Coping With Infertility
Our CT infertility program has been getting a lot of mail lately.
A lot of baby announcements.
Reminders of what we do and why we do it.
To create loving families.
To add to loving families.
For those of us still waiting, we wonder.
Will I be the one who doesn’t conceive.
Will I be the one who doesn’t have my baby.
Will I alone, be the only one who doesn’t have my family?
Will I be the patient that never leaves this infertility program?
Because the hard part is that there are no guarantees.
No one will say, “yes, after 1 year, 2 years, 3 years, you will have a baby”.
So we wait.
We wait with you.
We talk with you, laugh with you, cry with you.
We wait together with you.
You are not alone.
We know it’s hard.
No one wants to be the one left without a baby.
We’re here, with you.
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First, you need to want a baby.
I know that sounds kind of silly, rather obvious.
Except that some of us start this process not quite sure.
True confessions here. Something I've never spoken about here or anywhere else in public.
This is something that I've never actually talked about before, with anyone.
When I first wanted a baby, there was a definite sense that it was the next step. We met young and got married young.
We both had established careers and had advanced degrees in education.
Even though we were still young, babies seemed like the natural next step. The natural next step also, according to society. In other words we were hearing the questions that many of you are familiar with.
"When are you going to start a family?"
"Do you think you might have good news by the holidays?"
"How long are you thinking to wait for children?"
And on and on.
Here's the point though, for me.
Was I ready for children or was it really just the next expected step?
Secretely, I think I wasn't so ready.
Infertility though, then made me feel hyper ready. I went from wanting a baby, in a relaxed way to wanting a baby in a far, far less relaxed way.
Was it because it was proving to be difficult and therefore was more alluring?
I don't mean to minimize any of this. Alluring, appealing, inviting; none of those words express the depth and strength of my desire for a child once it became difficult. Once it became obvious that conceiving wasn't coming easily, my feelings became so much more intense, almost obsessed.
I wonder whether that was because infertility led me to understand how important having a child was to me or because it was something that maybe I wasn't going to be able to have.
It's possible that this is the place where I stand alone. Maybe I am the only one who only kind of, sort of was ready to have a baby. Maybe you all are more committed and have looked at your feelings more closely.
Maybe, though, there are one or two of you out there that were like me. Not quite sure.
Not quite ready.
Infertility Basics would have to start there.
Are you really ready? Is this what you really want?
If infertility becomes part of your path to a child, being truly ready makes it an easier path. And if you're not truly ready, infertility may help get you there.
I'm blessed to be able to speak to fertility patients and Fertile Yoga students all the time.
I hear you all wondering about these things. Taking breaks to have your "real life". Asking out loud about adoption. Considering childfree.
I applaud you. All of you.
There's a lot of conversation going on in the fertility world these days about having your own child. Or having a child "naturally".
Science, medicine and technology are all amazing things. I am awestruck when I realize what we can do with eggs, sperm, embryos and genetics.
We can separate one sperm from millions of others (ICSI) and insert it into an egg and see it fertilize and become an embryo. We can then remove cells from that embryo and test them to see if the chromosomes in that embryo are healthy and viable. We can then transfer that healthy embryo back into the uterus, knowing that the chances of pregnancy occuring are very high.
If necessary, we can use sperm from a donor, eggs from a donor and a gestational carrier to carry the pregnancy to term.
Maybe some would say that there's something unnatural about all that.
I get that it's more complicated than having sexual relations and becoming pregnant.
But there's nothing unnatural in using human eggs and sperm and creating a baby that is wanted so much that adult human beings are willing to go to such lengths to help bring into this world.
We're not talking about manufacturing eggs or sperm.
Every human being in this world who has ever lived has been conceived from a cell from a male and a cell from a woman.
Including the babies described above.
Those babies too, come from one cell from a man and one cell from a woman.
Nothing at all high tech about that.
Nothing at all unnatural about that.
And in case I haven't convinced you, look carefully at these babies.
Are they loved?
Are they cherished?
Is there anyway at all that you could pick them out from any other babies?
One female cell. One male cell.
Pamela Madsen, my best friend and fellow fertility blogger, wrote a wonderful essay, many years ago, about waiting for babies.
It was an essay, blogs didn't exist back then. I am not entirely sure that laptop computers even existed back then.
She spoke poignantly about waiting with her two closest friends for their babies to come into the world.
I was one of those friends.
I'm reminded of this because I now have the immense joy and pleasure of seeing my fertile yoga students become pregnant.
And, like all of us at rmact, we hope that each pregnancy ends in a baby. We mourn when a pregnancy ends abruptly and there is no baby.
We ooh and ahh over the baby pictures and luxuriate in the joy of our students, our patients with their new family.
We wait. We hope, we mourn and we rejoice.
And we do it together.
While we work and wait for these babies to arrive.
We wait together.
Ladies Night In this week. RMACT Danbury office on Wednesday. RMACT Norwalk office on Thursday. Please call Carrie Van Steen at 203.731.2520 ext. 289, for all the details!
It's beautiful here, at the beach.
