Friday, September 14, 2012

Infertility 101

I haven't written about Alex's and my journey with infertility yet, in part, because we are officially "on hold", and I didn't want my writing about it to stir a renewed desire to plunge head first into the pursuit of parenthood again.  Infertility is a very strange medical condition for several reasons.

First, it's the only medical condition that I'm aware of that directly affects the affected person's spouse.  I don't just mean in the sense that one spouse has to provide care for the other spouse, as in some medical conditions, and thereby both their lives are affected.  I mean that because of the nature of infertility (namely, that it takes two to tango), regardless of whose body is not doing what it's supposed to, both spouses have to undergo medical tests, and depending on the specific diagnosis, both may have to undergo treatment.   

In the case of male factor infertility, while the medical condition lies entirely in the male spouse, the brunt of the treatment that is offered by modern artificial reproductive technology (ARTs) falls on the female spouse.  What makes it even worse, I think, is that if there is anything that can be done to reverse or improve the condition without bypassing it via ARTs, this has to come entirely from the affected male spouse's desire.  In other words, the wife cannot change her diet, her lifestyle, in order to fix the problem, but she's the one who has to go through treatments such as IVF that generally bypass trying to find a cause or cure of the acutal medical condition.

That's another strange factor of infertility.  Most medical conditions, I would hope, are addressed as follows:  symptoms are noticed and reported to the doctor; doctor runs various tests to determine the cause of the symptoms; results of the tests determine the treatment plan; treatment plan is pursued in hopes of a cure; the happy result is the alleviation of symptoms with the dissipation of the cause.  However, it has been my experience that the moment you contact a reproductive endocrinologist, they assume that your goal is not so much to address what's causing your infertility, not so much the cure of your infertility, but instead the end result - a baby.  Most REs will immediately pursue a so-called treatment plan designed to maximize your chances of conceiving a baby, regardless of what is the medical condition that is preventing you from doing so naturally. This may have something to do with the reason why most health insurances don't cover the more advanced fertility "treatments" - because they don't actually treat the problem; they seek to bypass it.

Infertility is also one of few medical conditions that come with serious social stigma. Probably mental illness and physical disfigurement are the only conditions with more social stigma than infertility.  But why?  Infertility is generally not something that a person could have avoided, so it's no one's "fault".  Lung cancer in smokers should be more stigmatized if following this logic.  And yet many people are too ashamed to talk about their infertility.  This becomes exponentially more true if the medical condition lies with the male spouse.

Even though infertility is not something you can "catch" by being around other infertile folks, many people seem to want to get away from the subject as soon as possible.  They offer unsolicited advice based on old wive's tales at worst, or partial information at best, neither being in any way helpful or comforting to the afflicted patient.  So just to clear the air, let's establish a few things right off the bat, before I share any more of our journey.

1. Whatever it is that you have heard may help us conceive - acupuncture, vitamins, yoga, meditation, crystals, whatever -  YES, I've already heard it, tried it unsuccesfully, or otherwise established that it is a bunch of hogwash.

2. Before you try to make me feel better by reminding me that things could be worse, let me tell you that a) I am perfectly aware of the many blessings in my life, and b) this in no way diminishes the pain of infertility.

3. There are many types of infertility, so it is completely inappropriate to suggest any one specific alternative without knowing what we're dealing with.  A sperm donor is not going to help a couple whose problem lies with uterine polyps and resulting recurrent miscarriage.  A surrogate is not going to help a couple whose problem is with sperm production.

4. Likewise, there are a lot of ethical considerations with many fertility alternatives, so to suggest that we should "just" do x, y, or z expresses ignorance in the fact that there may be very good moral reasons why a couple does not feel comfortable pursuing a particular course of action.  In-vitro fertilization, for instance, is condemned by some religions, especially when the traditional IVF is used, which banks on the creation of "extra" embroy that are then cryopreserved and often destroyed when no longer needed. 

5. Finally, we do not live in a hole, so yes, we have thought of, considered, and even pursued adoption.  Yes, we tried domestic adoption.  Yes, we tried international adoption.  Yes, we tried foster care. 

In a word, after 4.5 years of living with our diagnosis, please believe that it is us, not you, who are the experts in our condition and our options. 

That said, there is something you can do to be helpful - just listen and sympathise.  Don't offer advice, just be a sounding board.  Agree when we say it's not fair.  Express your understanding of why we may feel sad, angry, or any other emotion.  Under no circumstances say that we just need to relax, or that this must be the will of God.  The truth is, you don't know what God's will is any more than we do.  Likewise, we were perfectly relaxed at the start of our journey - the stress you may be recognizing in us came after our diagnosis; it did not cause our diagnosis. 

Now that I've gotten all of the preliminaries off my chest, I should be able to go into more details of our journey in future posts. 

Genesis 1:28a

God blessed them; and God said to them, “Be fruitful and multiply, and fill the earth, and subdue it."

(Ehem.  Easier said than done. Sigh.)

No comments:

Post a Comment