Thursday, February 19, 2009

Where Are You on the Infertility Age Spectrum?

I have two friends entering the IF rollercoaster, both of whom I referred to my RE’s office (J’s snarky comment: “Oh yeah, because they’ve done such a great job getting us pregnant!”). One friend is 43; the other is 32. And I just turned 37, so I’m right in the middle. The differences between our reactions to the IF are stark and I find them interesting.

My 43-year-old friend, T, just got married two years ago. The way she sees it, she came late to the party and now has a chance to try for a child, but she knows she has to work with what she’s got. When she came to me for information on IVF, she seemed totally at peace with it. It’s not that being a mother is less important to her, or that she’s calm about the process itself (shots and hormones and surgery, etc.). But she has known for years that time was running out. For her, infertility is not a disease—it’s a hurdle she faces because of the way her life has played out. She understands that the odds of IVF working are long, and that she might have to use donor eggs. But she’s decided to take her shot at it, and if it doesn’t work she’ll do what she can to adopt.

I don’t mean to make light of her problems. I’m sure she’s scared and hurting. But I almost envy her lack of trauma over the idea of infertility itself. I think of my first year of infertility as a “lost year” in my life, which I can barely see through the haze of shock and desperation I was going through at the time. And it wasn’t like it happened all at once, either. For most of us, it takes a lot of treatment before you know how bad your infertility is, before you realize that you could actually reach the end of the road without a baby.

I know that’s how I was. I didn’t consider us “infertile” when we first went to an RE to check things out. After all, we’d conceived once on our own, so surely all we needed was a little nudge. And our tests came back fairly positive, so we assumed that the trip to the RE was just a little glitch in the parenting road.

Even then, when I thought that going through IUI was just a hiccup in the rhythm of our lives (I’m metaphor-happy today), it was traumatic. I can remember sobbing in the RE’s office when I first was told we would need IUI. I can remember freaking out over the expense ($1,000). And then one BFN after another, and the shock at learning we would have to go to IVF (again, the expense even with insurance seemed so daunting). And then learning about the fibroids, and then the miscarriages, one after another. The decision to have surgery, and the decision to take out the second mortgage and do the shared risk plan. The feelings of betrayal when our RE finally decided—two years too late—to try to treat J’s hormone deficiencies. And the struggle to accept the likelihood of donor sperm as our only option.

So I look at T, who seemed to skip all these steps, and there’s just a little bit of jealousy on my part. She knew going into this that it was a long shot; she knows she might have to use donor gametes. She has a simple plan that will never drag on for years and years.

Of course, I prefer my odds over hers. And yet I wonder what that kind of peace would have been like.

My 32-year-old friend, D, is on the opposite side of the spectrum. (I know, a 22-year-old would be closer to the true other side of the spectrum, but most of the women I know tend to wait until their 30’s to start trying to conceive.) She and her husband have been TTC for over a year, and she’s been charting (TCOYF) for more than half of that. We’ve spent a lot of time talking about what steps she should take. She seems inclined to go to her gynecologist for advice, while I have been urging her to just skip all that and go straight to the RE. (I know that my RE would repeat all the tests anyway.) I can’t tell whether she’s in denial or if I just assume the worst.

But while we talk about the facts, we have yet to discuss how she’s feeling about all of this. And I don’t know how to broach it. I don’t want to say “I’m sorry,” because that’s assuming infertility (and the need for real treatment), and I know she’s hoping that a simple does of clomid might do the trick. And it might, and I really hope it does. Mostly I think she’s not ready to talk about her feelings until she has some answers.

Right now, she’s where I was 3 years ago. And it’s hard to watch that and want to help, but to fear overwhelming her with my own advice. On the one hand, I wish I knew 3 years ago what I know now. I wish I’d known how hard it could be, how long it could take, and even how much strength I would find in myself and my marriage. On the other hand, she already knows some of this—she’s been watching me go through this, after all. And I don’t want to scare her.

So where are you on the spectrum, and how has it affected your perspective?


luna said...

having come to the point of needing to accept that I will never have a biological child, I have a different perspective too. I'll always feel that grief, I think, but I have a hard time even hearing about people going through treatment since that door has closed for me.

maybe if we had greater resources and emotional capital to gamble on IVF a few more times I'd feel differently.

