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Perceived Infertility

Jezebel had an interesting article today on the opposite effect of the public believing that they’re fertile way into their fifties. (What do you mean that fertility has an age-limit?  More celebrities have twins at 48 than McDonalds serves hamburgers.  We’re talking billions and billions.)  It’s younger people believing they’re infertile when they’re not.

According to a study by the Guttmacher Institute, 13% of men and 19% of women ages 18-29 think they’re probably infertile. Actually, only 6% of women in this age group are likely to be infertile, so women are overestimating their risk quite a bit. People who identified as Hispanic were more likely than those of other races to think they couldn’t conceive; guys were less likely to think they were infertile if they were college-educated, had taken sex ed, or, interestingly, were single. And at least among men, presumed infertility was linked to a cavalier attitude towards birth control — guys who figured their sperm didn’t work were more likely to say they’d probably have unprotected sex in the next three months.

I haven’t read the original study yet, but the context reads:

Perceived infertility is an individual’s belief that she or he is unable to conceive or impregnate, regardless of whether this belief is medically accurate. This perception may lead to contraceptive nonuse, which may, in turn, lead to unintended pregnancy. Little research has examined perceived infertility among young adults, including potential associations with contraceptive behaviors.

I’d be fascinated to hear why the women think they’re infertile.  Is it based on wonky periods?  Are they currently trying to conceive and not having any luck?  Is it just a gut feeling.

Okay — and at this point, raise your hand if you had a gut feeling that trying to conceive might be difficult even without any evidence.  I did.  By which I mean that I both worried that I might have trouble AND I believed that I would conceive on the first try and was therefore shocked when it didn’t happen.

Jezebel is correct in that sex education generally covers don’t-have-sex more than and-this-is-what-you-do-if-you-want-to-have-a-baby.  Part of it is knowing your audience and sending them the correct message for that time in their life.  But the reality is that most people don’t go on to take sexual education courses at the college level or swing by Planned Parenthood to pick up materials on understanding their cycle.  And therefore, we have a dearth of information about fertility during time period for when people really should be thinking about fertility.

What are your thoughts on the study/article?  I can understand a woman believing that she is fertile by seeing story after story of celebrities in their late 40s having babies, but I don’t really understand the source of this belief — that you are infertile even without the evidence of a diagnosis.  Where do you think it comes from?


1 robin { 02.07.12 at 11:36 pm }

I was reading the comments and it seemed like this perception was shared by a lot of people – mostly people who were using risky “contraceptive” measures that they were told would for sure get them pregnant, and they hadn’t gotten pregnant. But because they were told they would DEFINITELY get pregnant if they did this (pull-out seemed to be the method of choice) and then they didn’t, they thought that meant they COULDN’T. Not that they were lucky, or happened to be doing it right.

When I was young I was pretty sure I would have trouble conceiving because 1) I didn’t get my period until I was 14, and 2) my period never came regularly (I went my entire junior year of high school without getting a period). Then I got my PCOS diagnosis which just confirmed what I had already suspected. But, like you, when we actually started to try, I was both validated and surprised/disappointed not to get pregnant right away!

2 Audrey { 02.07.12 at 11:50 pm }

I believed I would probably have fertility problems when my husband and I started talking about having a baby when I was 27 or 28. I told my husband to expect it to take the 6 months to a year they tell you it could, but in my heart I figured I couldn’t get pregnant. Because I am overweight. For no other reason than that. Okay, so maybe I thought that since I was creeping on 30 my fertility was probably starting to wain as well. But mostly it was due to my weight. When we got pregnant on the first try we scrambled because HOLY COW. I was so in the mindset of the other side that I had already started looking for support and what to expects and whatnot online. Which is how I found you. And even though I turned out not to have a fertility problem, I feel like it was life preparing me to be the rock my best friend needed when she turned out to have fertility issues a year or so later.

3 Audrey { 02.07.12 at 11:52 pm }

Oh, yeah. I should probably add that I started menstruating at 9, so that’s why I figured by 30 things would start to dwindle for me.

4 Heather { 02.07.12 at 11:52 pm }

My doctor put me on birth control when I was in my late teens because I had symptoms of endometriosis. But I didn’t know for sure until I had a laparoscopy. I knew infertility could be a issue, but was still disappointed when it was.

5 Cristy { 02.08.12 at 12:07 am }

I had a cousin who had this mindset. She has type I diabetes and assumed because she has this disease that she was infertile. Her daughter will be 3 yrs old this summer.

I need to read the study, but I think where a lot of this comes from is someone being diagnosed with something that requires medical intervention at a young age. Granted, there’s probably also the mindset that they got away with it a few times and nothing happened, but I also think that somewhere along the lines an adult said something that put this idea into their head (like my cousin).

6 Leah { 02.08.12 at 12:43 am }

I think it is because the risk of pregnancy is overstated in sex ed so sloppy or no use of birth control that doesn’t result in pregnancy suggests infertility to the person who took the risk. It’s probably better to educate the real “risk” because people are more likely on balance to avoid an unwanted pregnancy with a one time exposure than not. Best not to assume they have built in birth control if all they did was not have sex around ovulation.

