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High school sex ed did a number on me, and I spent most of my life living with a low-grade fear that I would get pregnant every time I had sex, even though I used the pill. That notion was further confirmed when I got pregnant with my first son the day my husband and I started trying. But when we decided to try to have another baby, things weren’t so easy.
I spent a year going through the roller coaster of trying to have a baby, hoping this would be The Month, and having to give myself a pep talk—again—when my period inevitably came. I kept checking in with my ob/gyn, who told me that nothing was wrong, I should keep doing what I was doing, and that I really only needed to circle back with him after 12 months of trying. It was an incredibly frustrating experience.
Finally, 12 months went by, and I spoke to my doctor’s receptionist about making an appointment to find out what the heck was going on. “OK! We have you down for an infertility consultation next week,” she said. “Oh, I’m not infertile—I just haven’t been able to get pregnant in a year,” I said. “That’s infertility,” she replied. I got off the phone and sobbed. In my mind, we were headed for IVF or adoption. And, while both are great options, it's not what I had my heart set on.
After meeting with my doctor who ordered a procedure called a hysterosalpingogram (HSG) (a diagnostic X-ray test that lets your doctor look at the inside of your uterus and fallopian tubes to see if there are any blockages), I ended up pregnant. And nine months later, my second son was born. I know I’m lucky—I was only technically infertile for a month—and I have friends who have dealt with infertility for much, much longer. But infertility is a scary and often misunderstood word, and it can be devastating to hear it. Here's what I want you to know about it.
Infertility is clinically defined as not being able to get pregnant after one year of having regular sexual intercourse without the use of birth control, according to the American Congress of Obstetricians and Gynecologists. The criteria for men is pretty similar: Men are considered infertile if they’ve been trying to conceive for one year with no success, according to the American Society for Reproductive Medicine. Basically, if you've been trying for a year and haven't gotten pregnant yet, you're infertile—regardless of whether or not you actually get pregnant in the future. About 8 to 15 percent of couples are unable to get pregnant within a year, according to the ASRM, so there are plenty of people out there struggling with this label.
Karen, the woman behind the popular Instagram account Hilariously Infertile, was one of them. (Karen doesn’t like to reveal her last name because she’s a teacher and her students know how to Google.) Karen tells SELF that when she wanted to get pregnant, she went off the pill and never got her period. “I grew up knowing that if you have unprotected sex and you don’t get your period, you’re pregnant, but I kept taking pregnancy tests and wasn’t pregnant,” she says. “A few months later, I went to my doctor who said this wasn’t normal.” She was eventually sent to a fertility clinic, where she was diagnosed with polycystic ovary syndrome (PCOS), a hormonal disorder that can make it difficult for women to become pregnant. Several fertility treatments later, she was pregnant with her first daughter, and her second daughter was born years later after a round of IVF.
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Karen wrote a book about her experience but wasn’t able to find a publisher, so she decided to post snippets online and create her Instagram account to help women who are struggling with infertility like she did. Now, she regularly posts infertility memes like: “Nothing says ‘I care’ like a trans-vaginal ultrasound” and “IVF: taking the fun out of procreation since 1978.” The hope, she says, is to help women laugh about the process like she did, especially when it comes to things like your partner giving sperm “specimens” and regularly having your legs in stirrups. “My husband and I kept seeing the funny side as opposed to the sad side,” she says. “That’s how we got through it.”
Advanced maternal age, defined as having a pregnancy at the age of 35 or over, is a biggie, Philip Chenette, M.D., a reproductive endocrinologist at Pacific Fertility Center in San Francisco, tells SELF. As you get older, your fertility gradually declines, which is why women who fall into this group may take longer to get pregnant.
Conditions like endometriosis, PCOS, having damaged or blocked fallopian tubes that can’t be treated with surgery, and premature ovarian failure (a loss of normal ovarian function before age 40) may also make it harder to get pregnant without reproductive assistance, according to ACOG. A cancer diagnosis or an abnormally-shaped uterus may make fertility complicated as well, Brian Levine, M.D., a reproductive endocrinologist and practice director of the Colorado Center for Reproductive Medicine - New York, tells SELF. There’s also something known as “unexplained infertility” which is exactly what it sounds like—you have trouble getting pregnant and doctors don’t know why.
It’s also important to keep in mind that it's not always your uterus that's the issue. According to the ASRM, male infertility is the issue in 20 percent of cases of infertile couples, while the CDC says that male factors contribute to infertility in about 35 percent of cases. So it’s important for your partner to be involved in the process and to undergo testing too. A semen analysis can tell doctors about sperm motility, shape, and concentration, all of which can play a role in fertility, says Dr. Levine.
“I always tell my patients to have a short-term and long-term plan with the various infertility options,” Sherry A. Ross, M.D., a women's health expert and author of She-ology: The Definitive Guide to Women's Intimate Health. Period., tells SELF. “The likelihood of the couple getting pregnant is extremely high but it may take creative medical technology to make it to the finish line.”
Some women may get pregnant after identifying and addressing whatever problem was getting in the way, while others may need to undergo rounds of a fertility drug to stimulate ovulation. There are also options like intrauterine insemination (IUI), which involves placing sperm inside your uterus when you’re fertile, or in vitro fertilization (IVF), which involves retrieving eggs and fertilizing them with sperm in a lab, then implanting those embryos in your uterus.
Shahin Ghadir, M.D., F.A.C.O.G, a reproductive endocrinologist at Southern California Reproductive Center tells SELF that “the majority of patients who walk through our offices are people who are diagnosed with infertility, and the majority of our patients who walk out of our offices end up pregnant.”
What exactly that pregnancy journey looks like will differ from person to person, but it's important to remember that there are specialists available who can help you go over your options and figure out what makes sense for you. In addition to treatments like IVF, there are other paths to parenthood like using an egg donor, having a gestational carrier, or pursuing adoption.
Technically, the recommendation is to check in with your doctor after a year of trying if you're under 35 or after six months of trying if you're 35 or older. That said, it can't hurt to check in with your doctor if you have questions, Dr. Chenette says.
However, if you have any health issues like irregular or absent periods, a PCOS or endometriosis diagnosis, a history of an eating disorder, a history of pelvic inflammatory disease, or a strong family history of infertility or recurrent pregnancy loss, it’s best to visit a fertility specialist immediately, Jennifer Hirshfeld-Cytron, M.D., a board-certified reproductive endocrinologist and director of fertility preservation for Fertility Centers of Illinois, tells SELF.
Above all, know this: Infertility is really common and it’s nothing to feel embarrassed about. Plus, there are many, many options out there that can help—it just may be a longer and more frustrating process than you anticipated.
Related:
- I Froze My Eggs at Age 15…and Did It Again at Age 19
- This Couple's IVF Story Is Captivating Thousands of Facebook Users
- Fertility Treatments and Heart Disease Study: Here's the Truth
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