Women’s Health, one in ten women in the US suffer from infertility. One in ten. That’s roughly 6.1 million women between the ages of 15 and 44. That’s just one figure. Others (such as the Mayo Clinic) have that number as 15%. Resolve, another source I looked at, said 12%. Roughly, that is 1 in 8 couples trying to conceive that are unable, or have problems conceiving. Resolve also states that 7.4 million women have run into some sort of problem requiring infertility services in their lifetime. Think of the women you know in your life again, and realize that chances are high that at least one of those women has been affected by infertility. Maybe she’s one of your best friends. Or maybe she’s you.

I admit, when I started looking into this subject, I had no idea that the numbers were so high. Society makes it seem so easy, with the amount of pregnancy test commercials, Huggies ads, and happy families that are shown on TV. We only ever see the happily ever afters, never or rarely the struggle to get there. Think of all the shows you’ve seen with a teen pregnancy or a surprise pregnancy. Now, think of all the shows you’ve seen that discuss infertility. Can you think of one? I can’t.  Okay, I take that back. There was the one storyline on How I Met Your Mother where Robin finds out she can’t have children. However, it’s a blip on the radar, and is quickly forgotten in the narrative of the show. Her grief is one split second, and the its over. For so many women, trying to get pregnant is a heartbreaking struggle that takes a toll on their entire life. The only show that I’ve seen lately that even remotely tackles the subject is, ironically, Fuller House. Spoiler alert, for those that haven’t seen the show, but one of the characters discovers that she can’t have children, and has to tell those she loves about it. She decides to use a surrogate to have a child. However, those are two examples out of hundreds of TV shows. It’s a very real problem that has little to no representation in our media.

So, exactly what IS infertility? To put it simply, infertility is inability to conceive after 1 year of actively trying, or 6 months of trying if a woman is over 35. One third of fertility issues spring from the woman, one third from the man, and then another third is simply unexplained. Any part of the fertilization process can be affected, but most commonly, difficulties arise with ovulation, for a whole host of reasons. It all sounds terribly technical, doesn’t it? The truth is, as easy as it may seem at times for a pregnancy to happen, it isn’t easy at all. The stars have to align exactly even in the best of times in order for a pregnancy to occur. Even in healthy couples with no issues, the chance of a pregnancy occurring is somewhere between 20-25% in any given month. That means the window for getting pregnant is extremely small. I don’t mean for this to be a biology lesson, but it’s important to understand the science behind pregnancy. So many factors play into getting pregnant, including but not limited to: weight, smoking, drinking, eating habits, chromic disease, environmental factors, age, STIs, endometriosis, and so forth. That’s JUST for women. For men, these factors include smoking, environmental factors, health conditions, and some even say weight. Head spinning yet?

However, the biology of fertility can’t explain to people the pain behind the struggle to get pregnant. Infertility can overtake one’s entire life. As a couple tries to conceive, or carry a pregnancy to term, their lives focus on that one aspect. Careers, relationships and even marriages can fall victim. It’s a certain kind of stress that permeates every aspect of life, and can do untold damage. L, a friend of mine, had this to say about her struggle: “You go through years of ‘maybe this time. I feel really good about this time,’ and every time you fall, you crash even harder.” Another friend, Y, had something similar to say. “A month after we got married I had surgery to have them [tubes] untied. Thousands of dollars went into this but I knew that at the end it would be all worth it. Two years in the making, tears, happiness, cycle counting, ovulation kits, tracking and planning, exhausting doesn’t do justice what we went through while in the ‘baby making’ phase. Every month waiting to see if my period wouldn’t show up. It is all we did. It really took over our lives and marriage. It’s very hard when you deal with the disappointment of not being able to fulfill that gift of life that you are trying to give your significant other.” Let me tell you something, friends. Hearing these stories from two women I respect and admire broke my heart. There’s such a sense of hopelessness associated with infertility. As a friend, I don’t know what to say, or how to broach the subject without being careless or crass. Quite simply, I don’t think there are any words or actions that can suffice.

You see, infertility isn’t just about having a baby. There’s a sense of loss when it repeatedly doesn’t happen. Something that L said stuck with me, and really brought home how a woman’s identity can become wrapped up in becoming a mother. She says, “It feels like the most basic right of a woman, and I can’t make my body do it.”  Studies have shown that women with fertility struggles experience anxiety, depression, and increased stress, somewhat akin to Post Traumatic Stress Disorder. Other health issues can even stem from the grief associated with infertility. Marriages can crumble from the weight of stress added to the relationship from doing something that society deems easy to achieve. It’s heartbreaking, isn’t it? Motherhood is something that (most) women are programmed to want, and to be unable to achieve that for whatever reason isn’t just devastation emotionally, it can make a woman feel as though she’s a failure. Your body is supposed to know what to do to create, support, and maintain a pregnancy, and when that doesn’t happen, it’s all too easily to internalize those feelings as guilt.