I am astounded at what some of my peers don’t know about ovulation. Including hearing of dodgy advice from a doctor about when you ovulate versus when you get your period, saying it was 14 days after the start of your period. Sure, with a 28 day cycle and perfect luteal phase! I reckon it resulted in a long ttc time period for this person who has a slightly longer natural cycle who was probably ovulating a mere 4 or 5 days later but missing it for months based on that advice. I think educating girls about their cycle is really really important, not just about periods. If nothing else it can help a girl with more irregular cycles predict her period and that’s handy right?

7 Esperanza { 02.08.12 at 12:45 am }

I have to admit, I absolutely believed I would have trouble conceiving. Mostly because of my amenorrhea (I didn’t get my period for the better part of a decade). Also, because my mom had a similar problem and it took her two years to have me, then she lost a daughter in the NICU and birthed three still sons. So I just assumed I “had” whatever she had.

I was very proactive when we started TTC, I was getting acupuncture from the get go because I hoped it would keep my period from disappearing completely. I don’t know if it was the acupuncture that helped or the 2.5 years of birth control but something seemed to be working right and I had ovulated every cycle while I was TTC.

I have heard of what Robin mentioned, people believing that because they never got pregnant using less-that-stellar methods (like the pull-out) they probably would have trouble getting pregnant. I know at least three woman my age (early 30s) who have thought that.

8 RelaxedNoMore { 02.08.12 at 4:53 am }

I raise my hand. Even before we started TTC, I had this gut feeling that it would be difficult. That was one of the reasons why I started to feel a little resentment towards hubby because he kept delaying. I even went to see my ob/gyn before we started to see if there was anything that could be checked out before we even startedn.
But then again, I was already 37 when we started, so I had some basis for my thinking that it would be difficult.

When I was younger, I didn’t really think about this much, since I was mostly concerned with avoiding to conceive. However, even then I always thought that if I couldn’t have a biological baby, I’d try to adopt. Of course, even this will be difficult if not impossible now that I’ll be 40 next year, and hubby isn’t ready for trying adoption (yet).

9 serenity { 02.08.12 at 7:43 am }

I had no idea we’d be infertile. We were relatively young and healthy people when we first started trying. My mother conceived me the first month off birth control pills. And though she had a couple of miscarriages between me and my sister, she got pregnant right after my sister with my brother (they’re 13 months apart).

I had been on birth control for years, so I thought maybe it would take a couple of months for my body to adjust.

If I’m being truthful? I am still shocked that we’re infertile. I mean. My brother and SIL have an extra 200 pounds of body weight between the both them. They were hard core smokers and drinkers before deciding to start a family. Yet they conceived right away.

And my sister and I, who are exercise nuts, smart about what we eat, normal weight, etc etc etc, have 6 failed IVF cycles between us.

I don’t get it. So no, there was no perception of infertility for me. Even when I KNEW I was infertile, I figured with #2 we’d get pregnant pretty quickly with our remaining embryos.

10 Courtney { 02.08.12 at 8:11 am }

I have a cousin who had “perceived infertility” because I was dealing with IF and she reads my blog. My real life problems became her own phantom issues. She was not on birth control, got pregnant (with a man she’d been dating for a mere two months). When people reacted with a “WTH?” she told everyone she was told she couldn’t conceive – for no apparent reason. Didn’t you know you can tell someone is infertile just by looking at them?? Liar, liar pants on fire. Now she has a baby and has self-diagnosed herself with cysts even though an u/s showed nothing wrong (again she reads my blog, and my problems are now hers.) It’s wrong to assume to have a serious issue like IF when so many are truly suffering to have a child. I wonder if a lot of the infertility urband legends come from people who “claim” they are infertile when they are in fact not. :::blood boiling::::

11 gwinne { 02.08.12 at 8:20 am }

Interesting topic. I suspected I’d have trouble conceiving because once I started charting I had a very obvious luteal phase defect (and indeed, when my RE tested my progesterone 7 days after my first IUI, it was 7…and I started spotting the next day). But that’s evidence of a problem, later confirmed by a doctor. Never occurred to me just HOW infertile I’d end up being (RPL, donor egg in my 30s, yadda yadda).

What’s interesting to me along these lines is every woman I know who’d been casually told by an ob/gyn that she’d have trouble conceiving (due to PCOS, endo, or LPD) and therefore assumed from a very young age that she was infertile, conceived immediately (like first try) for multiple pregnancies.

12 KT { 02.08.12 at 8:38 am }

I had absolutely no reason to think that I was infertile, but I had it in my head that we were going to have problems. I got my period was I was 11 and had regular periods every month. Friends of mine from college would go off birth control and then a month later, would be pregnant. When my husband and I started to get closer to trying, a friend and I shared our worries about if we would have problems getting pregnant. She ended up taking 9 months to get pregnant with twins (naturally) and I’m still trying.

13 Brandy { 02.08.12 at 8:47 am }

Raising hand! I had no reason to think I would ever have issues (started period at 13, always regular), but in the back of my mind I just knew we would have problems. I even started reading blogs about IVF about 2 years before we started trying, because I wanted to prepare myself for that.