Walking, the sun is shining and bouncing off the water energetically, sending sparkles in every direction.
There are children everywhere, in all stages of growth. Babies, toddlers, youngsters, tweens and up.
Pregnant women too.
It's hard to tell if the adults that are hauling bucket after bucket of water for sand castles are parents, grandparents, older siblings, aunts and uncles or family friends.
One can't make assumptions about that anymore.
My sister, who is walking beside me is a member of a happy family. She is content, fulfilled, happy and in love with her husband of 19 years.
She is also childfree by choice. Not infertile.
We both admire the families that we see around us. Giggle at the adults racing after the little ones, just trying to keep up.
These families look very little like the ones that I grew up with.
The families that I grew up with had very different make-ups. Mainly, they were young mothers, many of whom who worked. They were young fathers, all of whom worked. There were grandparents who helped out regularly, with childcare, cooking, cleaning and more.
There were very few divorces. There were very few parents in their 40's and 50's.
Occasionally, there was an "oops' baby. A family, with teenagers, all of a sudden with a newborn.
There were a few of my friends who had much younger step siblings because of a divorce and a new marriage.
These situations were unusual.
These days, families have blossomed into many different configurations.
It's hard to tell who's who in a family anymore. Who's a parent, grandparent, aunt, uncle, sibling or family friend.
Or maybe, it's just ridiculously easy.
A family is made up of love.
And that does look all different ways.
That is not always a child born of your blood or union. That is not always a child who lives in your home.
There are happy, content, fulfilled families that are devoted, committed, and connected to children and who are not parents.
I know. I'm lucky enough to be related to two such people. Two sisters who are childfree but are still members of our family.
Friends who are not related in any way by blood but are family, none the less.
Those are the things that make up family.
If you have a baby, does that make you fertile?
What if you go through 3 IVF cycles (in vitro fertilization cycles) before you get pregnant and have a baby, does that make you fertile?
When and do we ever get rid of the infertility label and stigma?
Many of us do continue, after our children are born, to let people know that we've had difficulty creating our families.
Some of us never speak about our infertility to any of our friends, family or colleagues.
We come in all shapes, sizes, color, backgrounds; united in a desire for a family. Despite our differences, whether we get together online or in person, we talk, we ask questions, we laugh, we cry. Our differences melt away as we talk the common language of fertility.
I got this wonderful comment about a blog I wrote over a year ago. A Naturopathic doctor, from Australia, wrote to comment on how helpful she found it to read a blog that truly seemed to understand infertility.
From Australia. I love it. Really.
We all have our reasons to talk or not talk about our struggles with infertility. And I respect each and every reason that I've heard in the last 22 years.
It's scary though, sometimes, when you hear the level of desperation, isolation and shame that is so often hand in hand with fertility problems.
Brings me back to the question.
Do we ever stop being infertile?
We don’t want to be pregnant. We don’t want perfect eggs or perfect embryos or perfect cycles.
What we want are babies in our arms.
When miscarriages are experienced, we don’t necessarily enjoy the next pregnancy. Even after we pass the time of our previous miscarriage, we don’t go on to enjoy the pregnancy. As one of my Fertile Yoga students said this weekend, she’s just waiting for the other shoe to drop.
When we undergo fertility treatment, we know that sometimes it’s successful and sometimes it’s not. Pregnancy rates vary from infertility program to infertility program; you can check on the SART (Society for Reproductive Technology) website to see what they are for the programs in your area. And while we understand that sometimes fertility treatment doesn’t work, we don’t really understand it, especially with IVF (In vitro fertilization).
With IVF, we know that we are transferring fertilized, dividing embryos back to the uterus. Sometimes we literally see the cells dividing, under the microscope at our programs. We know that they are alive and well and functioning just as they are supposed to, to become babies and children.
So really what happens is that each IVF cycle becomes a loss. A miscarriage. While no pregnancy test has come back positive, we know that egg and sperm had met, the egg had fertilized and that there was an embryo dividing and alive.
And when that pregnancy test comes back negative, we feel a loss. That embryo is no longer alive, no longer has the potential of the baby we are dreaming of. If we’ve had positive pregnancy test results that have ended before our baby is born, believing in the positive results next time because even more challenging.
So if you’ve been struggling with infertility, been in treatment, had positive pregnancy tests and then find yourself unable to enjoy the positive test, give yourself a break. The anxiety of “will it work better this time?” can be nearly insurmountable. The inability to feel happy actually makes perfect sense. Especially to a heart that has been wounded by infertility.
So maybe the best advice that I can give you is that if you are not jumping for joy with a positive pregnancy test, especially with past losses, you are not alone. And it is ok. Perhaps at some point, you will be able to enjoy the pregnancy.
If not? Perhaps the very worst, if you do experience a healthy pregnancy that you feel anxious through? Nine months later, the pregnancy will be over and you will enjoy your baby.
And that would be a happy enough ending for most of us.
The holiday season is now in full swing. Christmas songs are all over the radio, holiday lights are up. Parties have begun. Drinking, eating, celebrating, and oh yeah, shopping.
