What to Do When You Can’t Get Pregnant

NOW THAT YOU’RE having a baby, life is sweeter than ever. But somewhere down the line you may wonder whether it makes sense to tell your child about ART. Couples often wrestle with the idea of telling their child the truth or keeping their prodigy in the dark. Parents who use donor eggs face giving an even more complex explanation about their child’s biological origin.

Discussing adoption in public was once taboo. People mentioned it behind closed doors to protect those involved—adoptive parents from the scar of infertility, mothers from the scorn of having out-of-wedlock babies, and children from the stain of illegitimacy. Sixty years later adoption is routine. But for the millions of couples who need IVF along with donor eggs or surrogacy (see chapter 9), public opinion on “what to say” lags far behind technology.

Questions can arise like, “Why make him worry?” “Won’t this just confuse her?” “We want to be honest with him, but how do we discuss this?” “Will this make her love us less?” or “Will he want a relationship with his donor?”

Telling your IVF child about her conception is an ethically and emotionally charged topic. Just the thought of this conversation can dredge up the pain and agony you experienced with infertility. It also raises red flags about how the truth will affect your child and how telling will affect the entire family. This is why you’ll want to examine your feelings about your IVF experience, the attitudes of your immediate family and friends, and your motivations for telling early on.

Before you make a decision, consider how it all started. You and your partner shared a desire to have a child. Your child was conceived with love no matter what vehicle (insemination, ART, third-party reproduction) was used. There’s no doubt that this love takes center stage. But consider the mechanics of uniting sperm and egg for what they are—a backstage event. Whether performed in the privacy of your bedroom or in a sterile lab, the end results are the same: your child is born.

Now consider the general population. Every day babies enter this world by happenstance. Their parents’ stories are familiar: miscalculated ovulation, missed birth control pill, or being carried away in the moment. But this is not the case for you. In fact, your situation is the opposite. Does that mean your child is inherently different from the rest? Only in the sense that you and your partner put great thought into his arrival. Your desire to have a baby was so great that you did something about it. If anything, it means your child—whether you used traditional or nontraditional ART—was loved way before you ever knew him.

Children can cope with almost any information as long as parents deliver it in a truthful manner. Glossing over the truth or withholding information can make kids uneasy.

Couples often wonder whether telling their child the truth will scar her for life. Is this possible? Absolutely not. But you should put some thought into how and, more importantly, when to tell her. Like anything in life, there are times and places for everything. You wouldn’t tell your two-year-old who was cheerfully gazing at the lights on Macy’s Christmas tree, “There’s no such thing as Santa Claus! And by the way, forget about the Easter Bunny and the Tooth Fairy. It’s all nonsense.”

Making IVF okay depends on you. Examine your own feelings about your experience. In case you’re not sure how you feel about it, here’s a list of questions to help.

•Did you have a support system (family, friends, coworkers, or neighbors) during treatment?

If you answered no to any of these questions, chances are you have some negative feelings about IVF. If you feel different from friends who had children using traditional methods and often long to have the same experience, you need to resolve these feelings before you tell your child about his IVF origin. If you’re ashamed or embarrassed about needing fertility treatments, imagine how your son will feel when he detects your sentiments.

Ease into the conversation when your child’s a toddler. Make it simple. Keeping your conversation honest, open, and age appropriate can make all the difference. You can begin with simple language like, “Mommy and Daddy needed a helper to bring you into this world.” If you’re shaking your head and thinking, I don’t know—two or three sounds too young to me, don’t. We have borrowed everything we know about telling children their biological origin from adoptive families, for which there are years of experience in family counseling and evaluation.

Unless you give your child specifics about how he entered your family, you risk having him find out some other way. Keep in mind it’s the knowledge from the answers you give him that will help him understand. It’s the mystery behind secrets that will drive him to investigate further. Many times offering a simple explanation like “Mommy and Daddy had a helper” is enough. What you want to avoid is creating a haunting wonder that silence doesn’t fill.

Young children are naturally curious about where they came from, so be prepared. Questions like, “Mommy, where did I come from?” usually surface during preschool years. This is the time children begin to talk to each other, notice mothers and teachers who are pregnant, and discuss the arrival of new baby brothers or sisters. With all these observations and discussions, how could they not be curious?

It’s important to share with David who his surrogate is. We are proud of what Summer did for us. I kept a baby journal for David since the beginning of my first transfer. Even members from my support group wrote David a letter about the importance of his birth. I have lots of pictures of my surrogacy for David to see one day. He’ll know that Mommy’s tummy was broken and he had to grow in Summer’s tummy.

Overwhelming your child with detailed information about IVF is a common mistake. Don’t go overboard. Listen carefully to what your child is asking and only answer specific questions. Drawing diagrams, reading scientific findings, or overloading them with too much information can set off alarms. If your child asks where she came from, it’s up to you to figure out if she wants a discussion on the birds and the bees or she’s curious about the city she was born in. Repeating or paraphrasing her question is an easy way to confirm what she’s asking. If you’re still not sure what she’s asking, follow up with another question to confirm before launching into a discussion you might regret.

Children take in only so much at this age. If your child asks where he came from and you’re certain he wants a preliminary discussion on the birds and the bees, give him a simple reply like, “You came from Mommy and Daddy.” Rarely do children at this age press for more information. But if your child’s the exception, then you might want to read age-appropriate stories about families and weave in your own story.

Conceptual thinking begins to take place at this age. Children readily comprehend reproduction, biological processes, and the function of sperm and egg and even an embryo. At about nine or ten your child may ask about sex, conception, and even IVF. If you find the discussion heading this way, you might want to emphasize the importance of a man and woman having a loving relationship while trying to have a baby. The best advice is to keep it simple; even though your child may seem obsessed with the idea of sex, she also finds it repulsive.

