Infertility, and the 5 stages of grief

March 7 | Guest post by Sarah K.
Five Stages of Grief figurines by Etsy seller TheMidnightOrange

I stopped taking my birth control a month before my wedding. After nine years of being on the pill, I was excited to be done, and anticipated becoming a wife and mother.

During the first six months of marriage, I wasn't too concerned about my fertility. After all, I was unaware of any fertility difficulties within my family. At the six month mark, I began feeling impatient, since I believed getting pregnant was supposed to be as easy as buying a pregnancy test. Up to that point, I thought we were doing all the "right things" — taking prenatal vitamins, monitoring my fertile window, etc. Nothing.

I then downloaded a couple of fertility tracking apps, bought a basal body thermometer to track my temperature, started using ovulation predictor kits, continued with the prenatals, and "baby danced" every two to three days.

Still nothing after eight months. This is about when I started going through the stages of grief, in relation to infertility…

Denial

I was in denial that it could take a while to get pregnant, so I went to a gynecologist. She said typically it was best to wait a full year before seeking infertility treatment. Again, being Ms. Impatient, I was ready to problem solve why I couldn't conceive right then.

Over the course of the next three months, I was put on synthetic progesterone and had a hysterosalpingogram (HSG). The progesterone did nothing but lengthen my cycle from 25/26 days to almost 30(!). The HSG showed a blockage in one of my fallopian tubes, so I had to go in for a sonogram to investigate.

Anger

The day of the sonogram, I was a wreck. It was very painful and I was nauseous for a few hours after. I cried on the way back to work and texted my husband saying that this would be the last invasive test I took. The sonogram showed that everything was fine and I may have just had a spasm during the HSG.

We hit month twelve and my mental health was suffering. It was agony waiting for two weeks every month just to see that I wasn't pregnant. Around month 13-14 I stopped everything — taking my temperature, using ovulation predictor kits — and tried to relax. That didn't work either. I stopped going to my now-former doctor. I was angry, because I felt like we were wasting time (and money!) and nothing was working.

Bargaining

I was now in the bargaining stage… I remember negotiating with God that if I could get pregnant I'd go to church every Sunday.

Depression

Around month 18, I hit the depression stage. We lost our cat to a chronic illness, and a number of people I knew announced their pregnancies around the same time. I was happy for them, but their announcements coupled with the loss of our cat magnified the emptiness in our house. My husband was incredibly supportive at this time (still is) but it was definitely wearing on him too.

Shortly after our cat died we went on a brief vacation and that was the most relaxed I had been in months. However, two weeks later, I was devastated again. I remember standing in the bathroom at 8am on a Saturday morning, sobbing, because I had my period. I felt like my body was broken and I couldn't do something as basic to living things as reproduce. My husband had a sperm analysis done twice and his results were within normal limits. I thought infertility was my fault.

I eventually found another OBGYN, and the day of my first appointment with him was a nightmare. There were so many visibly pregnant women in the waiting room. I fought hard to hold back tears, and almost lost it when a nurse asked if I had ever been pregnant and I said no. While waiting for my doctor in his office, I couldn't contain the tears. He was understanding though and walked me through my fertility plan, which included two (unsuccessful) rounds of Clomid, blood tests, the works.

Acceptance

It's now month 25 and my period started today. Although I'm certainly not pleased, I'm in a much better place than I was even a few months ago. Through testing I found out that one of my hormone levels was half of what it's supposed to be, which is why I didn't respond to the lower doses of Clomid. I'm about to start round two of the higher dose. And if that is unsuccessful, then we may try more invasive methods such as IUI (intrauterine insemination) or IVF (in vitro fertilization). Depending on this cycle, we may stop before doing IUI.

I'm in the acceptance stage now. I acknowledge that I may never get pregnant. And that's okay.

