Infertility in Real Life (or 10 Ways Hollywood gets it WRONG)

When you're dealing with infertility, you see it everywhere. Innocuous abbreviations in your work life turn into moments when you are wondering why your education job is looking at luteal phases or interuterine inseminations. (For the record, they meant lesson plans and interdisciplinacy unit interims). It seems like everywhere you turn, it is difficult to get away. It is lurking everywhere. It disrupts your thoughts at the most inopportune moments. It puts everything in your life under a different lens.

Often, I turn on TV or watch a movie to unwind in the evening. It seems like every time I sit down to watch something new, there is a pregnancy or infertility story line. I know that art is supposed to imitate life, and I understand for many people pregnancy is a natural part of life. However, the real issue I have with Hollywood depictions of pregnancy and infertility are the huge and glaring inaccuracies they are allowed to pass off as truth.

Fertility and infertility seem to be hot topics on prime time shows. However, the depictions of the emotion involved, as well as the actual processes, are often truly works of make believe. Let me explain.

1. You'll never have children. It is rare---truly rare-- for a doctor to tell a woman she will never have children after an initial office visit. If your uterus has fallen out, or perhaps spontaneously combusted, then you might hear these words at your consult. Otherwise, your first consultation with a reproductive endocrinologist or an OBGYN is usually a whole lot of talking and blood draws.  Maybe even an ultrasound or two. These doctors do not go around making life altering pronouncements to women they met 10 minutes ago. Finding out you are truly unable to have children is usually a much lengthier process of trial and error. When nothing works, then you are unable to become pregnant. Even then, doctors might suggest options like donor eggs or surrogacy. Although those are not options for every woman, there are many measures doctors typically try or suggest before declaring you "barren" like the arctic tundra.

2. IVF works every time. It seems like each time Hollywood cooks up an IVF storyline, they show success the first time. That's not reality. Many women require several attempts if they find success at all. IVF doesn't "implant" a "baby in your belly." It places an embryo in the uterus. From that point, it may or may not implant. It's up to God, or fate or science as to whether or not it works from there. If IVF worked every time, no one would be infertile.

3. Women at fertility clinics are looking for multiples. I correspond with a large number of ladies who are pursuing medical intervention for pregnancy. Of the group, I know most would be grateful for twins or triplets, but virtually no one wishes for them. They would be happy with them because it would mean they have a baby to hold in their arms. With few exceptions, infertile women don't want something crazy. They understand better than most the doctors say there is a "risk" of multiples because it is just that... risky. Multiples make the pregnancy harder for mother and babies. Typically, mutiple births are delivered before single births, necessitating more neonatal care. Those of us pursuing fertility treatments have a discussion about multiples with our doctors at the onset of every course of treatment. If you overstimulate and choose to go through with the cycle, you have another discussion about high order multiples. Most women aren't looking for many babies at once. They just want a family. TV does a poor job of portraying this.

4. Infertility can be solved easily.  This is another one that really upsets me. People tell you to "just" do whatever it is they think is best (iui, ivf, adoption, etc). Each "solution" to infertility comes with its own list of difficulties. There are the medicines that affect you in so many ways. There are the numerous doctors appointments that require you to miss work or other important parts of your life. Then, there is the cost. Hollywood never bats an eye at the cost. $20,000 for one try at IVF. Upwards of $50,000 to $100,000 for surrogacy. $20,000 or more for adoption. None of these "solutions" are a "just" thing. For the average person, they require budgeting of time and money. They require a huge physical, emotional and financial commitment. And... they aren't guaranteed. Many celebrities that suffer from infertility make it look easy because they can throw money at the problem. Jimmy Fallon openly admitted that the average person would have difficulty going through surrogacy as he and his wife did in order to have a family. Tom Arnold admits to spending upwards of $200,000 on fertility treatments. Most average families can't afford that, plain and simple.

5. Relaxing gets infertile women pregnant. This is the "conventional wisdom" fertile women everywhere torture infertile women with. Many women will conceive within a year of trying. For those women, perhaps destressing is helpful. I'm sure a tropical vacation would be relaxing. But, if you do not ovulate, or any other of a number of other medically caused infertility conditions, the warm breezes of Fiji will not fix your infertility. Shows love to send couples away to come back with a solution to their problems-- a vacation baby. That doesn't work for most infertiles. Trust me, we would rather shell out $20,000 for an awesome trip to the Bahamas than the money we're handing over for catheters, plastic cups and syringes.

6. Adoption gets infertile women pregnant. This goes right along with the myth of relaxation. The story is when the stress of "trying" is removed by adopting a baby, women miraculously conceive. I'm not saying this never happens. What I am saying is studies show that the number of previously infertile women who get pregnant after adopting is no different than women who do not adopt but go on to get pregnant. Also, adoption shouldn't be a "back-up" plan. It should be a plan you are committed to 100% because you know it is right for you and your family.

7. Women are typically the problem. It seems like every infertility story line on TV centers around the woman being unable to have children. In some cases, that is absolutely true. However, in a roughly equal number of cases, male factor infertility is the culprit that prevents or complicates pregnancy. In about 20% of cases, both the man and the woman have some factors that make pregnancy difficult or impossible. Finally, in about 10% of infertile couples, there is no good reason why, medically, they cannot get pregnant. This means infertility isn’t just a woman’s problem. It’s a societal problem that affects both genders equally. But, you wouldn’t know that from TV.

8. You can take a pregnancy test immediately and know if you are pregnant.  This one KILLS me. In the trying-to-conceive community, everyone must endure what is known as the two week wait. Let’s go back to high school health class. From the time of ovulation, it takes about two weeks for the embryo to travel to the uterus, implant and start producing pregnancy hormones that can be detected in blood or urine. That means it is impossible to know if you are pregnant immediately after ovulation.

9. You know whether IVF "took" the same day. This one goes hand in hand with the immediate pregnancy test myth. While IVF puts you “ahead” of the TWW as far as waiting for testing, it’s not that far ahead. No woman will come home from an embryo transfer and take a pregnancy test to find out if she is pregnant. It just doesn’t work that way. See # 2 above.

10. Infertility is taboo. I appreciate that Hollywood is talking about infertility, but it’s still fairly taboo. It’s something women might talk about, but it’s not something we are ready to have a serious understanding about in this country. Millions of men and women deal with this disease. It affects people you know and love, although you might never know it. Hollywood hasn’t opened the channels for meaningful dialogue because they just keep getting it wrong. Many of us facing this disease are willing to talk about it because only through education can understanding occur. But, Hollywood has such a huge platform to springboard this issue into the light. If they could get it right, and make it seem less shameful, millions of us would stand up and cheer.