When I was very young, perhaps three or four, I used to run down the hallway of our little ranch house clutching a doll in my arms, reenacting a scene from Kramer vs. Kramer.
It wasn’t until years later that I was able to trace the scene to that film. I just remember a man (Dustin Hoffman, it would turn out) running down a city street, a bloody-faced child bundled in his arms. Perhaps it was the urgency of the bloody face that compelled me to save my doll from a similar fate, and so I’d practice over and over, whisking her at top speed to the safety of my bedroom, where I’d lay her down on the bed and breathlessly assure her, “it’s alright baby, everything’s alright now.”
If I had pursued a career in health care, I’m sure I would point to this memory as an early sign of my innate desire to heal the afflicted. As a high school English teacher, however, I’m rarely confronted with a medical emergency (though I did bandage up a nasty paper cut for a tearful sophomore last week). But it illustrates something I’ve always known about myself – I’m driven by a need to protect the vulnerable, to care for small things who depend upon my strength and stability. I always took this as a sign I’d be a good mom.
When I was diagnosed with infertility several years ago, I had a hard time reconciling this intrinsic certainty with the reality my doctor was trying so patiently to explain. “No, see, I’d be a good mom,” I kept wanting to insist, clinging stubbornly to a naive belief in some sort of cosmic justice. But that, it took me years to learn, is just not how it works. In fact, in our case, nothing really works at all.
I’m part of the 20-30% of women experiencing infertility who receive the particularly frustrating diagnosis of “unexplained infertility”. Which means my husband and I did the complete work-up and all the tests came back normal. There is no apparent, medically discernible reason we can’t get pregnant. We defy explanation.
“Unexplained infertility” is sometimes also known as “idiopathic”. Combining the Greek words for “peculiar” or “personal” (idio) and “suffering” or “disease” (path), the word refers to any disease or condition whose causes are unknown. Another translation of “idio” is “distinct, separate, alone”, and that’s how infertility quickly began to make me feel. With every birth announcement and Christmas card that came in the mail, I felt like I was being set further and further apart from my friends and family as they happily peopled their little tribes. Before the diagnosis, I talked to lots of people about our plans to have kids as soon as possible (we married a bit late; he was 34 and I was 31). But after, I felt like I’d just depress them, or worse, like I had somehow let everyone down.
That’s the problem with how our culture treats infertility. Despite it being so common, we rarely talk about it openly, which leaves women like me feeling completely isolated. As the years went by and it became clear that there wouldn’t be any little Den Otters in our future, I have to think my friends and family knew. They had to have figured it out. And of course, none of them said, “please don’t talk about your infertility, Lora”. But nobody asked about it either. So I kept it to myself, determined to face and survive this challenge on my own. For help, I started reading.
The world of infertility books suggests there’s an answer in religion (Trying to Conceive Through Faith) or science (It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant, Prevent Miscarriage, and Improve Your Odds in IVF) or homeopathy (The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant). They all seemed to overpromise (Conquering Infertility) or threaten to make me feel even worse (Empty Womb, Aching Heart). I decided to start with simply trying to make sense of the sheer volume of information I was suddenly expected to know and keep track of, like my average basal body temperature during my follicular phase, or which cycle day I have my LH surge. The infertility learning curve is a steep one, and I knew I needed to understand the vocabulary and data points if I was to have any hope of extrapolating something meaningful from them. So, at the suggestion of my lovely sister-in-law, I read Taking Charge of Your Fertility by Toni Weschler.
I was immediately emboldened by the title. Yes, take charge, that’s what I’m going to do! Information would become my weapon in this war. It was empowering, and it really did feel like the shot in the arm I needed. To call it a book doesn’t really do it justice; it’s more of a uterus owner’s manual. Weschler, a nationally regarded women’s health expert and educator, breaks down and explains in detail how every stage of a woman’s reproductive cycle works, including how to maximize (or prevent altogether) your chances of getting pregnant using the Fertility Awareness method. This involves taking your temperature at the same time every day of your cycle, examining the consistency of your cervical fluid, and even checking the position of your cervix (I skipped this part). Then, you record all of this information, as well as dates you have sex and everything about your period (color, flow, cramps, etc.), on an incredibly complex chart, which, after a few months, is supposed to give you a clear idea of where the trouble lies.
It turned out that my entire chart was trouble. My periods: too long. My luteal phase: too short. My temperature: FUBAR. In a normal cycle, your temperature is supposed to be lower during the first half (the follicular phase) and then rise just after ovulation and stay higher during the second half (the luteal phase). Mine went in reverse, and on top of that, my BBT was consistently lower than average, no matter the phase. I remember googling “is my body temperature too low to get pregnant?” and not exactly being comforted by the results (the answer: “possibly”). But my blood tests had ruled out a hormonal imbalance, so what could be causing it? My OB-GYN sure as hell couldn’t explain it.
