Tuesday, April 25, 2017

What I Think You Should Know About Infertility

This week is National Infertility Awareness week, so naturally I wanted to bring some awareness to what Jk and I have been going through. When I get an idea for writing, it lingers in the back of my mind. Festering and combining itself into words, concepts, and strings of thoughts until finally it is ready to come out. These thoughts happened to form at 3:30 in the morning while I was sound asleep. Like an alarm they rang and demanded my attention until I put aside sleep and typed them into the notepad of my phone. As a side note–why are phone lights so blazingly bright in the dark? Huge apologies to my husband.

I don’t claim to be an expert. All I know is what I’ve experienced, what has been shared with me, and what I’ve read online (always a solid argument). Here are some questions I’ve been asked about infertility and what I think you should know:

Who is affected by infertility?
According to what I've read, one in 8 couples experience infertility. Since coming out of the infertility closet, I've been contacted by several strangers informing me of what they are going through, but even more surprising have been the messages from couples my husband or I have known for years. These are couples who have had experience with PCOS, miscarriage, infertility not yet diagnosed, endometriosis, infertility linked to health problems, some abnormality of the male or the woman's reproductive system. Every variety and combination of factors that have forever branded them with the heartache of infertility.

People from all facets of my life have shared their stories with me: grown women I knew from my childhood, successful women my age, girls I knew from my days in Young Women's. There is a good chance that several people you know have experienced or will experience infertility.
How can an infertile couple have children?
In the past I thought that fertility was something that you had or didn’t have. Like the best representation of infertility was a fragile woman in the Bible with an empty womb whose body was entirely unable to carry a child. It turns out that infertility has various degrees of severity and and not just among women. In our case, I am able to have children, but my husband has low sperm count & morphology. This doesn't entirely rule out the chances of pregnancy, but it significantly lowers the probability. It seems that the case with most couples is that they are not entirely 100% infertile, but the odds are not in their favor to conceive without some assistance.

These varying degrees of infertility are why you hear about a singular family with children conceived in different ways: conceived naturally, through IUI or IVF, and/or received through adoption. If a couple wants many children but does not want to wait years, they might go through a procedure for one child and adopt another. And this is my dream for our future: children brought to us from all avenues, if possible. There are so many ways to create a family.

I was most surprised to receive messages about the infertility from couples who had children. Without insight into their personal lives, it seemed they had effortlessly conceived; when in reality, they had endured months of trying with no success, doctor's appointments, and other trials I was completely unaware of. While many of those who message us have struggled and come out the other side of infertility, several are still in the midst of their trials.

How can you know if you will be infertile? 
As far as I can tell, there are a variety of ways in which individuals and couples have found out that they struggle with infertility. I have heard a few stories where the woman knew before ever getting married that she would have difficulty getting pregnant. In some cases she has been told by a doctor, in others she is just aware that her health may result in complications. Women can be affected by things like PCOS, endometriosis, weird chromosomes, Lyme disease, and so much more. However, sometimes the couple has no idea that they will suffer with infertility until they have been trying for several months with no success. This is how it happened for us. After a few months, I began to worry there was a reason we weren't getting pregnant, but I wanted to be patient. The months dragged on as we expected to be expecting. At 10 months, I knew that something was wrong, despite being told by an infertility doctor that we needed to give it more time. When we finally reached our year mark, we needed to find answers.