Anyone else feel like they went, or may currently be going through, the stages of infertility grief? If you're dealing with it, you may find some comfort in our infertility archives

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  1. Don't hesitate to pull yourself out of or avoid situations that are tough for you, like baby showers or hangouts with a group of pregnant women/moms. One on one it can be easier to not have conversation revolve around a topic that is painful for you. On social media, I hid some people from my feed and others I would like the baby pics and then hide them half a second later.

    You're in for a bumpy roller coaster of a ride, I'm sorry to say. I've been on it and found it was really helpful to find others online or IRL going through it too. It will pop up in your life at times you don't expect and, unfortunately doesn't go away when you do get pregnant with a healthy pregnancy. It gets easier but doesn't go away.

    If there is one in your area and your insurance covers it, a reproductive endocrinologist could make a huge difference. It has for me. Also, my insurance didn't cover letrozole (similar to clomid but potentially a touch more effective) but it turned out that the dosage needed per cycle cost the same out of pocket as my clomid did with coverage.

    11 agree
    • Thanks for the feedback! I've opened up to a friend who is going through a similar struggle and we were both relieved to find someone who "gets it." The next step if this round of Clomid fails is to go to a RE, but I'm not sure if we're ready for that yet.

      • I know that an RE sounds serious and intense but mine was just like seeing a different gyno who specializes in a specific area. Also, it meant not seeing pregnant women in the waiting room. Mine was clear that they wouldn't show children in their materials and patients cannot bring children to appointments. Quite a relief.

        Sending you best wishes for your next cycle!

    • Hooray for Letrozole! Papers have been published that show women with PCOS (a frequent hormonal cause of infertility) are 20% more likely to get pregnant (and stay pregnant) with Letrozole over Clomid, despite the fact that they're both used to stimulate ovulation. I struggled with infertility and reoccurant pregnancy loss due to PCOS for over a year and was able to get pregnant using Letrozole twice – each time after about three months.

      I also wanted to mention another point for a potential emotional tidal wave: Diagnosis. I experienced a lot of denial and anger around my diagnosis. In fact, I was diagnosed with PCOS by three separate people (a naturopath, a reproductive endocrinologist, and finally a nurse practitioner at my OBGYN office) before I actually began to sit down and accept it. Once I agreed to consider the diagnosis, I started researching and that's when I got angry. When reading about the condition it seemed like fewer symptoms actually described my experience than those that didn't. On top of that most of the research around managing the disease and how you come to get it had to do with the symptoms I didn't have (here's looking at you, insulin resistance). I was only able to get past the emotions once I accepted that my hormone levels are what they are and no amount of kicking and screaming or ignoring a diagnosis is going to change that.

      The most important advice I got was to remember that you're not alone. There are a lot of people fighting the same fight. It made me feel so much better to seek out other people who were struggling with infertility and pregnancy loss and reading or hearing about their experiences and stories. I often found that hearing from other people helped me put my own experience in perspective and helped me process my emotions.

      1 agrees
      • so glad there are new drugs around for PCOS, its to late for me at 50 and now with no reproductive organs due to cancer but just good that things are moving on so younger women with this horrible condition can be helped sooner

        1 agrees
    • I second absolutely everything CoveredInBees says. I discovered that my RE had the resources to "customize" my treatment cycles based on more thorough test results he ordered, and my preferences and timelines. My regular gynecologist had been following a standard treatment checklist that turned out not to work at all for me. I made much more progress towards success much more quickly with an RE. I recommend wholeheartedly. Also, letrozole. Great drug.

  2. Thank you for sharing this today. I'm going through similar issues, and it's so nice not to feel so alone.

    4 agree
    • I'm glad it was helpful! I debated about whether to share my story but I realized how important it is to talk about infertility struggles, especially for women who are under 30 like myself.

  3. We went through three years of this. I felt very isolated sneaking away before work to have blood work done every other day, isolated when things didn't work, and even sometimes isolated from my partner (not his fault, we just had our own feelings). I wish you luck and peace as you continue on.

