Do you have children?” a new acquaintance will ask, in a natural effort to prompt conversation. My grip tightens around my wine glass, and for an instant, I glance away.
Sometimes, I consider lying. “We have a daughter. She’s starting Oberlin in the fall. We think she’ll major in English.”
I imagine her, athletic and strong, a young woman who smiles easily and sincerely. I find her beautiful.
“No,” I answer, always adding, “we weren’t able to have children.”
My husband Tom and I started trying to conceive a child when I was 35. According to medical opinion, I was older than ideal for a first child, but I felt the right age emotionally. I thought that was more important. I still do. At 34, Tom, too, was eager to embrace fatherhood. Our timing seemed perfect.
When six months had passed without success, we recognized there might be a problem. After a battery of tests (including one in which Tom’s sperm was mixed with hamster eggs, of all things), infertility specialists offered their explanations, more or less: “male factor” and “hostile cervical environment.”
Tom’s immediate response to this frustratingly vague diagnosis was, “I’m shooting blanks,” and because he delivered this line with a rueful smile, I didn’t understand how upset he was. Although tests had confirmed he was not sterile, he heard “male factor” as “my fault.” And part of me actually felt relief, because I worried I’d waited too long to conceive.
My diagnosis of “hostile cervical environment” was marginally more instructive, suggesting Tom’s sperm couldn’t survive in my cervical canal, perhaps due to some immunity issue. It was possible my body was producing antibodies to destroy his sperm, acting as if they were bacteria or a virus.
“Can I get pregnant without medical intervention?” I asked our doctor.
“No,” she replied.
“Well, then, what do we do now?” I responded.
“Intrauterine insemination,” she said. “We’ll bypass your cervix altogether.”
Both Tom and I had MBAs. We were accustomed to “managing for success.” In our experience, achievement of an identified goal was a function of sound strategy, dedicated resources, and focused implementation. We could do this. We didn’t ask ourselves if we should do this, at least not initially, and, so, we embarked on what turned out to be the slippery slope of treating infertility.
I started taking Clomid, a drug designed to stimulate my ovaries into improved production, thereby creating a “target rich” environment. Once a month, on the day estimated as the day I ovulated, I left my office in the Chinatown neighborhood of Philadelphia, invariably at an inconvenient time, to walk the 10 blocks to my doctor’s office at Pennsylvania Hospital. I’d walk along briskly, barely looking at the people I passed, isolated by the upcoming appointment’s strange intimacy.
Once there in my doctor’s examining room, wearing a disposable gown about as sturdy as a paper napkin, I lay on a metal table staring at the ceiling, my legs apart, knees bent, feet in the metal stirrups. As much as possible, I focused on trivia: the wallpaper pattern in the room (as I recall, overly cheery), my laundry and grocery lists (no starch, milk), what Tom and I would have for dinner, my latest scheme to lose five pounds (potentially at odds with the dinner menu).
After what always seemed like hours, my doctor would arrive, carrying Tom’s washed and spun-dry sperm in a syringe. Once she deposited the fluid in my uterus, I continued to lie on the table with my knees bent waiting the requisite 10 minutes before leaving, hoping sperm would fertilize egg, and this would be my last trip.
When I look back on these visits now, I am subtly appalled Tom and I didn’t go to any of these appointments together. He’d fly into the hospital, retreat to an examining room, ejaculate into a cup, and then veer off to his next meeting. To limit my own absence from work, I, too, would arrive at the last minute. We were parallel comets, each whizzing in space, each focused on our separate parts in this venture.
Once, I arrived to find that Tom had been delayed, his airplane circling the crowded Philadelphia airport. When his plane finally touched down, he called our doctor in a near panic. Canceling the appointment (and potentially losing our monthly chance at pregnancy) seemed like the worst possibility imaginable. Tom eventually arrived, but even on that occasion, we missed each other, and I finished the appointment alone.
Had I asked Tom to join me during these encounters, he would have, but it didn’t occur to me. I’m not sure why precisely. Surely pragmatism played a part (after all, we knew how to allocate resources effectively). Denial, too, no doubt. Without Tom, these appointments lost much of their emotional weight. I could pretend they were routine gynecological exams. No expectations were ever attached to those, other than a clean bill of health. And the nature of the therapy didn’t require or encourage his presence, only his sperm’s.
“This is a means to an end,” I kept telling myself, “Soon, it will all be worth it.” But the waiting began to wear me down, like chronic pain. I interpreted each month’s passage as failure, ensuring I’d stay on the treatment treadmill for another month. I felt frozen, as if the rest of my life lay dormant, hostage to this one blossoming. Or, as though I stood at a crossroads, and having chosen the path I wanted, been forced to stop. Few decisions are as momentous as that of having a child. Because we’d made that choice, the delay felt interminable.