This is about the time I started to lose faith in the medical professionals I’d so far consulted. My doctor (his name, and I swear I am not making this up, was Dr. Dick) was nice enough and seemed eager to help as far as he could before handing me off to an RE (reproductive endocrinologist), but I was getting tired of hearing “well, this latest test ruled THAT out, so we’re nowhere nearer to understanding why you can’t get pregnant”. I’d done three rounds of Clomid, the gateway drug of infertility hormones that tricks your pituitary gland into producing more follicle stimulating hormone (FSH), which then goads your poor ovaries to give up that egg (or eggs; there is a slightly higher chance of multiple pregnancies occurring as a result of taking Clomid). All it did for me was produce a rather uncomfortable sensation of the Fourth of July in my uterus. I wasn’t a fan. It had been nearly a year since the diagnosis and I was feeling more alone than ever. I wanted to hear that others had been through what I was going through, understood how I felt. I needed to hear their stories.
Many women experiencing infertility have doubts about the efficacy of Western medicine alone and look to more natural, homeopathic treatments. Listening to what your body needs and making lifestyle changes that create the ideal conditions for a baby to grow and develop is the premise of Julia Indichova’s Inconceivable: A Woman’s Triumph over Despair and Statistics. After having had one child, she and her husband struggled to conceive again, a condition known as secondary infertility. Her memoir describes how they try everything, bouncing from one medical specialist and nontraditional healer to the next in a fruitless attempt to achieve the perfect hormonal balance required to conceive. Finally, Indichova decides to listen to the wisdom of her own body and embarks on a mind-body-spirit journey that eventually leads to a successful pregnancy.
I found the honesty and simplicity with which Indichova shared her story both refreshing and comforting. I was feeling pretty dejected about how little we still knew about why we couldn’t conceive, but it gave me hope to read about a woman whose chances of conception at the time of her diagnosis had been much slimmer. Perhaps it was time I explored alternative treatments as well.
After the Clomid adventure, I turned to Chinese medicine to try to unravel the mystery of my infertility. Molly, my acupuncturist, asked me a litany of very specific questions about my digestive system, examined the topography of my tongue, and then set to work trying to regulate my periods and wrangle my whacky BBT back in line. Every week for a year, I left work early to get to the historic office building on the edge of downtown Saint Paul, blocks from the house where F. Scott Fitzgerald developed his inferiority complex, to have tiny needles stuck in my feet, shins, abdomen, forearms, and forehead.
Molly also prescribed herbs, different concoctions depending on the stage of my cycle, that I was to mix with hot water and drink twice a day. “Oh yeah, and just a head’s up,” she said as I left one day with another paper sack of dried bark and leaves, “that one’s going to taste like blood.”
It did, but I didn’t mind. I drank my blood tea and meditated and did yoga, all in the hope that this natural path would eventually lead to a baby, without all the complications and stress of the Infertility Industrial Complex. It seemed so easy; all I needed was to unblock my Qi.
And it was sort of relaxing, lying there in the dark under the heat lamps, indigenous flute playing softly on the office PA. I floated in this warm, semiconscious limbo, feeling the waves of energy flowing through my blood, balancing, grounding, maybe even healing me. And it did work; my periods got shorter, at least. My temperature chart stopped looking like an EKG test. But when I still wasn’t pregnant a year later, I decided to part ways with Molly and resume the benign neglect that had characterized my relationship with my fertility before we started trying to get pregnant.
If it happens, it happens, we said. If it doesn’t… well, we never really talked about that. And not talking about it all these years finally caught up with me. When you’re on the infertility treadmill it’s easy to get so caught up in the tests and appointments and strategic lovemaking that you conveniently ignore the emotional effects. And once you’ve decided, like we did, to step off of it for a while, avoiding the subject altogether can be a way of deluding yourself that you’ve accepted it and moved on.
Last fall I realized that I had very much not moved on.
Many factors spurred my latest re-dedication to having a baby: the news that my brother and sister-in-law were expecting another child. The practical realization that I’d be 38 on my next birthday and if we were going to do this, we were running out of time. A video I saw on Twitter of a mother cradling the tiny heads of her premature twins in both of her elegant hands. These swirled around inside me, creating a vortex of anxiety and sadness and a love so profound that I could barely choke out the words to express it. I knew that if we had any chance at all of making a family, it was likely to be found in IVF.
I was in Dallas on a school field trip to a student journalism convention and I hadn’t slept all night. I called my husband around 3:30 and said simply, “I’m not ready to give up on having a baby.”
