Tuesday, October 19, 2010

My Experience With Infertility, Part 2

I felt like my first post hadn't pissed everyone off sufficiently, so I've decided to take things a step further. I mentioned this internet discussion to my mother (who is not just a Mother in Medicine, but also a Mother of a Mother in Medicine), and she wanted to share her story. With KC's permission, I'm posting what she wrote to me below. Get ready to flame because the people who didn't like the first post are going to HATE this one:

I got pregnant for the first time after three nervous tries when I was just 29. I went to my doctor and I remember him saying when my pregnancy test was positive, "You saved us a lot of trouble." I was to find out just how much trouble less than ten years later.

My husband wanted to have another baby right away, but I was never satisfied with my career as a teacher so I decided to instead go back to medical school first. I assumed the myth that if you can have the first child, you have all the time in the world to have the second. This was wrong, wrong, wrong. Not only does fertility decline 50% from age 35 to 40, but I didn’t count on other unforeseen things like my first husband leaving me when I was 33. At this point I was in a sheer panic to find someone else fast and have a second child.

The infertility spiral began slowly. I was remarried at 38 and immediately even before formally getting married, tried to get pregnant again. At first I was really excited about trying and finally having a new baby, now that I had a new husband and had a stable job as an attending physician. This time when I didn’t get pregnant on the first try, I went back to the same doctor and he started doing tests. I had to have an x-ray of my tubes which initially showed that my tubes were blocked. I had to then have a surgical procedure which showed that they actually were not blocked. I had several other tests and each month would go by and I wasn’t pregnant. Finally after what seemed like forever, I started getting injected with a massively potent drug called perganol which not only did not work, but left me with a disabling tinnitus that cut my infertility treatments short. The tinnitus was so bad that I couldn't sleep and nearly lost my job as a result. As if that was not enough, the perganol caused me to get uterine cancer about 15 years later.

I became miserable and bitter and the worst part about it was that it all didn’t have to happen if I didn’t just wait too long for no reason at all. I wasn't infertile when I was 29. What was I doing that was so important that I had no time to have a second baby? What about my work was so important that I had to do that instead of having a second baby? There is no job on earth that is worth giving up having a baby. I was horribly envious watching all the women on the street pregnant and with baby carriages wheeling young babies. It got so that I couldn’t watch people on TV who were pregnant, even if they were dead and in reruns like Lucille Ball. I could not go to any family functions or have anything to do with anyone who had more than one child, which was practically everyone.

I hated knowing that there was no way my daughter would even think of having a baby herself until she was done with medical school. I just worried that she would have to go through all the misery and dangerous treatment that I went through. If there was one good thing that came out of my infertility, it was hoping that she would learn from my mistakes.

In answer to your questions, she was serious about the Lucille Ball thing. She has been really bitter about this for the last 20 years and this is really how she talks. Perhaps you can now understand how much I want to avoid turning out that bitter and angry.


  1. I think it is definitely personal, and it is a gamble either way. I wanted kids and was worried about infertility, so I had one earlier than I would have if infertility wasn't a concern (I do have PCOS, so I know that problems are likely). I knew I wanted kids and I knew there would be no "perfect" time, and I knew it may take awhile, so I went with it. I LOVE my daughter dearly, but I do wish I would have waited a few years to allow myself a chance to experience some of the things I wanted to do, but now can't because of time. Would I trade my daughter? That's why you won't hear mothers talking about how they wish they would have waited, unless they were VERY young. The proper answer is "No" and it's true, but the truth of the matter is this: I love her, but I wouldn't love her if I never knew her. I would probably have started my family now if I would have waited, and I would love the child that I had now just as much if I had known him/her. If that makes sense. If I didn't get pregnant at all, it would hurt. But getting pregnant too early also hurts. Like I said, it's a gamble.

  2. I totally agree, Anon. If fertility weren't an issue at all, I think I would have definitely waited till residency was over or maybe even longer to start having kids. Life with children is wonderful, but life without children is much freer and simpler. But hopefully once people read this post, they can see why I didn't feel comfortable taking the risk and not just tell me I'm being randomly judgmental.

