(Making) life is hard.

Loving and remembering the children we’ll never meet.

The day my wife, Colleen, and I suffered a miscarriage, we went to an open house in our town. We weren’t looking to buy a new house, but we like seeing homes. Colleen is a designer, and loves getting inspiration from how people decorate. Plus it is always fun to dream about what life would look like in a home that is just a bit bigger, or right on the water. 

On this day, we weren’t going for inspiration or to daydream. We were going because it was something to do. That morning, we had had our eight week ultrasound and were hoping for an update on the progress of our pregnancy, but had been sadly told the heartbeat was no longer there. The appointment started upbeat and hopeful, and began unraveling in slow motion. The technician went quiet, we couldn’t see much of anything on the screen, and then the news was delivered. So we drove home mostly silent, numb, and decided to go to this open house because it was something we might do if this hadn't happened. Before we walked in we cried and held each other, and when we entered the living room the listing agent seemed like he could tell. He gave me a look that was more bewilderment than sympathy, even as I complimented the backsplash.

This wasn’t our first miscarriage, but it was different.

Three years ago, Colleen and I uprooted our lives in Southern California and moved across the country to a quaint suburb in New England to be closer to our families and to start one of our own. That decision, to take the next step in life, was a really exciting, albeit scary, one. We’d had our youthful west coast adventure and were ready for more. We found a home in a seaside town that we loved and began trying to conceive.

In the film Mean Girls, which came out in 2004 when I was also of high school age, the character Coach Carr aptly says about conception, “Don’t have sex, because you will get pregnant and die!” A silly line, but also generations of sex education boiled down to a succinct idea that is engrained in most of us from a young age. If you have unprotected sex, you will get pregnant. While this is true for lots of people, for many like us, it’s far from an accurate depiction of family-building.

After a year of disappointing results, we sought medical help. Colleen was diagnosed with Polycystic Ovary Syndrome (PCOS), which is a condition marked by an excess of androgens, a kind of hormone that can cause all sorts of symptoms including disrupting the ovulation cycle. The good news was that it can be treated, and our prognosis was that we would have a high chance of pregnancy, but we might need help. So we began in vitro fertilization (IVF) treatment, including retrieving eggs, creating embryos in a lab and testing them for chromosomal abnormalities. 

They say life is a miracle, and this process proves it to be true. When we did Colleen’s egg retrieval, the doctor collected 22 eggs, which is a very high number. From there, 15 fertilized, and finally, 5 matured enough over a several day period to be saved and frozen. Five out of 22, which is considered very high performance.

We tested them and four came back normal, while one was inconclusive, so the doctors said to keep it as a backup. We wouldn’t need it, we will be pregnant soon, was the idea. We were told each embryo given its grade had roughly a 60-65% chance of success.

Of course, that’s not how it played out. Over the next two years, we dealt with setback after setback. Three frozen embryo transfer failures, an early miscarriage, and a handful of exploratory surgeries for my wife, mainly due to follow-up testing. Colleen has had to take a myriad of hormones and medications, not the least of which being the progesterone injections that I, a writer, have to give to her for weeks each time we try a frozen embryo cycle. She certainly deserves better than my unsteady hand. And this is not to mention the insurance delays in approval that pushed out protocol time and again in the early stages. 

Which brings us back to this final, “inconclusive” embryo, which we transferred without much hope mainly because insurance would compel us to before allowing us to create more. We had sought a second opinion and while this new doctor validated everything had been done correctly, we were told that we were having “repeated unexplained failures,” and that they essentially had no idea why it wasn’t happening for us. And then, on this last try it worked. The test was positive, and it kept growing. A week before losing it, for the first time in three years Colleen and I saw a fetal heartbeat on an ultrasound. It was a moment of immense joy, washing away years of heartbreak and giving us hope for the first time we could remember. 

Even though we knew we were far from the clear, we made the decision to tell our parents. I’d be lying if I said I was confident in the pregnancy at that stage, but after years of calling them in tears, we wanted to experience making the phone call we had dreamed about. And we don’t regret it, it was a special moment, even though we had to call them again in tears a week later. It was Mother’s Day weekend, which heightened the stakes. Mother’s and Father’s Day are hard for us, the people yearning to join the club, as I imagine they are for people missing their own parents or parental figures, or who have lost children, or experience any other personal tragedies that might dampen the message of the holiday.

Infertility is really hard. Each loss and setback chips away at you, taking chunks out of your armor and letting more darkness into your mind. We stopped saying “When we have kids, we’ll do…” and started saying “If we have kids, we’ll do…” And then we stopped talking about it all together.

