The thing about plans

I’m a planner.  Perhaps most of us in academia are.  I planned on completing a Master’s, going on for my PhD at a new institution, finding a partner during that time, getting a job, and then starting a family shortly after that.  I have a lot of friends who have/had similar plans. Life doesn’t always go according to your plans, unfortunately.

My partner and I started trying to conceive two years ago. Two years ago I was in my mid-thirties.  Two years ago, I thought it would happen within a few months of trying, I would finish my PhD, have a baby, and we would move on to bigger and better things.  Two years ago, I didn’t know that one in eight couples face infertility.  Two years ago, I didn’t imagine that we would have to face aggressive and expensive fertility treatments without the ability to pay for them.

This is national infertility awareness week and I think it is important to get this conversation started by sharing my experience.

Infertility and academia

I was well aware of the research showing fertility and birth defect rates plotted against maternal age and age of the average PhD graduate because I was reminded of this at least once a year during my graduate program.  Every chart shows a steeply descending fertility rate and sharply ascending rate of birth defects and miscarriages starting at age 35, with the average age PhD degree prominently marked at 36.  Nothing like a good scare/depress-the-shit-out-of-you chart thrown in your face every time you start to get comfortable in academia.  Needless to say, when I turned 35, I entered some sort of a mid-life panic mode.  I felt like I was thrown off the fertility cliff and I was doomed.  I still sometimes feel like it is my fault.  I waited too long.  I’m too stressed out.  I should have done this, or shouldn’t have don’t that…  Although this probably did not help matters, it’s not the cause of our fertility problems.  This is just the hand we’ve been dealt.  And it sucks.

I feel like a failure as a woman and as a professional.  First, I feel like my body is defective.  Women have evolved to get pregnant, yet I can’t without medical intervention.  I feel weirdly less feminine, yet at the same time, by wanting to get pregnant so badly, I feel like I’m too feminine for academia.  How do I let go of everything I’ve worked so hard for in order to pursue a family life?  I’m not putting my career first right now, so I’m out of the club.  Being at an R1 institution and having friends go on to R1 jobs has given me the impression that to be a good scientist or professor, you need to put your career first above anything else, certainly above anything in your personal life.  The thing is, I’m not getting any younger and my odds for conceiving go down every year.  Those are the facts.  So, I need to do a little priority juggling right now to focus on attaining this coveted goal while not letting go of trying to get my career off the ground.  It’s a tricky balance.  I’m not going to lie: it is extremely difficult to try to finish my dissertation, when 1) I’m bored and frustrated with my project to begin with, 2) I see little point in finishing if I don’t plan to go down the professor path, and 3) now I see it as an obstacle that prevents me from being a parent.  I’m hanging on by a thread here.

Which brings me to finances.  I look at myself and ask, how did I get to be in my mid-late thirties and still make so little that I qualify for food stamps??  As a grad student, I still make slightly more than my partner and carry the medical insurance.  (Not that insurance covers any part of infertility expenses in my state). Not including medication, in-vitro fertilization (which has the best odds) is at least $13,000 per cycle, which is a little less than what I make annually.   Maybe throwing the towel in on the PhD in order to get a job with a stable income doesn’t seem so crazy now.  Maybe then I would feel like I have some control over my life.  Right now, I have no control.  Not with finances, finishing the PhD, or our fertility.

I feel alone.  Some of the grad students in my department have started having families (by the way, all of them are guys) and my closest friends are younger, so starting families is still a future goal for them.  I feel like I can’t talk about infertility with anyone because it’s embarrassing and I don’t want the pity/ostracism that comes with it.  Also, I think it makes people uncomfortable—like I’m diseased or something, or perhaps because sex is implied. I look around me and see so many people getting pregnant seemingly without trouble.  However, I’m not the only one having trouble.  One in eight couples face infertility, but rarely does anyone talk about it.  This needs to change!

Support

For those of you who might be struggling with infertility yourselves, I highly suggest checking out the many articles and links that are provided by RESOLVE.org, such as coping with the stress of infertility.  Both my husband and I have found these resources particularly helpful.  You might also find the video campaign “the truth about trying” helpful.  Many women share their infertility experiences, which was at times hard to watch, but overwhelmingly helped me feel less alone.  I’ve learned that many communities have support groups for couples facing infertility.  Most importantly, you’re not alone.  Ask for help.

