Clare’s Advice: 14 Things Your BFF Would Tell You About Fertility Treatment

(Submitted by Clare of

Falling pregnant should be the most natural thing in the world, but unfortunately for some of us that isn’t the case. When you want to have a baby finding out you or your partner have fertility issues is heartbreaking, and it can make you feel very alone.

I didn’t know who to talk to when we discovered that it wasn’t as easy as we thought it would be to get pregnant. Luckily my fertility clinic had an online forum set up. Overnight I went from having no one to a whole new list of complete strangers friends who knew exactly what I was going through. Over the following months and years we have experienced each other’s lows and highs through our treatments

I asked a few of them to help me out with this article, and between us we have compiled a list of things your BFF would tell you if you told her that you needed to have fertility treatment.

Infertility BFF

  1. Try not to let it take over your life.  It’s easier said than done, but the more relaxed  you are, the more likely the treatment will be successful.
  2. Be prepared for your mood to be affected by the medication you might need to take, and make sure your partner is prepared too! You might find yourself arguing more than usual, but it’s not you. It’s the drugs talking.
  3. Prepare to lose your dignity.
    • You will have to talk about elements of your sex life with a doctor, in front of your partner and you will also have to undergo a number of internal scans, which can be a bit of a shock the first time.
    • Don’t worry though because once you’ve gone through your cycle, you’ll not care a jot when you’re prodded and poked during pregnancy and labour!
  4. Involve your partner as much as you can. Have him administer your injections (if he’s not too squeamish) and encourage him to attend your follicle scans.
  5. Find someone to talk to, even if it’s a complete stranger on an internet forum. Infertility is a taboo subject, but it doesn’t need to be. I was surprised to discover an old friend was going through treatment at the same clinic as me!
  6. Be prepared for the treatment to be unsuccessful the first time. Sometimes it can take a couple of attempts for the clinic to perfect your treatment plan.
  7. Before you start your treatment sit down with your partner and discuss how many attempts you are willing to have. Once you are on the roller coaster it is hard to have that conversation and think rationally.
  8. Stay away from Google. During your treatment do not look up your symptoms or your follicle count etc. as you will only cause yourself unnecessary stress.
  9. Make sure you are emotionally ready. A treatment cycle can take a toll on you emotionally and is exacerbated by the drugs you have to take.
  10. Once you start your treatment cycle do not make plans for anything. You need to be available to go to the clinic as often as they need you to for scans.
  11. Don’t worry about the embryo scores. A poor quality embryo can still result in a precious baby, and unfortunately a top quality embryo does not guarantee a pregnancy.
  12. Be aware that getting that precious BFP (Big Fat Positive) is just the start. Many of us fell pregnant only to miscarry. Hopefully that won’t happen to you, but as your BFF it’s only right that we tell you.
  13. Be prepared for a number of ‘hurdles’ that you have to cross during treatment.
    • First you have to wait for your period to arrive (and this is the one time she won’t be bang on schedule!), then you have to go through a number of scans as you wait for your follicles to grow.
    • Then the day of Egg Collection arrives and you’ll nervously await your results, how many were collected, how many fertilised.
    • Then there’s the sleepless nights and anxious days waiting for the calls to say how the embryos are progressing.
    • Then there’s the dreaded two week wait as you wait not very patiently to see if you got that priceless BFP.
    • And that’s just the start of it, because if you do fall pregnant you will worry every minute until that baby is safely in your arms. (Then you still worry because then you’re a mama and that’s what mamas do!)
  14. Do everything you can to give your body the best possible chance.
    • Lose excess weight before your treatment.
    • Get fit and healthy.
    • Use acupuncture or hypnotherapy to relax.
    • Take time off work during your treatment cycle if that’s a possibility. Or if you think you’ll get more stressed at home by yourself then go to work but take things easy.
    • There is nothing scientific that says if you don’t drink alcohol, tea or coffee and stay on the sofa after the embryos are implanted that you will fall pregnant, but if you think that will help you then do it.
    • The real key is to do what you can to stay relaxed and keep positive, because remember it’s not over until the fat lady sings!

If you’re about to embark on fertility treatment then we wish you all the luck in the world and hope that you have a positive outcome.