  3. Having had my own infertility issues myself, and having struggled to find the light in it all, I know that there is an option besides being bitter for 20 years about an inability to conceive...adoption. We have a beautiful baby girl who came to us at age 11 months from Korea and I wouldn't trade her for anything.

    Though there is some lingering sadness from not bearing my own child, I am overwhelmed with joy and can't help but think that not being able to conceive was a blessing in disguise, because now a little girl who needed a family and a family who needed a little girl have been united.

  4. My mother tried the adoption route too, but it didn't work out for her. She tried in this country and had two people back out on her. Then she tried to adopt from Russia and had a child all lined up, but when she went there, it turned out the child had major medical issues and disabilities that hadn't been revealed to her (I've heard this is not uncommon with Russian adoptions). She was in her late 40s at that point and felt she didn't have the energy to take good care of a child with special needs, so she went home empty handed. Once again, lots of heartbreak.

    Obviously, lots of people adopt though and have great experiences.

  5. I read this and thought: Going through a divorce with 2 young children could have been a lot more difficult than with one. Though your mom clearly doesn't feel this way, there are 2 sides to every coin.

    I also see a lot of fellows who are in their 30s and still single who are FREAKING OUT because they want kids but they don't have husbands yet. They're in a tough place. It's hard enough finding a good husband when you're not in a rush. I can't imagine how stressful it must be to try to find one if you're obsessing about your biological clock.

  6. Once again I congratulate you Fizzy and your mum for bringing this very important discussion to the fore.

    I think whats so important about your mums personal account is that fertility treatment is not modern medicine's wonderful answer.

    I am thankful not to have been through it myself but the people i have spoken to have been through the wringer to say the least and sadly there is not always a baby at the end of the process.

    This is why we need to talk about it!
    To dispell the myth of "choice". The choice is not when to conceive. The choice is when to stop contraceiving. The rest is well and truly out of our hands. Despite every effort to the contrary this is something we do not have control over.

    It is a personal decision. But it needs to be informed and the women in professional positions need to be supported should they decide to have children in their early years.

    Why should spending 60+ hours a week away from your baby or stopping your career temporarily or permanently be the only choice?

  7. OMDG: I think I may have done my mother a disservice by being an incredibly well behaved kid. If she had a kid that was a fireball like my half-brother, she might not have been as eager for a second :) I also suspect that even if she had two kids with my dad, she would have then been hysterical over having a third, because she knew people who were freaking out over not being able to get pregnant for a third time.

  8. Bekkles, I totally agree with everything you said. I think there needs to be more support for women who choose to have children earlier and not be made to felt like a pariah. Although actually, things are no better now that I'm an attending, so I think it's an issue no matter what stage of training you're in.

    I guess one of the consequences of what happened to my mother is that I don't have confidence in fertility treatments. Also, as she mentioned, they do have side effects. In addition to the side effects she brought up, she also started getting recurrent UTIs from the hormones that were really bad.

  9. "I don't have confidence in fertility treatments"
    That is quite a statement. Things have changed so MUCH since your mom's treatments. pergonal is not used. There are also better treatments for causes of infertility. I have the GREATEST of confidence because I KNOW that I would not have my wonderful 4 year old without the medical intervention.

  10. Kellie, I'm glad things worked out for you, but it doesn't for everyone, even these days. Unfortunately, I have friends who have recently failed some of the modern fertility treatments in the last few years. It's much better than it was, but there are still limits to what medical science can accomplish.

  11. Wow. I think we should all publish mom posts, so we can understand each other better. Maybe that should be a topic week. We can explore why we are the truly wonderfully messed up individuals we all are.

    Seriously:) I loved reading this post. I don't think it would have been capable of inspiring more hate, I just think opened up a lot so we could understand where the first post is coming from.

    After reading these posts and all these comments, I feel truly privileged to have gotten knocked up twice within a couple of weeks of deciding to try, back when I was married. I just didn't realize how lucky I was. My heart goes out to all those people struggling to make the very personal decision of when the time is right for you and to those who are struggling with infertility. Believe me - divorce is tough - but I imagine it can't hold a candle to infertility issues.

