Infertility and Loss

DEDICATION - I wrote this as much for myself as I did for my dear friend, MWK, and all the others like us who have hoped, become excited, and suffered heartbreak.

Women who struggle with infertility deal with more heartbreak than happiness, if they see happiness at all.
It's not just the emotional roller coaster that comes with hormones, pills, and negative pregnancy tests. It's not just hearing the diagnoses and the partially known, unpredictable outcomes. The woman struggling with infertility also has her support group, both online and in person, and those around her who know every single detail of the successes and failures.

Devastating Diagnoses
People who share "proven methods" for getting pregnant often have no idea of the complications both single women and couples have when seeking to create a family.

• Polycystic Ovarian Syndrome I was 20 when I was diagnosed with polycystic ovarian syndrome or PCOS. Simply put, it's a hormonal imbalance, involving insulin, androgen, follicle stimulation hormone, and lutenizing hormone, that prevents ovulation. Some women can conceive by simply taking a diabetic drug. Many women like me have to undergo more rigorous infertility treatments with no guarantee of success. Women with PCOS are at risk for heart disease, diabetes, and ovarian cancer.
• Endometriosis For women who DO NOT want children, endometriosis is a rational and legitimate reason for a hysterectomy. For everyone else, it's a curse.
  The normal monthly female reproductive system has the uterus build up an endometrial lining in preparation for a pregnancy. If there is no pregnancy, the uterus sheds the endometrial lining. For a woman with endometriosis, parts of the endometrial lining grow outside of the uterus and continue to grow every month. This disease makes both sex and menstruation painful. And, of course, conception can be extremely difficult.
• Male Infertility Infertility is not just a female problem; though, with a man, there are mostly only emotional, not physical symptoms.
  Male infertility can mean low sperm count, sperm morbidity (how long, if at all, does the sperm stay alive), low motility (slow swimmers), or low morphology (malformed sperm). In some cases, medication or vitamin supplements can help resolve these issues. In other situations, artificial insemination such as interuterine insemination (IUI) or in-vitro fertilization (IVF) aids in resolving male infertility complications. In the worst of cases, a couple could seek donor sperm to achieve a successful pregnancy.
• Unknown Perhaps the worst diagnosis one could receive when trying to conceive is unknown. When everything is working correctly, but you still can't get pregnant, it must be extremely frustrating. What's worse is the blame game. Someone has to be the guilty party. If not the male or female, then maybe the doctor was wrong. And, then the same diagnoses are given. Ten percent of all individuals seeking pregnancy fall into this category.

There are other diagnoses of course, but these are the most common with which I am familiar.

Emotional Rollercoaster
No one infertility story is identical. I can only share mine as one example. The names of medications may be similar, but the dosages and progression, even the extent to which women or couples will go to achieve a pregnancy if possible are unique.
I told my husband before we were married about my diagnosis of PCOS, and we sought out a reproductive endocrinologist. He first wanted me to start with a diabetic drug and lose weight. By the end of 2002, I had lost more weight than I ever had in my life, but the diabetic drug had done nothing - still no ovulation and, of course, still no pregnancy.
Then, we moved on to a combination of the diabetic drug and Clomid, an ovulation induction drug. Each month the pregnancy test was negative, and each month we increased the dosage. After 3 months at the highest dosage, we decided it was time for something else. We researched online for methods and clinics and finally settled on an infertility clinic in Tacoma.
They listened to our history of conception attempts, and, together, we decided IUI was the logical next step. I did not get pregnant with this first IUI, but instead suffered Ovarian Hyper-stimulation Syndrome (OHSS), was hospitalized twice, and had two liters of abdominal fluid removed from my stomach. We returned to Clomid after I recuperated, using again the highest dose, but I was no longer concerned about weightloss.
Four years later we considered IUI again but with a better clinic. They conducted more tests and determined that PCOS was the only hindrance to our achieving pregnancy. We were ready to aggressively pursue this path again. After three canceled cycles and two safe but non-productive IUIs, my doctor recommended ovarian drilling. It was an hour-long surgery, and I went home the same day. We again pursued IUI trying different combinations of Femara, Clomid, and follicle stimulating hormones.
In 2008, I experienced my first pregnancy, then a second, and then a third. The three pregnancies were followed by three miscarriages. The emotional and physical toll the process took on me was too much. We stopped after seven years of trying, and three years later, I'm still grieving the losses and still blaming myself.
At this point, we are unsure if we will try again. My tuberous sclerosis and conversion disorder have further complicated the issue. In 2012, we may revisit the idea of a having a biological child.

Friends and Family
During our infertility trials, I often wondered what was more difficult - never falling pregnant or falling pregnant and miscarrying. I think it is the latter. Everyone knew when and how we were trying to get pregnant. It was easier than being asked over and over when we were having kids. I came in late for work after blood draws and ultrasounds, so my employer and everyone I worked with knew what was happening. And for some reason, I told my boss about each pregnancy the same day I found out. I also belonged to an online support group, so they knew all my details. In other words, my life was an open book during our struggle with infertility. Everyone hoped with us and was excited for us, and some shared their empathy with our miscarriages. Somehow, the lows we experienced at negative pregnancy tests couldn't compare with the lows experienced with miscarriage. Hope followed by disappointment was nothing like hope followed by incredible excitement followed by heartbreak.
In her book, After Miscarriage, Krissie Danielsson tells her readers some of the worst things well-meaning friends and family members have said to women after they miscarry:

• It was for the best.
• At least you know you can get pregnant.
• Something was probably wrong with it.
• Maybe God knows you aren't ready for children.
• You're trying too hard. Just relax, and it will happen.
• Maybe you should get a dog instead; they're so much easier to take care of.
• It was just a blob of cells. It wasn't a real baby.
• At least you weren't very far along.
• It probably happened because ....

I don't care if I proved to myself that I could get pregnant. I don't have a 2 1/2 year-old asleep in the next room. I still have PCOS. And, I'm still grieving over my loss three years after the fact. I own my own feelings, but I can't help but hear the echoes from family and friends who instead of meaning well, should have known better.
Eventually, I left my online support group, and it proved one more thing to me: Even if you have suffered a miscarriage, you have not experienced it in the same way I have. I can tell you it brings heartbreak, but I can't tell you how long or how deep yours will be. We all experience grief and loss in different ways, and concurrent life situations may further impact your feelings.

Infertility can only resolve itself in one of three ways: successful pregnancy, adoption, or reluctant acceptance of being childless not by choice. It should be easy then to understand how great the happiness can be or how deep the heartbreak.