I'd also be inclined to want to warn your younger friend, but if she has seen where you've been then I think if she wanted advice she'd ask for it. it's hard though, because you may be a bit jaded and she is so optimistic...

Seriously? - Erin said...

I have a 28 year old friend who has been off bc for three years and after about 18 months I encouraged her to see an RE. She waited until the three year mark and now has found her DH has azoo and she has a blocked tube. I know she kicks herself for not going sooner now.

Because of my family history of infertility I jumped on the bandwagon right after my first m/c. I always assumed I would have some difficulty carrying a child so I didn't grieve for that, just my lost child.

I think your age, experience (friends or family with IF issues) and your expectations of your own body really play into what your reaction is to IF, pregnancy loss, etc.

Nikki said...

I too started off like most everyone does - not ever imagining how far and how long this road was going to be, and how hard.

For me, it feels like "1 step forward, 2 steps back" - at each step, we have found out something, a new obstacle which we have had to find the strength and means to deal with.

Entering the world of infertility is like entering a pitch black dark room - you can't predict or pre-empt anything!

Your friends are lucky they have your experiences to learn from, as they start their journey. I wish I had someone who had been in my shoes when I was starting out. I wouldn't be so naive about everything then, perhaps!

Lovely post - I never thought of things with this perspective. Thanks!!

Good Egg Hunting said...

I'm at the point somewhere past naivete and approaching weariness. Way past that wide-eyed entry into this whole thing, believing a second round of Clomid might be the hardest it would get. I can hardly believe how wrong I was, but here I am. I can definitely see your interesting conundrum of wanting to be the kind of knowledgeable friend you wish you had at the beginning of your journey, but not wanting to freak her out or be presumptuous in assuming she will follow a similar path. But I'm sure you are not overbearing and that she values having a "go-to" on all this stuff. I think we should celebrate how far we've come, even if it seems like this process will never end. I would never want to be back at the beginning, even with all that hope.

Me said...

I was 26 when we started trying. I was still 26 three months later when a burst ovarian cyst landed me in the ER. I saw an RE just a month or so later, because that's what the ER doc told me to do. I was in TOTAL denial that first visit with the RE. He wanted me to have an HSG right away and start me on Clomid. I left his office and didn't come back for six months ... when we had reached the requisite 12 months benchmark. All along our journey I have kind of been like that. Never quite ready to take the next step. Always him-hawing around. Waiting. Thinking it would happen on it's own if we just gave it more time. Proof of my denial is the fact that in three and a half years we've only done three medicated cycles. Now, granted there are some mitigating circumstances in there (including finances and my husband's health problems). But even so, our RE wanted us to move on IVF when my response to IUI stims made it apparent that was not the road to parenthood for us. But I wasn't ready.

Pepper said...

I'm in a different place on the spectrum altogether; somewhere between denial that I'm actually infertile and resolution (fear?) that ART will never work. The denial comes from my inability to TTC every month and the rationale is something like this: How do I know I wouldn't have been pg a long time ago if I were baby dancing like a bunny rabbit? The resolution that this may never work comes from the knowledge that I've done something like three home insems, two natural IUIs, three Clomid IUIs, two injectable IUIs and one IVF, all without so much as a hint of a BFP.

It's a strange, strange place to be indeed.

Kim said...

I am 30 and constantly go back and forth from admitting that we are infertile, denying that we are infertile, wanting desperately to have a child right now and not caring too much if it doesn't happen soon because we are only 30. We have had 2 mcs, 1 ep, and currently have 12 unassisted cycles under our belts with no bfp. I love gathering information/advice from those that have been exactly where I am, whether they have chose IUI, IVF, continuing unassisted, or to live child free. I am not going to run out and make rash decisions just because someone told me this is how it happened to them. But, I am certainly going to consider their possibilities and discuss it with my doctor.

Joonie said...

I was a bit of an extremist when it came to IF. For years I was in denial, like you guys, we did conceive once on our own, so all must be well. Right? Well not exactly.
However, after my first visit with the RE, I didn't hesitate, I skipped clomid, IUI, etc and jumped straight into IVF. I wanted to get to the end of the line as fast as possible, I had no patience for taking it one step at a time.

IF is such a personal journey, and everyone has to find their own path. I think you can share your experiences, but it's hard to recommend one course of action or another to someone else.

peesticksandstones said...