Clare Swindlehurst is mommy to fifteen month old Girl/Boy twin toddlers who are already partners in crime and like to run rings around their mommy! She blogs at and can also be found hanging out on Twitter and Pinterest, looking for activities to keep her kiddos occupied.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

Elizabeth’s Story: Why I Can’t Eat King Cake — Out and About After Miscarriage

From HDYDI author Elizabeth.

It’s Fat Tuesday, 2005. I’m sitting in the teachers’ lounge of the elementary school where I teach. Not in the mood to talk, I’m grading papers as I eat. It’s common knowledge among the staff that I’ve recently had two miscarriages and that I’m still feeling fragile.  From the other end of the table I hear my name called and look up to see the tiny gold baby from the king cake being slid to me.  “Here, Elizabeth! It’s a baby. Now you can be happy!” Everyone at the table claps and laughs. I plaster on a fake smile, pick up my prize, say thank you and spend the next several minutes trying not to cry. Eventually the room clears and it’s only my principal and I at the table.  She grabs my hand and softly says, “They don’t know.” We sit in silence until it’s time for us to leave.

At the time her statement made me angry.  I knew she had suffered from secondary infertility. She often told me that she was praying for me and offered words of encouragement and hope. I trusted her and looked up to her.  I knew she understood my broken heart and her words left me feeling betrayed.   In my mind there was no excuse for the teasing I’d experienced. Their words and laughter were insensitive. They should know better, and she shouldn’t make excuses for them.  I added her comment and the tiny baby to my ever growing list of things that hurt and offended me.

My list was long and varied.  All pregnant women, all women who had been pregnant or thought about being pregnant, ads for baby items, ads including babies, strollers, car seats, cars with strollers and/or car seats were all on my list.  Also included were baby showers, first birthday parties, the colors pink and blue, the word bump, and comments such as : “I’m a mom.” and “I have kids“.  Everywhere I looked I saw babies, families, and pregnant women. It seemed that every conversation centered around babies, and stories of labor and delivery. I felt left out and slighted.  Every comment was a slap. I took it all to heart and every bit of it personally.

A heart broken by infertility colors the world.

Five kids and eight years later I have the gift of perspective.  It’s obvious to me now that my broken heart colored things. My sweet friend was right; unless you have encountered infertility or loss you can’t know.  It’s an experience that requires grace in order to survive. You must give it to yourself and extend it to others.

Be gentle with yourself. It doesn’t matter how long you grieve or how angry you get. You feel how you feel. Embrace it. It’s ok to skip the baby shower and to look away from the pregnant women you see.  Just as important is making the decision to believe that people mean well.  For the most part people care and really don’t intend to be hurtful. Give them the benefit of the doubt.

While I still dislike king cake, I’ve made peace with the little gold baby living in my jewelry box and the people who gave him to me. Unlike the truly insensitive colleagues that planned another teacher’s baby shower in front of me, I know the “king cake crew” was just trying to make me laugh. I wish I could have saved my tears for the times that truly warranted them. I know that my journey would have felt a lot less lonely.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

Stacey’s Story: Coping with Infertility

This story of her path to parenthood comes from Stacey Skrysak. She gives voice to the many silently coping with infertility. This post was originally published in June 2013 when Stacey was expecting her triplets, Parker, Abby and Peyton. Stacey is a news anchor, MoM, and loss survivor. You can find her blogging about life with her surviving triplet at Perfectly Peyton.

It’s a topic that people don’t really talk about, infertility. For some reason it’s a taboo subject, yet so many people go through it. So why am I sharing my personal struggle? This isn’t a pity post… it’s not a “woe is me” moment. I want to share my story to help others going through a similar situation. Looking back at the last few years, having people I could relate to made my journey so much more bearable. Now I know the way that I got pregnant might go against some people’s morals, but I’m OK with not everyone approving. I am finally pregnant and happy to shout it from the rooftops!

Anyone that knows me would tell you I’m a strong girl. I’m happy and positive about 90% of the time. And while I wear my heart on my sleeve, I never want sympathy. I simply brush off anything that has happened to me as no big deal. But after years of heartache, I finally reached a breaking point. I remember visiting our close friends in Michigan last fall. When the topic of pregnancy came up, I cracked. I broke down and cried to them. Not just watering of the eyes. I’m talking big fat rolling-down-your-face tears. After years of telling people I’m fine, I finally realized it’s OK to let your friends in on your problems.

