The Evolution of an Infertile

The Behavioral Stages of the Infertile (or a case study of Ms. Smartypants)

Stage 1: The Pre-Infertility Infertile, also known as the Blissfully Ignorant Infertile (BII)

The BII is not yet aware that she will struggle with infertility. Her belief system includes the following:

• I must take birth control pills to prevent pregnancy.
• If I stop taking birth control pills, I will immediately become pregnant.
• I can plan my pregnancy ahead of time so that the baby will be born at the most convenient time, i.e., during summer vacation, just before the holidays, on my birthday because that would be so cute.
• Infertility happens to other people, or in movies, like on Lifetime Television for Women.
• Sex is for enjoyment.

The BII is able to enjoy her friends' and relatives' pregnancies and birth announcements, as she is certain it will be her turn soon.

Stage 2: The Trying BII

The Trying BII has now gone off the pill and is actively trying to get pregnant. She has counted nine months ahead and decided that yes, getting pregnant right now would ensure that the birth does not disrupt any planned vacations or big work projects.

Infertility is still something that happens to other people, and now sex is for enjoyment and procreation.

Stage 3: The Curious Infertile (CI)

It has been perhaps, 4 or 5 months, and no pregnancy. She has heard, of course, that "it could take 3 months!", and so she is beginning to wonder what is going on. She isn't worried yet, so much as curious. She buys her copy of Taking Charge of Your Fertility(TCOYF) and reads it cover to cover, believing with all her heart, that she is in charge of her reproductive efforts, and all she needs is a little knowledge and empowerment. The CI has become an expert in discerning the subtle color and texture changes in her cervical mucous and makes the stretch-it-between-two-fingers-technique as natural a part of her bathroom protocol as wiping. The alarm clock on her bedside table has been pushed to one side to accommodate the body temperature charts and thermometer.

Sex is now less about enjoyment and more about timing.

Stage 4: The Getting-Worried-and-Seriously-Annoyed Infertile (GWASAI)

A few more months have passed, and the GWASAI has realized that TCOYF is a crock of shit. She has given up on the charting and mucous-inspecting and has bought a bulk supply of ovulation predictor kits.

She no longer cares about a conveniently timed birth, she just wants to be pregnant.

She is starting to worry that maybe, just maybe, those Lifetime movies were based on true stories.

She is finding it hard to remember a time when sex was for fun.

When the OPKs have proven useless, the GWASAI either goes to her regular obgyn who refers her to a specialist, or she visits the nearest RE directly. A number of invasive tests are performed including one particularly pleasant procedure that involves the clamping of, and inserting dye into, the uterus. The GWASAI's husband may also be forced to endure the humiliating task of wanking off into a cup to have his sperm put to the test.

Based on the outcome of these tests, a diagnosis is made.

Stage 5: The Newly Diagnosed Infertile (NDI)

The NDI is dealing with a range of emotions including intense rage, debilitating sadness, and overwhelming frustration. She is mad at herself, her husband, the world.

Eventually, though, the NDI musters up a little hope. There is a diagnosis now, which means there is understanding. And with understanding (and science and medicine and a gang of white-coated professionals), there may be resolution. After hours on the Internet researching the diagnosis (even if the diagnosis is "unexplained infertility"), the NDI and her husband begin to discuss their options. It is time to become proactive. It is time to do something.

She thinks sadly to herself, "My life could BE a Lifetime movie."

She now wants a baby more than anything, and finds it difficult to think about anything else.

Sex? What is sex?

Stage 6: The Newbie-in-Treatment Infertile (NTI)

The NTI is experiencing a renewed sense of hope and excitement. She believes that there are ways around this infertility. The NTI believes that surely, medical intervention will work for her! In fact, maybe they'll be one of those couples who, as soon as they start treatment, poof! gets pregnant all on their own! So many of her friends are telling her these stories, it must be pretty common, right?

She joins various on-line support groups where the women have usernames like justgottabelieve or wanttriplets or baby4me. The women there shower each other with baby dust and words of encouragement. They are all also NTIs and so they all believe that ART (along with lots of positive thoughts and perhaps a little prayer- for the Christian Infertiles) will bring them the baby (or 3!) they long for. They eagerly compare treatment plans and protocols.

The NTI just can't wait to get started. If she is doing IUIs, she swallows her clomid happily, thinking maybe this is the pill that will get me my baby. If she is doing IVF, she anxiously awaits her stimulation, inserting each needle slowly and carefully, while her husband stands by rooting her on.

The NTI has told very few, if any, people about her infertility. She believes there is no reason to as it will all be over very soon.

Sex is back. (is that what JT is singing about?!)

Stage 7: The Veteran Infertile (VI)

The VI has now been through numerous failed infertility treatments. She has long abandoned her perky on-line friends for other vets who are bitter and angry like herself. There is no baby dust there. In fact, if someone so much as mentions baby dust, they should be prepared to have it shoved so far up their ass it comes out their nose when they sneeze. The VI and her friends post on message boards and blog about the horrendous-ness that is infertility. For many VIs, this on-line misery-loves-company support is the only thing that keeps their heads above water. It connects them with someone who actually knows how they feel.

The VI has to sit on her hands to keep from smacking anyone who tells her to think positively because "I had a cousin who..." or because "I know just how you feel, it took us 3 months!" (though it has been noted that some don't bother sitting on their hands...)

The Vet inserts her needles while simultaneously talking on the phone, eating dinner, and knitting a sweater.

Many people know about the infertility. You can't miss that much work and not expect people to ask questions. The VI has by now given up many of the hobbies and activities she used to participate in because treatment takes up too much time, too much money, or just too much energy.

She avoids events and activities that she knows a pregnant woman or new mom will be attending. So, she avoids A LOT.

She begins to believe that she may never become pregnant.

Stage 8: The Newly Pregnant Infertile (NPI)

The NPI can be recognized by the appearance of 4 distinct qualities:

1. Absolute Elation. The NPI is ecstatic to have achieved pregnancy after such struggle.

2. Utter Disbelief. She can often be caught pinching herself.

3. Persistant Fear. She is constantly worried that this pregnancy won't make it.

4. Confusion about where she belongs. She is aware that she is no longer in the trenches with so many of her on-line infertile friends. (But her heart is still there with them.) And yet, she also doesn't feel comfortable among the fertiles, either, as she most certainly is not one of them.

Editor's note: I'm still working on figuring out this stage. Hopefully I'll be able to add one more: The Parenting After Infertility Infertile (PAII)...