If You’ve Got Something Fertile to Say…Please Keep it to Yourself!

I wanted to smack her right in the face. The flight attendant’s snippy, “I’m the mother of 6 children,” comment was enough to put me over the edge. Really? Yes, my child is screaming and doesn’t want to sit in her seat, but knowing that you are a fertile, super-mother with 6 loads of experience is not going to calm my 2 year-old or me for that matter. In fact, using your mother of 6 status is the last thing that any woman in the middle of several failed infertility treatments needs to hear. Why don’t you go take your own seat!

Sorry, to sound hostile, but time and time again the fertile mother either innocently, unknowingly, or even intentionally says something that stings. I do my best to dismiss the innocent and ignorant comments, but sometimes it just gets to be a little too much! So, I thought I would provide those of you blessed with super fertile powers a quick tutorial on what not to say to a woman without kids, someone with known infertility, or any woman you don’t know much about. This isn’t all inclusive…but it is fairly lengthy! For all those who do or have struggled with infertility, feel free to add your suggestions in the comments.

What Not To Say In An Infertile World:

1. When are you planning on starting a family? Hint…Hint? (Please, stop asking!)

2. You know the clock is ticking, right? You aren’t getting any younger. (My ovaries are none of your business)

3. Don’t you guys want kids? (Of course not. Don’t most women despise the idea of motherhood?)

4. Do you have any news (pregnancy implied)? (If I wanted to tell you I would have.)

5. How many kids are you planning on having? (Is that really any of your business?)

6. Do you only want one (said with disbelief)? (If I did what’s wrong with that? But, no, my heart is breaking trying to have another!)

7. It’s about time for another isn’t it? (Thanks for keeping track of our family planning.)

8. Your daughter needs a sibling! (No kidding!)

9. Having one is so much easier. (Not when you have to go through infertility treatments to have another)

10. You should be happy you only have one. (Why don’t you try it?)

11. I can’t believe I’m pregnant again. We weren’t even trying. (It must be amazing to be you!)

12. I wish I weren’t pregnant. (I will gladly take your baby)

13. Being pregnant stinks. (Being infertile sucks!)

14. So, you guys are more focused on your careers, right? (Having a career doesn’t mean you don’t want kids!)

15. As a mom of x number of children, let me tell you…(Please don’t.)

16. Life is so easy when you only have one. Just wait! (I am waiting.)

17. I would never want a test tube baby! Oh, your baby is so cute! (She’s a test tube baby.)

18. Be glad you aren’t pregnant right now! (Seriously?)

19. That’s so nice that you don’t have any kids yet. You can travel and do such fun stuff. Be glad you still have your freedom. (I’d prefer to lose my freedom!)

20. I have a great book on how to get pregnant. (I wrote it.)

21. Have you tried putting your legs over your head? (Yes, for 48 hours at a time.)

22. You need an ovulation kit! (My ovulation is just fine thanks.)

23. I have a list of fertility foods that will get you pregnant in no time. (I’ve tried eating from the Garden of Eden. Fertile foods are no match for incredibly low sperm counts. It’s going to take more than pineapple core.)Beautiful young woman making Yoga exercises on the beach

24. Have you tried essential oils? (I practically drink them. Thank you.)

25. You guys just need a weekend away. (Hmm…pretty sure three days in bed isn’t going to do the trick.)

26. You need to stop stressing. (Stop talking, please. You’re stressing me out!)

27. Why don’t you just adopt? (Why don’t you?)

28. Let me tell you what worked for us. ( I really don’t care.)

29. Can I give you a piece of advice? (As though I can say, “No” without sounding rude)

30. Maybe God has something different for you instead of motherhood. (How consoling!)

31. Dr. Oz says…(Why do I care what a cardio-thoracic surgeon has to say about my fertility?)

32. The power of positive thinking is amazing. Visualize yourself pregnant. (What do you think I’ve been doing for the past 5 years!)

33. I know how you feel. It took us a whole month to get pregnant! (Wow, that must have been hard!)

34. Are you taking your vitamins? Maybe going gluten free, caffeine free, dairy free, soy free, and deodorant free would do the trick. (Am I allowed to eat?)Girls Kissing Mom's Belly

35. Isn’t this like your zillionth time going through IVF? (Thanks for reminding me.)

36. Maybe you should focus on learning to be content with what you do have. Isn’t having one enough? (Isn’t that between me, my spouse, and God?)