“Well that’s fine, sweetheart,” he replied calmly. “If that’s what you want, let’s do it.”
I haven’t said much yet about my husband, Jeff, but he deserves a thorough description. He is everything I’ve ever wanted, and more than I ever thought I deserved. When we met (technically, reconnected, as we’d first become friends working part time jobs at a movie theater when we were teens), I was trying to find my way out of an unhealthy marriage. Rekindling our friendship helped me to realize that I’d developed certain notions about myself that just weren’t true. My self-esteem was at a low point, but the way Jeff treated me, the person he mirrored back when he smiled at me, slowly helped me discover the confidence and self-worth my ex had all but crushed out of me. That’s the reason infertility has been so heartbreaking – when I finally found the greatest love of my life, who makes me a better person and fills my life with such happiness and hope – that even the power of our deep and abiding love for each other can’t overcome this medical mystery – it’s just so completely unfair.
And there’s another reason, and this one is really hard for me to talk about, because it is my greatest fear. I hesitate to even bring it up because I hate thinking about it. Jeff is in the military. He served three tours in the war in Iraq, and it’s all but certain he will be deployed again in the near future. If the worst happens, and my nightmare becomes real, my Jeff will live on forever in my heart and in my memory, and in those of the people who love him, but not in a child. The mischievous blue glint in his eyes, the way he looks like he’s weeping when he laughs really hard, that radiant, disarming smile – I’ll only see them in pictures or in my mind’s eye. Nowhere else.
So you can understand the renewed urgency, right? Last December I began working with an infertility specialist to find out if we’d be good candidates for IVF. I had more blood tests (they wanted fresh ones) and did a lot of research about success rates and payment plans. I began talking a lot more openly with Jeff about the hard time I was having accepting that we might not be able to have a child, that this might be the end of the road for us as far as that was concerned. And, as before, I sought more stories to help me feel some kind of connection or commiseration with the other couples who’d traveled this road too.
I have to admit, the main reason I picked up How to Make Love to a Plastic Cup was the funny title. I also thought it might be enlightening to read a man’s perspective on the confusing journey Jeff and I had been navigating pretty much alone. Greg Wolfe and his wife Julie tried all the same interventions we did, except they went the extra yard into IVF. I thought I’d be reading another memoir, that there would be some examination of the changes in Greg and Julie’s relationship and how they weathered them together, or some reflection on how the process affected him mentally, emotionally, and spiritually. Instead, this book reads like a “What to Expect” advice book. I was put off by his constant use of metaphor (a woman’s body is a car… or a bank… or a golf course; the miracle of conception is the Allied invasion of Normandy) and by the way he talked to his audience as though they were assholes, morons, and grown-man-babies. Also, and this is fairly minor, but it drove me crazy – whenever he talked about “your (hypothetical) doctor”, he always, 100% of the time, used the masculine pronoun. UGH.
What I did appreciate was the thorough description of the IVF process, from the daily hormone injections to the egg retrieval and fertilization, to the implantation and agonizing 2-week waiting period. How to Make Love to a Plastic Cup was the clearest and most straightforward explanation I’ve seen of the practical concerns of IVF – including the financial considerations.
Ultimately, Jeff and I decided not to go the IVF route, and the financial considerations were one of the main reasons. Without getting into a detailed description of our wherewithal, it would have presented us with a significant debt burden that we felt would be irresponsible to take on. He and I are both firm believers in the doctrine of doing the most good you can with the time and resources you have, and we decided that borrowing that much money would force us to work against our strongest conviction.
The other reason is a little harder to explain. After reading about all the stress Greg and Julie went through and hearing the same, and worse, from the women in my infertility support group, I’ve come to the conclusion that I just don’t want to. I don’t want to put us through that. Which makes me wonder if I was ever really cut out for this fight. Infertility is often described in just those confrontational terms – fight, battle, victory, triumph. But I’m a born pacifist. I’m like Ferdinand the Bull, lying down in the grass to smell the flowers instead of joining the bullfight. I’m like that Vietnam War protester sticking flowers in the guns. I haven’t let infertility defeat me. I just don’t want to fight anymore.
I’d be lying if I said I’ve fully resigned myself to not having kids, or that there is no longer a deep well of sadness and a stinging sense of injustice inside me. I still cry when I hear “Isn’t She Lovely?” But at least I’m talking about it now. If I’ve learned anything from 13 years of teaching English, it’s that there is power in stories. In expressing and sharing them, we connect and empathize and discover a truth within ourselves we’ve always perceived but never understood. I’m grateful for the women and men who’ve shared their infertility stories and I’m proud to offer my own. Our stories help dispel the specter of shame and stigma that still haunt a diagnosis of infertility. They come together and calmly repeat in one still, soft voice: You are not alone.