The Bad & The Ugly of Fertility & Infertility for that matter...

This was written by a dear friend of mine, and I am going to share it with you all. I fall into some of these categories, but not all, but it does really kind of put perspective on what someone who has been trying for years has and is going through. So without further adue, Infertility: The Bad & Ugly of Fertility, and Infertility for that matter

I don't know if Miss Manners, Martha Stewart or any other blond woman keen on handing out the rules of genteel and polite society has come out with a primer on things best not to say to women who have been pumped full of mind-altering hormones and endured an alphabet soup of invasive procedures (ART, IVFs, ICSI's, IUI's), one or more miscarriages and/or had failed adoptions.

So even though I am only a redhead who occasionally confuses my desert fork with my salad fork, I thought I would take this matter into my own hands and create a guide of what not to say to someone who is infertile, going through infertility treatment or has just had a miscarriage. Perhaps if I do this I and others who are in my position will stop enduring these comments that hurt more than a progesterone shot in the rear.

For those of you who have endured any or all of these statements you might want to print this and pass it out to all your family and friends to stop them from further inappropriateness. And, those who work in a reproductive endocrinologists office, you might want to give copies of this to each patient and have them give it out to their friends and family as they begin treatment. I am only half joking about this. Really, people need to learn what is okay and not okay to women who have extremely high levels of stress and estrogen.

These following statements are just not okay:

1. "You must not really have wanted to have a child or you would have one." Really, is that the problem? Me and Alex... we just didn't want it enough. Thanks.

2. "You must have some psychological block that is preventing you from getting pregnant." I am guessing that means Jamie and Britney Spears are totally free and clear of psychological issues. Good to know.

3. "If you would just change your beliefs about all of this, you would get pregnant. Have you seen 'The Secret'?" This question always makes me want to ask the well-meaning questioner if they have seen my middle finger. I believed I would get pregnant -- I mean, I believed. I believed so strongly that I had names and furniture and preschools picked out. If I didn't believe, I wouldn't have shelled out $100,000 in my attempt to conceive, and I certainly wouldn't have endured that kind of pain and suffering.

4. "If you would just quit trying you would get pregnant," or, "If you would adopt you would get pregnant." No, this myth is just that: a myth. According to RESOLVE: The National Infertility Association, "Studies reveal that the rate for achieving pregnancy after adopting is the same as for those who do not adopt" -- and the percentage of people who get pregnant after failed infertility treatment is even smaller. I find the notion of adopting in order to get pregnant totally unconscionable. If you want to adopt then you adopt, but you don't do it as a means of getting pregnant.

5. "God has another plan for you. God doesn't want you to be pregnant," or, my personal non-favorite, "God wants you to be in service and if you had a child you couldn't do God's will." Please, please, I beg you, unless God has phoned you up or shown up in your living room with choirs of angels, would you please do me a favor and not be a spokes person for any deity on my behalf. Only I know my relationship with God, and God doesn't really have much to do with having sex, and creating a baby... a sperm and an egg do that... chromosomes do that... God is just a belief, something I believe in, and not everyone else can believe the same, nor do they choose to. I choose to believe in God, but sometimes, when it comes to fertility, its a lot easier to not go the route of "God didn't want this" or "God has another plan"

6. Another of the God ones that should to go unsaid: "Maybe God knew you wouldn't have made a good parent." Following this logic one would have to infer that all the people who have children are great parents. One trip to Mc Donalds will disprove this absurd theory. "God" gives all manner of incompetent people children. I know many parents that any higher power in its right mind would have never chosen to care for a houseplant let alone a helpless child, and I also know many parents who don't really deserve to be parents...

7. "I am thinking about having an abortion." No, do not tell me this. I am all for choice. Really, I am. I just cannot hear about your choice just now, because I am wanting a child so so bad, and your choosing to murder your child, why?

8. "I had six kids, and as soon as I had them I realized I didn't want to be a mother." It was 6th child that made you realize this? When talking, it is important to be aware of your audience. This is not something you say to a woman who was not able to have one child.

9. "I have a very small family, I only have four kids." Please be quiet.

10. "You can be a mother to your friends kids." I know people mean well by this. But, to those of you who say such things, let me tell you that babysitting for your kids is not the same thing as being a parent. It just isn't.

11. "Well, why didn't you try and adopt?" I did, and it hurt more than the IVF when the mother decided she had changed her mind and she would instead go on welfare and drop out of school so she could keep her child. I can't do it again. And by the way, even if I managed to adopt, I would still be grieving the loss of not being able to have my husband's child.