    4 agree
  4. I'm currently in year 5 of infertility. We looked at all our options and gave ourselves an out date (i.e., a date when we'd stop evaluating options and start to acknowledge there would likely be no children). The outdate was last December and, while no options we pursued resulted in pregnancy or children, like you, we've found ways to move forward and the pain of not having children or the failure each of us feel is diminishing. Infertility is a strange wasteland of emotions and shame and dealing. I hope you and your partner find peace in whatever happens.

    9 agree
    • I appreciate this. Keeping busy and having a great support system have definitely helped.

  5. Since I got married almost five years ago my husband and I have been on what I call the "baby path". I have PCOS and he is trans so there were many obstacles in our way, not to mention crappy insurance and only one income.

    Last December my stepson and his wife had a baby (my husband had children early in life and he and I are 14 years apart). It was the day my daughter in law was induced that I decided we needed to focus all our love and resources on our grandson. They live a few states away so getting to see them costs money and they don't really have the resources to travel right now.

    While I have accepted that this is the baby I am supposed to love there are still moments of grief. I am definitely still processing this change in plan and the fact that my PCOS has gotten worse in the last month or so hasn't helped. My cousin and his wife are having a baby in May and I had to tell my aunt that no we wouldn't be attending the baby shower, it was just too difficult for us to do. Not to mention I haven't seen this cousin for over 10 years and I have never been close to him.

    Thank you for writing this, it definitely came at the right time.

    3 agree
    • I'm happy that this was helpful. It's tough when it seems like there are near-weekly baby announcements but at the end of the day I think it's important to stay aware of my own emotional reactions and engage in self-care

  6. I went through this and it'snot easy, I never did get pregnant, I would have liked to adopt but suffered a severe mental breakdown as a result of the trauma of the entire thing and I have never got over it. I had to eventually have all my reproductive organs removed because of cancer. My infertility was due to PCOS which wasn't diagnosed til later in my life, at least these days girls get diagnosed younger and can get more help younger so they will get more help earlier if they want to have a family. Now as I reached 50 my peers are going through becoming grandparents so I am re living it all again.

    3 agree
    • Wow, that sounds so tough. I can somewhat relate to your thoughts on adoption. I'm not in the mindset for adoption right now because I feel like it's a reminder of what I couldn't do. We may reconsider in a few years.

  7. This article has come at a good time for me as well. I'm about to turn 34 at the end of this month, and have now officially been trying for a year to get pregnant. It seems longer than that though because even though we wanted to start trying earlier we couldn't because of finances. We've now been through two early miscarriages and had my first round of blood tests which came back "mildly abnormal". My best friend started trying this year as well and got pregnant within two months, and the same week I got my test results back I learned that my sister-in-law is pregnant with her third child. They spent much of that family dinner joking about how all her husband did was look at her to get her pregnant. I cried in the car on the way home. This has been harder than I ever could have anticipated and I definitely feel like there are stages to the grief.

    3 agree
    • I'll be 30 soon and I have several friends and family members around my age who are on kid #2 and #3. I wish more people talked about infertility so help keep expectations more realistic.

  8. Hugs to you all. Infertility is painful and it sucks. You are definitely not alone. Feelings around infertility are complex and contradictory and messy.

    I went through many years of infertility. Included in that was a miscarriage that happened right before my sister-in-law announced she was pregnant. This was the first grandchild on my husband's side of the family, so I was both happy for them and grieving our loss — and the fact that the first grandchild was "supposed" to be ours (yes, i know that is illogical and selfish, but that's where I was at the time).

    Eventually we did the whole thing — clomid (x2), gonadotropins (x3) and 3 rounds of IVF. Oh, and to top it all off I have PCOS so there was also a period where I had to take a break from treatment to essentially starve myself into losing 75 lbs to increase my chances of success. Round 3 of IVF worked, but when I remember the heartache we went through and the significant debt we incurred, I feel betrayed by my body. I love my son and I feel privileged to have had access to insurance and the ability to afford ART. But I still resent all I needed to go through to do what comes so easily to others.

