If you are reading this article, you do not need to be told how devastating the diagnosis of infertility is. I have met a few people who had feared that they would have a difficult time conceiving, but for the most part, even if you are approaching 40, the possibility of waning or compromised fertility is often the furthest thing from your mind. So when the boom is lowered, the shock and disbelief is likely to throw the most stress-hardy into a tailspin. Infertility is an enormous blow to the ego and sense of well-being.
Despite the miracles of modern medicine, treatment is no picnic. Sifting through the treatment options and making decisions in the face of an emotional free fall is an endurance test, which makes keeping your balance feel like trying to walk normally when the laws of gravity seem to have changed.
In addition to needing the stamina to endure, another difficult aspect of dealing with this crisis is that it is so all-consuming. Females live in their underwear (I should be bleeding but I’m not; I should not be bleeding but I am). Should I buy clothes that won’t fit me if I’m pregnant? Should we plan a vacation when I may need to be at the clinic? How are we going to afford this? Happily married couples may have gotten away with different or less than optimum coping and communication skills up until now; but needing more emotional resources, and maybe realizing that you need more resources, can seem like looking up at Mt. Everest. How do we learn what we need to know about coping in ten minutes or less? What if we never have satisfying sex again? Your social world leaves you in a place where other people’s happiness makes you feel sad or angry. You cannot think about the future in a normal way, thereby merging limbo with hell. A highly charged emotional situation is made worse by the typically ongoing nature of the problem. Often people feel the need to escape from the ordeal from time to time so as not to explode or implode from the pressure.
For most people, the dust settles and some process of sifting through the rubble begins, with or without psychological guidance but usually with medical guidance. I believe it is part of the human condition for us to find within us even that tiny spark of hope which drives the process toward parenthood. Whether clumsily or with determination and direction, whether consciously or unconsciously, that hope is accessed and, in a way that is usually not neat, couples make their way. Hope usually looms larger than vulnerability and despair at this difficult time. Even if you do not feel it strongly, hope is what keeps you going. And with the advances in medical technology these days, the majority of couples have reason to be hopeful that they will produce a baby that is either 100% or 50% genetically theirs.
Besides hope, the other factor that drives the engine of the infertility nightmare is the anticipated rewards despite the trials and tribulations and enormous responsibility of parenthood. For most, those anticipated rewards are sincere and meaningful.
But for some, maybe you, the hope of a pregnancy runs out. Then what? Resolving the infertility crisis demands navigating one dilemma after another. But the final decision has to do with moving on to adoption or choosing to live childfree. Arriving at one of these two choices is the last decision which, while it does not end the life-long process of maturation and facing choices, it does at least answer the question of whether or not you will add a child to your family. Once you have made this decision, you can expect that the emotional residue will linger like the tail of a comet and never fully disappear. We cannot unhave our history. But we can work through it and live fully in the present moment of the new reality that a decision yields.
The key to moving on is metabolizing grief and loss. There is much that is attached to this process. There is loss of experiencing the process of pregnancy, birth and breast-feeding. There is the loss of the feeling of physical normality. There is the loss of reproducing if you are fine physically but your spouse is not. And what if your spouse is opposed to sperm, ovum or gamete donation but that is your hard-won choice? There is the loss of dreams and the loss of feeling the power to be in control of life choices.
It is hard to see any of these issues as one that belongs to both of you, but it is. It might be hard to navigate your own grief, never mind your partner’s. Whether adoption or childfree living becomes your choice, grieving the loss of reproductive potential is important. But grieving cannot be legislated. It has its own time, space and way for each person. Life gets complicated if spouses grieve at different paces and with different styles. But grieving is healthy and will free you to make your final choice with an unburdened heart.
Traversing and transforming grief does not mean that you will never have sad moments again about not carrying and birthing an infant. It does mean that you have moved through the grief to acceptance, where new possibilities and new blessings abound. Navigating grief necessitates giving up one kind of hope but accessing another.