So how did I get to this point?

About three years ago I went in for a routine exam. A few days later I was in the hospital for surgery, missing parts of my ovaries due to massive cysts. The recovery was a long and painful process: 6 weeks at home recovering and complications ever since. Our doctor thought we should start trying to get pregnant, so I went on fertility drugs. No luck. I have had a surgery every year since then because my body just doesn’t want to heal. So on top of chronic pain, I was having trouble getting pregnant.

It’s funny… you spend so many years worrying about getting pregnant. I never thought in a million years that I would have trouble when I was ready. But month after month, that pregnancy test came back negative. And every month, my heart sank a little deeper. It became such a routine—I’m probably one of the few people that actually clip coupons for ovulation kits and pregnancy tests! (Yes, I’m a frugal shopper!!!)

Over the years I went through a roller coaster of emotions. It started out as frustration, then I started taking pity on myself. Why did God deal me this hand? So many nights I would lie awake as Ryan was sleeping next to me, sobbing in the dark. I was meant to be a mother, so why wasn’t it happening? I would cry because I didn’t understand why I was the one chosen to have neverending health problems. I would cry because of the financial burden of ongoing hospital bills. I would cry because I felt like no one understood. I would cry because I felt empty. I had a wonderful husband, a dog we treated as our child, yet I still felt all alone and empty, sinking further and further into a deep pit of sorrow.

And let me tell you, Facebook is not a place to be if you’re struggling to get pregnant. I’m in my 30′s, so just about everyday, an acquaintance was posting their wonderful news. Every time I saw a post like that, it was a blow to my gut. I would turn red in frustration and tear up. I’m not a person that gets jealous, but deep down I was. It is such an amazing moment in life… getting to share your pregnancy with your friends. And while I was genuinely SO happy for all of those people, I would cry because it wasn’t me. I’m not proud of that. I was secretly jealous, feeling like such a bad person. With years of trying, even my close friends would fear having to tell me their exciting news. And that, too, would break my heart.

Last summer, our doctor told us he thought we had an 8-10% chance of getting pregnant on our own. Rather than going through each option of fertility treatments, he thought it was best to go straight to IVF. So we signed up in the fall and had a few months of anticipation.

It was an exciting time, knowing that we finally would have a decent shot, but it was also a time of anger for me. I had already spent tens of thousands of dollars on medical bills and surgery, only to find out my insurance does not cover fertility treatment. WHY?!?! So, after hearing wonderful news that IVF might work, we have to scrounge up $10,000-$15,000 to pay for it? People get pregnant every day by accident and couples who are not trying end up with an “oops” child. Yet, I’m someone who longed to have a child and had to pay thousands of dollars just to try. It didn’t make sense. It still doesn’t.

The part that made me even more angry is that I live in a state where it is mandated that insurance companies cover the cost of fertility treatment. But, there are enough loopholes that most companies don’t end up paying.

Ryan and I began IVF at the beginning of the year. I won’t bore you with the details, but I can tell it is an emotionally trying and sometime painful process. You don’t just pay up and instantly have a child. I gave myself daily shots, my hormones went through the roof and I went through a lot of pain, not to mention the stress of whether it would work or not.

Needless to say, we were SO lucky. I am pregnant with triplets from our first round. So many couples go through it time and time and get with no luck. I had the best experience at the SIU fertility clinic in Springfield IL. Dr. Loret de Mola works magic. Plus his staff made my husband and me feel like we were all family.

As I write my story, tears are rolling down my face as I think back at all of the heartache over the years. But every time I see the babies’ heartbeats, those tears slowly turn to tears of joy. So what’s the moral of the story? I may be missing parts of my ovaries and have tubes that are blocked, but look at me.

I’m pregnant. What seems to be impossible can happen.

If you’re reading this and have gone through a similar situation, there are ways to get help. There are grants out there for financial help, as well as support groups. Just send me an email and I would be happy to help! May 7 is Advocacy Day. It’s a day where thousands of people will bring up the issue of infertility to Congress and raise awareness about the need for accessible medical treatment. Just look at Resolve’s website for more information.