And then, I got pregnant. For a weekend. Apparently, one can be “a little bit pregnant.” My pregnancy was no sooner detected than it deteriorated. I didn’t acknowledge the loss at the time, since I’d hardly had time to accept the gift. Had our doctor not told us, I would have assumed my miscarriage was a late period.
Still, a failed pregnancy, however brief, seemed like progress, and from a medical standpoint, it probably was. At least I could become pregnant. I recommitted to the monthly treatments, not necessarily with enthusiasm, but with a grim and rigid determination.
A couple of months (and cold metal tables) later, in mid-summer, a blood test confirmed I was pregnant again! This pregnancy felt like the deserved reward for our efforts. See, I thought, we were meant to be parents. Instead of following conventional wisdom and keeping the news to ourselves until after the first trimester, we shared our happiness with family and friends; their enthusiasm enhanced our joy and confidence. We chose names: Christina if a girl and Daniel for a boy.
That Labor Day, a close family friend, someone who’d known me since childhood, visited. As she’d not seen our house, I offered her a tour, saving the spare bedroom for last.
I loved this room, the way the dormers and sloping ceiling made the space feel like a cocoon. Tom and I had resisted decorating, leaving the walls blank and the furnishings sparse. We’d kept this room available, waiting.
As we stood on the threshold, watching the soft evening light wash over the cream-colored walls, I asked, “Do you think it would make a good nursery?” (I’d been silently rehearsing this line all evening.) She didn’t respond at first, but then turned to me.
“Really?” she asked.
“Yes,” I beamed, “I’m pregnant.”
Her eyes lit up and she laughed like I’d never heard her. It was the sweetest moment I’ve ever shared with her.
Our fertility specialist followed my progress with blood tests and ultrasounds. After eight weeks, I arrived for what was to be my last visit before being transferred to an obstetrician. I lay on the examining table eager for what I would see, wondering if I could get a copy of our baby’s first photograph for Tom. At eight weeks, an embryo should be about the size of a raspberry, a fragile fruit with an infinitesimal beating heart.
As the exam began, I watched the monitor for that tiny dark form within the mottled gray of my uterus. I saw nothing. The doctor continued to move the probe around. I realize now she was searching for some activity, the flicker of a heartbeat, but I didn’t understand at the time. She withdrew the instrument and told me to get dressed and meet her in her office. I fumbled with my clothes, my hands numb.
As clearly as she could, she explained I’d miscarried. She wondered if I’d felt something was wrong, but I hadn’t, or had not acknowledged it. Another miscarriage just wasn’t in my field of vision; I’d never considered its possibility.
I drifted back to my office, mildly surprised by the weather’s perfection, by the day’s easy progression into loveliness. It was one of those exquisite intervals between summer and fall with a flawless blue sky, trees still heavy with green, and the air crackling with promise.
“How’d it go?” asked a colleague. “Not well,” I stammered; my expression told the rest. Then I closed my office door and dialed Tom at work. His phone barely rang once.
“Well?” he asked, and I had to tell him.
“I’m OK, just very disappointed,” I finally said.
Much later, Tom told me he’d just sat at his desk crying.
Losing this pregnancy was like running into a stone wall. Depending on your speed, you’re bound to break something. At a minimum, you’re left dazed. Tom and I were stunned into silence. I look back on the days after that miscarriage and cannot remember our talking about it in any meaningful way. Instead, we immersed ourselves in work, as if productivity would allow an escape from feeling. It’s telling that the only thing that stands out for me during that time is the exhaustive preparatory work I did for a client’s strategic planning retreat. (Here I was helping to chart another’s future when I was lost myself, but I didn’t see the irony at the time.) One weekend, I even enlisted Tom’s help. My presentation was spread out across the kitchen table, our two heads bent in concentration. Collaborating again, yet like two professional associates.
Just as the treatment had focused on me, so did the sympathy. Loving and well-intentioned people offered comfort, but I couldn’t feel it. My mother called telling me to remember I was her baby, and that she’d do anything she could to help. My sister called and burst into tears, as if that would help. I couldn’t respond, so I accepted her emotions as an adequate stand-in for my own.
Thanksgiving and Christmas were approaching and Tom and I agreed to suspend the infertility treatments until the New Year. Our doctor remained full of confidence.
For me, infertility felt like an indictment from which I could escape prosecution in one of two ways: Tom and I could conceive a child through whatever medical measures were necessary, or we could adopt. I believed I had to be a mother or be forever excluded from an essential aspect of female life.
