No one ever said it would be this hard

In his book, Sex, Drugs, and Cocoa Puffs, the pop culture essayist, Chuck Klosterman discusses how most men resent Coldplay; the Brit pop group who write melodramatic alt-rock songs about unrealistic ideals of what love should be whilst using four gloomy guitar chords. "For you I bleed myself dry, sings the blandly attractive frontman, brilliantly informing us that the stars in the sky are, in fact, yellow. How am I going to compete with that shit?" In Klosterman's case, he couldn't. Perhaps his particular bitterness stems from the fact that he arranged to spend a romantic weekend with his girlfriend at the Waldorf-Astoria in New York, but she chose to fly to Portland to see Coldplay's first US appearance. Perhaps because Chris Martin is a fellow countryman, Husband rather appreciates their music and in fact, The Scientist is one of his favourite songs. Perhaps because it is a song about his profession. Although the song seems to be the sad tale of a geeky scientist who was probably dismissed by a girl who was out of his league and still yearns for her. As I tend to do, I recently thought how the lyrics relate to infertility and pregnancy challenges.

Nobody said it was easy
No one ever said it would be this hard

While it may be true that nobody particularly declared that the process of procreation is easy, one of the most painful aspect of infertility is watching how others make it seem so easy.

The One Hit Wonder
The couple who conceives on their first attempt. This scenario has the potential to inflate the male ego and to convince himself that he must have the Michael Phelps of sperm. (I truly hope it's not the case; but how ironic would it be if Michael Phelps had male factor infertility issues?) A fellow blogger put these couples in their place by pointing out that you do not have super fertility powers, you're just fertile and lucky. Actually, this makes you normal. Average, in fact.

We weren't even trying!
Many of us have endured a pregnancy announcement where the couple adds that note as an exclamation point, just to emphasize how effortless it was for them. As if they're entitled to some type of extra credit bonus points. Interestingly, upon further questioning, it is often revealed that the couple was intending to conceive. 'Not trying' just means that they weren't on a sex schedule based on menstrual charts, OPK results, BBT recording, you know, like a crazy infertile person.

We used to be indecisive, but now we're not sure...
I've encountered some couple who describe that they're not pursuing but not preventing a pregnancy and merely figure, "if it happens...it happens..." We are actually talking about the enormous responsibility (and cost) of bringing another human life in to this world and you regard that decision as if you were selecting 'chicken or fish' from a wedding menu?

The unexpected "surprise"
Then there are some for whom their fertility is a burden and a pregnancy is described as being an "accident". Even after ten years in clinical practice, I am still baffled when a patient is surprised or shocked about her pregnancy. "So, you weren't planning to get pregnant, but you were having sex and you weren't taking any measures to prevent pregnancy?" Do you know how the process of human procreation works? Do you need to read a copy of 'How Babies are Made'? Arlene Fowler explained it well during a recent episode of True Blood:
"When you stick your Mr Happy into a lady's hoo-ha, and don't wear a raincoat, babies come out!"

Oh, if only it could be so easy...While there are fertiles who suffer miscarriages and pregnancy complications; for the majority, everything about their pregnancy seems easy. The first ultrasound reveals a perfect little bean with a flickering heartbeat. Blood testing is all normal. The anatomy ultrasound is a fun experience viewing the baby and discovering if it's a boy or girl. Months later, the baby arrives and they live happily ever after. They would think nothing of celebrating and announcing immediately after a positive test, or prematurely shopping for baby items. For them, a BFP equals baby. It's that simple.

Although it is irrational, I still feel it is logical to expect that if it is so difficult for infertiles to get that BFP, the rest of the pregnancy should be easy. We accepted that it's not going to be easy to get pregnant. Procreation involves multiple injections and ultrasounds, porn and masturbation, retrieval and transfers, sometimes freezing and defrosting. Yet, no one ever said it would be this hard to have a baby.

Just how difficult? As I am a numbers driven person, I compiled statistics on the 30 blogs that I follow. I will admit there is quite a bit of population selection bias, as I tend to follow bloggers who are about my age and who have also had a miscarriage. The Clinician in me knows that some of the factors contributing to infertility may also lead to early pregnancy failures. That bloody recurring theme of gamete quality. The petulant child in me knows it's a second helping of unfairness. I feel these numbers demonstrate that it's not as easy as 'just do IVF'. Infertility is such an evil bastard that even successes must be handled with caution.

Spontaneous conception = live birth - 1
Spontaneous conception = early miscarriage - 12

Clomid/Injectables with TI = live birth - 2

IUI = currently pregnant - 2
IUI = chemical pregnancy - 2

Fresh IVF = live birth - 1 (twins)
Fresh IVF = currently pregnant - 4
Fresh IVF = early miscarriage - 4
Fresh IVF = chemical pregnancy - 3
Fresh IVF = BFN - 10
Fresh IVF = Cancelled cycles - 6
First time IVF (or ET) Success - 4

FET = currently pregnant - 5
FET = chemical pregnancy - 2
FET = BFN - 6

Required surgical correction (septum, fibroids, endometriosis, etc..) - 6
>2 IVF/ET failures - 9
Never pregnant - 8

I was just guessing at numbers and figures
Pulling the puzzles apart
Questions of science, science and progress
Do not speak as loud as my heart

Nobody said it would be easy
No one ever said it would be this hard
I'm going back to the start

If only I could...