I think a lot of times, we don’t see infertility as a loss, but it is. It’s a loss of ideals, of hope, of the gift of bringing a life into the world. It’s a loss of faith in your body, or maybe even your partner. It’s a special kind of disillusionment that brings on very real feelings of grief that need to be acknowledged. Loss isn’t simply the act of having something taken away, it’s also the absence of what you thought you could have. When a couple starts on the journey to conception, it starts with such hope, you see. However, every time she gets excited, thinking every cramp and twinge is the fruition of her dreams, and she is let down, it’s crushing.

Little by little, hope can be destroyed as a couple tries and tries everything to become pregnant. Yes, there are procedures that can be done, and many couples do them, but they are expensive, with no promise that the procedures will succeed. One of the most common procedures, in vitro fertilization, is a lengthy process that requires a woman to take different forms of medication to boost ovulation. The goal is to get her body revved up so to speak, and spike egg production, so that more than one egg is primed and ready to go to be fertilized. Once this is done, the eggs are retrieved via a long, hollow needle. Sperm is collected from the potential father, and then, egg and sperm are placed in the same petri dish. If fertilization occurs and the cells divide, the embryos are then placed into the woman’s uterus. All of this, not even considering the pain, discomfort and various side effects from medications, with no real assurance that at the end of it there will be a baby.

I know some of you may wonder, why would any woman go through that? Why would she put herself through that pain? I think the answer is simple. People are built with the drive to procreate. Obviously, not all want to, and that’s fine, but it’s that drive that keeps humankind going. It’s primitive, and as ingrained in us as the need to breathe. Wanting a child is not the same as wanting a chocolate sundae or a new car. Once that feeling starts within you, it’s all encompassing. There’s an ache that comes with it. After all, our bodies are built to make babies, but when it doesn’t happen, it can lead to feelings of depression, anger, guilt, and inadequacy. Yet, even with all the uncertainty, the pain, the discomfort and the loss, couples keep trying.  It’s not desperation, though I am sure some see it that way. In my eyes, is the epitome of strength.

So, why don’t we talk about this? If upwards of 6-8 million women are struggling at any given time to have a baby, why do we never hear about it. That is not a small insignificant portion of our society. In fact, it’s a huge chunk of people that suffer every day in silence with no outlet to vent. As I was speaking to my two brave friends about why no one seems to mention infertility, Y said, “People have made women feel ashamed for it and that’s the reason people don’t talk about it. It’s horrible. It’s such a lonely feeling.” Likewise, L stated, “No one wants to talk about it because it’s so painful for those going through it, and so foreign to those not.” Those are sobering thoughts, aren’t they? That we have friends, relatives, even in some cases people we are very close to that are suffering every day, and they have no public support. They suffer in silence because to share their story means to open up completely about what they are going through, and risk derision or blank stares. The truth is, infertility could happen to ANYONE. Yet, we bury the subject under the rug because it’s uncomfortable to talk about. I’ll admit, writing this has been uncomfortable for me, because I can’t see just facts and figures. I see faces of those I care about. I see their heartbreak, and their struggle, and the pain they feel without being able to talk about it. Just because it’s uncomfortable doesn’t mean we don’t have a responsibility to talk about it, or stand up and say that we support these couples.

What can we do? Honestly, I am not sure. We can open our hearts and ask them what it is they need in the moment. I think that we shouldn’t offer unsolicited advice or downplay the severity of what someone is going through. I think we should allow them to use our shoulders to cry on when they need to. I think we should offer unconditional support when someone opens up about their struggles. More attention from the medical community to find the reasons why infertility exists for some people, and better ways of managing it should be discovered. Most of all, we shouldn’t judge others. There should be compassion. This isn’t a bad haircut or a lost job. For many, it’s an agonizing, expensive journey with no assurances. We need to lift the women and mean that are hurting from these experiences up, and tell them, loud and clear, that they have done nothing wrong. There is no need for them to feel guilt. We need to let them know that the wars they are waging, though unseen, matter. THEY matter. Their mental and emotional fortitude should be an inspiration to us.

I realize I’ve talked mostly about women in this blog, but men also struggle too. This isn’t just a battle for women, but for both sides of a couple dealing with infertility. Both sexes should be able to talk about infertility freely, and openly, without scorn or judgement. Infertility is complex, with a vast amount of moving parts and its effects are wide reaching. For some, after all the struggle comes the light, and a baby is born. For others, that doesn’t happen, and that is an incomparable loss for them. Whatever happens, the journey is littered with tears, tests, medication, and determination. To L and Y, thank you for your bravery and candid discussion of your trials and struggles. I couldn’t have written this without you. I hope that I have done you proud. I can’t tell you how much I respect you both. I hope this discussion has made such a varied topic seem a little more real, and brought it home for those that don’t really understand. If these words start even one discussion about infertility, and the men and women that fight it every day, then I will be happy. Below, I will link some of the references I used in my research on infertility.

https://www.womenshealth.gov/a-z-topics/infertility

https://www.health.harvard.edu/newsletter_article/The-psychological-impact-of-infertility-and-its-treatment

http://americanpregnancy.org/infertility/in-vitro-fertilization/

https://resolve.org/infertility-101/infertility-faq/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113688/