37. Infertility treatments are so unnatural (Clearly!)

38. There are worse things in life than infertility. You could actually have a serious medical problem to deal with. (True. That helps me cope how?)

39. Infertility isn’t really a medical problem. Having kids isn’t medically necessary. (Umm, who gave you your honorary medical degree?)

40. That’s nice that you can afford IVF. I hear that’s only for rich people. (It’s called debt. The most cost ineffective way to make a baby.)

41. You are saving yourself a fortune by not having kids. (Actually, I’m spending a fortune trying to have one.)Six pregnant bellies at different stages of pregnancy.

42. If you had more kids you’d understand…(If you had infertility you’d understand).

43. I totally know what you’re going through. My friend had infertility. (How could you possibly know what I’m going through.)

44. You do know how to make a baby right? All it takes is some good old fashioned sex! Do we need to get you a room? (Hmm…baby making can be a little more complicated!)

45. EVERYTHING ELSE EVER SAID

For those of you who are offended by my comments above…I don’t apologize. I have uncomfortably experienced every single comment mentioned above. And, while my real life responses were always gracious, I decided it was time to let off a little steam. Please know that that I don’t hold grudges. So, if I just quoted you in the 45 comments above…know that it has already been forgiven and forgotten.

You don’t have to walk on egg shells around those of us with infertility. We are happy that other babies are being born in the world. We want other people to be blessed with little ones. But, sometimes (most of the time) we do need a little sensitivity. Just think twice before the fertile you makes an overly fertile comment:)

Disclaimer: This article is clearly one sided (from the infertile perspective). It isn’t meant to criticize those with numerous children who are amazing parents with their own set of challenges. Nor is it meant to minimize the challenges of an unexpected pregnancy. Please take it as what it is…a rant from someone in the middle of infertility treatments for an extended period of time.

From,

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It’s a Hush, Hush Word…Infertility

SHHHHHHHH…..I’ve got INFERTILITY ISSUES! People put autism puzzle stickers and breast cancer survivor stickers on their cars, but I have yet to see an “Infertile Couple” awareness sticker. Is the diagnosis of infertility any less of a diagnosis? Insurance companies lead us to believe this by their lack of coverage for medically necessary infertility services (a blog for another day).  Although infertility may not be life threatening like breast cancer, it is a painful and limiting condition that profoundly impacts many lives.NEW YORK - MAY 24: Actress Sarah Jessica Parker attends the prem

I assume that the stigma of infertility in part stems from the fact that SEX is broken. Who wants to admit that their sex doesn’t “work”? And, although Sarah Jessica Parker may have normalized talking about explicit sex over the dinner table, many of us don’t want to share the intimacies of our relationship with friends, let alone strangers. In my mind, one of the beauties of intimacy is that it is something shared just between my husband and me. And, although I don’t shy away from joking about sex with friends now and then, I don’t make it a habit to share what I do in private. Talking with girl friends about periods, child-birth, and boobs is no big deal. But, infertility doesn’t naturally or comfortably fall into that “normal” girl talk.

Our culture is inundated with sexuality, but the idealized kind filled with Victoria’s Secret Angels, Tatum Channing physiques, and Ryan Gosling charm (okay, and physique!) Infertility is poor performing sexuality. Who wants to talk about that? Not men, and not most women. No, men hate bringing up (sorry for my choice of words here) their struggles with erectile dysfunction. Most aren’t even able to verbalize their complaint. Instead, they just point at their crotch and stutter, “I can’t, umm,” followed by a fill in the blank. And, in the past 15 years I have only had one woman come to me concerned over her lack of orgasmic ability.Lovers

Thus, infertility falls into the hush, hush sensitive topic category. It is sensitive, but the shame and stigma associated with it prevent women and men struggling with infertility from getting the resources and support that they need. Breast cancer used to have a similar stigma associated with it. Women should not openly talk about their breasts! How improper! Yes, it was cancer, but the “unmentionable” kind. Thankfully, the shame that used to accompany the diagnosis of breast cancer has been diminished due to proactive campaigns encouraging and empowering us to embrace our womanhood, “feel our boobies,” and kick cancer in the butt. This change in culture has led to life saving advancements in breast cancer research and treatments.