For more of Stacey’s infertility story, read her more recent post “Infertility Woes“.

Thoughts on coping with infertility from a mother who has been there.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

Martha’s Story: Miscarriage, Blocked Fallopian Tube and IUI

This story comes from HDYDI reader Martha.

Our fertility story started about four years after we were married.  We tried for months on end with no results. Resorted to peeing on sticks to see just when the right time was. After about a year and a half of that I was finally pregnant.

I remember thinking—I’ve never told anyone else this to this day—I remember thinking, “I wonder how long will this last?” Self fulfilling prophecy? Probably. I miscarried right at  6-8 weeks, the very night we had people over for the Super Bowl and announced my pregnancy.

I remember passing that baby into the toilet. It’s brutal, but it’s the truth.

My doctors told me that since I had gotten pregnant I should keep trying.  Fast forward a year and still no more pregnancies. So we decided to see a fertility specialist. I was “advanced” in age according to fertility docs so it didn’t seem like a crazy idea.

IUII had a procedure to check everything out to make sure everything was working ok. It turns out that I had a blocked fallopian tube. It  was blocked with some body tissue, nothing that was a problem. They blew it out of there with some compressed air.

Did you know that you don’t always ovulate from alternating sides each month? You don’t. I was ovulating most often from the side that was blocked, hence the no pregnancy thing. Well, that made the most sense in the whole world!

Hallelujah!!! Now we can get pregnant!

But there was still nothing after a few months, so we opted for IUI. Our first round of IUI was supposed to be a trial run. I had no idea what we were getting ourselves into and didn’t know what to expect.

I did the injections. My faithful husband did his work with the cup. On the day of the insemination we happened to have tickets to a concert at the Erwin Center [large performance center in Austin). We went to the doctor, I got inseminated (totally not thinking this would work given the odds!), we went to Scholz Garten and drank a few beers and went to the Erwin Center to watch a concert. On the walk there I was visibly uncomfortable: the hormones they had given me to inject to induce ovulation had kicked in and I could feel it in my bones. The beers did nothing to hide the pain!

Flash forward a few days.

After my blood test following insemination, I heard “Congratulations! You are very pregnant!!!” said the nurse. Huh? Just how pregnant? My hormone levels were three times those of normal single pregnancies. I was freaked out!!!! I had done IUI. I knew that at the time of insemination I had ovulated four eggs. WAS I PREGNANT WITH FOUR BABIES???????

I was constantly nervous for the weeks that followed until we found out how many babies we were having. I knew it could have been four. The hormone level was that of three.

As I sat in the waiting room that day I wanted to vomit, I was that nervous. We were led into the exam room and the doctor did the vaginal ultrasound and announced that we were having…twins!!!  Oh thank the good Lord in Heaven! I was worried about three or even four!  At the time I thought, “Twins, I can handle.” And we have.

That was 9 years ago. Our twin boys are happy, healthy, smart, and funny. They make good grades and have friends who complete them. They are each others best friend 98% of the time, then they fight.

I wouldn’t trade the experience for a million dollars. Our twins were meant to be. They are perfect in every way. And our family is completed in every way because of them.

People ask me “How did you do it?” and my answer is always a stupid, “We didn’t know any better.”

Those of you expecting multiples know this: do not worry about the details. You are the parents of multiples. You are blessed beyond belief and God will lead you through this, whatever your situation needs.

Take one day at a time and enjoy your little babies because one day they will grow up and it will all be gone: that sweet baby smell… the naps… the nice kids…. Mine are 9 now and they stink. Boys just stink. They sweat: it happens. But one of my twin boys is as tall as my chin and he’s only 9!

What will the next 9 years hold? I can only hold my breath and wait.  Because it’s gonna be a great ride!!

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

On Anonymity and Infertility

(This post was submitted anonymously.)

Over the course of this week, several writers will be posting anonymously. I am one of them.

In some ways, I feel guilty about staying behind the curtain.

I hate that infertility can seem like such a taboo subject…a subject that nobody talks about, and when they do, it’s often in whispers. My keeping quiet is doing nothing to promote the cause that speaks to my core.