At the same time, when we did start to try, I was shocked and devastated when it didn’t happen. It’s like my brain was living two different realities, one that knew the truth was that we were infertile, and the other that was adamantly in denial about it.

14 gurlee { 02.08.12 at 9:38 am }

I remember “joking” with a friend that I was going to have difficulty because I had been having sex with my husband for many, many years with less than reliable birth control methods (aka the pullout). When we finally started to TTC and had been at it for more than a year it was hard to embrace the label of an infertile. Despite my joking around, I still couldn’t believe it wasn’t working and didn’t work until I had 2 surgeries, 3 IVFs, an FET, and the diagnosis and subsequent stabilization of a wonky thyroid.

15 Emma { 02.08.12 at 9:45 am }

I didn’t think I was infertile, but I thought I would have problems conceiving because it took a over a year for my parents to conceive me. They went through numerous tests and ended up conceiving me naturally, but I worried that if they had trouble, then I would too.

After losing #1, I had no doubt I could get pregnant, but it has definitely made me worry about the quality of my eggs/hubby’s sperm and being able to stay pregnant when I got pregnant again.

16 Anna { 02.08.12 at 9:50 am }

I find the idea behind the study fascinating. I hear a lot of generic anecdotal talk about how we are becoming less fertile as a society, chemicals in the water, the pill etc. so maybe people take the idea onboard. Maybe gains to our community in infertility awareness also mean that people are more likely to see the possibility for themselves. From a psychological point of view, it is very difficult to get people in general to believe that we are average, research suggests that we tend to see ourselves as not average in our health risks, life chances etc. Maybe people (mis)understand their fertility with this bias.

I remember saying to a friend that I didn’t think that it would be easy to get pregnant years before I knew how not-easy. Wonky periods and a gut feeling. Since then (some similarities to Courtney’s comment here) my sister has had a baby with somebody in a difficult situation prompted by huge anxiety that she had the same problems as me, despite having no evidence. I remember her phoning after 2 months of trying to complain that it was taking too long and she didn’t know what to do. Anyway, maybe that gut feeling I had she experienced too and I was just unlucky that mine was accurate. Or maybe the spectre of infertility in the life of somebody else is so powerful that it is in some cases ‘viral’.

17 JustHeather { 02.08.12 at 9:56 am }

It looks like I am in the minority here. I got pregnant way too easily when I was 21 (with DH) and had an abortion. It was only when I was 32 that DH and I were ready (as he’d ever be) to start trying. I thought for sure it would be easy for us, but not too worried that it could take the 6mo to 1yr. It was only as the year marker was approaching that I started worrying, with good reason. It was then that I was diagnosed with endo. 🙁

I did have an ex that thought he was infertile. Not sure why, maybe because of his drinking and smoking and being young and invincible. lol

18 BigP's Heather { 02.08.12 at 10:12 am }

I never thought I would have a problem- ever. My mother and sister are both very fertile. I took my birth control faithfully. I knew I had wonky periods in my early teens (thus, the birth control to easy my heavy cycles and cramps) but I never equated that with fertility. Of course, once on birth control my cycles were like clockwork… so I never thought anything of it again until I went off birth control to try to conceive.

19 Emily { 02.08.12 at 10:30 am }

Yes! Despite the fact that my Mother got pregnant every time my Dad looked at her, I had some gut feeling that it wouldn’t happen that way for me. But then I also imagined that the first time I had unprotected sex we would make a baby. Weird.
Interesting study…

20 Ellen K. { 02.08.12 at 10:42 am }

Before going off the pill, I didn’t think I would have problems because my mom also had irregular cycles but conceived very quickly. I went to the obgyn for a pre-TTC checkup and was told that I should chart for 6 months to track my cycles. But I didn’t really think it would be a problem until the end of that first cycle TTC, when I took a PG test around 14dpo and it was negative. I remember going back to bed, heavy with a sudden intuition that we would have problems. A couple of days later, I mentioned this to my college roommate. I think it was partly based on the sense that things had always gone smoothly for D. and me and we were due for a struggle.

I saw the article on Jezebel, too, and thought about the adolescent’s uniquely bizarre sense of fatalism plus immortality and how sex education is never quite accurate. A few of my cousins and friends got pregnant in high school because they thought they were protected by irregular cycles, or because their boyfriends smoked pot, or some other form of non-contraception. Those are real but not absolute hindrances to fertility.

21 loribeth { 02.08.12 at 10:52 am }

I’ll admit, I did not really think I would have problems when the time came to ttc. Anyone I knew or read about who had fertility problems had had problems with irregular periods, or had a STD, or had used an IUD, something like that — not applicable in my case. I was 34, almost 35, when we finally made the big decision to toss the pills, so the age thing did give me a bit of pause, but I honestly thought it would take 4-6 cycles, tops. Silly girl. :p

Hindsight is 20-20, of course. When I was a kid, I had a lot of kidney/bladder issues. One kidney is slightly smaller than the other & I had an issue with one of my ureters which created a backwash & contributed to infections. I was in the hospital several times for various tests between the ages of about 6 & 12, & when I finally did get pg, my mother told me I should make sure the dr knew about it, because she had been told by the drs then that there might be some issues when I had babies. I (and I think my mother) took that to mean issues during the pregnancy, overtaxed kidneys, etc.