IVF requires a strict adherence to a schedule that you can’t plan for. I’ve heard other patients describe it as “hurry up and wait” as it is so dependent on cycle monitoring. As a result, we’ve had to cancel so much of our life at the last minute because we are called in for an appointment. Bachelorette parties, weddings, birthdays, family holidays, work trips, and more have all become casualties of our IVF journey. At my step-brother’s wedding, we had to leave to give Colleen a progesterone shot midway through the reception. The lies we’ve had to tell about missing things are hard to keep straight sometimes. We have “Covid,” or are “out of town,” or “dealing with some unidentified stuff,” so very often. Getting sick during treatment is not an option, lest we risk cancellation and more delays, so when we’re in protocol, we don’t see friends, we wear masks everywhere, and we avoid public gatherings like concerts or movies. 

For three years we’ve slipped into a kind of purgatory. When it’s not clear when you’ll have children, or if you will, simple life conversations like “where should we live?” or “what kind of car should we get?” become really challenging.

We’re in our mid-30’s, living in a quaint seaside suburb, so it’s hard to escape constant reminders of our losses. Seemingly everyone we pass has a stroller. One time we took an Uber to the airport and the driver asked if we had kids yet. “No,” we replied. “Well, you gotta get going!” he told us.

And of course, every other week someone else close to us will call and excitedly share the news that they are expecting. This creates such a complex and devastating emotion, because we are genuinely so happy for our friends and family when they share this news. We love watching our friends become parents and spending time with their kids. I can’t emphasize enough how much fun it is. Yet each time we receive that call it's a deeply harsh reminder of our own journey, and the ultimate fear that we will never be parents ourselves. We hate that we can’t fully be there for our friends and family members during what is one of the happiest times of their lives. It’s another layer of heartbreak.

I don’t want to dwell on the negativity. I don’t want to sound like I’m just complaining about the specifics of our particular situation. And I always try, at least when I’m writing, to pull out some silver thread. But I imagine that other people going through this may have experienced the same emotions and fears, which are so difficult to work through, so I think it’s important to be honest about them.

The day after our most recent pregnancy loss, I brought Colleen in for a dilation & curettage (D+C) procedure, a surgery which helps to remove abnormal tissue following a miscarriage. While I waited, I went to a local diner and ordered blueberry pancakes. Then I sat there, at the counter by myself, and openly wept. A million thoughts raced through my mind, including: Will my wife, who is 100x the person I am, ever be a mother? Will I ever be a father? The baby was due on Christmas, will we even celebrate this year? Where do we go from here? I hope the server didn’t think the pancakes were bad, they were quite good actually. But grief is weird, and sometimes it comes out at inappropriate times.

Making life is increasingly difficult.

I would not wish this experience on my worst enemy. Unfortunately, however, more and more people are experiencing infertility worldwide. According to the World Health Organization, an estimated one in six people globally are affected by infertility, with very little variance from region to region. Shockingly, the rate of male infertility has risen more than 75% since 1990. Every year, roughly 1 million pregnancies end in miscarriage in the US, which is about 25% of the overall total. Our experience backs up these statistics, as we share waiting rooms bursting at the seams with other people desperately hoping for parenthood.

With this in mind, one may expect that national dialogue and policy around family-planning would be far more open and moving in a progressive direction. And yet, the opposite is true. There is still such a stigma around infertility and pregnancy loss, which contributes to an overall discomfort with all forms of family-planning. Some couples prefer to adopt. Some individuals who want to be parents without a partner need access to medical intervention. And of course, some people prefer to not have children at all. All of these outcomes should be accessible and equally acceptable, especially in a modern society.

Despite our sadness, we wake up grateful every day that we live in the state of Massachusetts, one of just 13 states in the US that require insurance providers to include in vitro fertilization as part of their care coverage for people with demonstrated infertility. Without coverage, the out-of-pocket cost for families can be between $15,000-30,000 per cycle without any guarantee of success. And if you decide to pursue a gestational carrier (commonly known as surrogacy), the cost can be roughly $150,000 out-of-pocket. The sad reality for so many Americans is that having a child may be financially out of reach for them. 

