Commonly Asked Questions About Infertility

Pinnable image that reads “Questions about Infertility.”

Since “coming out” that we needed help having kids, we’ve received many questions about infertility and the treatment we used. Some questions have come from family and friends, while others have come from women about to embark on the journey themselves. When we started the process, there wasn’t a lot of information out there, and what existed came from organizations—not the people who’d been through it. The information was mostly clinical and very little personal. Infertility is the opposite: mostly personal and a little clinical.

Which brings us to this post. It contains 11 of the most common questions about infertility posed to us. Coincidentally, the first 8 are questions we sought the answers to during our own journey. The remaining 3 are ones we wished we could have communicated the answers to on behalf of ourselves and every other person battling the big bad IF.

Pregnancy announcement following IVF. Heart made of needles and empty med containers surrounds onesie and ultrasound picture.
A friend’s moving pregnancy announcement following secondary infertility and IVF.

When should I be concerned about infertility?

This depends on several factors. RESOLVE: The National Infertility Association provides the following guidelines:

  • Under 35 yrs of age—Consult your OB/GYN if you’ve been trying to conceive for 1 yr.
  • Over 35 yrs of age—Consult your OB/GYN if you’ve been trying to conceive for 6 mo.
  • Over 30 yrs of age and have a medical history that could pose a threat to your fertility—Consult your OB/GYN immediately.
  • Over 30 yrs of age and know that your partner has a low sperm count—Consult your OB/GYN immediately.

I’d had a sixth sense since I was a teenager that I’d have trouble having kids. Don’t ask me why—I couldn’t tell you. So when a few months of “relaxing and having fun” didn’t yield us a pink line after POAS, I started charting my cycle with an OPK and phone app. My ovulation was all over the place, so I consulted with my OB/GYN. She wrote it off as “normal” and said to see her in another 6 mo if I wasn’t pregnant. I wished I’d advocated for myself a bit more … although insurance might have put up a fuss about turning to infertility treatment “too soon,” making it a moot point.

What should I look for in an infertility specialist?

Think about the standards you used when finding an OB/GYN. Now place them on crack.

Infertility treatment is an invasion of your personal modesty to the nth degree. Your infertility specialist (aka RE) will ask about your sex life and direct you when to and not to have sex. They’ll be all up in your lady parts more than your partner is—sometimes multiple times a day. They’ll know exactly what your male partner is doing in that little room, and they’ll know exactly how well he “performed.” Once you’re finished with infertility treatment, you’ll have very little—if any at all—sense of modesty left.

This means that you want an RE who treats you with respect and compassion. They don’t need to be the warm and mushy type, but they do need to make you feel like a person. Because, trust me, you’ll feel more like a lab rat than an emoting human being.

My RE was one of the “best of the best” in our city. But that’s not entirely why we went with him. He brought a wealth of knowledge and experience to the table, but he always left the final decision to us and never made us feel bad about our choice. And his staff was phenomenal. While he lacked in the warm-and-mushy department, they made up for it tenfold. The MAs chatted with me about mundane topics like my outfit or hairstyle, the U/S techs gave cheerleaders good competition, and the nurses held my hand and cried with me during difficult procedures. I walked into my RE’s facility feeling like less of a person—less of a woman—and walked out with some of my dignity reinstated.

Box of medication and supplies for infertility treatment organized in bathroom.
The box of infertility meds and supplies I organized in my bathroom to make administration easier. Several meds are not pictured, as they had to be refrigerated.

What treatment will I undergo for my infertility?

This will vary by doctor and your personal situation. You may be able to conceive simply by timing your intercourse, or you may have to adopt embryos or seek out surrogacy. Your RE will place you through a battery of tests that will help determine the best course for you.

Prior to consulting with an RE, I underwent a hysterosalpingogram (HSG) to verify that everything was open and receptive. Once that yielded nada, we were referred to an RE, who ordered hormone bloodwork and a semen analysis. Based on our age, medical history, and test results, our RE advised that we start as least invasively as possible and advance as necessary.

Over the course of 1 yr, we went through the following procedures. (Read a basic explanation of each here.) Each procedure contained its own cocktail of hormones and additional medications tailored to my body.

  • 1 cycle of timed intercourse
  • 2 cycles of timed intercourse with ovulation induction
  • 2 IUI cycles (1 canceled, 1 unsuccessful)
  • 3 ERs (1 canceled, 2 successful) with fertilization using ICSII
  • 1 FET of 4 embryos (1 fair, 3 poor quality)

An interesting thing about all of this is that the cause of your infertility can’t always be determined. I know women who still don’t know why they had difficulty conceiving. My own struggle is still a bit of a mystery, although through bloodwork, we did determine that I have mumps antibodies in my blood—meaning that I was exposed to and likely had the mumps during puberty. My RE feels that this may have caused mumps oophoritis, which may have placed me in premature ovarian failure, which may have decreased my fertility. If I recall correctly, my RE said this happens to 1 in 10 of his female patients. There’s nothing I love more than being a statistic.

