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Reader, I know exactly how you feel. I struggled with infertility for 3 years (which felt like a lifetime) going to multiple fertility specialists, taking all the vitamins possible - I studied that It Starts With the Egg book like I was writing a thesis on it - no carbs, no sugar, visualizing, putting together vision boards, praying, doing multiple IVF rounds which resulted in a lot of embryos (10 usually at a time) that all tested as genetically abnormal. Honestly, there were times when I thought I might die from the process. I did hours of therapy for myself and couple's therapy with my husband and finally after crying and threats of divorce, etc we got on the same page and decided that we would do one final round of IVF and one final round of genetic testing and then that would be it.

We planned a trip to Spain (we've always loved traveling together) so we had something to look forward to. My husband surprised me with tickets to Taylor Swift's concert in a very close row! And as I endured the agonizing weeks of waiting for the genetic testing results I also came through into a state of acceptance. I was ready to move on with my life. I felt like I'd been in this limbo, waiting for some kind of change for 3 years. It was time to finally move forward.

I was about to head out the door to the Taylor Swift concert when I got the call from the geneticist that I had one normal embryo. I literally am crying now thinking about that moment. Though it continued to be a process (would the embryo successful unfreeze, would it implant, would everything continue as normal), my pregnancy felt fraught and stressful because of all that I'd been through.

I successfully gave birth to my son in March and he turned 6 months today. :-) Reader, I hope if you're reading this please know that so many people are going through what you are going through. You're not alone, and however it turns out please know that there's a happy ending for you. I look back and think that my other self who didn't get these results would have had an amazing life traveling and writing and maybe even living abroad and that would have been just as wonderful as what I'm doing now which is emptying the dirty diapers from the pail and helping my son through his frustration of trying to roll over.

Sending you a virtual hug.

- Christine

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😭

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Sep 8Liked by Haley Nahman

I just want to say what a generous and thoughtful response this was, Haley. It felt like a warm tight hug in letter form.

I struggled for years to get pregnant. Worked with 2 different fertility centers, underwent IUI and IVF. We did get one healthy embryo, but I miscarried a couple months into the pregnancy. The loss was devastating and took so much longer to recover from than I expected. On the other side now, I can see how depressed I was the entire time, through all the treatments. If I was offered a do-over, I don’t think I would seek fertility treatments at all. The isolation, depression, and physical trials for me were just too much.

A dear friend said the loveliest thing to me before I began fertility treatments and I never forgot it. She was just as desperate as I was to be a parent, and at this point she had 2 beautiful kids. But she looked at me so honestly and said: “with hindsight, I would have been happy either way.” I believed her. I had built this fantasy around motherhood that I couldn’t shake. And for someone who was a mom to admit that actually, though she loved her kids, she would also have been equally satisfied child free, gave me a sense of freedom I didn’t know I needed.

I also wonder sometimes if our deepest desires to parent are because we have so much surplus love to give, and motherhood/parenthood is the most obvious place to express this love. The truth is, there are sooooo many way we can love and caretake and parent without being biological parents.

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Sep 8Liked by Haley Nahman

i am a person with so much love surplus, and i am excited to be a “third person” (like a third space) in many of my friends’ kids’ lives. i somehow had a lot of single older women as my neighbors growing up, and they were all influential in their own way to my life. my partner and i don’t plan on having kids (i don’t ever want to be pregnant, he doesn’t see himself with kids) and while i mourn some of the things in life i wont be able to do, im excited for what it opens up to me.

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Yes I love this!

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In the thick of IVF right now and this has made me cry. Thank you!

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Navigating infertility is so much more difficult than I realized at any stage of it. My husband and I have a 4 month old now and we couldn’t be more in love with him. But the trauma of the process to get here is still a cloud in our lives. It took us 5 years from our first natural pregnancy miscarriage to the birth of our son and the millions of moments of pain and disappointment and grief have shaped us into different people. As we get to know our son and sort out parenting, we are also trying to process all that we have been through and who we’ve become. It’s really hard.