At this age elementary discussions of how sperm and egg unite make sense. Be sure to use the correct anatomical medical terms when referring to specific body parts. It may be helpful to mention that once an egg is fertilized and grows into an embryo, it matures in the uterus like every other baby.

The same philosophy holds for this age group. Don’t bombard them with information. If you find that you want to launch into a full-blown IVF discussion, stop yourself. The worst thing you can do is overload your child with more information than they can deal with. Sharing your medication regimen, blood tests, and barrage of ultrasounds is not the best idea. While this might seem like a harmless trip down memory lane to you, it could cause your child needless stress and anxiety.

Eleven- and twelve-year-olds are beginning to understand the world around them. They display increased responsibility and a need for knowing how things work. They may worry about inheriting your infertility and may ask you if your problem was genetic. Somewhere in your discussion they may even demand the truth. Don’t worry—questioning at this age is normal and shows abstract thinking.

Don’t be surprised if your child gets upset that his conception was different from that of the rest of his friends. Reactions like this are expected. What you’ll find is that once you air these discussions, your relationship with your child will strengthen. The key is how you go about them. Always keep your conversations brief and age appropriate, and pay attention to your child’s nonverbal cues. If he’s looking away, fidgeting with his hair, or falling asleep, you probably could have spared him the last ten minutes.

If you’re religious, talking about your decision to have a child may seem awkward without giving credit to God. This conversation will mimic the ones we’ve already discussed except you’ll explain how procreation is a collaboration among you, God, and your doctor.

As far as God’s role, we’re not very religious people. If and when the subject comes up, John and I will say that God did have a part. We’ll explain that God is watching over their twin brothers, who passed away in ‘98 a week after their 2002 birth. God wanted us to have children. That’s why he gave us two more boys to enjoy.

Genetic origin is a big deal only if you make it one. Knowing that your child will react to what you say is essential in visualizing an upbeat discussion. If you make a big deal out of his conception, then he will too. If you treat it like an everyday event that happens to millions of people who want kids, he’s likely to treat it that way as well. Conversely, if you’re nervous, ashamed, or fearful of telling him about his conception, your feelings will come through in your message. In this case consider postponing your discussion until you feel more confident.

Why are more parents telling their kids? Telling has become easier with all the publicity and attention given to IVF. But revealing your reproductive past isn’t easy, especially if your infertility seemed to take over your life at one point. Give yourself credit for sharing an important part of your history (and your child’s), but also take an honest look at your motivations. If you’re still having doubts about telling, table this discussion until you can accept (without feeling blame or shame) that you were not able to have a baby using traditional means.

On one hand, I don’t think they need to know. They don’t need to feel strange about realizing how clinical it was to conceive them. On the other hand, I feel that they would feel so loved and treasured that we went through so much just to have them. That having them was our greatest dream and what a miracle and blessing it was when they were born. Ultimately, it will depend on if the question comes up. I hate to lie to them, but if they never ask, I may not offer the information. But if they probe, I may tell them.

Remember, the responsibility of telling your child how he came into this world lies with you. Some parents put their child’s conception completely out of their minds, making it a nonissue. If this applies to you, then you probably won’t give telling a second thought.

For others the issue of telling never goes away. It may arise unexpectedly during an early conversation about where babies come from, discussions about family traits, or while giving a medical history when your child is ill.

Telling your child about her conception is not suggested in religions or cultures that frown on ART. If there’s a possibility that someone might harm, shun, or ostracize your child over this information, then by all means keep it to yourself. Some religions and cultures believe egg donation and even IVF is morally and ethically wrong. They view this type of ART as an act against God. If this reflects your current situation, reconsider telling your child about his origins. If you’re still not sure what to do, ask yourself what’s in the best interest of your child and then do that.

Experts overwhelmingly favor disclosure, arguing that children have the right to know their medical and family histories. Some of these groups include the ASRM, Resolve (the national fertility association), and the American Fertility Association.

Others believe disclosure in a society that is quick to ostracize is nutty. Ultimately, it’s an ethical, moral, and personal decision that you have to make yourself. Obviously there is nothing wrong with the desire to have a biological child. But before you decide whether to tell your child about ART or to remain silent, understand your feelings and motivations, and after assessing your child’s maturity level, do what’s right for yourself, your child, and your entire family. After all, disclosure, just like any other aspect of parenting, is a judgment call.

IN AN EGGSHELL

• Examine your feelings about IVF, the attitudes of those around you, and your motivations for telling early on.

• Children can cope with almost any information as long as parents deliver it in a truthful manner. Glossing over the truth or withholding information can make kids uneasy.

• Consider your child’s chronological age and maturity level before you decide when and how to begin the discussion of where your prodigy came from.

• If you feel different from friends who had children using traditional methods and long to have the same experience, you’ll want to resolve these feelings before you tell your child about his IVF origin.

• Avoiding secrecy is the best way to breed trust in your family.

• Sometimes families disapprove of IVF. If you find yourself in this situation, you might want to tell family members gradually.

• Keep your conversation with your toddler simple, honest, open, and age appropriate. When the conversation begins early in life it becomes a lifelong process.

• Overwhelming your child with detailed information about IVF is a common mistake. Listen carefully and only answer specifics.

• If your religion or culture frowns on ART and telling your child puts his well-being at risk, avoid telling at all costs.

• Once you’ve assessed your situation, do what’s right for you, your child, and your family. Disclosure, just like any other aspect of parenting, is a judgment call.