Additionally, following the Supreme Court decision to overturn Roe vs. Wade, an increasing number of states have moved toward aggressive abortion restrictions which challenge the ability for families to conceive through treatment such as IVF, and frankly make it difficult to even carry a natural pregnancy safely to term. In Idaho for instance, multiple women have had to be airlifted out of the state in cases where abortion was necessary to avoid “dire health risks” to the mother. In February, a ruling by the Alabama Supreme Court briefly halted IVF treatments at three leading providers in the state. This despite the fact that a definitive majority of people (>60%) in the United States favor access to abortion in all or most cases, according to the Pew Research Center. IVF, a miraculous medical intervention that enables couples like us to pursue the dream of having a family, has somehow become politically divisive. At one point, our doctor told us, “don’t worry, you’ll always be able to try to have children in Massachusetts,” which is a surreal thing to have to tell your patients.

Why am I writing this now?

Over the past three years we’ve opened up to more people. And that’s tough too. They don’t know what to say, though they always genuinely want to help us. 

• “Just pray and it will happen!”

• “Why don’t you just adopt?” 

• “Have you thought about getting another dog?”

• “I know someone who couldn’t get pregnant and then they did!”

• “At least it must be fun trying so much, eh!?”

When you’re struggling with any personal issue, it can be difficult to share it with others. They might not understand, or become too supportive, or inadvertently say the wrong thing. But holding in something that has come to define this part of our lives has also been excruciatingly difficult. It’s hard to work sometimes. It’s hard to be in social situations. And it’s hard to find joy in the parts of ourselves that provided so much of it before we were here. 

As a male partner, it took me a long time to feel like these losses were also “mine.” Colleen has endured hell on our behalf to try and grow our family. My role, it turns out, is pretty marginal, at least physically. I’m almost window dressing. And so, while I’m in awe of her strength and resilience, initially, I felt like I was suffering only because my wife was hurting. I tried to be there to help her as best as I could. But this journey has profoundly impacted me as well. We both want to be parents. We both have had to grieve five losses with potential children we had imagined our life with. Our marriage is fortunately stronger than ever, even if individually we’re far from our best selves. 

I never tell my friends to have kids before they are ready. But I do wish that someone had told me to go get tests done before we were ready to conceive. Learning that you and/or your partner may need help with fertility should never bring shame. And the sooner you know about what you may be facing, the more you can plan ahead of time. It sucks to find out that it will take you years to have kids at the time you’re ready to have them. 

Thankfully, there are organizations working to shed light on these issues and bring solutions to the market that can help people like us (where there is a problem, there is usually a good case for innovation). From 2020-2027, the market for fertility services is anticipated to double to $45B. Companies like Carrot Fertility, Modern Fertility, and Kindbody are providing services to educate and test people who are in all phases of their family-planning journey. A growing set of employers are realizing that adding fertility coverage benefits is an attractive way to bring in top talent. 

In those dark moments, when the fears and doubts creep in, I try to lean into gratitude. We’re so fortunate to have the support we have from incredible friends and family who love us (I cry often thinking about these wonderful people, and I’m not making that up). We’re privileged to have access to medical treatment and the financial means and security to pursue multiple options for building our family. Adversity and grief are an innately human experience. Others go through it in different ways, and this just happens to be our set of hurdles right now. 

Naming this experience out loud is scary because it means it is real. But it has always been real, and our hope is that by acknowledging it we can take some of its power away. I’ve always processed my emotions best through writing. And I’ve found, more often than not, that being transparent about the hard things has brought me closer to people. Especially against the cultural backdrop above, Colleen and I both feel like sharing our experience now will do more good than harm. Infertility doesn’t define us or others enduring it, and there are many ways to construct a family. While I’m not sure what the future holds for our little family, I know we do not plan to give up on our dream of being parents someday.

The truth is, I’m not generally good at keeping the faith, at remaining hopeful. I go dark quickly and am prone to self-loathing thoughts. Fortunately, love is a powerful antidote to the parts of ourselves that warrant fixing. I’m stronger because I love my wife and she needs me to be. I’m more resilient because I love the children we’ll never meet beyond measure and they deserve parents who keep fighting for the dream of a future.

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If you are experiencing infertility or loss of any kind, I am sorry that it is happening to you. I wish it weren’t. You should know that you are not alone. And if you are in a position to help advance the need for services and regulations that make it easier for children to come into the world, I hope you use your power for good. 

You’ve heard the phrase “everything happens for a reason.” I’ve never believed that. But things happen to all of us, and we have to find ways to learn from them and move forward. Life is long and hard and beautiful and worth fighting for all at the same time. Be good to yourself and each other, as everyone is struggling through something they may not be ready to express.

Written with support and approval from the love of my life, Colleen.