I feel confident about our future because we checked in along the way, we never did more than we felt comfortable with—never pushed beyond either of our limits with procedures or rounds—we listened to ourselves and each other. We both believed there was a lot for us with or without kids, but we wanted to try and we kept wanting to through each phase. For additional context, if you asked us 6 years ago if we’d be open to taking our specific path to conceive we would have definitely said no…but as it happened, it was our path. And I couldn’t feel more grateful for our ability to endure it.

I don’t really know what I think about fate or the meaning of life or what-have-you—despite how hard I try to explore these questions—but I know there is something deeply important to me about what I strive for and how I strive for it, what I experience and how I experience it, what my big questions are and how I explore the answers. I’ve learned that I cannot control much about outcomes but I can value all of the phases of my life for what they teach me and who I am becoming because of them…as difficult as that has been sometimes.

I guess my suggestion for the questioner would be to hang in there ❤️, go until you can’t, and have courage that you’ll find your way wherever that takes you. Sending you so much loving energy. 💕

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Beautiful 🥲

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Sorry, sent too soon…by “can’t” in the last paragraph, I just mean until you feel it’s time to stop based on the measures you (and your partner) are using to determine that…for us it was our mutual agreement at each step.

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Sep 8Liked by Haley Nahman

Hayley the part about already possibly being depressed is so astute. I just became pregnant through IVF after suffering from secondary infertility- we have a daughter we conceived naturally but couldn’t get pregnant on our own again. I was sure I was remaining “neutral” about the outcome, that I would be delighted to be pregnant again but I’d also be accepting, maybe relieved, to only have one child. But only after being on the other side of this journey, getting the clarity you mention, could I see how down I had been during this time I called “neutral” and how badly I was hoping for a pregnancy. I was desperate to just know one way or another, to move on from the strains infertility imposed on my life. The clarity really is the relief. The podcast with Dr Jaffe provided so much perspective when I felt disoriented, I highly recommend to anyone struggling. And to the reader who wrote the question- you’re not thinking too far ahead, it would be impossible not to imagine how this will all play out. Despite that, take everything one step at a time, one decision to the next. The process, arduous as it may be, will be the thing that provides some sense of control.

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Sep 9Liked by Haley Nahman

Piling on with appreciation for this response, Haley, it goes so deep into so many different facets of this struggle, and in such a loving way.

Before I had my daughter I felt so sure my life would be incomplete without motherhood being a part of it. And when I went through multiple pregnancy losses it was so lonely, and so destabilizing, and it made that idea of completeness really burn in a lot of ways. But I want to echo Brooke and a few others here: I actually feel quite sure now, having had my daughter (who, yes, I adore) that my life would have been rich, beautiful and complete either way. I'm happy where I am *and* I'm much more aware of the trade-offs and the life I might've lived had it all gone a different way. There are heart-exploding brain-expanding futures to be found either way; I didn't know that then but I definitely know it now. I wish the reader a way forward that isn't too shaky and isn't too long, whichever way it goes.

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❤️❤️❤️ lovely

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Sep 8Liked by Haley Nahman

This is such an important conversation to give space to, thank you for doing that! There are therapists who specialize in reproductive mental health specifically (I am one of them!) which can be so key - there is a shared language, you don’t have to explain to someone what diminished ovarian reserve means, etc. Anyone on this journey can use those key words in their psychology today search!

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Sep 8Liked by Haley Nahman

Thank you for this, Haley! We are still fairly early in our TTC journey but it’s been the biggest mind fuck I’ve ever experienced. Thank you so much for trying to put words to the difficulty of holding so many possible futures at once. What I’ve found particularly unnerving is not knowing what state my body will be in a few months from now. Making any plan more than 3 weeks out is accompanied by a strange mental dance of “is this an event I’d enjoy if queasy? Is training for this race a waste of time because I may need to bail on it? Would these social plans be fun if I were totally sober? Will this conference flip from a perfect networking opportunity to a prime place to accidentally reveal my pregnancy to my manager before I’m ready?” Before trying had no idea how fucking hard it would feel to keep chugging along with a massive unknown hanging over everything. So I really really appreciate this part of your answer: “Whatever you’re feeling right now is authentic, involuntary, and impervious to judgment from people who aren’t in your position. And that includes your former self.” Thank you.