I am so thankful to those who speak on behalf of this cause, but I can’t be one of them.  Not right now.
Anonymity and infertility. The taboo is hard to break.

I am so very proud of our twin daughters, ultimately conceived via IVF, after many rounds of fertility treatments. I am proud of our journey. And I am so thankful for our team of doctors and the medical advances that made possible our family of four. In many ways, I want to shout from the rooftops, “Look what we did!!!

But I choose to keep these details private. Only a handful of close friends know, and a couple of family members.

See, I grew up in a pretty conservative area. One conversation sticks out in my mind, having heard it spoken of a family in my hometown who underwent fertility treatment when I was growing up. She was pregnant with triplets, and lost them when she was five or so months along. “If the Lord wanted her to be a mother, He’d have given her the chance. Some things are just meant to be. We’re not meant to mess with fate.”

That cuts deep. It’s something, even more than 20 years removed from, that I can’t shake.

I didn’t want to open myself up to the judgment.

And even now, having long ago moved from that very conservative area, I’ve still heard people utter phrases like “test tube baby”. I’ve had a handful of people remark to me in the grocery store, “Are they natural? You know everyone is having twins these days because of the things those doctors do.”

I can’t risk having that said of my girls.

One day, I will tell my girls the story of our journey. They need to know, in case there are genetic links to the problems I encountered. And I want them to know how very deeply their daddy and I wanted them…how, when I tell them now, “You were always in Mommy’s heart,” it was that resolve that kept me focused on the prize. I never lost faith that I would hold my children in my arms.

But I want to be the one to determine when the time is right for that conversation. I don’t want them to be scurrying around the playground while some Nosy Nelly whispers to her girlfriend, “Those girls aren’t natural.” I don’t want the next-door neighbor’s kid to have overheard our story and tease the girls, “You’re a test tube baby.” I hope these are far-fetched scenarios…that people have moved beyond such judgments…but I can’t be certain.

In the meantime, I’ll continue to respond to the random, “Are they natural?” questions…the continued inquiries from my uncle, “I just can’t believe it! Twins just don’t run in our family!

My standard line? “Yes, we got lucky. Very, very lucky.” Because we did.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

How do you do it? Parenting Link Up #21

Skip to this week’s links | Skip to featured posts | Skip to linkup rules

Welcome to the How Do You Do It? parenting link up party. Here, you have an opportunity to share your posts with other parent bloggers and the followers of How Do You Do It? and What’s up Fagans?.

How do you do it? is a community of mothers of multiples that believes in supporting each other, in sharing our experiences and questions, in friendship, and in encouragement. The link up is open to all of our readers, whether you have multiples or not, where you can share your wisdom, your favorite posts, your insights, with our online community here at HDYDI and What’s up Fagans?.

Each week, we pick some of our favorite posts and feature them the following week on our site! Plus, we pin them on Pinterest, tweet them on Twitter, and share them on Google+ and Facebook! Get some more exposure for your great content, and don’t forget to check out the featured posts from last week’s link up!

Plus, ldskatelyn of What’s up Fagans? is co-hosting our link party on her blog as well. One party on two blogs means double the exposure and community.

Each HDYDI parenting link up party accepts new links from Monday morning through Friday at noon.

So tell us: How do you handle conception, pregnancy, prematurity, birth, and postpartum recovery? How do you handle tantrums, diapering bills, stress, and potty training? How do you handle education and special needs? How do you balance the needs of several children with a marriage? How do you manage being a stay-at-home mom, a working mom, or a single parent? And how do you find time for yourself?

How do you do it?!

This week’s featured posts:

tips for expecting and new moms of twinsOur most clicked link from last week was from Christina of My Twin Lady Bugs. She shared part one of three about life with newborn twins, because it really is such a whirlwind that first year! Her tips for expecting and new moms of twins are spot on.

what-to-do-when-you-need-a-break-as-a-momBarb of A Life in Balance has been feeling stressed and overwhelmed by life lately. As moms, as women, that is just sometimes our reality, so I loved reading her awesome tips and advice for getting through those time when you just need to stop doing life.

20 fun spring activitiesSpringtime is here! What memories are you creating for your kids this year? The Lou Lou Girls are sharing 20 fun things you can do. Check it out and start having a great time with your family.