For friends and family who don’t know how to support someone facing infertility, there are resources for you too!  These include things like infertility etiquette and myths and facts.  Most important:

  • Don’t tell someone to just relax.  This is a myth.
  • Don’t minimize it.  The couple has to cope with loss on a recurring monthly basis.  It’s real grief; treat it that way.
  • Don’t say that worse things could happen.  Who are you to judge?
  • Don’t gossip.
  • Don’t stop inviting them to baby-themed events such as showers or birthdays.  However, be understanding if they decline.
  • Don’t be quick to push adoption.  We need to first mourn the possibility of having biological children.

Finally, NEVER ask ANYONE when they will start a family.  This is none of your damned business and no one needs to be reminded that the clock is ticking.  Plus, for those of us struggling with infertility, it is truly salt in the wound.

GracieABD

30 thoughts on “The thing about plans

  1. GracieABD–Thank you for your post. I was born with a congenital birth defect called MRKH (named for 4 long-deceased German men). Women with MRKH are born with a severely underdeveloped reproductive tract that includes the uterus, cervix and upper vaginal canal, which precludes carrying my own child. Each of us has a different phenotype, and other symptoms include unilateral kidney, scoliosis, heart abnormalities, tinnitus and other morphological changes. MRKH affects 1 in 4500 women, and you can read about it here: http://www.beautifulyoumrkh.org.

    I struggled with infertility throughout my career. As a grad student in my late 20s, early 30s, theoretically my fertility was fairly good; however my insurance did not cover anything related to fertility and my low salary precluded us even thinking about it. As a postdoc in my mid-late 30s, my health insurance covered the drugs (WOOT!) and anything that happened to me, but the IVF procedure, transplantation or surrogacy costs would have had to come out of our savings. With total costs approaching $100K, coupled with my increasingly old oocytes, I decided that the financial risk was not worth the overwhelming odds that we would be unsuccessful, as IVF and surrogacy success decreases sharply after 35. (The odds are much better if you are not doing IVF and surrogacy).

    Your post highlights that infertility is a very real struggle for a large number of couples, and raising awareness helps to decrease the shame of infertility. Thank you for having the courage to talk about your struggles and let those who are going through this journey know that they are not alone.

    Thank you again for bringing infertility into the topic of conversation.

    Amy Lossie

  2. The before conception time was the hardest time of my life. I remember feeling exactly as you describe, and now looking back it was a mini mid-life crisis. This is so hard, and you are right we don’t talk about it enough. Thank you for sharing, and I hope you have a happy ending, whichever path you choose/end up on.

  3. Thanks for talking about this important issue. I struggled to conceive during my PhD and all of the things on your list of what not to say/do where said/done to me. While I’m now a happy mother, I still remember that period as one of the hardest times of my 20s. And like you said, it’s not something that women graduate students find easy to talk about with those around us.

  4. Thank you for your post. I, too, am struggling with infertility while finishing grad school. We are entering our second month of treatments. We are lucky that we are young, our insurance covers a percentage of our costs, and we have not progressed to IVF yet. Though, we do talk about it constantly. We know we have a hard road, but are so thankful for people like you who are able to stand up and say something. Thank you for your courage.

    • Thanks for sharing GSL. We went through 5 months of clomid (which, I hate!!!! The side effects were awful for me) and an HSG, which was the most painful thing I have ever experienced yet. We’re moving onto our first IUI cycle this month with a new drug, Letrozole. We haven’t progressed to IVF yet either. I don’t know what we’ll do if it comes to that, but I know there is financing help out there.

      After reading a lot of the information on the resolve site and watching some of the “truth in trying” video, I am feeling less frantic. Seeing and hearing about other couples struggles, and especially how long couples struggled, surprisingly helped me. I went from thinking “ok, next month it will happen” to understanding that this could take years to resolve. It sounds depressing, but for me it is uplifting and has helped calm my anxiety. I also recently started on Prozac, which I will stay on until I 1) finish my phd or 2) get pregnant. It is also helping with the depression and anxiety.

      Good luck to you and your partner! You’re not alone.

      Gracie

  5. 31-year-old infertile assistant professor here — hi! Thanks so much for posting about this. We hear a lot about the academic timeline and having babies, but we hear far less about the academic timeline and *not* having babies. It’s something I honestly never considered until it happened to me. I think the hardest part for me has been just not knowing what’s going to happen, i.e., not just having my plans derailed one after another, but rather the complete inability to *make* plans. This is probably the time in my life when I’ve most wished I could get just a peek into the future — if pills aren’t going to work, then I don’t want to waste my time on them, but is the all-consuming expense and hassle of IVF really necessary? What if it doesn’t work even after all the expense and hassle? Compare this to how I felt when I first started trying to conceive (when I was trying to plan the month I’d have a baby around the academic calendar — ha, what a luxury!), and it’s like being on a different planet.

