Saturday, 3 August 2013

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..." 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...


  1. I would find myself in the 2+ IVF failures :(

    You are right, no one ever said it would be this hard. I would also like to add that no one ever said adoption would be so hard. In fact, many people saw it as an easier alternative to infertility treatments. I think we did too- in the beginning. Once we got the infertility diagnosis, we said to each other "rather than going through all that, let's just adopt" ha! How naïve we were to think we could "just" adopt.

  2. Thank you so much for making that point, I wanted to include it, but didn't have the same statistics that would balance. Adoption has just as many challenges, and it seems that like fertility there are some who seem to in the right place at the right time and the process happens quickly, for others it's years of waiting. I mentioned that my sample size is skewed, but nearly one-third are >2 IVF failures and what the stats don't show is that some of the >2 failures are also in the currently pregnant categories and one is postpartum :)

  3. Agreed. While objectively I knew that IVF was not a guarantee, I don't think I ever really expected it to fail...until it did. It's not a fun lesson to learn!

  4. >2 IVF/ET failures and never pregnant, reporting for duty. :( I remember thinking when I started this journey and first started reading blogs that I never wanted to be one of those people with an infertility resume as long as my arm. And now, I'm getting there. Although I will say that I still think I'd rather never get pregnant at all than have to suffer through a just seems to be adding horrible insult to injury and I'm so sorry for anyone who's gone through it. I don't think I'll be able to listen to "The Scientist" without thinking of IF anymore.

  5. same boat. I never thought I would be infertile.I never thought I would "not pass God, not colect $200" and head straight to donor egg IVF. I never thought I would be in teh "2 failed DE/IVF" cycle category. blah. But I would rather not be pregnant at all then have a miscarriage or a failed adoption placement. So I will also count my blessings, in addtion to counting my losses.

  6. First, I would like to say that hubby and I both also like Coldplay (but only the X&Y album and previous...not a fan of more their more recent stuff). And I LOVE how you wove together the lyrics of "The Scientist" (great song!) and your musing on infertility stats. You seriously have a talent for weaving together different cognitive threads in a single post.

    The stats you pulled together from all our blogs are really fascinating. I've been thinking along a similar line of thought lately regarding not just the feat of achieving pregnancy after infertility but maintaining a normal pregnancy and bringing home a healthy baby. I have this huge fear that if I am able to get pregnant again, something else will inevitably go wrong. It's almost like once the bad luck fertility gods see us, they won't stop raining down on us.

    People like my sister and all my cousins get pregnant with no problems so OF COURSE their pregnancies proceed with no issues whatsoever and their babies are perfectly fine. But when an infertile gets pregnant, we're all holding our breath. Sometimes she lucks out and scrapes by unscathed, but oftentimes the joyous announcements end in sadness and despair. The lyrics you quoted are so spot on here: True, nobody promised us this would be was easy, but then again, not one of us ever imagined it could be this hard.

  7. Those statistics are interesting to read. And depressing. You're so right-- it's irrational to think that someone who has struggled so much to get pregnant will be rewarded with a textbook-perfect pregnancy and delivery, but it only seems fair.
    I hate how hard it is for me, and I hate how hard it is for all my blogger friends. Not what I imagined my family building journey would have been like.

  8. Never made that connection to the song lyrics, but I will now. My pre-IF miscarriage wasn't so bad. I mean, it was horrible, but less horrible than the ensuing DOR diagnosis and failed IUI & IVF cycles. But to miscarry now, knowing how unlikely another pregnancy is...that would really be awful...

  9. I can't believe you took the time to accumulate these stats from all our blogs. You are amazing and I love it! It really is sad how much we invest (literally!) into having a baby, while others can do it so easily, and we have no guarantees. Others have mentioned that they would rather never have a bfp than to experience a miscarriage. I want to put a different spin on that. With my chemical pregnancy, I at least found out I COULD get pregnant. With my miscarriage, it was devastating, but I also discovered that it was because that baby would have been very, very sick due to trisomy 18. While it was incredibly difficult to experience that loss, it was also the very first time I got to experience being pregnant, even though it was only for a short time. It was so hard, but I wouldn't trade those small moments that my husband did get to share. You might say its was for me to say that now that I am pregnant again, but I felt that appreciation even before this current pregnancy. If something were to happen now and we lost these babies, well honestly, I'm not sure how I would handle that since this is the end of the road for us, our last opportunity. I would be absolutely devastated. I think I'd still be grateful for making it farther than we ever had before though. It would be extremely painful, but I think I'd still appreciate experiencing pregnancy and getting closer to our dream of a family.