Why is infertility such a big deal?
Infertility is capable of inflicting grief just as any traumatic event might. I've been told that infertility cannot be as difficult as losing a child or never marrying. Maybe that is true. But maybe that’s not the point. All I know is the feeling that comes after 486 days of weeping and pleading with God to give you a baby only to find that you are still empty. All I know is the impossible trial of digging deep within yourself to find joy for couple after couple who rejoices in pregnancy while you are still made to wait. And I know the grief that infects your mind in perfectly ordinary moments of everyday life, causing you to break down crying in the shower (or wake up in the middle of the night to write a blog post). I don't know much about child loss or life without a spouse–but I do know about heartbreak that beats on you until you can't breathe.
At the end of the day, what do you say to someone going through infertility? 
Hint: It’s not "Be patient" or "Keep trying" (even if those things are true). I recently came across Emily McDowell Studio, a company that makes empathy cards with honest tag lines for difficult situations. I love the idea that even if you don't know what to say, you can say something. Personally, what helps me is knowing that someone is there for me. I don’t expect advice (in fact, oftentimes advice comes across as wildly insensitive); I think most people struggling with infertility just want to feel validated and supported. I love what the prophet Alma said about followers of Christ; they should be “willing to mourn with those that mourn [...] and comfort those that stand in need of comfort” (Mosiah 18:8). Infertility is no exception.

Here are some suggestions for what you can say to comfort someone struggling with infertility:
I am here for you.
I am thinking of you.
I am sorry for what you are going through.
Even if infertility is something that you will never experience, there’s a chance someone you know will be affected by it. Know that infertility is real and not an overreaction. Be sensitive in what you say. And to those struggling with infertility, know that you are not alone.

Monday, April 17, 2017

I Can't Put My Life on Hold for Infertility

This morning I realized that I’ve been silent on the blog for almost a month. Since the unexpected call from our fertility doctor, we’ve taken just as many steps forward as we have back. Mostly we’ve been in limbo (and it’s hard to send a postcard from limbo). We’re not sure yet what’s nexteverything could change or it could all stay the same. The great paradox of infertility is that you can always expect uncertainty. The challenge comes in stepping away and finding other things to occupy your mind. 

In January, after long months of waiting to reach the year mark of infertility, I decided that I needed to get involved with activities that didn’t include worrying. In fact, I wanted to fill my schedule with all things stress-free! Fun, relaxing, life-enriching activities. Anxiety was inevitable; grief was unavoidable. I knew that I needed to counter-balance darkness with light. And so came Yoga, Pilates, and the temple. 

As a university employee, I took advantage of free tuition and enrolled in two student activities classes. I dusted off my Yoga mat, bought some stretchy pants, and gave my husband the googly eyes. Together, we committed 4 nights a week to improving our health. It didn’t take long to feel the effects (i.e. the amazing double-edged sword of sore muscles!). Taking just an hour each day to concentrate on my mind, body, and spirit was the best stress relief. It’s hard to feel anxious when all of your energy is focused on relaxation, centering, and breathing. It was also really fun to see my husband roll around on a giant exercise ball!
In addition to physical health, I knew that I needed to do something to strengthen myself spiritually. It’s not that I stopped praying or studying my scriptures, but I was finding it hard to focus on my blessings when my misfortunes were so apparent. Months of waiting on insurance and test results put a weight on my shoulders that I couldn’t lift alone. I talked to my bishop about volunteering to be a temple worker and shortly after, I started in the Provo City Center Temple. Every Friday night, I spent hours interacting with people in every stage of life, sharing the Spirit of the temple. Serving in the temple is a huge sacrifice of time and energy, but at the end of every shift, I felt the Savior give me enough strength to carry my burdens another week. 

With all of that said, I still thought about our infertility every day. No matter how many hobbies I pick up or ways that I find to improve myself, babies will continue to be in the back of my mind. We are still waiting to hear back from the fertility clinic about whether or not our insurance company changed their minds. Their decision 1) could lead straight to IVF or 2) could defer us another few months before we reevaluate a new plan for our family. It is driving me crazy not knowing what comes next, but worrying won't bring answers. I can’t put my life on hold for infertility.

Thursday, March 23, 2017

A Surprise Call from the Fertility Doctor

Most days, I do okay. But some days I'm just over this infertility thing. For a few months now, we have shared our ups and downs and it wasn’t until recently that I ran out of words. Two weeks ago, we received a phone call and then a letter confirming that our insurance provider would not pay for In Vitro Fertilization (IVF). I took the news, swallowed it, and let it break my heart. I get that we were put on this earth to grow and all, but lately my prayers have been a little like: Thanks but no thanks, Heavenly Father. I think I’m good on the growing thing.