My attitude should not be especially surprising when one considers some synonyms for infertile: unproductive, sterile, barren, unfruitful. Infertile finds itself in the dictionary between inferno, whose meanings include a raging fire and a scene of horror or distress, and infest, meaning to overrun with disease. There I was, suspended between hell and decay.
And yet, come January, I could not return to the infertility treatments. I had grown tired of sacrificing the present for an uncertain future. I was fed up with setting the rhythm of our lives to my monthly cycle. And most of all, I was exhausted by the presence of strangers in the most private parts of our life. What had been something so natural and intimate had become a process managed by physicians and guided by technology.
Admittedly, I was also afraid. I feared my miscarriages were intended to warn us of a danger we could not yet see. Something told me that if we persisted, if we insisted, the warnings would become crueler. I could not continue down this path. If I got pregnant, it would have to be without medical intervention.
Tom and I both hoped that’s what would happen. Friends encouraged us, “Just relax and you’ll get pregnant,” or “You’re too thin, that’s the problem. Put on some weight, you’ll see.” I wanted to believe this advice, and Tom wanted to make me happy. If he had strong feelings about suspending treatment, he didn’t express them. I realize now he would have continued indefinitely if he’d thought it was what I wanted, because he blamed himself for our inability to have a child.
As cover for our decision to stop the treatments, I told our infertility specialist we were investigating options for adopting a child. We told ourselves the same thing. Instead of facing infertility’s emotional impact, we shifted our attention. We’d still have a child, but through adoption. We attended meetings, collected information, and stockpiled the many application forms. The idea of adopting a baby girl from China seemed particularly appealing; yet, as the months passed, we could not translate this idea into reality. We, who had managed to wade through voluminous forms to join the U.S. Peace Corps, who’d earned MBAs, could not bring ourselves to complete the mere administrative preliminaries necessary to begin the adoption process. It may be that we were unable to proceed, in part, because we couldn’t move past our infertility. Adoption is not a “cure” for infertility; it’s a different journey.
Tom and I also came to understand that our desire to procreate was nearly as powerful as our desire to parent. We would not have reached for the former without committing to the latter, but giving birth to our own child felt like irreplaceable preparation to parenting that child. I wanted to discover the child Tom’s and my combined genes would create. Tom wanted someone who would be a part of him as no one else could be, not even me. Adoption could not fulfill those needs.
And on a deeper level, each of us yearned to pass on some aspect of ourselves in a primal and physical way. We hoped a child would be our legacy, ensuring a tangible part of us would endure. It may be a selfish wish, but that doesn’t diminish its power.
Now, some 17 years later, I have arrived at détente, if not peace, with our infertility. When Tom and I talk about the child we couldn’t have (and we do talk about her occasionally), “male factor” and “hostile cervical environment” aren’t relevant. Assigning responsibility for our failure to conceive may once have been part of our strategy, but it is no longer. Still, a kind of longing remains. I grow wistful when I hold a baby, and movie scenes involving childbirth invariably make me cry. Although I was less sure than I was willing to admit at 35, today I’m confident I’d be a good mother. But that time has passed.
There is a certain social awkwardness to being childless. When I tell myself otherwise, I remember my impulse to explain that we weren’t able to have a child whenever the subject comes up. I think I’m afraid I’ll sense a flicker of judgment, “Oh, here is a woman too self-involved to be a mother.”
Tom and I didn’t pursue all available options to become parents, so, in that sense, we chose to let go. For a number of years, though, we still hoped for the miraculous. Perhaps, had we continued treatments, we would have conceived a child eventually, and I would have been able to carry her to term. We will never know. What I do know, is that loosening my grip on that goal was the right choice at that time. That said, its consequences are still unfolding.
And that’s one of the funny things about infertility, about not being able to have the child you want. There is nothing to balance that absence in the near term. There is no comparable alternative, no “here’s what my life amounts to without children, here’s what I’ve achieved.” What infertility yields in terms of one’s life develops over years.
Sometimes I imagine that having a child would have made Tom’s and my life together easier in some respects, though parents may dispute that claim. Perhaps “simpler” is a better word. A child would have imposed a kind of order, in the sense that our shared task would have been raising her. We have always worked well together; focusing on that mission may well have further united us. Instead, we’ve had to cultivate other ways to draw closer. And we have.
Over the years we’ve had to learn that we cannot work or think ourselves out of grief. We’ve had to feel it. It’s counterintuitive to suggest, as I do, that we’ve had to embrace our infertility in order to separate ourselves from it. The key is to accept it as a fact of our life together, without letting it define that life.
I’ve heard my friends exclaim that being a mother is transformative, offering a kind of love that is wholly unique. I believe them. Without children I remain separate, removed from that intimacy. I will not rename this distance as something other than loss. But I’ve discovered that loss is part of life. The emptiness it creates is fallow ground, full of potential.