  12. Kellie, I know 4 women who've had to use the fertility treatments and only 1 had a child through them. 1 gave up after 16 years, 1 adopted 2 foster children, 1 got very sick, had some heavy duty treatments and got pregnant 6 months after (oddly enough, with treatmetns that could have caused infertility) she'd tried for 8 years. Even the 1 mom had to try for 4 years.
    It works for some, but not at all for others and takes years for others.
    If we don't talk about these things, then it becomes a shock when, like my former PCP, decides to get pregnant at 36 and doesn't actually DO so until 39.
    They don't understand ...they are confused and if we talk about it as a choice ... then women know what they may be facing and can make a fully informed (consent?) decision.

  13. to round out the perspective here I would only add that one reason to wait (my reason) is that I think i might become a depressed horrible person if i had a baby while trying to make it through residency. Its just something I know about myself. And would i sacrifice 2 years of sanity (and possibly my marriage as I'm very sure I would become a raving lunatic) for the *chance* that I might not get pregnant. My answer was no. In order to be a good parent I have to honor my limitations. And my husband and I are also open to other ways of making a family (IVF, adoption, etc.).

  14. I honestly don't think that either of these posts should be so controversial. Most of us would agree that if you want to have children your career shouldn't come in the way. Some people don't want kids and that's completely fine, but most people do and for them this is a very essential, very basic desire. The tricky part is how to make it work. It's a problem of our current medical training system that it is so difficult to have kids and that so many people feel pressure to delay childbearing. I'm guilty of the same thing- I have one child, but having seen the sacrifices that both my family and training program have made as a result, I have put off having a second. Now I am 35 and coming up on fellowship. It's entirely possible that I won't end up ever having a second child due to my career. And I think it's wise to stop for a second and think "is this a reasonable sacrifice to make?". Sure it hits close to home, but it's a decent point.

  15. Giz: I did think this post might make people angry, but it didn't at all. Maybe because it's more clear how affected she was by this? Or maybe everyone just ran out of steam?

    Bossmd: I understand how you feel because that's the reason I've waited to have a second. Most people have their kids two years apart, but if I had done so, I would have jumped out the window. So it was worth the risk for me. I like your explanation better than people who say they're not "mentally ready" because who the hell is mentally ready for their first child? Nobody.

    Dreaming again: It's also a good point you made that often women who have infertility issues end up taking much longer than they expected to have a child. We all make such careful plans, but I guess my original point was that this is something that you can't really plan.

    RM: I wasn't surprised people got upset from my post, but I do think it's odd anyone would say it's controversial. It's not like I'm making claims about vaccines causing autism... it's a fact that fertility declines as a woman ages. But childbearing is an incredibly emotional topic for women. I think that Anon woman who made all the comments on my last post is secretly very worried about her fertility and sick of being reminded about it all time, which is why my post touched a nerve.

  16. Fizzy- I cannot say I was offended by your first post. When I was 27 I knew I wanted kids but had not met the guy I wanted them with. At 30, I was worried but luckily we had 2 pregnancies with no problem. Our third took a year and two miscarriages and a lot of angst. That said, many people will have a hard time getting your mom's intensity and the conclusions you made from them. The one statement I can definitely agree with is that professional women should support each other in their separate and equal decisions about children and timing and society as a whole needs to give working women of all stations more support.

  17. I love your two posts Fizzy and am glad that you brought the subject to the forefront. I'm a second year and actually wrote to ya'll not too long ago about when is better to have a baby, between 2nd and 3rd or 3rd and 4th. I got numerous responses (thanks everyone!) and ultimately decided to go ahead and start trying now. Why wait, ya know? We definitely know we want children and we know we want a big family so you have to start somewhere. But I think it's sad that medical training puts so much strain on your life that you feel pressure to hold off or you don't even feel mentally stable enough to have children. It probably doesn't help that I go to a very academic med school with 90% of my classmates being traditional students (young, straight out of undergrad and still party really hard).
    Oh, and for the record, I don't think you were being judgmental at all.