Today He responded, Nope, and sent another bump in the road.

I was sitting at work when my cell phone started vibrating and my caller ID read, Reproductive Care Center. It’s been a few weeks since we talked with our fertility clinic; I just assumed that because our plan fell through, there was nothing else to follow-up on. Curious, I answered the phone and expected to hear the voice of a nurse or receptionist. Instead, I spoke with our fertility doctor.

He apologized for the outcome of the insurance request and told me that it had honestly surprised him. He was calling to let me know that he had written a letter of appeal and had heard back from our provider—their response was positive! He said that they are willing to approve the procedure if we can provide some compelling documentation. Our next step is for Jk to meet with a urologist (male fertility doctor) and to basically get a doctor’s note saying that neither medicine nor surgery will solve the problem. Out of the blue, IVF is back on the table!

I just want to take a minute to say that I was so impressed that our doctor had taken the time to call me. That’s just the kind of guy he is. He even gave me his personal phone number! Even if all of this doesn’t work out, I will forever be grateful for the compassion and care we have received from this doctor.

So here we are again, back on the cusp of everything or nothing. This journey hasn’t been smooth and it definitely hasn’t been easy. But I can promise you that every single time I am ready to give up, the Lord has shown me mercy. Just when I think every ounce of my faith is used up, He sends me hope. Over and over, I am learning to trust that He will guide me in this journey that at times can be terribly difficult and dark.

“Assurance and hope make it possible for us to walk to the edge of the light and take a few steps into the darkness—expecting and trusting the light to move and illuminate the way.” - Elder David A. Bednar

Friday, March 10, 2017

Feeling Awkward About Infertility

Recently I was asked the question, "How can infertility feel embarrassing?" Surprisingly, I didn’t know how to answer; I couldn’t put my finger on it. It was just a few months ago that I was keeping such a significant part of my life secret. Like many couples suffering with infertility, I thought that my husband and I would keep it to ourselves until we had “success” with pregnancy. But now, after being so open about our infertility journey, I'm thinking more about that question. How can infertility feel embarrassing, awkward, or totally taboo? Here’s what I came up with.

One: This doesn’t feel like my story. 
I remember the first conversation Jk and I ever had about children. It was summer, bright and hot outside; we sat on the street underneath a shady tree while we sipped slurpees. We were dating and I was hungry to know every detail about his beautiful soul. We curiously asked each other questions for hours, back and forth. Hesitant and wide-eyed, Jk asked me how many children I wanted. We hadn’t talked about love or marriage so the question hung heavy between us. Children. Each of us might have children some day. Maybe even together.

That memory feels fragile and sacred to me now. As I talked with my blue-tongued boyfriend that day, I had no inclination that we would ever suffer from infertility. Babies felt far off, but certainly not unattainable. I guess that’s why I say that this doesn’t feel like my story. Fertility appointments, blog posts, and IVF needles never crossed my mind. And as silly as it sounds, I’ve found myself feeling embarrassed that it’s not as easy as I thought it would be.

Over time, I’ve come to accept infertility as just another part of my life. Every person deals with unique challenges and this is mine. I can’t wish it away and I can’t pretend it doesn’t exist. But I can make the best of it. I can share my ups-and-downs and I can soak up every last drop of this good life that God has given me.
Two: Infertility can put me in an awkward place with other women, especially mothers. 
I have so many girl friends who I love and adore, but I’ll be honest...Infertility can feel isolating. For women who have never experienced infertility, I understand that it can feel impossible to find the right words to comfort a friend. For those who are expecting or who are already mothers, maybe you feel guilty that it has worked out for you and not someone you love. Infertility can feel like an awkward barrier sometimes.

I recently had a really good friend tell me that she and her husband are trying to get pregnant. I didn’t feel awkward or envious. In every corner of my heart, I genuinely wished her success and happiness! Speaking from the perspective of someone suffering with infertility, I’ll admit that I’ve felt the jealous knee-jerk reaction at seeing a pregnancy announcement. But just because I want a baby doesn’t mean that I don’t want anyone else to have one. You do you.