    4 agree
  9. I'm another one who has been on this road. I saw my doctor about eight months into our infertility, and she looked at me with my binder full of charts and tracking and told me that clearly I just needed to relax. I burst into tears – so, so hurtful. I had an HSG (painful, for days), three cycles of Clomid – nothing. Finally, in September of last year, she told us we'd never conceive naturally and she was referring us to a fertility clinic. (In a stroke of horrible luck, my sister was diagnosed with cancer the same day. She's doing okay – finished chemo today, on to radiation.)

    The first IUI at the clinic resulted in a biochemical pregnancy a week before Christmas. The second IUI worked, and I'm 6 weeks along. Not out of the woods yet by a long shot. My other sister also walked this road, and she's been so wonderful and supportive through this.

    Sending so many warm thoughts to all others struggling with this. That year and a half was truly horrible, and I know how lucky I am that it didn't go even longer.

    3 agree
    • Thanks so much for this comment. What was the IUI like? By the way, glad to hear that your sister is doing better!

      • The IUI wasn't too bad. I had to do a trigger shot two days before. I was pretty nervous the first time, but it ended up not being a big deal. (I kept thinking of IVF and diabetes and all the other things that require way more needles, so that put it in perspective.) I'd compare the IUI itself to being at the dentist, maybe having a cavity filled or something. It was a couple minutes of intense discomfort, but once the catheter and speculum were out, I was fine.

        One thing that helped me through the infertility was realizing that it could be worse. My husband's sperm was useable, and that saved us thousands of dollars. (For work-related reasons, I saw the invoices of the IVF treatment of a client and her wife, and just getting the semen shipped from one side of the country to the other was several hundred dollars. I had no idea, and it made me realize how privileged I am, despite the heart-break of our experience.)

        And thank you! My sister is seriously kicking cancer's ass. (That's her motto.)

  10. This! You describe it soooo perfectly! My husband and I are in month 15 of trying and it is SO hard. Hitting a year was absolutely brutal! I swear I am close to tears at all times these days, and avoid friends and acquaintances who are pregnant/have babies. Luckily we've started the treatment process and so far everything looks good, so they suspect tubal factors (yay). Just waiting for the dreaded period to arrive to book the wonderful HSG. I think the most frustrating thing (apart from the crushing feeling of failure and the anger at my body), is the USELESS advice. The mental health advice for people in our situation is to not isolate yourself, HOWEVER I find MOST people do the ABSOLUTELY USELESS "all you need is to relax" "you guys just need to go on a vacation!" ect ect. Do they realize that when they said that, it makes it ALL MY FAULT?? If all I could do is RELAX I would get pregnant?? Even though I know that it's not true, it really makes me not want to open up to people at all.

    As you can tell, I'm waffling between the anger and depression stages, somehow passing over bargaining completely. Thank you for this article, it's exactly what I needed today.

    2 agree
    • I'm glad this was so timely for you! I hate it when people say "it'll happen" or as you mentioned, "just relax." I understand that people don't really know what to say and may be trying to be polite, but I'd rather they say nothing.

    • I got all that oh relax and it'll happen, as if relaxing would magic my PCOS, (the nasty PCOS that gave me a moustache at 11,) would go away

  11. It's such a hard path to be on. We have been trying to have a baby for more than three years. Three rounds of IVF also haven't work. We plan to try one more time and if it doesn't work then, we will try to accept it and try to move on with our lives. It's very hard being in this limbo land not knowing either way. Wishing you lots of strength going forward!

  12. You are wise to think about and experience the grief. It is a loss and a trauma. I "skipped" that part – we dithered around for most of our 30's because my husband wasn't sure he wanted kids, and by the time we decided, I was 39 and I have PCOS and there were issues with our sex life, so we went straight to adoption. Yay, us! So rational. No issues at all.

    Then we had to respond to our daughter's need to meet her biological family, and ran headlong full-tilt into the grief and anger we had not dealt with before. Hello, therapy. We were lucky to find a smart, adoption-focused therapist who is also a skilled couples therapist, and we got through it – and, in retrospect, I realized that the avoidance cost us years of deeper intimacy and connection.