How much will infertility treatment cost?

This was a primary concern when we first started out, and we had difficulty finding a hard-and-fast answer to it. Medication costs, facility fees, procedural fees, doctor’s fees, and insurance coverage provided too many variables to what seemed like a simple equation. I do remember our RE quoting us $35K to $45K for just one FET cycle. This included the ER and ET but did not include medications and cryopreservation of embryos.

My best advice to you is to scrutinize your insurance plan to see what, if anything, is covered, and then look at your options. I know couples who petitioned their employers for coverage, took out personal loans, and moved to different states to make the cost of infertility treatment affordable.

We were blessed in that Chris’s company is very generous with its insurance coverage. Very. We didn’t pay a dime for infertility treatment—not a single penny. This freed us to make decisions based on heart rather than pocketbook, and we will be forever grateful to his company. Without its generosity, we may not have the family we have today.

How will I feel during infertility treatment?

The answer to this is complicated. Are you asking what emotions you’ll experience, or are you asking how your body will feel physically? I’ll tackle both.

Emotionally, you’ll be all over the place. Infertility is a roller coaster that’s driven by your own feelings and taken on a joy ride by the medications you’re placed on. If you feel cray cray about not being able to get pregnant, imagine that feeling amplified by a daily cocktail of hormones. It’s not pretty.

At any given time, you’ll experience several—if not all—of these feelings (in no particular order): sad, angry, resentful, bitter, hurt, abandoned, lonely, self-loathing, less of a person, incompetent, unsexy, abnormal, desperate, vulnerable, irritable, envious, jealous, guilty, broken, battered, depressed, ashamed, scared … the list could go on. A friend described it as being a hormonal she-beast. She wasn’t far off the mark.

Infertility treatment will also beat up your body pretty well. Depending on your treatment plan, you could be shoving multiple hormones into your body on a daily basis. While my last ER stim cycle involved 4 injections and 5 pills a day, my FET stim cycle involved 4 injections, 6 pills, and 2 creams a day. My stomach was battered, bruised, and bloated. I had to wear baggy clothing at certain times during my stim cycle because I couldn’t (a) fit into my regular clothing and (b) stand the feeling of certain textures against my sensitive belly. Some of the medications made me nauseous and gave me headaches. Others made me reach for my deodorant and dread menopause. And the PIO shots … let’s just say that my butt involuntarily clenches every time I think of that long-@$$ needle.

By the end of our third retrieval cycle (1 yr after we began treatment), I told Chris that I wasn’t going through any more of it. If we didn’t get pregnant with the embryos we had, we’d need to consider other ways of having kids. My body—my whole body—just couldn’t take it anymore.

Woman’s belly during an IVF stim cycle. Needle marks and bruises are visible.
A picture of my belly during an IVF stim cycle. Note the needle marks and bruises.

How else will I be affected by infertility?

I struggled with how to word this question … and how to answer it. Infertility doesn’t simply touch your health. It’s like a snake that slithers its way into your world and coils its scaly body around every area of your life.

Infertility treatment is a time commitment. It requires numerous doctor’s appointments for discussions, monitoring, and procedures. At certain points during treatment, I was in the doctor’s office for monitoring every day for at least 1 hour. We often couldn’t predict when a procedure would be done until the day before, and several procedures involved bed rest for 24 to 48 hrs. I was very fortunate to work for an understanding and supportive employer. As long as my deadlines were met and the quality of my work didn’t suffer, they allowed me to come and go as I needed. And the day I found out I was pregnant, the VP of my department practically shoved me out the door 2 hrs early so I could tell Chris in person.

Everyday commitments weren’t the only ones affected. To speed the process along, Chris and I opted not to leave town and minimize time off at work. This meant no vacations or mental-health days. When the Tagalongs were born, I rolled over enough PTO that I was able to take off a full 2 wks between when they were born and when I returned to work (I took maternity leave when they came home from NICU.) without dipping into that year’s PTO. And we haven’t been on a vacation since 2013.

You’d think hobbies wouldn’t be affected by infertility, but mine were. Look for posts describing how I had to put aside plans to complete a half-marathon due to my RE’s concern about placing even more stress on a body that was already going through the ringer.

Perhaps the biggest area that will be affected by infertility and its treatment is that of relationships. Infertility takes a toll on your relationship with your partner as sex becomes simply a vehicle for reproduction and you both deal with shared and separate emotions about what you’re going through. You’ll most likely find it difficult to be around parent or pregnant friends, and your seeming lack of interest in their lives might cause hurt feelings on their end. If you choose to go public with your struggles, attempts at support could either fall short of what you need or smother you (see below), which could lead to tension. And if you’re religious, you might find yourself in a bit of a quandary. I know several people whose faith grew through their struggles and just as many people who lost faith during their journey … and quite a few people—myself included—who found themselves somewhere in the middle. Infertility teaches you a lot about yourself and the people in your life.