If you were featured above make sure to grab our featured button and display it proudly on your blog! How Do You Do It? Featured Post

Parenting Link Up Party

Rules for the How Do You Do It? Parenting Link Up Party:

  1. Follow and connect with HDYDI on the social media platforms that you use. Facebook | Twitter | Pinterest | Google+ | Blog Lovin
  2. Follow and connect with What’s up Fagans? on the social media platforms you use: Facebook | Twitter | Pinterest | Google+ | Blog Lovin’
  3. Link up to 3 great parenting posts below! Please, no recipes posts! Of course, link directly to a post, not your main page. Also, under “name” put the title of your post.
  4. Check out at least 3 other links! This is a party, so mingle!
  5. Leave an awesome comment for those you visit and tell them you found them at the HDYDI link party! And pin them/share the posts that you really like.
  6. Tweet: Add YOUR #parenting #advice to @hdydi's #linkup! Tell everyone #howdoyoudoit! #motherhood #momwisdomTweet about the link party, pin our link party badge, share it on Facebook, or otherwise promote this party! The more the party grows, the more exposure your posts will receive, the more fun you’ll have, and the more encouragement and ideas we’ll all receive!
  7. HDYDI Parenting Link Up PartyPut How Do You Do It?‘s Parenting Link Up badge on your site! Put it in your side bar, at the bottom of the post you shared, or on a party page!

Sadia’s Perspective — On the Outside Looking In: What Infertility Means

Infertility from a fertile woman's perspective. You can't really understand if you haven't been through it.

I don’t really know what infertility means. I know the science and biology of it. I’ve witnessed the emotion and pain of it. But I’ve never experienced it. I don’t really know.

When we at How Do You Do It? decided to put together this week’s posts, to lay bare how infertility is a very real part of mothers of multiples culture, I volunteered to coordinate things. Because that’s what I do.

As I sat down to write the post calling for submissions, however, I found myself stumbling. Instead of the smooth way in which the words usually pour out when I’m blogging, I found myself writing in pained spurts. I was pondering the right words, getting up close and personal with the Backspace key, even folding laundry, hoping a break would bring me the right way to phrase what I was trying to say.

I needed words that acknowledged the uniqueness of each infertility experience, the sense of kinship within the infertility community. The fact is, though, that I’m not part of the club and will never really understand. Then I realized that it’s because I’m not part of the club that I don’t have the words. As a mother of multiples, terms like “singleton,” “NICU,” “mono/di” and “fraternal” just slip off my tongue, but I’ve never really lived in the infertility world.

So I did my best as an outsider.

“… many of us have suffered from infertility.”

No, that’s not right. Suffering is a passive state. I know many of these men and women. They’re fighters.


“… many of us have fought infertility.”

That doesn’t work either. Do you fight infertility? Treat it? What about parents who went straight to adoption after trying to conceive didn’t take? They accepted infertility for what it was and came up with a Plan B.


“… many of us were infertile.”

Ew. No. Being infertile isn’t a core human characteristic, like being blonde or short.


“… many of us walked the path of infertility.”

Okay, Sadia. You’re a wordy kind of girl, but this is getting ridiculous. And is the past tense even appropriate? Do you really stop living with infertility when you finally have your child? Do you begin to consider yourself to be in the fertile camp? Are “parent” and “infertile” opposites? I imagine that for some parents, they are. For others, they’re not.


“infertility has been part of the journey.”


That’ll have to do. It gives infertility too much agency, but perhaps that’s right. Perhaps infertility becomes the third wheel in the relationship. And “journey” is good. It doesn’t require an end to have been reached yet, but allows for it.

Walking around the world as a mom of twins, it’s impossible to be unaware of infertility. Even if I never hung out with other MoMs, the strangers on the street would never let me forget. “Are they natural?” they ask, so often.

It’s such a loaded question: “Are they natural?” I know it comes from a place of curiosity. I know it comes from a vague knowledge that fertility treatments have led directly to an increase in multiple births. I know they don’t mean to ask whether I’m part of the Infertility Club. If they knew anything about the Club, they would have chosen different words.

Because children conceived with medical assistance are as natural, as miraculous, as extraordinary as my spontaneous little ones.

