Why Does It Hurt So Much?

A couple sat to eat lunch with me after I had spoken at an infertility symposium. As we began to talk, I asked the wife, “When you grieve over your infertility, what is your greatest loss?”

She didn’t have to think about her answer. “It’s the loss of a dream; my heart’s desire is to have my husband’s child and raise it together.”

I turned to the husband and addressed him. “And you?”

He looked at her, then back at me. After hesitating a moment, he spoke to her gently, and stroked her arm, “Don’t take this wrong, honey, but…” Then he looked at me. “It’s the loss of my wife—she is not the same woman I married. Infertility is really taking a toll on us.”

“You’re normal,” I assured them. After enduring a decade of infertility treatment that included multiple pregnancy losses, three failed adoptions, and an ectopic pregnancy, my husband and I had talked to numerous couples. And I recognized their stress, which—though different in each couple’s case—was still a normal response to an abnormal experience.

Infertility is hard stuff. In fact, “The depression and anxiety experienced by infertile women are equivalent to that in women suffering from a terminal illness,” says Alice Domar, Ph.D., director of the Mind/Body Center for Women’s Health in Beth Israel Deaconess Medical Center at Harvard Medical School .

Why is it so difficult? We’re not talking about buying a new living room set here. We’re talking about having a child—someone who will throw her arms around you, even throw up on you. The idea of conceiving child as the product of two people’s love is a precious dream, and a deep longing. Thus, what a comfort it often is for couples to discover Proverbs 30:16, which tells us that a “barren womb” is among four things on earth that are never satisfied. The intense desire to have children is part of the way God structured the world. The drive, the longing, that “unsatisfied” feeling—these are part of the design.

What Causes Infertility?

Infertility is the inability to conceive or carry a child to term after one year of unprotected intercourse. There can be many causes, but don’t believe the myth that “infertile couples just need to relax and they’ll get pregnant.” In ninety-five percent of cases, there’s a diagnosable medical reason. About sixty-five percent of couples seeking treatment eventually have a biological child, but the percentage drops significantly for couples choosing not to pursue medical treatment.

“It seems there are as many causes of infertility as there are people,” says Dan Underwood, who has a low sperm count. “Some of our infertile friends have antibody problems, some don’t ovulate, some have tubal damage. In about a third of couples, both husband and wife have fertility problems. A lot of people think it’s a ‘women’s issue.’ But fertility problems are just as common in men as in women. The hardest seems to be when it’s unexplained. That happens about five to ten percent of the time. It’s tough to go through treatment month after month when all the tests indicate there’s nothing wrong.”

The number of couples diagnosed with fertility problems appears to be on the rise due in part to delayed childbearing and sexually transmitted diseases. Environmental factors may also play a role.

What Can Couples Do About It?

Couples today face a variety of options for satisfying their desire to parent, depending on how comfortable they are with them.

Medication – In the case of a thyroid problem or infection, medications are often the solution. For women with ovulation problems, fertility drugs can help, too. Some couples believe it’s wrong to use “unnatural means” to treat fertility problems. Others see taking medication as the equivalent to using chemotherapy to treat cancer or insulin to treat diabetes. Those choosing to use drugs should be monitored carefully by skilled medical personnel.

Surgical intervention – Diagnostic surgery can uncover hidden causes of infertility. And corrective surgery often helps. Surgeons may, for example, correct fallopian tube blockage or endometriosis, which affects the uterine lining. In men, surgery can reverse vasectomies or repair structural damage and varicose veins in the testicles.

High Tech Options – Most Christians believe it is ethical to use artificial insemination, in vitro fertilization, and other high tech procedures, provided doctors mix sperm or eggs of the spouse (as opposed to a donor) and take precautions to honor life even at the one-celled stage. Couples using in vitro fertilization should consider limiting the number of eggs fertilized to the number of babies they are willing to carry to term. This keeps them on the ethical high ground of avoiding selective reduction of “excess” embryos or pregnancies in which six or seven babies vie for the available resources in utero. Some couples opt for freezing embryos in this case, but others such as myself have reservations about cryopreservation, feeling that it takes unnecessary risk to the embryo and that it presumes on the couple’s future.

Embryo adoption – A Christian woman I know had three embryos implanted in her uterus and five frozen following an in vitro procedure. After she had triplets, she faced emergency surgery to remove her uterus. That left her with three choices—destroy the additional embryos, find a surrogate to carry them to term, or find someone willing to adopt the embryos.

Embryo adoption is relatively new—developed in response to the more than 100,000 embryos that sit cryopreserved, suspended indefinitely in frozen oblivion. The Snowflakes Embryo Adoption Program works like a full-service adoption agency connecting couples wanting to carry frozen embryos with couples not wanting their frozen embryos destroyed. At the moment this costs about $6,000. However, some Internet services charge less than $75/month for couples on both sides of the embryo adoption equation to advertise and connect with each other. It is left to the couples to negotiate the details after that. No matter what you believe about the ethics of cryopreserving embryos, embryo adoption is an option that is emerging as an alternative to destroying them.

Adoption – Pharaoh’s daughter adopted Moses. A family member adopted Esther when her parents died. And God calls all those who believe in Christ his children through adoption. Thus, the Bible draws a beautiful picture for us of the adoption relationship.

However, adoption is the solution for only one of the many losses in infertility—the loss of the ability to parent the next generation. Most experts encourage couples who pursue infertility treatment to exhaust medical options before pursuing adoption, as the two experiences require working through separate sets of losses. This is why so many infertile couples find it aggravating when their friends encourage with, “You can always adopt.” Some couples deeply grieve the loss of a jointly created child, the pregnancy and breastfeeding experiences, and a continuing family line. For them, adoption will never fill these voids. However, once they reach the “resolution” stage of their infertility, other options look more appealing. Only then can adoption become a wonderful solution for the longing and the loss.

This article first appeared in ParentLife magazine.

This article is also available in Spanish.

Check out our books, which also explore pregnancy loss.

The Infertility Companion: Help and Hope for Couples Facing Infertility   

When Empty Arms Become a Heavy Burden: Encouragement for Couples Facing Infertility. 

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