Inability to Conceive Knocks Life Off Course

(WOMENSENEWS)–Some days, taking a walk through the neighborhood is too much to bear; pregnant women and happy couples toting infants on their backs lurk in every coffee shop and bookstore. Of course, my husband, Steven, and I knew what we were getting into when we decided to move to Park Slope, Brooklyn, a neighborhood so full of young families we started calling it Strollerville. But there’s nothing like a bout of infertility to make you feel sad to your core every time a baby looks at you and smiles.

Last spring I was diagnosed with reproductive problems and life has not been the same since. It was not the surgery for endometriosis or the countless shots of ovarian stimulation hormones that have taken the biggest toll, although they have not been fun. Rather, I was knocked for a loop by the unrelenting emotional turbulence caused by my inability to get pregnant.

I don’t know whether it was all the stories about “older” celebrities giving birth or the apparent explosion in the number of multiple births, but I thought infertility was a condition quickly solved with a little medical intervention. When Steven and I started to try to conceive, I knew that at 35 I might have some difficulties. But in the worst-case scenario, I thought, I’ll visit a specialist and have my own set of twins soon thereafter.

Things didn’t go as planned. A month of invasive and sometimes painful diagnostic procedures revealed the possibility of endometriosis, a condition that causes the uterine lining to grow outside of the uterus and can impair fertility; 30 to 40 percent of women with endometriosis are considered infertile. The doctor recommended a laparoscopy, a surgical procedure used to both evaluate and treat the condition.

Injections and Hormones

I went in for the procedure and was back on my feet a few days later. During the follow-up, the doctor said that he had indeed discovered endometriosis and that he had removed a number of errant growths. Although he could not say whether the endometriosis had caused any permanent damage to my reproductive organs, he seemed upbeat about my chances of getting pregnant. He suggested intrauterine insemination (IUI), a non-invasive procedure that involves a doctor injecting sperm into a woman’s uterus at the time of ovulation. The insemination would occur over a period of daily shots of injectable hormones used to stimulate egg production.

For about 10 days, Steven, who gets faint at the sight of blood, dutifully administered the hormone shots in my arm. With each passing day, I grew increasingly uncomfortable as the bloating worsened along with my mood. I don’t know whether it was the hormones or the process or some combination of both, but the mere mention of anything having to do with babies or family made me cry. Sometimes tears would start rolling down my cheeks for no apparent reason. Other times my mood was so bad I would cancel plans and screen telephone calls.

On the day of the insemination, my mood would start to lift. Steven, his semen specimen in a container, and I would head off to the clinic optimistic about the prospects.

Then I would lie down on a table as the doctor inseminated me through a catheter, Steven sitting behind me sidelined by this awkward process. Over the course of the next two weeks, I would feel happy and encouraged, thinking every twitch or tingle in my abdomen was a sign of pregnancy. My period would inevitably be late. But then the pregnancy test would come back negative and I would spend the next few days in a deep funk of hopelessness, sadness and despair.

Sense of Loss and Apprehension

In November, after three rounds, I struck out. I knew I still had a good chance of getting pregnant through in vitro fertilization, a process in which eggs are retrieved and fertilized outside the body and the resulting embryos are then transferred back to the uterus for implantation. But I still felt a deep sense of loss, grief and confusion as I considered embarking on the next stage of the journey.

I was scared that I might never get pregnant; according to 2003 data from the Centers for Disease Control and Prevention, only 28 percent of in vitro fertilization cycles result in live births. I was also worried about the possible long-term effects of the hormones. There have been no conclusive results linking the hormones to levels of breast and ovarian cancer and the lack of information makes it difficult to make decisions about whether to continue with the treatment.

Although friends and family recounted story after story about all the people they knew who had gotten pregnant through in vitro, this did little to relieve my anxiety. Steven also tried his best to simultaneously support and humor me with sports analogies, like “We’re only in the fourth inning of a nine-inning game,” but nothing helped.

Stories of Other Women Abound

I started to find some comfort in conversations with women who had also experienced infertility. Stories abounded of women who had spent years trying to conceive using every imaginable intervention. One woman I spoke to endured 15 rounds of in vitro before she finally conceived and carried a baby to term. Another woman with unexplained infertility spent eight years trying different therapies before deciding to adopt. Other couples had undergone batteries of surgeries and treatments before opting to remain child-free.

For many people, I learned, the process of resolving infertility often takes years, not months. But what I found really encouraging was the peace of mind conveyed by each of the people I spoke with. Whether they adopted, used donor eggs or sperm, conceived through in vitro or decided to remain child-free, everyone said they were happy with the outcome. I began to take comfort in knowing that one way or another Steven and I would also one day arrive at the other end of this painful journey.

Ultimately, we decided to give in vitro a try. But we also started to weigh our options, from donor eggs to adoption. Drawing the lines around what we were willing to consider helped us start to reimagine the family of our dreams. Maybe our baby would not have our curls or our colored eyes. Maybe we would have to learn how to explain adoption to a child whose lineage was different from ours. Maybe we would be happy even if only one of us had a biological connection to our baby. All of these outcomes, we realized, seemed challenging but acceptable.

When my first in vitro cycle was cancelled due to my poor response to the ovarian stimulating drugs, I again felt like I was drowning in despair. But 48 hours later I emerged from the gloom, confident that Steven and I would one day walk down the street feeling right at home.

Jennifer Friedlin is a writer based in New York.

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