12. Here's one I am getting a lot of lately: "Get over it." I am not likely to get over it. This is a wound and emptiness that will be with me forever. Infertility is, as Shelagh Little writes, "like a low-level, lifelong bio-psychosocial syndrome. My physical inability to produce children has emotional and social consequences that I struggle with, at least to some extent, every day."

13. "You are soooooo lucky not to have kids." I can take this one now and then, but on the day after a failed IVF, I could not stand to hear how lucky I was and how horrible kids are. I know it may be true. I know the statistics about how childless couples are happier and have more satisfying marriages -- but we were going to be the couple with the house filled with kids, bikes on the lawn, and a tree house in the yard. We would not be the couple who spends holidays at others' homes -- we were going to have a family, or so I thought.

14. "Don't ever give up. Keep trying. You can't stop now. Maybe just one more IVF and you will get pregnant." This is one that really gets to me. I once asked a friend of mine who has worked with the terminally ill if when people in the late stages of cancer decide they can't bare any more treatment if they are met with this same kind of attitude. She assured me that they aren't. With cancer and other terminal diseases there seems to be a collective understanding that at some point that the compassionate thing to do is give up and die with dignity. The same kind of understanding does not seem to be there for us infertiles. I suppose that it seems to an outsider that there is always something more you can do and that if you "really wanted a baby you would do it." We did IUI, IVF, and ICSI. That is as much as we could do. We could not do egg donor or hire a surrogate or attempt another adoption. There was a time when we could do no more. There was a point when trying to have a baby started to feel like it was killing my spirit, damaging my relationships and draining our finances. However, since there are more things we could have tried, I often get the sense from others that I don't deserve to grieve over our childlessness, that we should keep going, and only when we have exhausted every option do we then deserve to grieve.

Infertility treatment, according to the statistics, is likely to cause anxiety and depression equivalent to that experienced by those with cancer or H.I.V./AIDS. With infertility there is guessing, hoping, and odds that are often different in theory than in practice. Infertility treatment takes a significant toll on your body, relationships and finances -- and it is up to each individual to determine when she can take no more.

My suggestion on what to say when you learn that someone is suffering from infertility is very simple: If you find yourself at a loss what to say or an impulse to say any of the previous things that you shouldn't, just say a heartfelt "I'm sorry" -- that is plenty.

I could add a few more:

15: Are you crazy? Just wait until you are a grandmother.

16. One of these days you won't even think about it.

17. Advice of any kind-Giving unwarranted advice on any matter is not a good idea. Infertility is no different.

Did the woman ask you for advice?I have never asked anyone other than my husband and doctors for advice on this topic infertility, and yet many people feel it necessary to contribute their two cents. This is the most intimate and personal of all subjects, please refrain from giving unrequested advice.Do you regularly discuss a woman's ovaries, cycles, fertility signs, and methods of intercourse? Do you have no shame? Even if I didn’t struggle with these issues, I would never wish to discuss these topics. Ever. Never. My inability to conceive shouldn’t make these topics fair game for coffee conversation. Please have a little modesty.

18. Advice Disguised in the form of the Question: What you say: “Have you tried...? Am I supposed to or even allowed to answer "yes"? Do you really want to know the answers? Am I supposed to answer at all? Can I just pretend you didn't ask me those questions?

19. I just heard about.... (fill in the blank)... and immediately thought of you...a hybrid of the "Have you tried?" and the unwanted advice with an additional humiliation. "I just heard about this (doctor, method, theory, pill, shot, cream, herb, hormone, supplement, gel, suppository), and immediately thought of you." Imagine yourself in this situation: someone comes up to you in a public place, rests a hand tenderly on your arm, looks deeply into your eyes, is positively bursting with excitement, and says with the most eager anticipation possible, "I just heard from one of my friends who read an article in a magazine about your condition. There's this gel cap suppository for Irritable Bowel Syndrome and the second I heard about it, I thought right of you!"

Really? Does that instantly conjure up my image in your mind?

Please know that, this effects me so personally and deeply, I have done exhaustive research on this subject. I know you just heard about this (fill in the blank), I'm grateful that you want to help, but I've eaten, slept and breathed this topic for years. If I haven't heard about it (which hasn't yet been the case), I trust my doctor has and I'll discuss it with him soon. But please... next time you see a daisy, think of me.

20. Religious Consolation

What you say: “It'll happen in God's time.”

What I hear: "You don't trust God." "You're not patient enough." "I have insider knowledge that He will eventually give you children."