Can a similar cultural revolution transform how infertility is viewed? Yes, but only if people are willing to step outside of their comfort zones. If thirty year olds still refer to their genitalia as their “junk,” how are we going to have a real conversation about infertility. Using real words and talking about real life problems is a good starting place. Acknowledging that the human body often fails us, and that infertility is one of these physical and biologic failures that is out of our control, lessens the stigma, even if slightly. Normalizing the idea that infertility is incredibly common may also empower men and women to open up more readily about their struggle toward parenthood. The more that people talk about this culturally uncomfortable issue, the less uncomfortable it will become.Group of multiethnic babies crawling isolated on white backgroun

Reducing the stigma of infertility will positively and powerfully impact the infertility world. Infertile couples will have a larger support system if more people are willing to share their stories. This in turn will lead to increased social networks and social capital. With increased unity focused on the cause of infertility, more money will be raised for research, leading to improved infertility treatment options. Awareness campaigns may lead to political activism, forcing insurance companies to take infertility seriously and cover necessary treatments. Imagine a world where people have increased fertility because of improved infertility treatments and insurance coverage! If population control is your thing, then this may not excite you. But, for those of us hoping to add to the human race, this thought is utopia!

From The Mom in Me, MD

 

Our Infertility Journey (1.3): My turn to be the patient!

Young beautiful woman with depressionI stared at the computer screen, overwhelmed, dazed, and mad that we had wasted time trying to fix something that was a long shot. I regretted waiting to meet with the Reproductive Endocrinologist. That should have been our first stop instead of our last-ditch effort. Paging through countless infertility clinic profiles online was getting me nowhere. I needed to make an appointment somewhere…and I needed to do it NOW. I wanted to be a mother more than anything! I didn’t have any time to waste. Each second-hand strike on the clock was another moment counting against me, my ovaries, and my sanity.

I picked up the phone and made the call. I was sitting in the middle of the hospital cafeteria, surrounded by coworkers and strangers. It was the only place that I could get good reception and the only time that I had during the day while the infertility office was open. Not ideal! I’m already known to speak softly, and since I didn’t want to announce to everyone eating lunch that I needed an infertility appointment, my voice (which I thought was booming) was probably a faint whisper. The secretary on the line couldn’t hear a word of what I was saying. I felt my face turn ten shades of red as I turned up my volume. “I need an infertility appointment…I can’t get pregnant! Sex doesn’t work!” Had I really just screamed that at the top of my lungs? I quickly looked around, expecting to see shocked stares. Instead…nothing. No one even met my glance. My secret was safe, but strangely that only made me feel more isolated.Young sad woman alone in a black stone beach.

Hearing the woman’s voice on the other end of the phone jolted me back to reality. Three months? That was the next available appointment? Four months to get in with the doctor I preferred? The secretary reassured me that if a cancellation came up they would let me know. “Right,” I said to myself… like I would be top of the call list. I knew how these things worked. The only call I would be getting would be to reschedule to a later date…and I was right!

Four and a half months later,  my infertility appointment finally arrived. I was nervous but excited to finally get some answers and come up with a “get pregnant” plan. Choosing which infertility specialist to see had been challenging. Word of mouth was how I finally decided on my physician. Knowing OB/GYN residents who had worked with the doctors in the reproductive endocrinology practice was the most helpful. They were able to give me the inside scoop on personality, bedside manner, procedure skill level, and expertise. I had chosen a female physician who came highly recommended. I was told that she was “to the point,” but she was great at what she did. I needed great. I wanted amazing bedside manner too, but if I had to choose between success at getting pregnant and feeling cozy without getting pregnant… I was 100% for success.

Choosing a female physician wasn’t coincidental. As a female physician, I tell my male patients who are uncomfortable with a woman examining them that since I see so many body parts all day long, nothing shocks or embarrasses me. Penis, vagina, testicles, breasts…it’s all part of the job. However, as a patient, I wanted a female physician. Somehow, I felt like it would be just a little less uncomfortable discussing my most intimate concerns with another woman.Honeymoon couple romantic in love at beach sunset. Newlywed happ