  18. I work full time in reproductive endocrinology so this is at the forefront of my mind, every day. As we have residents rotate through our service, each and every one of them starts to panic about their ovarian reserve if they aren't in the place of childbearing yet.

    My biggest beef with either post, though, was this:
    The pergonal caused me to get uterine cancer...
    What are you basing that on? Huh??

  19. Wow, fascinating stuff. You guys should definitely do a moms week, if the moms of these MiM would go along with it.

    Just to reiterate what several others have said: This shouldn't be such a stark choice. We should not just support each other as professional women - we should work for real change to make real support and flexibility available.

  20. You know what's sad? I'm a high schooler who knows that children definately need to be in the future. These posts even have me scared as to when i will be able to have a baby if i continue on the route to medicine.

    I think, and this is purely my observation, that the reason why this has caused so much controversy is because anyone who feels the need to have kids is terrified that they won't be able to. It's a scary thought, whether you're 16 years old or 40 years old.

    Granted, i might be a little young to start worrying, but hey, life goes fast and before you know it i'll be writing for Mothers in Medicine right along side you wonderful ladies.

  21. Fizzy,
    As Anon #1 from your first post, I truly feel sorry for you. To be a better person, you must be able to look at your writing and opinions critically. The story in this post is not judgmental, nor is it written in a judgmental way. Your post, however, had some questionable statements. My original point is that you must be supportive of all women and whether you meant it or not, your comments did not come across as supportive. Instead of listening to a thoughtful response though, you became very defensive (and many of your statements after my post continued along the same line). Finally, in your introduction of the new writer you emphasized the word "HATE" and you even chose to write the word in capitol letters. Is this really the word you wanted to say the loudest? As a colleague, I would ask that in the future you really try to listen to other's opinions before becoming defensive. Also, try to start from a place of MUTUAL RESPECT rather than hate when you begin posts.
    Anon (from the first post)

  22. Anon #1: I should remind you that you were the one who immediately and insultingly dubbed my post as anti-women and didn't even have the courtesy to use any sort of real identity for yourself, so that I could properly reply. I don't think one person agreed with you that the post was "anti-women." There's no point in my explaining to you why, because you don't actually seem to be listening to anything I say. And you were the only person, even of the ones who disagreed, who was actually rude in your reply.

    I'm sorry you're so insecure about the future that you feel the need to take it out on me. If you were truly happy with the choices you were making, you wouldn't feel a need to attack me repeatedly. You would simply shrug and let it go. Every time you reply in anger just reaffirms your insecurity. This has nothing to do with me or my post, but about your own fears. You need to learn to be comfortable with your own choices and stop being so damn over-sensitive.

  23. BuckeyeNP: I forgot to reply to you earlier, but my mother said she got cancer from the Perganol because she read that it can cause cancer. If you can show me something that can prove otherwise, I would happily show it to her because it makes her miserable thinking that the infertility drugs caused it.

  24. Anon #1 -- Maybe it would help to take a deep breath and just try to understand that judgmental is just how Fizzy is. She will never understand -- much less admit -- that she comes across this way to other people sometimes. Trying to get her to do so is a battle that's probably not worth fighting. It's not personal. When she gets under your skin, take a deep breath, think for a moment whether she has a point, and then if she doesn't, ignore the rest and carry on with what you were doing before.

  25. F -- I agreed that your post was a little anti-woman. Just saying.

  26. Anon, you can read my latest post on the subject on being judgmental. And you're absolutely right: if Anon #1 is so bothered, she should just stop reading my posts. It's not like I'm bringing them to her house and reading them to her.

    Childbearing is incredibly emotional for women. If that's an anti-women sentiment, then I guess I'm anti-women, whatever that means. But I can tell you that it really really sucks to start trying for a baby at age 38 and failing month after month, seeing all your friends with babies, imagining how cute and cuddly they are, feeling really desperate, and knowing that if you had tried sooner, you might have succeeded. You can argue with me now, be angry at me, whatever. But if it happens to you, you are only going to be angry at yourself, not at me.


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