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To some, it sounds obvious: of course you should talk about whether or not you want kids with the person you’re going to commit to for the rest of your life. But believe it or not I’ve known several people who got married or committed before having the discussion, and they had very different answers and ideas about what they wanted.
With infertility on the rise, it’s not just should we have kids — the conversation becomes a long list of when, how, and for how long will we try, how we feel about different methods of conception, biology, genetics, and more. It might not happen, but 1 in 8 couples has difficulty conceiving. If you end up being one of them, it’s good to get on the same page — or at least know that you’re willing to open the book.
I’ve known others that, upon discovery that genetic children were not an option, made a unilateral decision that children, in general, were not an option…much to their partner’s devastation.
Avoid that pain. Here is some guidance on the talk all couples should have before committing for life because, as it turns out — baby, sometimes love just isn’t enough.
Talking to Your Partner About Potential Fertility Issues
First off, it's imporant to learn how to have hard discussions. If this is the person you want to share your life with, there will be a lot of hard discussions. Why? Life is hard. Money comes and goes, people around you will get sick and die, your relationship will have ups and downs. You will do both of yourselves a lot of favors if you set expectations for how you will handle these things in advance — or, at least, how you will handle the conversations. Will you sit down and take turns speaking? Will you make lists of items to cover? My husband and I have our best talks on hikes, walks, and long car rides.
Remember: Nothing good is ever achieved while yelling, and nothing positive comes from being hurtful.
Having children, and raising children, can be beautiful and fun experiences. And, like life, they can also be hard. Have the level-setting conversations: Do you both want kids? How many? What happens if you can’t have them? How far will you go — emotionally, physically, and financially — to have them? How do you feel about intrauterine insemination (IUI)? In vitro fertilization (IVF)? Donor eggs? Donor sperm? Donor embryos? Surrogacy? Fostering? Adoption?
Infertility: When Things Don't Go According to Plan
My husband and I both wanted children. Like most, we assumed it would occur naturally. Dr. Mary Wood-Molo, an expert in Reproductive Endocrinology and Infertility as well as Obstetrics and Gynecology, said it happens this way for most heterosexual couples. “It starts out giggly and fun, but it can turn into gruesome, hard, and sad work. It’s a terrible rabbit hole.” Indeed, it was. Through Sex Ed, I was taught that having sex more or less guaranteed pregnancy. I’m sure this was an effort to scare every teenager into celibacy (all it did was scare most of us into hiding our sexual activity. At 36, I still feel a hint of shame buying any kind of sex-related product).
The reality, of course, is that getting pregnant occurs during a pretty short window of time. I had no idea that my window was slammed shut for most of my life. It would take years of trying, testing, and transferring before we got pregnant — using a method we didn’t even know was possible when we started the process.
The Emotional
I felt a lot of guilt over my infertility, both in my marriage and as a woman. I felt like I failed. I was scared my husband wouldn’t love me as much, that he would leave me, that he would see me as somehow… less. That our lives would never be complete without a baby. That I would never be complete. I spent years going through ups and downs: highs after an IUI, dreaming of my baby, feeling phantom symptoms, and then devastating lows when my period would come. I spiraled into dark depressions. There were times when I was in so much pain that all I wanted to do was escape. I felt like a bottomless well of grief — several days a month. For years.
That is a lot for a marriage to endure.
I was in a state of constant loss. I lost friends. I isolated in my pain. Every month, I felt like I experienced death — of hopes, dreams, and the life I had always envisioned. I don’t know if I grew up, lost something, or just changed, but I came out of those several years as a much different person.
Women I came to know shared many of these same feelings with me. And while I met hundreds of women, if not thousands, through the fertility community, I only met a few men who talked about these feelings of pain, shame, and grief. That doesn’t mean they don’t feel it. Dr. Wood-Molo shared that it still seems to be a culturally sensitive area, and I agree. But, if it feels extremely isolating as a woman, I can’t imagine how lonely it must feel for men.
The Physical
There are a few elements to this: The physical toll on your body, the invasiveness, and the intimacy in your relationship. When we started trying with “help, " we were very confident we would not do IVF. We weren’t against it; we were pretty sure we would get pregnant with timed intercourse and medication. And then with medication and IUI.
It’s another rabbit hole. When it doesn’t work, it’s always the next cycle. The next drug cocktail. The next method. “Stopping feels too final,” Dr. Wood-Molo says. So we tried IVF. With our own eggs and sperm. When that didn’t work, we moved on to donor embryos, which finally did work.
The invasiveness of it all and the loss of intimacy. The testing and diagnostics take something beautiful and fun and make it clinical and cold. And, sometimes, painful and/or embarrassing. I cannot tell you how many times I had a pelvic exam. I know my husband was not thrilled about all of his “donations.” But we did it. We did it all. We wanted our baby.
And having timed intercourse with your spouse: it’s about as romantic as considering an open wound while you eat spaghetti. It can take a toll on intimacy. Dr. Wood-Molo says that it can be demoralizing for couples.
Again, how do you communicate? I would make dark jokes about it: At consults, I would say, “Wait, do you need me to get naked in this meeting? Where’s the speculum.” or, “Did you need a cup of [husband’s] sperm?” That’s how I coped. At home, I was usually the one to bring up the hard questions… But that’s always been my personality. I had to talk about it. I had to bring it up and into the light.
If I didn’t, I knew it would get worse. It always does. Resentments, like mushrooms, grow in the dark.
The Financial
It can be hard to wrap your head around how much fertility treatments — or adoption — can cost. While some states, and insurance plans, offer assistance, many people pay out of pocket. Ultimately, we paid $114,000 out of pocket between medications, consultations, tests, procedures, embryos, and every other little thing that was charged.
What is the plan for finances? Can you put money aside? Can anyone help you with a financial gift? Are you willing to put a cap on how much you’re going to spend before you call it quits — or pursue different avenues to parenthood? Dr. Wood-Molo says, “Couples need to have the conversation, ‘what-if’?”
Getting on the Same Page As Your Partner About IVF and More
There is a deeply ingrained notion that when we grow up, we will have our own biological children. For many, this is not the case. That reality can bring a lot of grief and a deep reshifting of expectations and what life will look like. Therapy — both separately and together — can be highly beneficial. The therapist we saw together while preparing for our donor embryo transfer told me: "I've never met someone who wanted to be a mother who didn't become one — in some way." But, therapy, too, can be an obstacle for couples, as some people are opposed to therapy. It adds another layer to the question: How far will you go to be a parent?
A List of Questions for Couples With Infertility:
- Do we both want kids?
- How many?
- Do we care about their sex?
- How do we feel about testing embryos for genetics and/or sex?
- What happens if we can’t have kids biologically?
- What if we can’t have kids who are ours genetically?
- Would we use a surrogate?
- How many years will we try without assistance?
- Will we try assisted reproductive technology? What kinds?
- How long will we try with medication?
- How long will we try IUI?
- How long will we try IVF?
- How do we feel about donor eggs?
- How do we feel about donor sperm?
- How do we feel about donor embryos?
- Do we have a financial cap?
- How do we feel about fostering? Young kids? Older kids?
- How do we feel about adoption? Young kids? Older kids?
- What does it mean for our relationship if we don’t align on these answers?
Kristin Diversi is a writer and versatile creative. She is passionate about reproductive health and justice and lives in Longmont, Colorado, with her husband and their son.