Although Dave was able to make it to our first appointment, I still felt slightly alone and uncomfortable. Anytime you are discussing infertility it just gets touchy. Trading in my white coat for a patient gown wasn’t my idea of fun either. At that point in my life, I wasn’t much of a crier. Yes, at home, I could have as good of a melt down as anyone, but never in public. I recounted our story feeling hopeful that the Reproductive Endocrinologist would simply say, “No, problem. We will get you pregnant in no time.” I knew that she would want to rule out any female factor contributing to our inability to get pregnant, but I was “pretty” sure nothing was wrong with me. My cycles were like clock work. I never missed. Deep down, I was hoping that there was nothing wrong with me. I am not sure why it made it easier, but it did make it just a little easier to know that I wasn’t the reason we were infertile. I wasn’t mad at Dave. It wasn’t his fault. But, somehow, it made me feel better to know that it really wasn’t my fault. Looking back, it is strange to think that it would make a difference; but, when you can’t get pregnant you get this feeling of shame…this ultimate sense of barrenness. It is hard to describe other than as a feeling of insufficiency and brokenness. Being able to say out loud or even say to yourself that,  “Nothing is wrong with me,” somehow makes being pregnantless a little less painful.

Our Reproductive Endocrinologist confirmed my thoughts on our next step. I would need a full work up, and Dave would need additional testing to see if there was any other reason for his low sperm count other than the varicocele. While sitting in the exam room, I noticed a fancy ultrasound sitting by the bedside. The vaginal probe was covered in blue medical gel and then carefully covered over with a condom. Very appealing indeed! Even more appealing, when she informed me that the probe and I would be making a very intimate acquaintance in a few moments. I was asked to undress from the waist down for the ultrasound. Feeling more than half-naked in my gown, socks and that paper-thin sheet, I dreaded what was to come next. It is funny how uncomfortable I initially felt about the ultrasound probe. 20-30 condom covered ultrasound probes down the road, vaginal ultrasounds felt as routine as brushing my teeth…okay, maybe not that normal!

With the ultrasound done, I was told to get dressed so that we could discuss results and options. If you don’t already know this, the one wipe and tiny tissue box the nurse leaves you to clean up the blue gel is pathetically insufficient. I actually discovered one reason to love the paper-thin sheet…extra large towelette! To my relief, I was told that the ultrasound looked great. Finally, some good news! I’m a bad news first kind of girl, so what came next threw me completely off guard.Worried woman looking at a pregnancy test in the bathroom.

I was expecting that we would start with intrauterine insemination. Dave would give a “sample.”  I would poke myself with a few shots…they would squirt the sample into me…we would get pregnant. To my dismay, this idea was quickly shot down. Because of Dave’s low counts the physician matter-of-factly told us that our best and only option was to go straight to IVF (in vitro fertilization), and not just IVF, but a more specialized type called ICSI (intra cytoplasmic sperm insemination).

As I mentioned, I am not a crier. Medicine teaches you to develop a thick skin. You can’t treat patients effectively if you cry with all of them. It teaches you to desensitize while at the same time to show sensitivity. Remove yourself one step away or you will become consumed and lose rationality and perspective. It teaches you these things, but when your heart is broken all in one moment for yourself, it is hard to keep from crying. I started swallowing so many tears that my nose began to run. All I could think of was IVF! Somehow, that felt like a punishment, a worst case scenario. IVF was a last resort, not the first step.

From The Mom in Me, MD

 

Our Infertility Journey (1.2): Another Bump in an Already Bumpy Road

dating and relationships concept - stressed man with man outsideAfter a thrilling day working in the dermatology clinic looking at skin cancer and warts, I checked my phone for missed messages. A text from Dave simply said, “Call me when you get a chance.” So, being the loving wife that I was, I gave him a call…5 hours after he had sent the text! Dave’s phone went straight to voicemail, but I didn’t have to wait long to find out where he was. My phone rang. It was the Emergency Room.

Dave quickly calmed my panicked state of mind by letting me know that he wasn’t dying, but he then sheepishly informed me that he had seriously injured himself that morning. No, not to worry, he didn’t damage his male parts (Although, that would make this story even more intriguing). No, he had ruptured his pectoralis major tendon, the tendon that attaches your chest muscle to your arm. He had been doing declined bench presses in the gym during a quick break from rounding on patients in the morning. In the middle of his set, something popped, electricity tore through his arm, and his weights came crashing down. Sadly, the tear was so complete that he was able to diagnose himself by simply feeling that the muscle was no longer attached. He now had a case of “saggy boob syndrome.”