This is such a thought-provoking post. Loved it.

You've really hit on an interesting thing I found within the "infertility community" I've been lucky enough to find in NYC. There's this divide, in a way. No one ever acknowledges it -- between the younger women (like me, who first saw an RE at 30) and the gals in, say, their mid 40s. Sometimes it even got kinda ugly, and I had my feelings hurt.

I never could understand what's at the heart of it (at least for me), but now I'm kinda getting it. My experience of IF was that if felt like a disease -- very truly. All these things that "should've" worked because I was "so young" did not, and I had to constantly discover new ways I "didn't work". It still affects how I feel about myself every waking moment of my life -- this discovery of how "broken" I was. And even now that I've gotten lucky enough to maybe be having a baby finally, I am absolutely haunted by a lack of confidence in my body/myself.

I know many older women also are discovering endo, other challenges to their fertility, but in a way I've also envied these women for having their 20s/30s be free of this knowledge of themselves as "infertile" or "diseased". Does that make sense?

So many interesting things you bring up.

Sarah said...

i'm 36. only married my husband feb last year, but we started trying immediately, as i was paranoid that something was wrong with me. when 4 cycles went by and one was irregular in temperature, i got nervous and dragged us to an RE.
imagine shock when turns out i'm fine, but husband has issues in all three camps. all i wanted to do was ICSI as fast as possible, but job loss/new job and stability issues held us back, RE reckoned 4 month wait wouldn't hurt.
a january IVF has resulted in a BFN this week, and all i can do is worry that it might not happen. ever. i feel so unlucky (accident in the lab with broken glass wiped out 10 of my 14 ICSI'd eggs) the doctors say they are confident, but rather than being in denial and sure it will happen, i stress that maybe it won't and I am not remotely emotionally prepared for that possibility. i wish i had the optimism of your young friend. i worry that my negativity will become a self fulfilling prophesy.

Shinejil said...

I guess I'm somewhere in the middle, at 34. I had some strange stuff with my cycle for years, and had a feeling getting pregnant would be difficult. That said, I was terrified of the IF treatment options, which seemed to take a one-size-fits-all approach and seemed really hard on a body.

I'm currently at a new place, and wondering what in the world will happen next. It's a whole new kind of terrible waiting.

annacyclopedia said...

This is an absolutely brilliant post, Babychaser. I've often struggled with feeling so weary with all of this, despite having only 6 cycles of trying under my belt. But with the stress of waiting for Manny's vasectomy reversal, the year it took to finally be told that it really didn't work, and the year after that it took to get through the various referral hoops to see my doctor, this has been a long journey already. In many ways I'm glad that this hasn't all come as a shock, for the most part. But knowing it wouldn't be straightforward is not the same as knowing how hard it truly turned out to be.

Thanks for writing this. I feel like a puzzle peace in my brain just clicked into place.

Ally said...

When I began TTC, I figured I would have some issues. My sister did, I wasn't regular, blah. And I think I knew, deep, deep down that it would be a really long and arduous process. But on the surface, I was expecting it to be somewhat easy. Oh, clomid for a few cycles, maybe even something a little more difficult, but it would work and we'd be pregnant in a year or so.

Oops. Not so much.

I occasionally kick myself for not starting sooner. But we weren't ready then.

I often kick myself for being so...confident this would work.

And now I feel like I'm in no-man's land. I don't know if we should keep going or if I should give up. And, like all of the not-knowing in IF, this is a horrible place to be.

Peeveme said...

Wow. Reading this post and all the comments. My heart just brakes for you, your friends, fellow commenters, myself.

I know I am overwhelming to women when I say this but I I tell everyone one I can: Run, don't walk, to an RE and be as aggressive as possible. You will not regret doing IVF. You will only regret waiting to do IVF becasue it might be too late.

You can do it now or you can wait 5 heartbreaking years from now and then it will be a lot harder.

I am an alarmist, I know. I just wish someone had sounded the alarm for me. I wish someone had said, "get over yourself, go into debt do whatever you have to to have a child now, not five years from now. By the time you feel ready it might be too late."

I might have not had to use donor eggs if I had followed such advice.

Lea said...