Then I learned I had a bicornuate uterus, which may or may not have contributed to my daughter’s stillbirth, and to my difficulty ttc. And I also learned that there is a high co-relation between uterine abnormalities & kidney problems. I keep wondering if the drs saw anything abnormal about my uterus back then, and if they did, if they realized its significance. It would have been nice to know about, if they had.

I’m not entirely sure why young women would think they’re infertile without any hard evidence. I can recall being highly annoyed by a fellow loss mom on a e-mail list I belonged to, who wrote “I have struggled with infertility.” She was something like 28, wound up with 3 living children & I think the longest it took her to conceive was about five months. I understand that women who have lost babies are often desperate to conceive again (hey, I was one of them…!) & I have seen many rush off to fertility drs when things don’t happen as quickly as they like. But I don’t think a couple of months ttc when you’re young & otherwise healthy is a sound basis for self-diagnosing infertility.

One other point, I agree with Leah. Girls/women have a woeful lack of ignorance about the female body & how it works. I thought I was fairly well read & informed — & I was completely blown away by how little I really knew when, ttc after Katie’s stillbirth, I bought a copy of Toni Weschler’s book, “Taking Charge of Your Fertility.” It ultimately didn’t help us with ttc, but I learned so much, and even now in perimenopause, I can still predict pretty accurately when Aunt Flo is going to show up. I think it should be required reading for every high school girl.

22 loribeth { 02.08.12 at 10:54 am }

P.S. Just to clarify, by using an IUD = problem, I mean the Dalkon Shield was big news back then. IUDs have improved immensely in the years since.

23 Gee { 02.08.12 at 10:57 am }

I’ll be honest, I had a hard time focusing on the article yesterday because of the comments below it – a LOT of “Well I *wish* I was infertile!” In what world is that ok to say?

24 EC { 02.08.12 at 10:58 am }

I had no reason to think I would have problems (regular periods, stated at age 12; no family history), but for some reason, I was either totally paranoid that I would or had a gut instinct that I would…hard to say now which it was. I remember reading a story about IVF when I was in my mid-20’s and feeling sort of panicked that I would have to face that one day. I was still devastated when my ex and I started trying and didn’t get pregnant in the first 6 months – then I knew something was wrong.

When I got remarried, I knew infertility could be an issue (again). I was disappointed when I came to the realization, but not surprised. I don’t know why I suspected I would have a problem in the first place, but I did.

25 k { 02.08.12 at 10:59 am }

Our old nanny believed this at 20. She was dating a chronically ill man who probably WAS infertile, but because she hadn’t gotten pregnant ever she assumed she was. Lo and behold she got pregnant (oops) while dating a heading-for-jail-delinquent-dad-to-a-two-year-old-daughter douchebag. Because those guys are always fertile. Not the employed, sweet, smart, chronically ill boyfriend who adored her. But I digress.

26 Denver Laura { 02.08.12 at 11:03 am }

Hand raised…

In high school, I had “regular” 45ish day periods. Nobody thought that was out of the ordinary. Went on the pill for 13 years and also thought it might take a month or two. But I had some suspicion and started charting anyway, a few months before officially TTC. I was able to use that as ammunition at the Endo’s office and even though I was 30, it was obvious that we were in the IF range and really couldn’t wait the full year of TTC.

Then I question the education system when I have a 43 year old SIL getting pregnant (had problems with her last one didn’t think she could get pg over 40), the other SIL who didn’t think she could get pregnant while bf, and the other one who becuase it took 6 months to concieve the first one, thought it would be really hard the second time around. I keep thinking maybe if I weren’t so educated I’d be pregnant by now.

27 Orodemniades { 02.08.12 at 11:24 am }

I never thought I would have problems conceiving, because I’d been regular since I was 11. My husband had conceived a child (terminated by his ex-gf) so I figured it would be easy. 8 1/2 years later, via IVF my son was born. I hope he doesn’t have fertility problems, but I fear for his future where children are concerned.

28 Rebecca { 02.08.12 at 11:27 am }

I’m not sure I thought I would be infertile — I think I was just more aware of the issues that can be involved so I think I had a more realistic idea of how long it could take. My mother took a year to conceive me and multiple relatives had gone through either loss or longer times to conception. And, I’ll admit, I wondered if those might be me, too. No reason why, just felt that it might happen.

29 EB { 02.08.12 at 11:33 am }

What an interesting study. I have to raise my hand too. I had a strange gut feeling I would have trouble conceiving. (My husband worried about his count for the same reasons as the men in the study — lots of “oopsie” moments but no pregnancies. Turns out he’s better than fine.) I got pregnant my first cycle of birth control, and I thought maybe all my concerns were in my head. Then I miscarried. Then we tried for a year. Then we started testing. And now I know I have a unicornuate uterus. I’m really not sure if I was just paranoid or really had an inner sense that something was wrong. My mom did have some reproductive issues, but didn’t have any trouble conceiving and carrying to term. I’m not really sure where my fears came from.