I remember before TTC I thought women’s blogs banged on about infertility to the point that it was scaring an entire generation of women into premature fertility treatment. Now I search out stories and writing about the subject like water in a desert. This old Ask Polly is a personal favorite: https://www.thecut.com/2016/09/ask-polly-why-do-women-obsess-about-babies-and-fertility.html. Does anyone else have recs for other essays/posts they’ve found helpful?

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Sep 8Liked by Haley Nahman

Haley and questioner, I don’t think this newsletter could have come at are more poignant time for me. I’m currently on day 10 of IVF stims ahead of my own egg retrieval in a few days. Male factor infertility also means a specifically timed surgery for my husband alongside my ER… but I wouldn’t say the odds appear to be in our favor.

I’ve been feeling all the same emotions as the questioner, on the precipice of learning what our future holds. I’m with you, I hear you, and I am so sorry. It’s an impossible thing to navigate. If you don’t have friends who have gone through it, I’d recommend finding an IRL or online support group of some kind. Speaking to someone who gets it is so incredibly validating and healing in itself.

Haley, thank you for speaking on this despite the topic being a little outside of your own experience. Sitting in the in-between of hope and low expectations has been the most taxing part for me, and I think you hit the nail on the head with that one. As someone who hasn’t always felt the call of motherhood and has dealt with a fear of pregnancy, I feel myself for the first time just this week becoming more certain it’s something I want and my body is capable of. But what if we can’t? The opposite and conflicting thought is always there…

Questioner - wishing you success and ultimately happiness, regardless of your outcome ❤️

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Sep 8Liked by Haley Nahman

Thanks for writing on this topic Haley, such a poignant topic for so many women.

Like so many other women commenting on this thread, I also have dealt for years with infertility. We were hugely lucky through the miracle of IVF to give birth to a baby girl a few years ago.

In case the question asker is reading this, one thing I wish I had known earlier in my journey is this “ Research has shown that women with infertility have the same anxiety and depression levels as women with cancer, heart disease and HIV.”

This if from the Mayo Clinic’s website but I have seen it sourced many places. I put it here not be downer but because dealing with infertility fucking sucks. And if you need permission to know that and feel those feelings maybe this will help.

I also imagined a child free life for me and my partner that was happy. If that had been our path, the infertility chapter would still have been part of that journey. I also really hope that knowledge for you somehow doesn’t spiral back as more guilt over your anxiety about wanting something else more. It’s not easy. Sending you all the love and luck. 💛

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Wow that research!

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I hadn’t heard that research before but it totally hits…thank you for sharing.

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Sep 8Liked by Haley Nahman

Thank you for this post. As someone who has been through infertility it is crushing/triggering and also very common/ normal to hear people's birth experiences. It helps SO MUCH when others acknowledge this. I just wanted to add in donor conception which is what I eventually did (both sperm and egg) after trying every combination (my egg, my husband's sperm) before that with 9 rounds of ivf. I also lost a baby at 5 months TFMR. Something someone told me who had a similar experience was "if you want to be a mother, you will be- although it might look different then you imagined" I thought of this many times. I worried about how I'd feel and now I can say my kids feel very much my own due to epigenetics. They will have the opportunity to meet their biological parents if they choose, and I hope someday they will think it's cool that science helped give them life.

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Sep 8Liked by Haley Nahman

OP, I’m so sorry you’re going through this. The childfree after infertility subreddit may be helpful even if you’re actively continuing fertility treatments: https://www.reddit.com/r/IFchildfree/s/wFu08vYD93

I hesitate to mention this in fear of sounding insensitive and I know how deeply lucky we are to have one child, but a lot of this struck a chord with me as someone dealing with secondary infertility. The limbo is brutal because you can’t quite get excited about either vision. What I try to tell myself is that part of the reason I want to JUST KNOW is so that I can start picturing the future but the truth is that we can never know the future regardless.

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Sep 8Liked by Haley Nahman

I just replied with a similar story, you’re not alone in that sentiment!