I went into four major retail stores, touted to have everything one needs for the holidays to get Chanukah candles and came away empty handed. A menorah, to be lit each night, needs forty four candles. Chanukah candles are sold in boxes of 44, usually easily found. Sometimes they are handcrafted, hand dipped, specially decorated. I was content for the incredibly inexpensive, somewhat homely mass produced kind.
Nothing. Zero. Nada.
Even for those of us who don’t celebrate Chanukah, we know about menorahs. It’s a mainstay of Chanukah. See, even my Microsoft word program capitalizes it if I forget! So I won’t even go into a tirade about how Christmas takes over the stores and that there are rows upon rows of green and red, as far as the eye can see in any store you walk into. I won’t go on and on that the Chanukah section is perhaps four feet wide if there is one at all. I’m used to that.
I’m not used to not being able to find Chanukah candles. In the stores that I went into, I asked for them and was shown fake candles. Yes, that’s the new thing. Fake candles that don’t light up and present a fire hazard. Ok, I guess I get it. I think though, that I might even have been appeased to have found an electrical menorah. Nope, none.
It hit hard. I knew that my reaction was moving deeper than my inability to find forty four ugly candles. It was being in the minority, being outside looking in; feeling the edges of the warmth of the season and not truly feeling warm or welcome.
Same exact feelings I had looking at babies and strollers and mothers. Because of course, all the stores are about shopping. And so much of that shopping is about children. There's Santa Claus, holding court, with child after child confiding in him what their secret wish is. Standing on line, sometimes for hours, just to sit on his lap and whisper in his ear what their dearest hope is.
Don’t you wish we could go sit on his lap? Not in some icky, creepy way. I wanted to go sit on his lap for years and tell him how good I had been. How I had given up drinking coffee, liquor, eating many of the “wrong” foods. How I moderated my exercise, took my medications, gave myself shots, went for ultrasounds, and did what my doctors told me. That I had been a good girl, that I deserved my secret Santa Claus wish.
My wish for all of us is that we stop being on the outside, looking in. That we get to join the “Mommy” club. That this year, Santa grants our deepest, most heartfelt wish. After all, we don't want the whole bag of presents, do we. We just want that one, special wish granted.
I’d much rather have that for all of you than find my Chanukah candles.
If you have gotten pregnant, (either on your own, or through infertility treatment), have experienced the despair of losing a much wanted pregnancy, and then conceived again, then you know the emotional difficulties of the next cycle in which you try to conceive.
When you've experienced a miscarriage loss, being pregnant again can make you feel vulnerable and downright scared. When do you know that everything is all right? When can you relax and feel secure that the pregnancy is progressing normally and in a healthy way? When can you enjoy knowing that you are pregnant?
If you have experienced recurrent pregnancy loss, than you have lost at least two consecutive pregnancies after having heard a heartbeat. That is the clinical definition of recurrent pregnancy loss. There are many of us out there that have miscarried more than one pregnancy, not consecutively, not hearing a heartbeat each time. Either way, these losses are wearing on us emotionally and physically.
Either way, knowing that everything's ok is a very different animal. Spotting or staining becomes a source of anxiety, fear and worry. Every twinge is that possibility that this is where the pregnancy stops being ok. Every twinge that you don't feel is the possibility that now is when you will lose this pregnancy as you lost the others. It may feel very trying to be around other happily pregnant women, who seem almost blissfully unaware of what could happen, what has happened to you. You may feel isolated as you don't fit in with women who are still struggling to conceive nor do you feel that you fit in with women who are pregnant.
The feeling of joy is elusive at best in these situations. The feeling of relief may come late, very late, much later and sometimes not at all, depending on how late your pregnancy losses were. This is normal! I rarely use exclamation points, but if you are like me and felt that there was something wrong with you because you couldn't enjoy a pregnancy, I want you to know that this is normal. Normal, normal, normal.
A few suggestions, perhaps?
Most important, create community. Our program (RMACT) has a specific support group run by Dr. Lisa Tuttle (clinical psychologist), on recurrent miscarriage and pregnancy loss. An entire group of women, led by a compassionate mental health professional to help you process your losses, help you enjoy the pregnancy you are experiencing or help prepare you for your next pregnancy. There are other places as well that you can find support, I will post those sites for you as a resource later in the day. Check back.
Sometimes creating a ritual can be helpful as well. A good bye to the babies that you have lost. Perhaps a letter written. Perhaps a tree planted. Some way of acknowledging the hopes that you had for the babies that were not born, but still loved by you.
Tomorrow's blog will continue on this theme of loss, with a look towards hope and birth. In every loss that we experience, there is a season to grieve and there is a time to move on. Those losses don't disappear, not by any means, but they do become the fabric of our lives, an experience that we process, absorb and still continue to live our lives.
I know exactly how old my children would have been that I miscarried. It's not a conscious thought, figuring out the years, just part of who I am. It was a long time ago; they are still part of who I am. I am a healthy, strong woman. And yes, I know how old my babies would be, as you probably will.
Twenty one in July, nineteen in September.