30 Tigger { 02.08.12 at 11:35 am }

My parents were married for 3 years before they had me – not for lack of trying, just took that long. They tried for another 6 years after me with no success. My sister was married 5 years before she got pregnant with her oldest (again, not for lack of trying) and there is almost 5 years between her oldest and her other son. I had not been the safest person in my teens/young adult years, and had never gotten pregnant, so yeah, I figured it would take us a while.

Once we started trying, and it didn’t happen, and I had a chemical pg, and we were past a year, we got tested. Our odds were <1% every month. We figured at that rate, it would take us 8 years of non-stop marathons every month in order to make it happen. We didn't manage the non-stop, but it took us 6 years and we'd been together 7 1/2.

31 a { 02.08.12 at 11:39 am }

I never thought I would have problems. The only family history we have is an aunt who had plenty of problems. Everyone else has as many children as they wanted. Now, I imagine everyone who is so casually confident that they will conceive easily will have problems.

32 Gail { 02.08.12 at 11:47 am }

For myself, I never thought I would ever have a problem. I thought that I would go off the pill, have sex and get pregnant within a month or two. Nearly 3 years later, that isn’t the case. However, after a couple of months, I knew something was wrong. It was just a gut feeling like so many other people have said in their comments. My doctor wouldn’t run tests until I had gone a full year of trying, though. So, I just had to wait 10 more months to be diagnosed with unexplained infertility.

I’ve had a few friends (both male and female) who’ve thought that they would have problems conceiving and have gone on to have little to no trouble at all. One male friend thought that he wouldn’t be able to father children because he’d been involved in martial arts and had been kicked or hit so many times in the “junk” (his term, not mine) and didn’t wear a cup. Anyway, he now has a daughter and a son on the way and was able to impregnate his wife within a few months of trying both times. I have 2 female friends think that they would have trouble getting pregnant. One started her period very young (age 8) and had extremely heavy periods as well as unusual discharge from her nipples. Although doctors never told her that fertility was a concern, she thought it would be. She is now pregnant with her first after only trying for a few months. The other female friend rightly believed that she would have trouble after being diagnosed with endometriosis and other issues. However, she got pregnant with #1 after just a few months and is due with her second in a few months for which they got pregnant on the first try.

As a side note, if you haven’t seen the movie “Idiocracy”, you need to check out this clip of the first 10 minutes. It sums up exactly what my husband and I see and feel. http://www.spike.com/video-clips/f8drn8/first-10-minutes-of-idiocracy-clip-1

33 Rachel { 02.08.12 at 11:53 am }

I had my first ovarian cyst at age 9. I remember we had to go back to the GYN’s office 3 days in a row because I wouldn’t let her put her hands where they needed to go (YOU WANT TO DO WHAT?!?!) and finally my mom promised me NKOTB tickets if I let the doctor do her job.

I know a lot of people who have been CONVINCED they weren’t going to get pregnant. My friend had an infertile aunt, and my friend’s periods were weird. That is why she was so shocked that she got pregnant 8 days after she went off of the pill.

My sister was convinced she couldn’t get pregnant, after a year of trying. I made her get an ovulation kit. She got pregnant that cycle. Turns out she didn’t understand you had to have sex when you were ovulating. (BANG HEAD HERE).

34 Gail { 02.08.12 at 11:55 am }

I never thought I’d have fertility problems. I never had any trouble with my period or anything and thought that I’d go off the pill and get pregnant in a few months. However, after just a few months, I knew something was wrong. My doctor wouldn’t run any tests until we’d been trying for a full year, but I knew that there would be an issue. I ended up diagnosed with unexplained infertility and, 3 years later, still have nothing to show for it.

I do know that some of my friends questioned their fertility. One male friend thought that he had been hit or kicked too many times in the “junk” (his term, not mine) while working on martial arts, but he was able to father one child and a second is on the way.

A female friend thought that she’d have problems because she started her period early (age 8) and had some discharge from her nipples. Although doctors never said she’d have a problem, she was worried. However, she got pregnant with #1 after only trying for a few months.

A second female friend rightly thought she’d have trouble after being diagnosed with endometriosis and other issues. But, she got pregnant within a few months with #1 and is pregnant with #2 after just a month of trying.

If you’ve never seen the movie “Idiocracy”, it is something that just has to been seen. My husband and I relate very well to the opening scene as shown here. Warning: NSFW language, but still hilarious.

35 Gail { 02.08.12 at 11:56 am }

that should read age 8. I guess following the number 8 with a closed parenthesis sign is a code for a smiley face wearing glasses. Who knew?

36 Alexicographer { 02.08.12 at 12:43 pm }

Interesting. I wonder how many women are given bad — inaccurate — information by medical professionals. I had a friend in college who had had an unintended pregnancy (and subsequent abortion) because her doctor had told her (based on her being amenorrhic due to anorexia) that she couldn’t conceive. My suspicion is that the doctor (I don’t know if it was a man or woman) was trying to frighten her into improving her diet but the results — need I say — were disastrous. Similarly, I know someone who was herself unintentionally conceived (into pretty difficult circumstances) because her mom had been told she couldn’t get pregnant. I don’t know exact details there and the story may be apocryphal or muddled, but it may not. I also have a friend who was told after breaking her pelvis that she wouldn’t be able to have children — a ridiculous thing to say to an 18 year old recovering from a bad accident, even if the risk is there — who knows?