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Sep 10Liked by Haley Nahman

Thank you, thank you, thank you, thank you for answering this question and opening up this conversation. I actually didn't subscribe to your newsletter before today, but this somehow came across my inbox as a recommended Substack, and wow, it was almost like it was divinely placed (not being dramatic!).

My husband and I have been facing infertility for a year so far and I frankly could have never prepared for what this experience would be like. Just yesterday I took my 20th negative ovulation test this month, forced myself to go to work where I had to listen to someone loudly discussing their wife's impending birth, work with my other coworker who just announced last week that he's about to become a dad, and then hear from a friend after work that our mutual friend just got pregnant after being married for one month (!!).

I have friends and family who are so good at supporting me and being there for me, and a lovely husband who also listens and helps and assures me we are a family no matter what but wow when it comes right down to it, I feel like this struggle becomes mine alone to bear. I feel equal parts some days like jumping out of my own skin, or hiding under the covers, or just screaming? Maybe crying? Scream crying? Even the days where I can hype myself up or distract myself, I feel like I'm often one casual conversation away from hearing about a pregnancy and having to like white knuckle through the next couple of hours.

Anyway, all this to say, to the reader who wrote this and to others in this comment section, you are so not alone. I'm sending you so many virtual hugs and good vibes and know that someone else is in it just alongside you in this not so great journey!

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Sending lots of love!!

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Sep 8Liked by Haley Nahman

To share my perspective, after 3 IUI’s, a surgery to remove a cyst, and then a cycle of IVF, I actually didn’t find the process of IVF to be that difficult. All the appointments were a hassle but it wasn’t as physically taxing as I thought it would be. The emotional part, the waiting and hoping and hurry up and wait sense for the better part of the year was by far the hardest part. It was a feeling of being stuck, not wanting to give up but also feeling incredibly frustrated that I felt like I could not make any decisions during this interminable wait. I got lucky and am writing this note underneath a napping one year old.

I am sending the letter writer love because any time I hear of anyone having a difficult time with fertility (or having a traumatic birth as I had a pretty serious hemorrhage and as Haley perfectly described, a ‘hormonal apocalypse’ afterwards) it brings me back and I wish there was something I could do to make this process easier for everyone. I had thought the physical process of IVF would be hard but it was nothing compared to the waiting.

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Sep 8Liked by Haley Nahman

Well I’m crying in my backyard hammock. Thank you so much for answering this question in your perfect Haley way. Thank you for sharing your time, energy, brain and heart so freely with us.

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Crying in a hammock!! Honored to be involved

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Sep 8Liked by Haley Nahman

I am in the same situation. Dreading starting IVF (already saw REI a few months ago just to set things up, then conceived naturally, then miscarried). If anyone has wisdom regarding doubts about/personal misgivings about/just not wanting to go through with IVF please share.

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Sep 8Liked by Haley Nahman

Emily, I’m so sorry about this miscarriage. I went through 2 rounds of IUI and 1 round of IVF. I didn’t have misgivings or dread in the beginning (though my husband did). I took on infertility like I wanted to be the best girl in school, acing every task. None of the treatments resulted in a successful pregnancy for me, and now years later all I can say is that I wish I’d listened to my body more, slowed down, been gentle and loving to myself. Infertility is hard on every level, so it’s easy to disassociate from your body and treat it like something that can be ‘fixed’. It was awful for my mental and physical health, and it took me a long time to feel fully integrated again. I knew after the first round of IVF that I couldn’t do it again. My body just couldn’t.

We took a year off and on the same day, exactly a year later, we got a call about a baby that 3 months later became our son. I’m rambling now but really just want to say, trust your body. Listen to your gut. Don’t push yourself beyond what you are comfortable doing. There are so many beautiful ways to become a parent ❤️

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Sep 8Liked by Haley Nahman

I’d underline Haley’s comment about the fear of the thing sometimes being the worst part. IVF stims have been difficult emotionally, but physically I’ve been surprised about how good I feel! I haven’t had my ER yet so I can’t speak on that or transfer protocol, but that has been my experience. If you choose to go through with it, you may surprise yourself.