You may wonder why this had any impact on our fertility or why I should even include this in the story. Well, now our primary medical focus was no longer on infertility but on his shoulder. After a stat MRI confirming his injury, Dave was scheduled for surgery to reattached the muscle to the bone with bone anchors. It was a grueling recovery. He was in an immobilizing arm splint for six weeks and was only allowed to lift something as light as paper and pencil for three months. The recovery included hours of physical therapy and hours waiting in the ortho office. Because his dominant arm had been damaged, he was unable to do most things for himself for quite a few weeks (I even remember changing the tire on my car while he watched.)Honeymoon couple romantic in love at beach sunset. Newlywed happ

Needless to say, trying to make a baby is a little tricky when you aren’t supposed to move your upper body… at all…and you are in a fun arm contraption that starts to have a lovely aroma after just a few days. So, baby making efforts were pushed to the back burner. Months later, with his arm finally on the mend, Dave decided he was ready for surgery number 2…his varicocele. After all that he had been through, this surgery now seemed minor. The operation went smoothly, but we had to wait another three months before we could repeat the semenalysis. We held onto the hope that Dave’s sperm counts would top the charts. But, instead of chart topping numbers, the count was at an all-time low.

dating and relationships concept - stressed woman with man outsiI felt defeated. Our chances of getting pregnant on our own were now next to none. It was my turn to become the infertility patient, and the thought turned my stomach. The fear of the unknown crept over me. Would I ever be a mother? What would it take, and how much was I willing to give?

From The Mom in Me, MD

 

 

Our Infertility Journey (1.1): Who’s to “Blame”

A man and a woman on a pierCrumpled up in a ball on the sofa, I stared at the television with heavy eyes. I was exhausted, but I had that strange high that sleep deprivation brings. Although I had been up for 36 hours, my adrenaline high had yet to fully fade. I had delivered several babies, coded a patient in the intensive care unit, and admitted over 20 patients overnight. I could never go right to bed when I made it home. My body longed for sleep, but my mind wanted just a few minutes to unwind. My usual routine on post-call days was to hit the sofa for an hour of mindless TV before trudging up to bed.

Lately I had been following the reality television show, Giuliana & Bill. On this particular post-call day, the show revealed that G&B’s only option for having their own child was to pursue In Vitro Fertilization. My heart sank for them, and then I thought of myself. What if that was our only option? What if we really couldn’t get pregnant on our own after all? I tried to shake the fear. I dismissed it as emotional irrationality from exhaustion. But, the next morning after a good night’s sleep, that same sickening feeling lingered in my stomach. What if?

My husband is an eternal optimist. I love him to death, but sometimes he doesn’t just see the glass half full, he believes that it’s overflowing! When he started to question if something was wrong with our ability to conceive, I knew that the sick feeling in my stomach was more than just paranoia. It was time to get some answers.Three Hands Pointing

Dave had been diagnosed with a varicocele in college. Many men have these harmless dilatations in the blood vessels in their groin, and they are usually nothing to worry about. In general, they don’t lead to infertility if they are small, but larger varicoceles can potentially heat up the testicle, leading to damaged sperm. Countless hours of standing in the operating room with gravity as his enemy had caused Dave’s varicocele to become rather large and uncomfortable. Because this was the most obvious issue contributing to our baby making struggles, he decided it was time to get it reevaluated. Part of this evaluation included a semen evaluation.

This was Dave’s first journey into the uncomfortable world of infertility. Our medical center had one small room for sperm collection (aka male masturbation station). The idea just seemed dirty, but it guaranteed the most accurate specimen. After uncomfortably waiting his turn for the room and accomplishing his mission, Dave transported his own sample to the lab where his swimmers were scrutinized for quantity, quality, and movement. Now we waited.

I remember Dave’s voice of concern laced with optimism when he called me with the results. His genetic components were great, his sperm movement was great, but…his count was incredibly low. I tried to sound positive, masking my dismay. I didn’t want him to feel worse than I knew he already did, but the sickening feeling in my stomach was so strong that it made me want to throw up. Something was wrong! Although my mind was racing in a million different directions, I managed to ask, “So, what now?”unhappy heterosexual couple

The plan was to repeat the count just to make sure that it wasn’t a lab error. When the repeat number was worse than the first, I was devastated but optimistic at the same time. Varicoceles could be surgically corrected! And, the urologist told us that we could still get pregnant on our own; It would just be more difficult. We decided that surgery was worth a try, and we didn’t want to waste any time. But, before we could schedule the operation, I received a call from the emergency room that changed everything!