    I will add that I hope you can get help for your feelings of failure, panic, and isolation. I know it’s easier for me in my early-30s when I still have a very positive prognosis, but I’ve found it really helpful to talk to my close friends about what’s going on — I have even found a couple others of the one-in-eight that way, and we’re great support for each other. Talking about it has also nipped those sly “so, you’ve been married for a while — where are the kids?” comments in the bud. This is a difficult but unfortunately quite common issue, you’re not in it alone, you’re not a failure, and if you really want to be a parent you can be, even if it’s not when or how you’d prefer. Wishing you all the best!

    • Hi! Thanks so much for sharing your story. I completely identify with struggling with the uncertainty that comes with infertility treatments, especially with unexplained infertility. You don’t want to waste time (or money) on something that won’t work, yet you don’t want to jump in with IVF right away either. It’s amazing to me how complicated and many parts must go exactly right in order for a pregnancy to occur; it sucks that we can only test a handful of these to see where a problem might exist.

      After reading a lot of the information on the resolve site and watching some of the “truth in trying” video, I am feeling less frantic. Seeing and hearing about other couples struggles, and especially how long couples struggled, surprisingly helped me. I went from thinking “ok, it has to happen next month” to understanding that this could take years to resolve. It sounds depressing, but for me it is uplifting and has helped calm my anxiety. I think that five years from now we’ll be able to look back at this awful time from a much better place. I also recently started on Prozac, which I will stay on until I 1) finish my phd or 2) get pregnant. It is honestly helping with the depression and anxiety that comes with both the phd and infertility.

      Good luck to you too!

      Gracie

  6. No, you are not alone. I have a history of endometriosis, and struggled conceiving. It is much more common than you think; most probably several people around you with or without kids went through different procedures and experiences. I had once seen another woman (in academia) I knew at the infertility clinic I was going to, and I wouldn’t have known she was going through a similar experience if it wasn’t for that coincidence.
    Another difficult topic of conversation is miscarriage. I am now comfortable talking about my difficulty conceiving when people ask me if we are thinking of having a second child, but I am still omitting the fact that I had a miscarriage and the probability of having a second child is nil. We actually decided not to go through with IVF (the only option at this point) considering my age, the emotional roller coaster, the time and effort, and the very high chances of another miscarriage.
    Maybe I should make a list of what not to say to a couple with an only child :-)
    Well, I am happy with what life gave me, and I hope that you will find your happy ending too.

    • Thanks for sharing your story, mamart. The truth in trying video had several women who talked about their experiences trying to conceive after one or two kids. I think no one really understands the heartbreak that happens no matter what the family situation is until they go through it. I really wish we could ban family planning questions from being a socially acceptable.

      I’m glad you have come to a happy ending, and I look forward to getting there myself–whatever that may be.

      Gracie

  7. Good post and list of resources. Infertility can be such a difficult topic to discuss, especially because discussion often leads to well-meaning friends visiting that list of things not to say to someone going through this struggle. It can be so hard to forget those hurtful comments, even when you know that the person meant well. While technically I don’t have infertility, I can empathize with these emotions after a longer journey to conception of 1.5 years with miscarriage along the way. I hope all the best for you.

    • Thanks for your comments, Colleen. It can be hard to forget these hurtful comments. We ended up sending the people we told the infertility etiquette link, which helped stop these comments. I wish everyone would read it whether they think they know someone struggling with infertility or not.

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  9. Pingback: Infertility and academia | InBabyAttachMode

  10. It’s sad but true that any topic sharing a Venn Diagram with Sex will be fraught with innuendo, raised eyebrows, and awkward conversations. I am if anything hyper-fertile, and have provided donor gametes for decades to couples experiencing infertility. Yet I too have to restrict what I say about this and to whom, as the entire topic still seems to be overshadowed by a complex of taboos. Failure or loss of function of any major organ or organ system, including the reproductive system, ought to be one definition of a fully insurable health risk. Infertile couples should never be paying out of pocket for this part of health care.

  11. Thanks for this. I’m dealing with infertility in a slightly different way: without a partner, barring the highly unlikely option of parthenogenesis, there is little chance I will conceive naturally. I recently bit the bullet and found a donor, but it’s not been an easy decision: even if all goes exactly to plan, I will be a single parent from the get go. But having children is such a priority in this stage of my life that yes, I am willing to put it ahead of my career, and oh do I ever feel guilty about that.
    This:
    “I feel weirdly less feminine, yet at the same time, by wanting to get pregnant so badly, I feel like I’m too feminine for academia. How do I let go of everything I’ve worked so hard for in order to pursue a family life? I’m not putting my career first right now, so I’m out of the club. Being at an R1 institution and having friends go on to R1 jobs has given me the impression that to be a good scientist or professor, you need to put your career first above anything else, certainly above anything in your personal life.”
    So true.

