INFERTILITY IS MORE THAN A STATISTIC
Many people are aware of the statistics: 1 in 4 women have experienced a miscarriage. 1 in 8 couples will or have experienced infertility. But that’s about where the knowledge usually ends - and infertility is so much more than a statistic.
Infertility is heartbreak. Infertility is waiting. Infertility is desperation. And infertility is so much more. When people hear the word, they think - “That’ll never happen to me, but I’m sorry for those it does happen to”...or maybe they think nothing at all. For many people, it isn’t even a thought, it isn’t even something they’re aware of. But for those of us who suffer from it, infertility is all consuming. It IS everything. It is more than a thought, it is every thought. Every action. Every day. Every minute. Every second.
My husband and I struggled to have our first child, but we were lucky - IVF (in vitro fertilization) worked for us. “IVF” and “lucky” aren’t usually used in the same sentence - but that’s how we felt. Lucky. And we are forever grateful to science for our son. But we don’t feel lucky trying for our second. Infertility has hit us again, and even harder.
We have to do IVF to get pregnant because of medical issues that I have, the woman, but it can affect either person in the relationship. One of my biggest issues is that it is so misunderstood. I am a young woman, with a healthy BMI, who exercises regularly and eats well. I am not the statistic people expect. I don’t look like someone who would suffer from infertility. But I do - in so many ways.
And when we started trying for our second, we naively expected that IVF would easily work for us a second time, especially because we have frozen embryos. It is a common saying that if someone is having issues, they should “just do IVF”, as if it’s magical and not hard at all. Now for those who aren’t aware of anything surrounding IVF, I will try to do a basic overview - but this doesn’t even begin to cover what’s really involved. This is purely the steps, not including the emotional and physical tolls a person goes through during IVF treatments. A woman is put on medications to grow eggs and keep her body from ovulating naturally. After 10-14 days (ideally), the eggs are removed from the woman's ovaries during an “egg retrieval”. The same day, these eggs are fertilised with sperm in a laboratory. The fertilised egg, called an embryo, must now develop and grow for at least 3 days, but ideally 5-6 days. If the embryo is still viable at this time, it can either be returned to the woman’s womb in a “fresh transfer” or frozen for a “frozen embryo transfer” in the future.
I cannot stress how simplified this explanation is. Mainly because this assumes that everything along the process goes well. But let me tell you, it often doesn’t. And I’ve outlined some common issues below. I don’t write this to scare people, as I have become far too aware of exactly what needs to go right in order to get pregnant. I write this to educate people, and to make people more aware and more understanding.
So often, those struggling with infertility hear the wrong things, although they mean well. When I told someone I was starting to try for a second, they told me that I was lucky because I could “choose” when I got pregnant again. But that’s not even close to correct, and it’s hurtful. I cannot choose when I get pregnant - I wish I could - but even with fertility treatments, I’m still no closer to my second child.
I have a list of many issues people face when going through IVF and FET (frozen embryo transfers). Personally, I was lucky with embryos and had success both times I did egg retrievals. My issue lies with my uterine lining - something I didn’t even know existed until treatments failed. It won’t thicken past 5-6mm most of the time, while 8mm+ is ideal, and I have lost 2 children because of this. There is a chance I will be looking into using a gestational carrier in the future, and although that’s currently hard to think about, I really just want a healthy second child, and I will do anything for that child.
As a peek into how difficult even just IVF can be, here is a list of things that can go wrong. Please be aware that infertility is SO much more than this list. There are so many more issues, too many for me to ever write down, as everyone’s experience is completely individual. I haven’t even touched on the reasons FOR infertility. But that’s for another day.
Here’s what can go wrong with IVF/FET:
● Retrieval is Cancelled: Cycle in cancelled and the woman has to repeat all of the
time and medications again just in the hopes she has eggs next time.
● No viable eggs: The eggs retrieved are not viable, and woman has to repeat the
entire cycle again.
● Eggs don’t fertilize: If there is an issue with the sperm or eggs, the eggs won’t
fertilize, and they won’t make it to day 3. If this happens, the entire process has to
be repeated, including the egg retrieval.
● Embryos don’t survive: There are many women and men who go through this
process only to have nothing at the end of it. This is devastating, and the entire
process has to be repeated.
● Embryos aren’t genetically healthy: Many opt to do PGS (pre-implantation genetic
screening) on embryos to ensure the embryos are healthy before transferring them, as this can increase the odds of a successful pregnancy. Even if embryos have survived to day 5-6, there’s a chance that none will be genetically healthy, and the entire process needs to be repeated.
● OHSS (ovarian hyperstimulation syndrome): an excessive response to taking the medications used to make eggs grow during the IVF process. This causes intense pain and a transfer would be cancelled, and any embryos would be frozen.
● Uterine Lining isn’t sustainable: For a pregnancy to be viable, the recommended thickness of a woman’s uterine lining is at least 8mm before transferring an embryo. If it’s lower than this, there is a higher risk that the embryo will fail to implant, or the woman will miscarry early on. Many doctors will not transfer an embryo if the lining is too thin, and a cycle will be cancelled. This would cause someone to have to do another FET (frozen embryo transfer) in the future. If the lining will never thicken to the appropriate level, a gestational carrier will be suggested.
● Failed Transfer: This is when a transfer is done, and a negative pregnancy test is the result. I have to stress that this doesn’t feel the same as having a negative pregnancy on a month you had sex to get pregnant - it’s a loss. It’s an embryo you fought for that’s gone.
● Chemical Pregnancy: a term used to describe a very early miscarriage which occurs before the fifth week of gestation and well before the fetus can be visibly detected on an ultrasound. This term is a slap in the face because this still counts as a miscarriage to me.
As I said, infertility is desperation. It’s longing. Crying. Hurting. Time lost. It changes a person - it makes you grateful for what you have, but also much more fearful of the future. I have found that I am way less optimistic than I used to be. I have come to expect horrible things to happen. And that’s terrible - no one should feel that way.
I write this and hope that I can bring solace to those suffering - you are not alone. You are seen, you are important, and you are fighting harder than anyone can imagine.
I also write this to educate those who are uninformed.
If you don’t suffer from infertility, please be more mindful that you never know what’s going on for the people around you. You never know that a simple question or piece of advice could cause someone immense pain. Stop asking when people will have children, or when they will have more. Stop telling people to get over a loss. Stop telling people to “just adopt”, as if it’s that easy or only ever used a second choice. Stop telling us to relax. Stop saying we’re too young or too old, or too skinny or too fat. Stop telling people you understand when you don’t. Stop saying that “it will happen”, when you don’t know if that’s true. All we want is for someone to say “I’m sorry that happened to you. That must be so hard”, and leave it at that. If we want to talk about it, we will. Otherwise, don’t ask. Please just respect our pain, and know that you really cannot understand what we’re going through. And if we’re jealous of all of your children, it’s not because we don’t want you to be happy, it’s because we’re painfully envious that we cannot be joining you in your good fortune.
And if we don’t attend something that is an emotional trigger, such as a baby shower - sometimes we just need to protect ourselves. Please understand it’s not personal, we’re just trying our best in a horrible situation.