When you decided you were finally ready to try to have a baby, you felt peaceful knowing you'd done everything right before this decision. You'd completed your education, found a good job, house, spouse, and knew you were set up for success. Then after six months of trying you realized something was wrong. At this point the feeling of guilt or questioning some of your past decisions may creep in, but you stop it at the door by doubling down on your efforts.
Like every other problem you've encountered in your life you faced it head on. You tried to figure out what you'd done wrong so you could fix it and move on. You got more information, tweaked your diet, and your workout routine, and used opks, and took your temperature, and quit caffeine and alcohol, and maybe you've finally connected with reproductive endocrinologist to make a plan for more testing, IUI, or IVF.
Even though no one intends to have their baby through ART (assisted reproductive technologies) sometimes making that decision can feel like you still have some power over the situation. And IVF is such a huge emotional and financial undertaking that women think "now this has to work!"
If you've been able to take control over your fertility up to the point that you're finally trying IVF, you feel like you've eradicated all possibility for error. Even though IVF success rates for a woman under 35 is between 40-55% and for a woman over 40 it's around 11%. Success rates vary wildly due to individual factors, and the CDC notes that success rates are increasing for every age group as the science advances and the doctors become more experienced. But notice, nowhere in the research does anyone say that IVF has a 100% success rate, or even close to that. However IVF still feels like the ultimate thing that will get you pregnant.
Women quickly recognize that loss still strikes even after they've started the IVF journey. And it's been accumulating from every month they began trying. Then there is the loss of natural conception, loss of eggs as 100% of eggs retrieved don't necessarily mature. There is loss of embryos that don't make it to day five blastocyst stage, and someone could end up with fewer embryos than they'd envisioned or none at all.
According to Dr. Kenneth Ginsburg there are seven Cs of resilience. After some internetting I've found nine Cs, but I think they can all contribute to your sense of well-being during this journey. One of those Cs is Control. So when something doesn't go right, we naturally look for something or someone to blame. And if you decide that person to blame is yourself, you're trying to maintain a sense of control. However, the blame sounds more like "Why did I wait so long to try to conceive?" or "I am being punished for past deeds." Blaming yourself leads to guilt, which just makes the grief worse.
You're devastated that your journey to parenthood has taken such a long, and circuitous path, but guilt, blame and fear can prolong and mask grief and make it harder to cope with the reality of the loss. Elizabeth Kubler-Ross, best known for her theory on stages of grief, said "Guilt will make you sick emotionally, and if you don’t let go of it, physically." It is unfair to make judgments about yourself in the past based on information you did not or could not have had. Remember that 37 year old self that believed she was doing everything right by having a good job, spouse, and place to live before trying to conceive? She knew the importance of these things contributing to the parent she wanted to be. And she did everything she could to make you (her future self) proud.
The reality is that no one could have predicted their infertility. In Dr. Brene Brown's research on shame resilience, she states that "empathy is the antidote to shame." You can know your own shame triggers, be willing to name your shame with others, and also willing to receive empathy from others. But if you're currently in it, the best thing you can do is take care of yourself, including being kind. You never would say the things you say to yourself to a good friend. Another one of the Cs of resilience is coping, (that's positive coping) which guilt and blame are not a part of. I would argue that another C of resilience could be compassion. Know this is not your fault. Find other compassionate people to talk to about it, and let yourself continue to grow and change while you are also creating the life that you want.
Allison Ramsey is a licensed clinical mental health counselor and fertility counseling specialist seeing clients online throughout North Carolina, Washington State, and internationally. She’s a member of Resolve, The Infertility Association and the American Society for Reproductive Medicine. Contact her to start feeling better.
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