    The thought that tipped the scale, though: I won’t ever regret having this (hypothetical) baby. Yes, it will be expensive (it already is), yes, it may cost me a lot career-wise. But if all goes well, I cannot imagine looking at my future child and feel sorry that I went through this and made these sacrifices to have him/her.
    But what if it won’t work? Will I regret losing money, and valuable time and energy pursuing this? When will I decide that enough is enough and give up?

    I wish there was more conversation about this, indeed. I find it nearly impossible to talk about, and I’m not sure what’s worse: confessing that I’m no hardcore scientist (I’m willing to sacrifice it all for being a mom), or the guilt toward my current lab/supervisor, who hired a single woman and does not at all expect maternity. Let alone single-maternity…

  12. Thank you so much for this post. I remember how horribly alone I felt when I was struggling with fertility. I started a tenure-track job at 34, and started trying to conceive shortly after that. Four and a half years later, I was struggling to fit in doctors appointments between rewriting drafts of articles to scrounge together enough pubs for tenure. I couldn’t look at a pregnant woman without breaking down in tears. I was a mess, and it was one of the most difficult things I’ve ever dealt with. There was a lot of grieving. And the news that I had received tenure coincided with news from my husband that he wanted to end our marriage. So I began my first year as a tenured professor with divorce papers, not a baby – not even adoption papers. SO different from anything I had imagined in my ‘plans.’ (And, like you, I am a BIG planner – I think many academics are.)
    But it forced me to do some major soul-searching – and, with that, ultimately, came acceptance. I’m 43 now. Looking back, I would never want to relive that time in my life – but I also wouldn’t trade it for anything. I learned so much about myself (and, honestly, what I need in a partner) that has served as the basis for building a really fulfilling life in the present. I occasionally feel that wistful longing for a family – but never so strong that I would give up what I have in my career, community, or my circle of incredible friends to pursue it.
    I guess I’m just trying to say that there is life ‘beyond’ the fertility struggle – and whatever happens, it can be good.

  13. Thank you for sharing! This post inspired me to write my own. It’s so important that we share. I really identify and appreciate so much of what you wrote, especially this point:
    “I feel like a failure as a woman and as a professional. First, I feel like my body is defective. Women have evolved to get pregnant, yet I can’t without medical intervention. I feel weirdly less feminine, yet at the same time, by wanting to get pregnant so badly, I feel like I’m too feminine for academia.”

    Academia can be a weird space to be dealing with fertility issues. And not having obvious physical indications (like a growing belly) of all the energy, money, and effort we’re putting into TTC makes our concerns that much more invisible and silent.

    Thank you for opening up this dialogue and offering concrete suggestions to the outside world on how to help and support women like us. Wishing you the best and lots of strength for this enduring journey.

  14. I’m 32 years old, just now ABD, and my husband and I have been trying for just over a year. We’ve begun the process of infertility exploration and treatments over the last few months, and you’re absolutely right–there’s almost no one to talk to, and to talk about this at all with anyone in academia means admitting that my dissertation isn’t the first thing (or the only thing) on my mind (what you said about femininity above is also spot on). It’s especially difficult just now, when we aren’t yet sure what’s causing our problems. I want to thank you for this post. To know that others are thinking and talking about this is helpful, and heartening.

  15. I also spent my last year of the PhD and first year after investigating my infertility. I had PCOS, a blocked tube, and my husband had male factor. Fortunately my post-doc was in a state that covered infertility, so I saw very little of the costs, and we were able to do more diagnostics and only monitored clomid cycles. I was fortunate also, I guess, to suspect that I might have a problem before ttc– an aunt on one side has POF and on the other PCOS, and I’d never had regular periods until going on BCP. After the first work-up I was mostly relieved that I didn’t have POF, because that was my biggest worry. But those two years were heart-wrenching, that knowledge that no matter how hard we worked at it, we might not get what we wanted more than anything in the world. And yes, once school was done DH’s extended family started asking about our baby plans at every opportunity. “We’re working on it,” we’d say over and over again.

    I was still miscarrying the week we came into town to buy a house for my new job. I cried every time we saw a crib.

    And after my first (living) child got to a certain age, people would start asking when I would have a second. Often at inappropriate times, like over dinner with a job candidate. It’s not that easy. Stop asking.