Wow. This was a great post, and really hit a button. I loved reading all the comments as well. I'm about to turn 32, which I know is young, but my husband is 41. I feel a certain sense of needing to hurry due to his age. But I also have always felt that it would be difficult for me to get pregnant. I'm not sure if that was intuition or self fulfilling. I worry about that a lot. We are going into our 3rd IUI and a year and a half of trying. Peeveme's comment just made me freak out a little bit! I feel like maybe we SHOULD just move to IVF. I just don't know. I hate all this waiting and unknown.

All that just to tell you that I wish I had someone like you to tell me how it could be. I too feel like the first year was lost.

Angie said...

Neat post ~ I can relate to your perspective of losing that first year of your life dealing with IF....while we *really* just started this journey about 14 months ago ~ I never imagined that we would be here today without our precious child. It is so hard to accept; yet, we must.

I do not have any older friends dealing with IF. I have a few younger friends though....and I tread those conversations lightly, too. It is hard not to be "doom & gloom" when you are traveling this road with no end in sight....but I try so hard not to bring them down, too. I try, try to just listen and be their cheerleader.

Jonathan & Meredith said...

I can't even begin to describe the relief I feel when I read your blog...No idea how I stumbled upon it either! I see you're in the DC area- we live in Montgomery County.

Darya said...

Just before my first IVF, I confided in a partner. I remember balling in her office as I spilled my guts about how much this was affecting my life and I how I didn't know how to handle it. How I wasn't accustomed to failure. How I never pictured myself as one of those women who cries at work.

I ran into her a few days ago and she asked me how things are going and how I was doing. I said "the same but I'm getting used to it.' So I guess that's my perspective. I'm used to failure, I'm used to the tears, and I'm use to the devastation.

Ms Heathen said...

Interesting and thought-provoking post, babychaser!

I can relate to what you write about infertility taking a long time to sink in. We started trying when I was still in my early 30s and were so deep in denial that it took us over two years to seek medical help. Even when we were told that our best chances lay with IVF/ICSI the full weight of it didn't really register - we had in the meantime managed to conceive naturally. It was only after two poor responses to stimulation and a diagnosis of diminished ovarian reserve that I was really forced to confront the fact that I could well be one of the people for whom treatment didn't work.

I wrote recently on my own blog about a couple of friends of mine, both of whom are of a similar age to you and I (37 at last birthday) and who have told me that they plan to wait a couple of years before they even start trying. They appear to be presuming that it's OK to wait, as 'there's always IVF'. As you say, it's very difficult to know how to deal with those who may be at a very different stage of the journey to yourself - part of me wants to tell them that it's not OK to wait, that IVF doesn't always work, but another part of me is forced to accept firstly, that this may not be what they want to hear, and secondly, that they may be among those lucky women who have absolutely no problems conceiving.

Barb said...

Oh wow... i'm so far into the end stages of that spectrum. I'm somewhat at peace, but there are times when the thought of not being a mother ever fills me with heart pounding dread. Yet I don't have the hysterics and anxiety I had about it a few years ago. It still pisses me off some considering I tried to do everything "right," and actually did start in my 20's (I'm 31 now).

Mostly what pisses me off is that I don't have the money to pursue various options to becoming parents. It's so awful that becoming a parent has to have such an up front price tag.

I also tend to be very pessimistic and think it actually won't ever happen for us. I tend to be pessimistic for other people too. It's what's happened to me after seeing this shit over and over.

As for your friend, I would keep encouraging her when she asks like you've been doing, but if you push too hard she will probably tune you out. She has to come to some of these realizations on her own.

Barb said...

It IS wrong. (per your comment) And state adoption is just so effing terrifying! Deep down, I guess I also just never feel worthy enough when someone else is judging my competence either. *I* know I can do it, but I don't trust myself to show someone ELSE that I can.

And of course we like the same books. :) Every time I look at your booklist, I have to double check that I'm not looking at my own. ;-) Feeling better, but still hacking and snotty. Lovely.

empty said...

love your blog so i’ve got an honest scrap award for you! you can get the icon off my blog…

Rambler said...

This is a bit of an old entry and I read it a while back and never sommented. Bur for some reason it's stuck in my mind, and afer lunch with a friend this past week, I remembered your words. About the "infertility spectrum".

You've written a great perspective and I'm going to reference this in my next blog entry.

Hope you are doing well with the twins! It's been a few weeks since you posted so hope to hear soon!