Despite the fact that there are questions to ponder which can funnel you in the direction of your answer, the ultimate answer lies deep within you. Considering these questions is much harder than having a recipe to follow. The profundity of this issue does not allow for cookbook answers. These questions will only point you in the direction of the mirror. Your truth will not stare back at you in the form of your face. Rather you must look past your face, indeed, inside your very being to your inner world – the place where the rough and tumble of your life history and circumstances collides with the essence of who you were born to be. You may be at a loss if you’ve never gotten in touch with that place where your truth resides. Although it may seem like an oversimplification, this can best happen if you can quiet down the mental noise of every day living and listen to that inner whisper. It is important to breathe fully and deeply in an undistracted place – a park, an easy chair with the phone shut off – and be solidly in the NOW, the present moment, tuning in to what comes into your conscious awareness.
Though only a starting point, answering these questions may penetrate the outer layer of any confusion you might feel while making this decision:
- Am I giving up too soon?
- Am I obsessing too long?
- Am I stuck in grief?
- Do I feel punished because I am not fertile?
- Am I so driven that I cannot take a break from trying, and if I took a break would I feel renewed energy or would I know it’s time to stop?
- Am I being influenced for or against either choice by prejudices of my family or friends?
These questions are part of the mental noise that, once considered, needs to be put aside so your answer can emerge.
If becoming a parent is the real goal over becoming pregnant, then see if you connect with what a patient said to me many years ago about her adopted child: “We feel as if we could not have done better ourselves and we can’t wait to do it again.” For this couple, the ultimate resolution of adoption was the right one.
The only people I know who by-pass pregnancy altogether and move immediately to adoption, abandoning any wish they might have had for a baby of their flesh and blood, are those who have a genetically inheritable disease that they do not wish to risk perpetuating. It’s not that this decision is easy; it’s just that some people in this position feel that a decision has been made for them.
Almost everyone else who is trying to decide whether to adopt or remain childfree has been through an infertility struggle. It is most common to flop around like a fish in the bottom of a row boat because of the magnitude of the question and the answer. As time goes by, a wrong decision cannot be reversed; one must adapt to it. Therefore the decision demands much scrutiny.
I have a few concerns for some of you. You should do all in your power to make sure that your decision is not influenced by earlier issues. For instance, if you were burdened with too much responsibility by raising siblings, you might feel that you’ve already been a parent. Or you might have had inadequate parenting yourself which has left you presuming that you will be inadequate also. Regarding adoption, perhaps you inherited a prejudice against it, a prejudice which would not be yours if you could identify the source and the real issue for that source. If these or other early traumas were worked through, would you still make the choice to live childfree? Just let it be a choice that really represents you.
The next step would be to make it a choice that you can truly embrace, not a choice by default. There is surprisingly little social support for choosing childfree living, given that feminism has been around for more than a generation. So in many ways, to arrive at a place where you value this choice might feel like swimming upstream. And again, how much freedom you feel to embrace this choice depends on whether you can look past your face in the mirror, to your inner soul where you can really know that the answer is the right one for you.
Most important in gaining clarity about this choice is realizing that generativity comes in many forms, of which procreation is only one. To feel that your life has a purpose and maybe even a passion is the key. Perhaps yours would be the passion of travel and experiencing the broad horizons, intellectual stimulation and excitement that immersion in different cultures can provide. Perhaps you have a dream that has lain dormant since your childhood, which having a child would preclude. Perhaps you have come to realize that freedom, to you, is more important than responsibility to others.
There are two considerations that you might find helpful in making the last decision of the infertility saga:
First, some decisions never feel like they are 100% right. A decision that is 51% to 49% is still a decision for one thing and against something else. This could be the case with adoption or living childfree. It would be recommended that you honor the 49% or the 30% or even the 1% of you
that wants the opposite of your choice and come to terms with it. This may require patience and kindness to yourself and perhaps even seeking out a skilled practitioner whom you can use to facilitate putting the issue in its place. It would be normal to look back years from now and
wonder what your life would be like if you had made a different decision.
And second, you may not realize that the challenges of crises and the difficult decisions that go with them would appear in your marriage eventually in some form or another, even if you had been as fertile as a rabbit. In fact, the silver lining in the clouds is that because infertility is so huge an issue, traversing the emotional challenges sets you in good stead later on in life when other crises strike. Infertility is an enormous opportunity for emotional growth. Although procreation is a genetically driven purpose for all species, human beings have a choice.
And procreation is not the right choice for everyone. The place within you from which hope has always sprung and will always spring is the place within you where the answer to your question resides.