I am reminded of the movie Steel Magnolias where as I recall the husband understood that his wife (Julia Roberts’ character) “couldn’t” have children when in reality the message was that she “shouldn’t” have children or that pregnancy would be dangerous for her.

As for me, hard to say. I was (mostly) very careful up until I wanted to get pregnant and by then I was married to a man who’d had a vasectomy years before, so our infertility wasn’t exactly a shock, but just how much work it was (and how slim our chances were, by extension) to achieve a pregnancy in the context of my (unanticipated) high FSH diagnosis was mind-boggling.

37 Mrs. Gamgee { 02.08.12 at 12:46 pm }

In contrast with my family history of uber-fertiles (mom, grandma, and sister all got pregnant young and unexpectedly), I admit I was concerned about my fertility, altho I had no concrete reason to think that. Yes, I am obese and, yes, we got a bit of a later start than anyone else in my family ever did (mid-30s), but I had very regular cycles, and there was no real indication that I would have difficulty getting or staying pregnant.

When I got pregnant after 6 months of trying, I thought that I had just been worrying for nothing and that I had nothing to stress about. Then we lost our first and second pregnancies.

I don’t know what made me think I would have fertility issues, but my gut instinct was correct.

38 KeAnne { 02.08.12 at 1:02 pm }

I was fascinated by IVF or IUI births written about in magazines when I was a child, and I’ve wondered if that my intuition telling me to pay attention. I had a series of bad UTIs in college that led my GYN to suggest I had endo (but not diagnosed until much later via lap), so I sort of thought I might have issues, but it did come as a surprise when we started TTC. Like Gwinne said, I had an idea I might have a problem but no idea of how severe the problem was: unicornuate uterus & stage 4 endo.

39 stephanie { 02.08.12 at 1:26 pm }

I worried about this. My first pregnancy at age 19 was unplanned and ended in a miscarriage. I assumed it was a harbinger of bad news. I did go on to have a string of miscarriages, so maybe my hunch was not incorrect.

40 Michele { 02.08.12 at 1:30 pm }

I always thought I’d have problems, even as an early teen. Part of it was because of my own birth story, part of it was because I was preterm, and part was just because I had a “feeling”. That, combined with weird periods and then a doctor telling me at 16 (in response to my wonky periods) that I’d have problems, let me to tell Peter before we married (at 18) that I might not be able to have kids. His response: we’ll still have fun trying!. Our first PG (and M/C) caught me off guard (it took 2 years of trying), but the next years didnt. Not really. I was 27 when I saw our RE and was one of her younger clients, even though we’d been trying since 1998 to conceive (so, 9 years, which was longer than a fair amount of her clients). I think that younger couples actually get more crap from people (“oh, you have time” type comments.) (Oh, diagnosis: PCOS combined with Hashimoto’s, and incompetent cervix)

41 Queenie { 02.08.12 at 2:06 pm }

I thought the article was really interesting. The point about there being a lack of information for women outside of high school sex ed is definitely all too true. Although I am highly educated, I confess that I was one of those women who used to think fertility extended into your 40’s. About 10 years ago, I remember there being a Time or Newsweek magazine cover about the reality of fertility. I was about 30 at the time, and totally shocked to read about declining fertility in your 30’s. It was an eye-opener for me. Of course, it didn’t change any of the decisions I made subsequently, because declining fertility be damned–I simply wasn’t ready.

I do have two friends who thought they were infertile in their early 20’s. They believed this because they had both been really sloppy about birth control, and neither had gotten pregnant. One friend got to the point where she never used birth control, and confided in me that it was clear that there was something wrong with either her or or her boyfriend. They went on to get married, and now have two kids, but I’m not close enough any more to ask about the particulars. My other friend was also sloppy with birth control with her now husband, and couldn’t figure out what was wrong when she started throwing up (pregnant in her mid-30’s for the first time).

So in short, it might be that young women who are sloppy with birth control are over-estimating their infertility because they are under-estimating their luck in not yet having experienced an unplanned pregnancy.

42 Pale { 02.08.12 at 2:13 pm }

I think if people in the study believe they are infertile … it must either be serious ignorance about the biology involved … or else … some kind of fatalistic streak (in the case of those who know they want children) about not being worthy … or a pessimistic streak. ??? Where there is family history … as with other health conditions … of course it’s a rational concern. But lots of people have health fears and hang-ups that don’t start with a real diagnosis. Maybe this is related to a kind of hypochondria?

I can only speak for myself. I worried from a crazy-young age that I would have trouble conceiving because my mother had trouble (even before I could think rationally about that as a major life choice or know enough about myself to know what I wanted in life … some of the assumption that I would want a family was cultural programming, some of it was in me all along). I was also very thin and I got my first period much later than all my peers … and then my cycles were always long and irregular. THAT convinced me I was doomed to IF.

The unspoken angst about IF in my house while growing up was so thick and oppressive, you could cut it with a knife. My parents were married 8 years before I was born. In that time they were advancing their education and their careers, but it was ~not~ common to defer family-building back then and it was not common to have only one child. And it was clear that the delay was not by choice.