This statement shouldn’t be taken harshly, because the person who says it is almost always a well-meaning little old lady. But it can be very hard to hear, for while intended to be consoling, it’s actually quite loaded. It assumes:

- that you know what God will or will not do for me (He WILL grant you children, just not right now)

- that I'm not accepting His will for me right now

- that I'm not being patient because I dare to desire children now instead of waiting passively

We will die in God’s time. It will rain in God’s time. Everything happens in God’s time. You’re actually stating the obvious and it’s not really relevant to the conversation. It gives hope for something that may never happen, and berates the woman in the meantime. Far from being helpful and consoling, this statement used to rile my feathers more than most of the others. Now I just smile and nod.

21. Affirming the Gift of Life While Insinuating…?

What you say: "This must really make you understand that children are a gift, hm?"

What I hear: "Kids are a gift and you ain't got ‘em."

This is actually a new one, and yet I’ve heard it more than a few times in recent months. Well, yes, I am in a unique position to understand that reality more than most people. And… so… you've been given several gifts and I've got none... what's your point? How exactly would you like me to respond?

22. You've already had two, a boy and a girl....that's perfect. Perfect for whom? What are you saying? I'm being greedy for wanting to have more children? With my beloved husband who hasn't even had one biological child that we have raised together from birth?

23. Everyone’s Perfect Solution

What you say: “Why don’t you just adopt?”

What I hear: dagger plunge, twist, thrust, rip heart out, leave her there to bleed to death

“Why don’t you just adopt?” Oh, that the answer to all of life’s most crushing pains could be so easily answered by such a simple solution.

“It’s never going to happen for you. Why don’t you just give up all of this nonsense of conceiving a child in the life-giving love of your marriage, growing bone of your bone and flesh of your flesh within your womb for nine months, sacrificing your body while giving birth, nourishing your child with her mother’s milk, bearing a child with your husband’s radiant eyes and sheepish smile… you’ll still have a kid and will be helping someone else out, too!”

Adoption is a calling, it’s not a fallback plan when all other methods fail. You don’t tell a woman in her mid thirties who hasn’t found a spouse yet, “Why don’t you just become a nun? Clearly you’ll never find a man so why don’t you just give up, give of yourself and go don the veil?”

Of course it’s a worthy call! Of course it’s a good thing to do! But you can’t guilt a noble calling upon someone because the desire of her heart isn’t happening.

Adoption doesn’t cure infertility, it eliminates childlessness. Something very real… entirely integral to what it means to be a woman, the primary purpose of her marriage, the centrality of her very being, is lost by the inability to conceive and bear children, to procreate. You can’t just plop a baby on her lap and expect everything to be all better.

And you know what? Maybe we do want to adopt. Maybe it is our calling. But your question requires a response I may just not want to give you.

The question proposes a quick and easy solution for a process that is far from quick and easy. The question assumes we can handle wait lists (especially for infants) that could last several years. The question assumes we are prepared for an adoption that can fall through at the last second, causing unspeakable emotional agony. The question assumes we have a separate bedroom in our house and a stable enough income to pass the home study. The question assumes we have the $30,000+ required to adopt.

But by all means...that is so totally your business.... Let me open my house, my bank statements, and my heart to you to answer your “simple solution” question.

Adoption isn’t as easy as going to the local group home, picking up a cheery cherub and taking her home. That’s what your question makes it sound like. Please, don’t think a) your simple solution hasn’t occurred to us, or b) your simple solution is, in fact, so simple.

And, Finally....my PERSONAL FAVORITE:

“God has a plan. Trust Him.”

God has a plan. OK, so I read about this kid, a teenager, who grew up in Rwanda and saw his parents shot before his eyes just before being kidnapped by a rebel army that turned him into a killer.

“God has a plan.”

What? Did God’s plan involve this child becoming an orphaned murderer against his own will? Does ‘God’s plan’ involve babies dying?

Being a believer doesn't mean you have to be so stupid. God may have a plan but there are environmental and medical factors causing fertility issues, and it is more and more common. Would you tell someone dying of Cancer or AIDS that “God has a plan”? Do you mean to say that God gave them cancer or AIDS?

I have a new slogan: “God has a plan: shit happens.”

Agree or disagree....

So What DO You Say?

Must you say anything at all? Tragic as its malfunctioning is, I don’t really see how my reproductive system should ever be our topic of conversation. But I assure you, if I ever do need to talk about it, I’ll broach the subject with you, my dear friend… my sister… my mother… my husband....my adult child.... not you, a casual acquaintance in a chance meeting.

No, I feel the need to say something. Alright, if you must say something, then please let it be a simple but empathetic:

“I’m praying for you,”

Especially if you actually are. I would never turn down a prayer! I truly appreciate them. I cherish them. I live on them.