This post on Motherwell captures perfectly the toll infertility takes on the rest of life.

Woman runner posing near tree.
Post-run before beginning my very first stim cycle.

Should I tell family and friends about my infertility struggles?

This is entirely up to you. There are pros and cons to being open about your experience, and there are pros and cons to staying mum. Do what you need to do to protect yourself throughout this journey. I know that this advice sounds very selfish to some readers, but this is a time during which you will be at your most vulnerable. Your heart will constantly feel like it’s shattering into a million pieces, and your body will feel incredibly beat up and irreparable. Do what you need to do to keep from being pushed over the edge. If this means telling the world, shout it from the rooftops. If this means locking your lips, then throw away the key. Do what you need to do for you.

Family and friends, if your loved one chooses not to tell you about their struggles but later “goes public” and speaks openly about it, find a way to come to terms with this. They’re not doing it to hurt you. They’re doing it because they’re finally OK with what they’ve been through. Because they’re removed enough from it to finally process it. Because they want to educate others about a topic that is still very taboo in our supposedly open and accepting world. As difficult as it may be, try to emulate the father in the Prodigal Son story: welcome their openness with outstretched arms, and celebrate their bravery.

Are there support groups for infertility? Where can I find them?

Yes! Start by asking your RE about local groups. Or, hop on the Internet, and let your fingers do the walking. I joined the online forums at Daily Strength, but I know several women who found support through RESOLVE and social media groups.

How can I support someone undergoing infertility treatment?

Ask how they want to be supported. Your friends may need and crave your sympathy, or they might find your sympathy smothering. Let them tell you what they need, and be open to their needs changing. Infertility is a rollercoaster that may start off with them wanting a shoulder to cry on, a box of Kleenex, and the biggest carton of ice cream you can find and evolve into them wanting to fold into themselves and shun the world. Roll with it as best you can. They’re just trying to do the same.

Sympathy card that reads, “There is no good card for this. I’m so sorry.”
Used with permission of Emily McDowell Studio.

How should I tell someone experiencing infertility that I’m pregnant?

This is a tough one. On one hand, they’re truly very happy for you and wish you nothing but the best. On the other hand, watching a loved one go through something they so badly want but haven’t been able to experience is like a knife to the heart. Add to that experiencing feelings of guilt at not being as excited for you as they “should” be and entertaining feelings of jealousy and resentment. They want to support and celebrate you, but they also want to avoid you.

My advice to you is to tell them, acknowledge that this might be difficult for them, and understand if they need to pull away from you for a while. When you tell them, you might choose a method like email. It’s a little more private than a face-to-face discussion, and it allows them to have whatever reaction they need to (and will) have without too much guilt. Be sensitive to their situation, but not so much so that it impedes your own joy. That would make them—and you—feel worse.

What should I say/not say to someone experiencing infertility?

“I’m here for you. How can I support you?”

That’s it. Nothing more.

No “It’ll be OK” (It might not.) or “Just try to relax” (You try relaxing when you’ve been going at it for over 1 yr.) or “Have you considered adoption?” (Some people really want to exhaust all options at having a biological child first.) or “Everything happens for a reason” (And what reason would that be?). RESOLVE provides a good list of things to and to not say to people living with infertility.

Along these lines, be mindful that you don’t always know what’s going on in a friend’s life. Questions like “So when are you gonna start popping out kids?” or statements like “You’ll understand when you have kids” can be intrusive and hurtful to people who either live with infertility or have lost the battle. Think before you speak.

Four embryos prior to embryo transfer in IVF procedure.
The four embryos we planned to insert during our ET. One didn’t survive thawing, so we transferred only three.

We hope this post proved enlightening. You can find out more about our infertility journey by reading “Flipping Infertility the Bird.” If you have more questions about infertility, leave a comment below. If you or someone you know is living with infertility, please please please please please don’t hesitate to ask us for support. As a future post will illustrate, having someone to walk with through the road less traveled makes all the difference in the world.

About Marcella Hines

Marcella Hines

Marcella wants to live in a world where she can escape to quiet rooms stacked high with books that come bundled with a brownie cookie dough DQ blizzard and cuddly purr monster. When she’s not finding creative ways to play with cars for the eleventy billionth time or shouting, “Undies! Pants! Sit! Pee!” at toddlers who have the attention span of a gnat, you can find her running to the beats of an audiobook/podcast or assisting writers in crafting their work through her editing business, A to Z Editing. Marcella likes talking about the day-to-day experience of raising triplets, like how to navigate toddler time and a park playdate with three toddlers in tow. Follow her running, English weenie-ing, and ice creaming on Instagram: @hineschica.

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