I don’t even know what to call myself. I don’t know what those of you in the Infertility Club call those of us on the outside. What do you call those of us who conceive spontaneously, easily, some even by accident?

I can love you. I can support you. I can cry with you. I can even lend you my womb. But I will always be on the outside looking in.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

Infertility Terminology

It seems so simple at first blush. Infertility means that a couple who wants to get pregnant just can’t. As soon as you start to dive a little deeper, though, the acronyms and jargon start flying. Secondary infertility. IVF. IUI. PCOS. TTC. Now you have to wade through both infertility and alphabet soup to have your baby.

In this post, I try to shed a little light on these terms, especially since you’ll see a lot of them here on How Do You Do It? over the next week.

Infertility Terminology

Non-Medical Terms

Hop onto any (in)fertility-related message board, and you’ll see these acronyms in use:

  • TTC: Trying to conceive. When a couple is TTC, the woman will often…
  • POS: Pee on a stick. Take a generic pregnancy test. A lot of women do this many times before seeking help from a fertility specialist. And that brings me to…
  • BFP: Big fat positive pregnancy test, whose less popular relative is the…
  • BFN: Big fat negative pregnancy test.
  • You might also wonder what secondary infertility is. I did. It’s an inability to get pregnant after delivering one or more kids without…
  • ART: Assisted reproductive technologies. ART covers pretty much all methods of conception beyond sex without contraception.

Medical Terms

Infertility, from a medical perspective, is defined as:

  • An inability to get pregnant after 12 months of trying (regular unprotected sex), 6 months for women over 35 years old. OR
  • Two consecutive miscarriages, or pregnancy loss in the first half (20 weeks) of the pregnancy. The death of a baby between 20 weeks and birth is called stillbirth.

12 ovulation cycles with no pregnancy to show for it can feel impossibly long, but that’s the official definition. Plenty of couples know there’s something wrong well before the 1-year mark, and kicking off the process of diagnosis doesn’t have to wait a full year of TTC. And the loss of one pregnancy can bring you to your knees, forget about two.


The first step in seeking out assisted reproductive technologies to overcome infertility is to get a diagnosis. This involves a lot of testing. The first step is to narrow down whether one or both partners is infertile. When the infertility diagnosis is the woman’s alone, this is called female infertility or female factor infertility. When the male is diagnosed, it’s male infertility or male factor infertility. Not infrequently in infertility testing, both partners are diagnosed with some reproductive problem. Unfortunately, even more frequent is unexplained infertility, where doctors can’t identify the source of the problem. The symptoms of unexplained infertility can be treated, but since the underlying cause isn’t understood, it can’t be specifically addressed.

The Process

Some of the tests include:

  • A hysterosalpingogram (HSG) is an X-ray of the inside of a woman’s uterus and fallopian tubes.
  • A hysteroscopy is a way to look at the lining of a woman’s uterus. The viewing tool is inserted through the vagina and up into the uterus.
  • Laparoscopy is surgery that allows a doctor to insert a lighted tube into a woman’s pelvis through an incision to look around. This is commonly used to definitively diagnose endometriosis.
  • Pelvic exams are standard, and most women are encouraged to have one every year. The doctor examines your vulva, vagina, cervix, uterus, fallopian tubes and ovaries visually and by feel.
  • Semen analysis is the examination of a man’s semen for how many sperm there are and how they move.
  • A sperm penetration assay (SPA) checks whether a man’s sperm can join with an egg.
  • Transvaginal ultrasound allows a doctor to see a woman’s ovaries and uterus. The ultrasound wand is inserted in the vagina. This procedure is also common early in pregnancy when abdominal ultrasounds don’t provide a very good image.

The People

A number of different medical specialists can participate in diagnosing and treating infertility

  • An andrologist is a doctor who specializes in male fertility.
  • You probably already know your obstetrician/gynecologist (ob/gyn), the doctor who specializes in women’s health, especially pregnancy, childbirth, and reproductive disorders.
  • Reproductive endocrinologists (REs) are specialists in the hormones related to reproduction.
  • A urologist, or genitourinary surgeon, is an expert in both male and female urinary tracts and male reproductive organs.