From The Mom in Me, MD

destigmatizing infertility in a baby booming culture

Beautiful young woman with pregnancy test. In bathroom.

In my previous blog I alluded to the fact that the inability to get pregnant is laced with stigma and shame. People put autism puzzle stickers and breast cancer survivor stickers on their cars, but I have yet to see an “Infertile Couple” awareness sticker. Is the diagnosis of infertility any less of a diagnosis? Insurance companies lead us to believe this by their lack of coverage for medically necessary infertility services (a blog for another day).  Although infertility may not be life threatening like breast cancer, it is a painful and limiting condition that profoundly impacts many lives.

I assume that the stigma of infertility in part stems from the fact that SEX is broken. Who wants to admit that their sex doesn’t “work”? And, although Sarah Jessica Parker may have normalized talking about explicit sex over the dinner table, many of us don’t want to share the intimacies of our relationship with friends, let alone strangers. In my mind, one of the beauties of intimacy is that it is something shared just between my husband and me. And, although I don’t shy away from joking about sex with friends now and then, I don’t make it a habit to share what I do in private. Talking with girl friends about periods, child-birth, and boobs is no big deal. But, infertility doesn’t naturally or comfortably fall into that “normal” girl talk.

Our culture is inundated with sexuality, but the idealized kind filled with Victoria’s Secret Angels, Tatum Channing physiques, and Ryan Gosling charm (okay, and physique!) Infertility is poor performing sexuality. Who wants to talk about that? Not men, and not most women. No, men hate bringing up (sorry for my choice of words here) their struggles with erectile dysfunction. Most aren’t even able to verbalize their complaint. Instead, they just point at their crotch and stutter, “I can’t, umm,” followed by a fill in the blank. And, in the past 15 years I have only had one woman come to me concerned over her lack of orgasmic ability.

Thus, infertility falls into the hush, hush sensitive topic category. It is sensitive, but the shame and stigma associated with it prevent women and men struggling with infertility from getting the resources and support that they need. Breast cancer used to have a similar stigma associated with it. Women should not openly talk about their breasts! How improper! Yes, it was cancer, but the “unmentionable” kind. Thankfully, the shame that used to accompany the diagnosis of breast cancer has been diminished due to proactive campaigns encouraging and empowering us to embrace our womanhood, “feel our boobies,” and kick cancer in the butt. This change in culture has led to life saving advancements in breast cancer research and treatments.

Can a similar cultural revolution transform how infertility is viewed? Yes, but only if people are willing to step outside of their comfort zones. If thirty year olds still refer to their genitalia as their “junk,” how are we going to have a real conversation about infertility. Using real words and talking about real life problems is a good starting place. Acknowledging that the human body often fails us, and that infertility is one of these physical and biologic failures that is out of our control, lessens the stigma, even if slightly. Normalizing the idea that infertility is incredibly common may also empower men and women to open up more readily about their struggle toward parenthood. The more that people talk about this culturally uncomfortable issue, the less uncomfortable it will become.

Reducing the stigma of infertility will positively and powerfully impact the infertility world. Infertile couples will have a larger support system if more people are willing to share their stories. This in turn will lead to increased social networks and social capital. With increased unity focused on the cause of infertility, more money will be raised for research, leading to improved infertility treatment options. Additionally, awareness campaigns may lead to political activism, forcing insurance companies to take infertility seriously and cover necessary treatments. Imagine a world where people have increased fertility because of improved infertility treatments and insurance coverage! If population control is your thing, then this may not excite you. But, for those of us hoping to add to the human race, this thought is utopia!

From The Mom in Me, MD

Sex at its Worst

Distressed Couple Finding Out Results Of A Pregnancy Test

The worst sex is baby-making sex. It starts off romantic, even inspired, but it quickly loses its charm. Some lucky couples may be exempt from my assessment. For example, the “oops couple” may have been having the time of their life only to find out that they are unexpectedly pregnant. Or, the “let’s stop the pill for one day and see what happens couple” may really enjoy the added benefit of being off of a medication that has a tendency to stifle orgasms and intense sex drive. For most of us, baby-making sex is timed, routine, get it done sex. It is layered with the stress of, “Will I ever get pregnant?” It may start off fun because the thought of making a baby together is beyond incredible, but when months start to pass and periods keep coming, the giddy gitters are replaced with a nervous question, “Will it ever happen?”