What I hope above all else is that women in every stage of life can find a way to strengthen and uplift each other. If you feel awkward about infertility, find another way to connect. Please please do not use isolation or avoidance to cope with differences. Surely we can find a way to love and appreciate one another.

Three: People just get weird when you talk about sex. 
I asked my husband why he thought infertility could be an awkward or taboo topic and that’s what he said… “People just get weird when you talk about sex.” Well, there you go! Most (normal) couples don’t go around talking about their reproductive health. I’ll be the first to admit that opening up about birth control, sperm count, and balloons in your belly can be totally awkward! (Especially when your mom, bishop, and brother are following your blog. Hi guys!)

What I’m trying to say is that infertility seems taboo because fertility is taboo. For many, conceiving a child is sensitive and private. These are the same individuals who believe that not conceiving a child should be just as private. To each his own.

Despite how you feel about privacy, modesty, and babies, I have found that for my husband and I, talking about our infertility journey has been the best thing ever. I’ve said it before and I’ll repeat it now, this kind of openness isn’t for everybody. We’ve found that for us, it’s the easiest way to tell our friends and family what we are going through. I’ve been able to access more information and connect with more women than ever before. I have awkward questions, but it is such a blessing to get answers from friends who have been through what I’m going through!

So yesinfertility can be uncomfortable and embarrassing, but so can a lot of other things! If I had waited until we had “success” to tell our story, I would still be silent today. I would spend months waiting and worrying alone. But instead, I have friends supporting me, strangers sharing their stories with me, and a whole community encouraging me to stay strong. Awkward or not, I’m embracing this infertility journey that is ours. 

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Afterword:

Every man, woman, or couple experiences infertility differently. Wanting to acknowledge the unique challenges that others face, I asked the members of an online IVF-Support Group, How can infertility FEEL embarrassing? Their answers were inspiring, heartbreaking, and gave me all the feels. Here is a look at what just a few of them said:

I don’t feel accepted in my religion or culture. 
- “We're Catholic and our religion is against it so we don't tell many people because I don't want to deal with the comments.”
- “It's embarrassing because in most South African or African Cultures and societies a woman is always the one to blame for infertility within a marriage and you get called hurtful names.”

I don’t want advice, questions, or feedback from others.
- “People just are not educated about infertility. They make ignorant statements not to be cruel, but because they don’t understand.”
- “Get on board and be supportive or move along.”

Infertility makes my husband feel like less of a man/makes me feel like less of a woman. 
- “A majority of the time I’m fine about it, open and frank with people. But, if I’m being honest, deep down I feel like less of a woman. Like a defective woman. I don’t talk about it with anyone. No one says or does anything to make me feel this way, but...there it is.”
- “I was embarrassed because I felt like I had failed as a woman and a wife and that I was letting people down because of it.”
- “I think infertility has made me feel like less of a woman, like I can’t just do the one big thing a woman is designed to do.”

I’m not embarrassed anymore. 
- “I'm much more open about it now. I didn't want this, but this is my life, so why should I have to hide that when it's such a big part of my life?”

Wednesday, March 8, 2017

In Vitro Fertilization and Insurance

About a week ago, I messaged an infertility blogger and asked for her thoughts on IVF (In Vitro Fertilization). Jk and I had just gotten back from our doctor’s appointment where our doctor suggested that we try IVF before our move to Arizona in 6 months. I fell hard and fast for the idea of being pregnant by June. But even after hearing an overview of how the process would go, I had a lot of questions. I turned to the author of one of the very first infertility blogs that I followed.

