The infertility diaries #2

There are questions she wants answers for and questions she doesn’t want to answer

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Diagnosed with “unexplained infertility” at the age of 28, I turn to books, articles, and podcasts in a bid to learn more about the science behind conception, and in an attempt to get to the bottom of my own infertility.

I realise my partner and I are not alone. According to the NHS around one in seven couples have difficulty conceiving. A study from the American Society for Reproductive Medicine estimates 15-30 per cent of couples who experience infertility do so for unexplained reasons.

For me, the diagnosis of “unexplained infertility” just doesn’t sit right. Imagine going to a doctor with a lump on your neck, and them shrugging it off as an “unexplained lump”, or presenting them with a rash on your skin only to be told it is an “unexplained rash”.

The more I read, the more I realise the vague wording of our diagnosis is characteristic of medicine’s quiet reputation for explaining away what is seen as a women’s health issue. Women’s bodies – and the ways in which they grow, fluctuate, and age – have long been misunderstood, reviled, censored, ignored and under-researched.

There are myriad factors that can affect a couple’s ability to conceive. The female reproductive process is a complex and delicate interplay of structural and hormonal processes. The deficiency or abnormality of one component can throw the whole thing out of whack.

When it comes to the baseline fertility investigations offered by the NHS, it turns out they don’t delve very deep. Do you have a uterus? Is it the right shape? Do your ovaries have the right amount of follicles for your age? Does a blood test on day 21 of your menstrual cycle confirm a progesterone surge that indicates you have ovulated that month? All yes? Then you’re fine: your infertility is unexplained. The end.

I read about investigations in the US that test for hyperthyroidism, vitamin D deficiencies, and even dental examinations following research that periodontal disease can affect fertility. I learn that when it comes to diagnosing a potential fertility problem, you have to do a lot of the work yourself. It involves tracking, recording and reading. I learn no one will advocate for you.

Against a backdrop of obsessive research, ovulation test kits, lifestyle changes and vitamin supplements come the well-meaning questions from family and friends. “When are you going to have a baby?” people ask, as if the thought hasn’t crossed our minds.

In the early days, I feel my throat closing up. I mumble something about waiting until we’ve finished renovating the house, or waiting until next year. Sometimes I just say “we’ll see”. But I soon realise the pressure of keeping our struggle a secret is making it even harder to live with. I am fine, until someone asks me if I’m expecting when they notice I’m not drinking at a party, and then I’m not fine, because I’m suddenly forced into a situation where I’m pretending to laugh off the suggestion that I could be pregnant.

So I just come out with it – gradually, and to trusted friends and family, and the load becomes much lighter. I start to see our infertility for what it is – a health issue – just like a slipped disc, a torn muscle or a disease. The only difference is my health issue doesn’t cause me any physical pain, it doesn’t prevent me from working or doing the things I enjoy, so as difficult as it is, I find a way to live with it.

But my feelings are not representative of others’. Infertility can be a lonely, debilitating, anxiety inducing, emotionally draining, heartbreaking experience that can push couples to the limit, particularly when they have been through unsuccessful rounds of IVF. And it is an experience that is compounded by those harmless questions by well-meaning friends and family, and in some cases strangers.

If you often find yourself probing childfree couples in their late twenties and early thirties about whether they are planning to have a baby, just don’t. They could be already pregnant, they could have just experienced a miscarriage or be going through IVF. They might be undecided about whether they want kids at all. If they want to discuss it with you, they will, but for now, ask them about their jobs, their hobbies, their holidays, their pets. And if you can’t do that, you can always chat about the weather.

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