There were few, if any onlies in my sphere … neither in my family nor at school (both Catholic and Irish/Italian); it was almost a freakish (or so it felt) distinguishing feature. People made stupid remarks about it (stereotypes, etc., which far from applied to me in most respects, but the labels were my inheritance anyway, like it or not). And I lived in a neighborhood without other children, which further aggravated my feelings of isolation. It was a badge of shame somehow (unlike today, when it is far more common and more likely to be an accepted, deliberate, empowered choice) … though for the life of me … the shame I carried around makes NO rational sense.

My parents, parenting after infertility and loss, were obsessively over-protective and their undivided attention was not a blessing most of the time. When I would ask if I would ever have a sibling, my parents would just squirm and change the subject. They communicated their discomfort and shame and little else. Marital issues may have also contributed to my “only” status for all I know … my parents had a rocky marriage (still do sometimes even today). Eventually the answer to questions about the potential for sibs became a definitve “no” as they aged out. Occasionally my grandmothers would talk about my mother’s IF history in hushed tones. My father’s mother let slip in a gossipy way once that my mother had suffered a miscarriage before I was born … and the fact that at the time of her marriage, she had made no secret of wanting a large family (so clearly, unlike me, she was NOT expecting IF). Eventually I learned my mother had had a large fibroid removed before I was born (I heard fibroids were not managed as well as they are now — hysterectomies were common … I guess I’m lucky that she still had a uterus after they were done). Eventually my mother said something in response to my concerns to the effect that … her infertility issues were not the kind that one inherits. She was a nurse, so she had some clue about that. But I couldn’t completely believe her and I continued to doubt that I would have a family … until here I sit … with a larger one that I ever imagined. She still makes comments at times about God not … ?? favoring her enough or something like that. The comments make me very uncomfortable; our views on religion are not too compatible. Even today, there is still such a dark cloud over the subject.

I do think we inherit the psychology of infertility. Certainly we inherit family baggage. There was so much shame about it in my house … I breathed it in for years and years. To the point where I was completely (and unnecessarily) fatalistic about my own prospects. It didn’t cause me to be careless about contraception. But long before I was ever ready to think about building a family (I started around 31?), I had an intuitive understanding of what it means to be the one who can’t get pregnant and I dreaded it. It did take a long time to get pregnant the first time … longer than it should have. Later, when we were going through secondary IF, I found a book by Niravi Payne (recommended by Christiane Northrup) what dealt with the mind-body-IF connection. There were many cases presented from her practice and a few of them had emotional histories strikingly like mine … issues that she claimed impacted their ability to get pregnant or stay pregnant … issues that often resolved when they let go of their baggage. It’s a bit woo woo … and of course we all know that “just relax” is beyond BS. But I do believe there is something to it for ~some~ people … that what you believe affects your biology/fertility for better or for worse. I’m sure a psychologist could have a field day interpreting my history in terms of this. My mother’s, too … she is full of Catholic guilt and church lady-like baggage about sexuality. I do wonder. But I will never know the whole story for sure. She doesn’t talk about it. And I’m more than fine with that.

43 Ann Z { 02.08.12 at 2:14 pm }

I also had a gut feeling that we’d have problems, though part of me simultaneously thought we’d conceive on the first try. I followed infertility blogs and forums long before we started trying. I don’t know what gave me the idea, I’d always had textbook periods, that is, until we started trying to conceive. I did know that my parents had trouble conceiving, so that may have contributed to it. Oddly, the problems my parents had (mom had a blocked tube) were not at all related to the problems we had (PCOS and low sperm morphology).

44 Sarah { 02.08.12 at 2:32 pm }

I always had this weird gut feeling. I hoped like everyone else I know the first cycle off the pill I would get pregnant, but in the back of my mind I knew I would struggle no matter who I was with. My poor husband didn’t believe in the “nurse” curse. I’m a NICU nurse to boot, so that’s even worse. So many of my co-workers have also struggled with IF. It’s kind of scary. Of course there are the ones who believe because the work with us IFers, they must be IF too. These women get pregnant without even trying and then wonder what happened.

There is no history of IF in my family. It took my maternal grandmother several years to get pregnant, but she had 3 daughters in the late 30’s and early 40’s. My paternal grandmother started having kids in 1939 at the age of 39 and had 4 kids no problem. I hoped since I was starting later I would have her eggs 🙂 Unfortunately, we still had to go through 5 IUI’s and one IVF to get our miracle. I was never given a definitive diagnosis even after just about every test possible. So we’re unexplained….my guess? it’s the NICU Nurse Curse

45 Eve { 02.08.12 at 2:55 pm }

Hmmm…interesting in reading everyone’s comments because I was maybe thinking that it’s normal for everybody to worry they are infertile…and the most get knocked up and forget about that worry. I was a worrier…perhaps rightly so as my mom had issues and so did several of my female cousins. The big thing that gave me hope was that my sister had NO issues at all…both times got pregnant the same month she tried. Grrrrr. I think what surprised even more than primary infertility was that I am not only awful at getting pregnant…but I’m also and BEING pregnant. I really thought that fight would just be in the getting. Seconday IF also kicked me in the teeth because I figured…hey, if I can do it once with the right meds, why not again?