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Sep 8Liked by Haley Nahman

If I had somehow known that staying with my now-husband would mean going through IVF to conceive, I honestly think I would have left him before we were married. Now, on the other side, with a 3-year-old and--we were truly lucky--success with our first implantation (second egg retrieval), it was not nearly as bad as I could have guessed. That's just my experience.

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I’d encourage you to revisit Haley’s comment about anticipation of bad things being worse than the thing itself 💙 Last November the doctors found a tumor had consumed and replaced one of my ovaries, destroying a decade’s worth of fertility in 6 months. While I waited for surgery, I was wracked by grief and dread about the fertility treatments I’d have to undergo if I wanted to ever have the hope of having a baby, rather than worrying about the potentially cancerous thing actively eating my body from the inside. I obsessed and worried about the disappointment I’d feel when it failed (I’d been told my odds of success were poor), and what the hormones would do to me emotionally and physically. I spent months anxiously trying to control my life to better my odds and experience, all the while expecting the worse.

And then, the surprise: embryo freezing ended up being an incredibly empowering experience for me. I had almost no physical or emotional symptoms, and we got one healthy embryo, which we’d been told not to expect the first time around. More than that, the experience reconnected me with my body and made me feel like it was strong, capable, and healthy in a way I hadn’t felt in months. I’m starting another round tomorrow, and I feel really lucky to get to do this.

This is not to diminish the experiences of people for whom it’s hell, but just hopefully to help you not waste too much time worrying about a hell that may not be there for you. 💙 Good luck — your body is incredible, science is amazing, and you are not alone.

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Sep 9Liked by Haley Nahman

I am so grateful for the reader, Haley, and all these comments. Conception - wherever it begins or ends - is such an unpredictable, unknowable, mysterious space. I was shocked to discover how little control I really had, and it was also the first time that I started to learn about my body and cycles, which added a whole other layer to my feelings about things.

The biggest struggle for me was that in between space. We were lucky to conceive quickly when we first started trying, but around 18 weeks it was clear there was something happening with our baby and we were booked with appointments with specialists, an amniocentesis, etc. The results from the amnio were slow to come back and the waiting for 'what would happen next' was the hardest time of my life. Be very gentle with yourself - it is hard to know how each day, moment, second will feel. It seemed to me like the earth was cracking open and I was suddenly realizing that things were out of my hands. When ultimately our girl decided she needed to let go, I felt massive grief and I also felt I could begin processing and moving through each feeling instead of existing in a liminal depression. Once we felt 'ready' again, we tried for months, had an early miscarriage, and ultimately conceived our girl (who is now earthside) about 16 months later.

Each stage of the process over the past few years has been challenging and confronting. Culturally and personally I think we put a lot of emphasis on achievement and control - I was torn between the messages I was receiving that things were going to unfold as they would according to nature, to 'trust the process', relax and not stress, etc - versus specific instructions, measurements, instructions to eat more protein, read it starts with the egg, on and on - which made me feel, or implied, that I had agency and power over the ultimate outcome with our girl, and I could harness my body to fulfill my wishes. I imagine that IVF can have a similar push/pull - you're working to support your body in all the ways you 'should', but ultimately the process, despite the amazing science we have on our side, still has an x factor that is out of our hands.

You and your partner are not alone, though I know it feels that way. Try to be together and do small things to connect when you are able. You are both stressed and processing in different ways but you are on the same team, though it may feel that the weight is heavy. Journaling helped me a lot as it allowed me to put my fears and anxieties on a page, and try and get out of thought cycles and be more present in the day to day. Finding doctors who I felt I really trusted helped me minimize thought patterns / doom loops. I often reminded myself that the only way out is through - you are on a difficult road, but you are still moving forward, even though it often feels like you're stuck. Keep your support system close while you do so - that can be close friends, your partner, even online communities that are walking alongside you. Doing something fun and very low effort - getting an ice cream, going to a movie, getting cozy and making popcorn - can be a small bright spot in dark days.

Sending our love x

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