I expressed my reservations about IVF as well as my confidence in our insurance provider. My exact words to her were, “We have [this insurance], which is supposedly the best insurance provider for infertility treatments. Not too worried about the cost.” As it turns out, she had experience using the same insurance provider and had some great insight to give.
I learned that she was denied IVF coverage because she and her husband hadn’t been trying to get pregnant for a certain amount of time. Immediately, a red flag came up in my mind. Jk and I definitely don’t meet that criteria… But our doctor seemed so confident that we would qualify. She continued to send helpful information, saying that if we were to qualify, our insurance would only ever provide enough to cover the first IVF cycle. Additionally, we would be expected to pay for the cost of medicine ourselves. My head was spinning with prices far more expensive than I anticipated. 

At the end of our conversation, my new blogger friend wrote, “I hope I didn’t freak you out with the whole insurance thing.” To be totally candid, I was freaked out. My impression after leaving the doctor’s office was that we would definitely be approved to do IVF and it wouldn’t be very expensive. I hoped that I wouldn’t have the same experience as my friend, but only time would tell. It wasn’t too long before a nurse from our clinic’s billing department called and I knew exactly what questions to ask. The nurse expressed that our insurance company had only started providing infertility care this year, so she couldn’t say for sure if they would approve us or not. We would just have to wait for feedback from the company.


Over the next week, my thoughts were all over the place. I tried to make a plan for the upcoming months, but I felt like a character in a Choose Your Own Adventure book; each choice only leading to more choices. At least twice a day, I texted my husband changing my mind about what we should do. Put off school, save money, do IVF in Utah... Move to Arizona, skip IVF, save for the future. Back and forth I went, not settling on any decision. Finally, on Tuesday morning, I texted Jk: Here is how I am feeling today. Even though I change my mind every day. // I am feeling like we should wait to do IVF or adopt until we are in Arizona. // I want a baby more than anything and it is so hard to wait but something inside me says it’s not the right time yet.

A few hours later, I received a phone call from the billing department, letting me know that our insurance provider would not pay for IVF. We were denied because we hadn’t been trying for long enough and we hadn’t had any failed IUIs. The nurse apologized and hung up. Standing there in the mother’s lounge at work (of all the ironic places), I felt a confirmation that Heavenly Father had been preparing me to receive that news all week.
So here I am, with a hundred feelings in my heart. First and foremost, gratitude to God for giving me a little cushion to break my fall. And close second, confusion about His timing. I wanted so badly for IVF to work out. I want to be pregnant! There, I said it—I want to be pregnant. Carrying a little baby whose name I’ve known for way too long. But that day seems so foreign to me. Some days I don’t feel brave enough to make it there.

Lord, I cannot. But you can.

Thursday, March 2, 2017

Getting an Answer!

For 400+ days, my husband and I had no idea why we couldn’t get pregnant. This week, we got our answer!

We were scheduled for an appointment with the fertility doctor in the late afternoon on Monday. All throughout the morning, my chest was filled with excitement and anticipation. This was the appointment when we would hear the results from our tests and we would make a plan for how to move forward! In my mind, I ran through every possible outcome—a problem with me; with Jk; with both of us; with neither. More than anything, I just wanted clear answers!
The weather and roads were really bad that day, so our doctor was running a little late with his appointments. Jk and I sat in the waiting room for nearly 30 minutes, going half crazy. Finally, we were taken back to speak with the doctor. I tried to gauge what kind of news he had for us, but his handshake wasn’t giving anything away. 
Finally (FINALLY!), we received our test results... It turns out that I’m a Fertile Myrtle! All this time, we suspected endometriosis or at least thought something was off with my body. We were wrong. As we looked through the results from Jk’s sperm test, our doctor explained that the numbers were shockingly low—like a 1% chance of us getting pregnant naturally. I know that I’ve joked about hoping something was wrong with Jk rather than myself, but in reality it didn’t matter whether it was him or me. Infertility obviously affects both of us! Of course we were bummed, but in a way we were also relieved. We had an answer!
Coming into that appointment, I had my mind made up that I was not interested in IVF (In Vitro Fertilization). In fact, a week before, someone asked me if I was going to do "those shot things” and I confidently said no. I had heard a lot of stories about failed pregnancies from IVF and also honestly, I am just really afraid of shots! But as we sat in our doctor’s office that day, we were given all kinds of helpful information. First, I realized that in the process of IVF, injections don’t even last 2 weeks and that the needles are tiny. More importantly, we talked about timing and possibilities. I was given hope that by June (4 months away!), I could be pregnant through IVF. My heart gushed and my brain shifted and I thought, We are going to be one of those couples who has a baby through IVF.
As we drove home, I wanted to shout Hallelujahs out the window! We could be pregnant before we even move to Arizona! Jk and I called our moms and told them the great news. I texted certain friends and family members, saying our appointment had gone well and letting them know that we made a plan for moving forward. I was on Cloud Nine. For a day.
The rest of the story is a roller-coaster that we’re still riding. After making up our minds to do IVF, we discovered that our insurance won’t cover a giant portion of IVF, which is the medicine. While setting up pre-authorization through the clinic's billing department, I started to panic. I heard the estimated price for medication and all of my hopes for getting pregnant in June slipped away. At this point, we are still trying to process all that has happened and we haven't made any definitive decisions. This is an entirely new level of infertility that I haven’t experienced before. I want to do hard things. But it turns out doing them is hard!