It would be nice to tie a bow around fertility and say that most of us have it. Realistically, one in eight couples struggles with infertility according to The National Survey of Family Growth from the Centers for Disease Control. That indicates that if more than eight of you are reading this, at least one of you is struggling with or will struggle with infertility. Not to rain on the stork’s parade, but this is something that women should be aware of so that they aren’t blindsided in their journey toward motherhood.

Knowing that you may struggle with infertility may be hard to acknowledge, but it may push you to seek help a little more quickly. Many women have embraced the career path, pushing back their nesting days into their thirties. In our culture this is more the norm than the exception, myself included. Although the typical rule of thumb is to try for at least a year before worrying about infertility, this doesn’t apply to those of us with ticking fertility clocks. Those of us desiring to enter the motherhood arena past the fertility prime of our twenties should be aware that the timetable is quite different. Women in their mid-thirties should actually consult an infertility specialist after only six months of unsuccessfully trying to make a baby the old-fashioned way based on current recommendations.

Although this may seem like a very short time to let nature take its course, the infertility workup path can be quite protracted. Many infertility clinics are booking out several months down the road. Completing a full infertility workup takes at least a month for all of the blood work, testing, follow up appointments, and decision making on how to proceed. So, if you haven’t gotten pregnant in six months, you most likely won’t even start infertility treatments for several months more. And, who is to say how many infertility treatments you will need before you actually get pregnant? Going into baby making in your thirties or forties with this knowledge may improve your chances of getting pregnant by encouraging you to be more proactive in investigating your fertility status sooner.

On a side note, some of you may be offended that I mention your twenties as your prime fertility years. Don’t start chewing me out. Biology and genetics are the ones running the show. I’m only stating the facts. Besides, it’s not like I’m in my twenties either. It is a confirmed fact that our ovaries have fewer and fewer healthy eggs with each passing year. Acknowledge it. Accept it. Embrace the fact that you are no longer in your twenties!

In addition to seeking an infertility evaluation sooner, knowing that one in eight couples struggles with infertility may also make you feel just a little bit less broken. People who are getting pregnant share the news. This is why it may seem like you are the only one not getting pregnant. People who are infertile often keep it to themselves. Infertility is a heavy word. It is weighted with shame, embarrassment, and feelings of inadequacy, despair, and desperation. Even the most optimistic couple can’t help but feel a little defeated when faced with this diagnosis. The possibility that parenthood may never be in their future can be world shattering. Knowing that you aren’t an anomaly can soften the blow…just a little bit. And, in the midst of an infertility diagnosis, any softening helps immensely.

In addition to knowing you aren’t alone with your infertile status, being aware that infertility is common (6.7 million women in the United States alone struggle with infertility according to the Centers for Disease Control) may nudge you to find a support system sooner than you would have. When my husband and I realized that making a baby the natural way was most likely unattainable for us, I struggled with the reality that I was an infertility patient. I went to most of my appointments alone, and even though I was in a waiting room filled with other women struggling with similar experiences, an uneasy silence filled the space between us. This silence was laced with pain, fear, and cautious hope. Why we didn’t reach out to each other always confused me. I assume that we wanted to respect each other’s privacy. We didn’t want to overstep the invisible barriers that each of us had build around us. Looking back, I would do things differently. I would risk a little more. I would trade in my pride for the support that these women could have offered. Maybe they didn’t need me (doubtful), but I needed the support that they could have offered. I now realize that enormous support exists for those of us carrying a diagnosis of infertility including online support groups such as Resolve, community support groups, and wow, probably one of our eight friends who is in a similar predicament. If we would be willing to share our story with others, they may just be willing to share their story with us.

If you find that baby making sex isn’t your forte either, embrace the fact that you can throw your birth control pills down the toilet for good! Sex can be entirely recreational and for passion and love’s sake alone. And, although the infertility journey may be the most difficult one that you take, starting the process sooner may increase your chances of success. You are not alone in this journey. Reach out early, and the stamina and strength you garner from other women’s stories may surprise you. Nothing is more powerful than women empowering other women in their journey toward motherhood.

From The Mom in Me, MD