46 Rachel { 02.08.12 at 3:37 pm }

I had some endocrine problems and was told when I was a teenager that I might have some fertility problems, so I always assumed that I might have some. I was surprised and happy that we conceived the first time we tried. Unfortunately, none of my conceptions were to turn into children and I still sometimes have difficulty comprehending that I will never have a biological child. Since my husband has our primary infertility diagnosis, I always assumed using donor sperm would work for us but that turned out not to be the case. Now that we’re starting the process to adopt a second child, some of those feelings have come back, though they are more muted than before. So I was both correct and incorrect regarding my beliefs about my fertility.

47 loribeth { 02.08.12 at 3:56 pm }

Interesting comments re: the hereditary aspect of IF. If anything, my family was (& to some extent still is) completely the opposite (i.e., tons of babies delivered to young mothers barely 7 months after the wedding but not at preemie-type weights, if you get my drift). I was far more terrified of an unplanned pregnancy than I ever was of infertility.

48 Kimberly { 02.08.12 at 4:26 pm }

I always had a gut feeling that we would struggle to get pregnant. But my thoughts vs. reality is that I thought I would be the cause, not my husband.

What annoyed me about the article was the comments beneath it rather than the article itself. The article was informative, but seemed to lack the real representation of percentages and numbers to show those that do struggle with infertility and the reasons behind the struggle. I wanted to scream as I read the comments though. Everyone is practically preaching the pull out method.

I think that we all should be taught proper sex ed. Not the religious take of “just say no to sex” but instead say, “you will want to do it, and if you do, these are your options vs. your risks.” Even then, they only lightly touch on your reproductive system and what to do if you feel that something is wrong. They don’t talk about the potential problems that can happen with your reproductive organs. I have single girlfriends with endo and PCOS who have openly admitted to me that they don’t know what to do, how to talk to a potential mate about it and what to do if they can’t get pregnant. They never thought to be tested to find out what can be done to make it possible for them to have biological children. They didn’t know that they could have eggs frozen for future use. They didn’t know about natural homeopathic medicine that will help them deal with PCOS or endo. My parents didn’t know this, they are even shocked by the information that I can give them. My mother didn’t even know that the WHO have declared IF a disease. My school sex ed course was crap because the teacher we had for all 3 years didn’t want to teach it. We were a class of mostly girls with a male teacher who blushed when he talked about the sexual organs. He gave us the book to read, told us what part of the books he would test on and then tested us. Everything I learned about reproductive health I have had to search for myself either through my doctor or through other sources (online or via books and discussion).

49 Jem { 02.08.12 at 4:28 pm }

I never even imagined I’d have trouble conceiving. I had the fear of getting knocked up young drilled into me. Fast forward 20 years, got married, started TTC. When we tried and and tried and it didn’t work, and were diagnosed as MFI, I thought I’d get pregnant easily doing IVF with ICSI. 3 IVFs later, no joy. Got pregnant with Donor sperm IUI on the first try. Go figure.

This whole discussion just illustrates how messed up our sex ed is. Despite having a copy of “Our Bodies Ourselves” on the family bookshelves, I didn’t really understand my cycle until I was actively trying to conceive and I bought a copy of Toni Weschler’s book, “Taking Charge of Your Fertility.” I was always crap at charting, but it still helped me be more in touch with my body, so to speak.

50 clare { 02.08.12 at 5:47 pm }

I always thought I’d die young or very old, and either have no trouble or lots of trouble conceiving. I guess I like planning for extremes.

And probably losing most of my ovaries before my virginity *should* have made me rethink over zealous sex ed idea and whether or not it actually applied to me any more (I agree with Leah’s comment that ” risk of pregnancy is overstated in sex ed so sloppy or no use of birth control that doesn’t result in pregnancy suggests infertility to the person who took the risk. “). When my doc recommended that Taking Charge of your Fertility Book as a birth control method that you can reverse to help conceive…. I realize that was the first time I had any real sex ed. That was the year all of my friends and I were reading and reading such information because while we had had to write papers in sex ed about what we’d do if we got pregnent tomorrow, memorized lists of STDs, flipped through birth control method flashcards, there was no actual explanation of the biology. It was all public health warnings and a bit of a video of someone giving birth… but no numbers around % of days one is fertile, % of people who are/aren’t, how fertility changes with age, … nothing useful to help us understand the basic probabilities and signs and things to look out for.

I almost think that we over protect the young assuming the truth will make them take more risks (“ah well, there is only a 20% of pregnancy if we don’t bother with a condom tonight”) and coddle ourselves as we age (“ah, well I can wait another year, right?”) so we worry less about things that we can’t change. Really, there are so many different situations, the basic human biology in our heads would only help everyone make better informed choices about there particular and evolving situation. Great post mel.. thanks for starting another fascinating discussion.

I know for many of us, there was nothing we could have done. But I also believe that keeping the current state of the art knowledge about how human fertility works from the general population is not a good idea. I much would have preferred an assignment of charting my cycle in sex ed than some of the ridiculous things they made us do and memorize!

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