Thursday, February 23, 2017

How to Talk About Infertility

A few months ago, I was interacting with a mother and her little girl. I made a comment about how I adore children and the mom asked me, “If you love kids so much, why don’t you have any?” I could not have been more surprised. Dumbfounded, I thought, Wait a minute! Someone can just ask you that? I panicked and didn’t know what to say. I wanted to give an appropriate response but I honestly couldn’t answer why I didn’t have any kids. My husband and I weren't using birth control, we were making an effort, and we wanted to get pregnantit just wasn’t happening.

How do you casually share the struggles of your fragile heart with an acquaintance? I didn’t want to make the situation awkward, and yet, it was an awkward question! In the end, I blurted out something about waiting for the “right timing”.

For nearly a year, I only talked about infertility with my husband and my best friend. On several occasions, I was asked by acquaintances and coworkers when Jk and I would start a family. With my walls high and my ego low, I would quickly and dismissively tell half-truths. I carried a dark, heavy secret because I was embarrassed and didn’t want to inconvenience to anyone. I was ashamed of my body and my inability to do something that seemed to come so easily for so many. I didn’t know how to talk about what I was going through without feeling like a burden to others.

Fast forward to February 2017. I am waiting in the longest passport line, talking on the phone with my best friend. We are talking about infertility, the possibility of adoption, and my upcoming appointment at a fertility clinic. I’m not talking loud enough to be obnoxious, but I’m not whispering. I am surrounded by strangers who can clearly hear my conversation. Shortly after I’ve hung up, a man standing in front of me turns and says, “I think I heard you talking about pregnancy... Are you expecting?” My heart swells. I smile and tell him, “We actually haven’t been able to get pregnant for a while now. But we are seeing a fertility doctor and we are really excited about it!” I’m not embarrassed. In fact, I feel self-confident!
One year ago, I wasn’t ready to have an open conversation with a stranger about infertility. Heck, I wasn’t even ready to have an open conversation with my mother. So what has changed? 

I’ve learned few things since then. 1) Infertility and pregnancy loss are much more common that I ever thought. 2) You can't change the questions you are asked, but you can change how you answer them. 3) The moment you open up, you are exposed to a community of other people who previously thought that they were suffering alone. If only we would share our experiences, these topics wouldn’t be so taboo. Lately I’ve been realizing that infertility is just another part of my life, rather than a tragic curse. Just as I would talk about my uncle breaking his leg on Christmas morning, I can share the fact that on Monday morning, my doctor inflated a balloon inside my belly!

Believe me, there are still hard days when the darkness comes and knocks me down. That doesn’t mean that I am obligated to blog about my every woe. I just think that if we are more open with our insecurities, we will see that our problems aren’t so unique. If we talk about the hard things, maybe they won't be so hard.