    One of my colleagues is currently experiencing secondary infertility and is gearing up for IVF. She’s just undergone surgery to get rid of scar tissue she didn’t know she had from a badly done c-section with her first 10 years ago.

    And no, you don’t need to put your career ahead of your family/life to get tenure any place worth getting tenure at. And academia is never the only path worth pursuing. The world outside academia can be remunerative in many ways.

    I wish you the best of luck with your journey.

  16. I also started trying to conceive at 35. I spent several difficult years struggling with infertility. I agree that the hiddenness of this condition can make it harder. Everyone I know recognises that we need to accommodate the needs of pregnant women and parents of young children at work (and I agree that we should do this), but typically your colleagues don’t know about your infertility struggles and how they are impacting on your work.

    Anyway, I ended up childless. (I went through an early menopause, and for various reasons my partner and I decided not to pursue adoption.) I just wanted to say that – though I couldn’t have imagined this when I was still trying – this is an outcome that I ended up coming to terms with. I wish you all the best in your attempts to get pregnant, but it is important to know that if they aren’t successful, it is possible to adjust to leading a happy life as a childless person, even if it isn’t the life that you imagined for yourself, and even if you do sometimes still feel sad that things didn’t turn out differently. At least, that has been my experience.

  17. Thank you for posting this. Having been born without a uterus, I feel you so much on this. My spouse and I very much want to have children, but the “easy” way doesn’t exist for us, either. As our parents pressure us as to when they’ll have grandchildren, it just stings that much deeper. I find that as I get older, I’m keeping an eye out for new role models of what motherhood can be when you can’t conceive.

  18. Thank you for this post–it really helps to hear someone else’s story and find out I’m not alone. So much you wrote resonates with me– the feelings of failure, my body letting me down. At 34, I’m starting a postdoc while dealing with infertility. After a year of trying and 6 months of tests, found out that IVF is our only option. One reason I decided to take the postdoc is that the insurance that comes with it will cover some costs, the location is near a ‘good’ clinic that will do some of the less invasive procedures I want and my work schedule is flexible. The cons are that my husband will have to commute for work half the month. However, I’m glad to have a job and some interesting academic work to do so that infertility does not take over my life. And I expect that most of the money I make will end up going into the black hole of infertility solutions!

  19. Pingback: Location, Location, Location | Tenure, She Wrote

  20. Thanks for this post! There is almost NOTHING online about dealing with infertility in academia. There’s less than I would expect about dealing with it in any work place, but of course we in academia face special problems – we’re not just struggling to maintain a good working attitude from 9-5 on weekdays, but usually working way more than 40 hours per week. We’re often trying to work more than 40 hours on our research/teaching/dissertations/writing/mentoring PLUS apply for postdocs or professorships. Add up the long odds of conceiving when you have fertility issues, the long odds of getting that tenture-track (or even a postdoc these days), the difficulty of keeping your mentor happy with your work and progress….sheesh!

    I just started fertility treatments (though I’ve known I had PCOS and endometriosis for a few years now) and I already feel like I am going to actually collapse with exhaustion and most likely am going to go insane. I’m on my second round of Clomid, and so far it is looking like I didn’t produce any large enough follicles this time even though I took a higher dose of Clomid (which made me even crazier than on the first cycle…and that is saying something). The hormonal and emotional rollercoasters are getting to me. And sometimes I am in too much pain, can’t stop crying, or I’m just too damn exhausted to go to work or to be very productive when I’m there. I also have had to time my treatment around fieldwork. I skipped a cycle last month to teach an international field research course, and that caused me to have a period that lasted 18 days before I realized it had been so long and contacted my doctor. Apparently non-stop periods happen sometimes when one takes break after Clomid, HSG, and progesterone treatment. So then I had to take a medication that is normally hormone replacement for menopausal women to stop the bleeding. I had to take it for 21 days, which further delayed when I could start this treatment. Now after all I’ve gone through this time, I might not have any follicles this month. I am probably looking at surgery to have another better look at what’s going on inside of my malfunctioning reproductive system.

    I don’t know if I should tell my boss/mentor or not. He is not the most understanding person in the world, but I’m afraid NOT to offer some explanation for my absenteeism and lack of energy lately. And I’m generally a very truthful and open person, and I feel a bit guilty for hiding this. Has anyone had a good experience telling their supervisor what they are going through? Or a bad one? By the way, I’m a postdoc in Germany, and I’m currently applying for tenure-track jobs back in the US (and asking my boss for letters of rec…not sure how they will be).

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