    As difficult as it is – and it's hellishly hard – you are facing the grief of it directly, in the moment, and that will serve you well no matter where your journey takes you. I'll be thinking of you.

    2 agree
  13. I faced infertility nearly 20 years ago and ended up childless. I hope to offer some words of comfort:

    1) The thing about the stages of grief is that the progression is not always linear. Everyone's experience is different. It is possible to jump around, back and forth, multiple times and even overlap multiple stages at once. The key for me was to remember that whatever stage I was in, it would eventually pass, and even if it came around again, it would never be permanent. While acceptance has been my normal way of being for many years, it can be interrupted by other stages at times. (Grand-baby fever is a thing, but it too comes and goes.)
    2) Don't be afraid to distance yourselves from painful situations and to be honest about why. When I declined to hold the new baby of a co-worker, I told her it would be too hard to give him back. Instead of feeling rejected, she tried comfort to me. I was nearly always met with compassion when I was honest. (I avoided going into details though.) When anyone responded critically, I would take time to reconsider the relationship with that person. But, it is important to remember that when people offer lame advice (even me ­čśë ) without criticism, they are trying to be helpful, they just don't know how.
    3) Eventually, you will be ready to spend more time with other children – nieces & nephews, godchildren, neighbors & friends. My husband was a volunteer with the SMART program which tutors children in the classroom who are struggling with learning to read. There are many child focused charities that need time and/or money. You will know when you are ready and how much time you can handle with other babies. It is important not to rush it.
    4) Always try to be kind to yourself and your partner. The urge/need to reproduce can take over your lives. When the baby making cycle becomes a chore, give yourselves a break and try to find other ways to be emotionally close. Try to remember all the other reasons you chose to be together – not just to create a child. I am incredibly grateful to be on this journey with my husband.
    5) Remember that you are not alone. Continue to seek out the comfort of others who are or have been in your situation. We are here and are blessed if we can help others.

    My thoughts are with you all and I hope you all find happiness.

    4 agree
  14. This article couldn't have come at a better time. My husband and I have been married almost five years. We started trying for a baby a week before the wedding. I was diagnosed with PCOS when I was 19, right after having a giant cyst removed from my right ovary. Which resulted in me losing my right ovary, and tube. I believed the doctor at the time when he said I would be able to get pregnant just like anyone else. I was 19 at the time. I did NOT want any children. I always said I never wanted kids until I met my husband. He made me want to have a family that consisted of more than just fur babies. Last May 2016 I started to have familiar pains in the left side of my body. Went to urgent care, and discovered another huge cyst on my remaining ovary. We have been seeing a fertility specialist since. I have been poked and prodded more times these last nine months than I have ever in my entire life. I'm 32, I'm reasonably healthy. Seeing these articles have helped me cope a lot, and seeing a therapist recently. (Which I started seeing for totally different reasons.) Hopefully we will be able to conceive without having to go the IVF route. Our current specialist seems to think we will. My husband has been the most loving and supportive person in the whole world. He would love to be a father, but he has told me numerous times that it will be ok if we don't have a child. I'm lucky to have him.

  15. So empathize with what you shared. We went through this too. We tried for three years, also seeing a fertility specialist, charting, doing everything we could short of in vitro. Finally after 3 years, we conceived, but I was devastated when that long awaited pregnancy ended in miscarriage. At that point, I started looking into fostering or adopting. And then, amazingly, we had a successful pregnancy. I have two children now, and I think God everyday for them. But when we were dealing with unexplained infertility, I remember feeling every feeling you describe here. It was such a painful time. I pray for you that your children will soon cone to you. It may yet happen! I am proof. AND one more thing… don't buy the oft sold message that you "need to relax." It may be well intentioned when people share it, but the stress and sorrow infertility causes us are real, and it's OK to feel those feelings as you so beautifully describe here. I feel like the "just relax" thing is one of those things that can make us feel worse than we already do in this situation. It did for me, at any rate…

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