Thursday, May 28, 2009

Infertility: From the Inside Out

On June 12, 1993, on a blistering hot Chattanooga day, I married Kristi Cheryl Poe. It was a big wedding. Lots of family. Even more friends.

There is a picture of my wife from our honeymoon in Bermuda. She is standing in the bedroom of an old house that has been turned into a museum. Her hands are cupped in front of her, her shoulders hunched and a guilty smile crosses her face as she looks back at the camera. She’s standing over a baby’s crib. The cradle at her feet and the guilty look speak volumes about the direction she wants our lives to go. It’s clear. She wants kids.

To be honest, I hadn’t given much thought to children at this point, but it was plain to see that this meant a lot to her. When we got back from Bermuda we placed that picture, among others, on the wall in our den. That picture reminded us of very happy times.

We thought our lives were fabulous. Like many young couples, we were not in a rush to start a family, but we also didn’t try to prevent it from happening.

So in the beginning, not getting pregnant in a given month was no big deal. We knew these things took time. So time passed.

More time passed. Months passed. Seasons passed, then years, and anniversaries and the births of friends’ children. Then birthdays of children.

Throughout all of this, month after month, the picture on the wall hung there, reminding us of what she, now we, wanted very badly. The picture on the wall had not changed. My wife still had the same smile on her face, but now instead of looking guilty, it started to look a little sad.

In fact, every time I looked at that picture of my wife, I secretly wondered if we were not meant to have a child. That made me sad. So much optimism, crushed.

I can’t say this didn’t wear on us a little. We began to lean on friends and confide in them. Most of them were absolutely wonderful. They just listened. But I have to confess, it was hard to hear advice from some people who had easily gotten pregnant.

“Relax,” they reassured.

or

“Oh, you’re just trying too hard.”

or

“I know someone who adopted, and then got pregnant!”

or

“I know someone who quit trying and then BAM, got pregnant!”

You get the gist.


If you’re reading this, you’ve probably heard these stories yourself. I was too early in my career to know anything about something called “recall bias” (more on this later in an upcoming post). I assumed that stress was a major cause of infertility. And I knew what these people were saying. It was apparent without reading too far between the lines.

They were essentially saying, “It’s all your fault. You’re causing this.”

If these people were trying to help us relax, I confess it had the opposite effect.

All of this occurred at the beginning of our nearly 10 year journey with infertility that would take us across more than 600 miles and to three fertility centers and more cycles of IVF than I can remember reliably. Over the coming months, I’d like to document that journey and use this as a touchstone to talk about infertility treatments and tests.

It is my hope that this blog will help two groups of people: those who are struggling with infertility, and those who are giving advice.

Every couple is different. Having been a patient and a doctor who treats these conditions, I’ve seen what infertility can do to people and to families. I’ve seen it from many angles and from the inside out. I’ll tell you what I’ve learned.

Our particular journey as a married couple started with a trip to Bermuda. That little picture on our wall is a reminder to us of who we were and what happened to us along the way. It is a reminder of the joy and the unspeakable sorrows, the hope and the disappointments we experienced along the way. For better or for worse, our experiences with infertility shaped us as a couple. These experiences shaped me as a doctor.

For me, that picture of my wife in Bermuda says so much. It’s a constant reminder of how cruel hope can be and of how fragile and how strong we all are. For these reasons, it is still one of my favorite pictures of my wife.