Common diagnoses for infertility include:

  • Endometriosis is a condition in which a woman’s uterine lining tissue (endometrium) grows outside the uterus. This tissue can cause blockages. There can be huge variation in how and where the tissue grows and exactly how it contributes to infertility.
  • In an ovulatory disorder, a woman’s ovaries do not consistently release eggs. Clomid is a common medication prescribed to encourage ovulation.
  • PCOS (polycystic ovary syndrome) is a condition in which a woman grows small cysts in her ovaries and has hormonal problems. PCOS can have a wide array of health consequences in addition to infertility. A low estradiol or E2 level can indicate PCOS.
  • A varicocele is an enlargement of a vein in a man’s scrotum, kind of like a varicose vein.


  • Intrauterine insemination (IUI) is the placing a man’s sperm inside a woman’s uterus. This is a relatively straightforward and simple approach to tackle infertility.
  • In-vitro fertilization (IVF) is the fertilization of a egg in a laboratory, followed by transfer into the mother’s uterus. Several steps are involved.
    1. Controlled ovarian hyperstimulation with follicle-stimulating hormones (FSH) encourages a woman’s ovaries to produce multiple eggs ready for fertilization. The trigger shot is the final dose of medication that sets ovulation in motion.
    2. Egg retrieval uses vaginal ultrasound to locate the eggs and aspiration to remove them from the woman’s body.
    3. Sperm retrieval usually takes one of two forms.
      • Most often, the man provides his own sample through ejaculation. I don’t think I need to explain that here.
      • Testicular Sperm Extraction (TESE) is a surgery to retrieve sperm directly from the testes.
    4. Sperm washing separates sperm cells from seminal fluid.
    5. The sperm are mixed with the eggs in the lab and allowed to fertilize them.
    6. Laboratory staff examine the fertilized eggs after they’ve divided a few times for embryo quality. Each embryo is given a grade between 1 and 4, where 4 is in the best shape to grow into a baby.
    7. In embryo transfer, promising embryos are placed in a woman’s uterus , in the hope that at least one will implant in the uterine wall and grow into a bouncing baby.
    8. Viable embryos that are not being immediately transferred can undergo embryo cryopreservation, being frozen for future use.
  • Intracytoplasmic sperm injection (ICSI) involves the direct injection of a man’s sperm into a woman’s eggs. This is done in a laboratory in place of just mixing the eggs and sperm and letting them do their thing.
  • Sometimes, the mother isn’t a good candidate for embryo transfer. In this case, the parents-to-be may opt to use a gestational surrogate, a woman who will accept the embryo transfer, go through the pregnancy of behalf of the mother, and give the baby to his/her parents after birth.
  • Parents with frozen embryos in storage may decided that their family is complete or otherwise choose not to transfer their remaining embryos. In such a case, the couple can choose to participate in an embryo adoption, where they give their embryos to another parent to transfer, gestate and raise as her own.

After the Procedure

As you might expect, after working this hard to help an infertile couple become pregnant, doctors monitor the woman very closely to determine whether she has, in fact, become pregnant.

  • Clinic pregnancy tests are far more sensitive than the home POS kind. Medical staff will draw the woman’s blood and measure her human chorionic gonadotropin (hCG) level. An hCG level of over 100 is considered to be positive test result. You may also see hCG test referred to as beta hCG or just beta.
  • Multifetal reduction is the controversial practice of decreasing the number of fetuses in a woman’s womb to increase the chances of a healthy pregnancy for the remaining fetuses. This is usually considered in higher-order multiple pregnancies, of triplets or more, due to the high chance of premature delivery and related complications.

What other terms have you encountered in fertility clinics?

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

From the Archives: Infertility

This week isn’t the first time we’ve touched on infertility on How Do You Do It? Check out these posts.

General Thoughts on Infertility

Personal Stories that Feature Infertility

  • 10 Week Newbie: felt increasingly marginalized as she was suck deeper and deeper into infertility treatments, but on finally achieving pregnancy with twins, the MoM community felt like home.
  • Recovering from Infertility: Even as the mother of 16-month-old twins,  feels the sting of infertility. This is her infertility tale. In Random Ramblings, she thinks about what it would take to grow her family further.
  • On the other hand, has put infertility behind her, she tells us in Am I a Fraud?
  • In Inseparable, Carissa tells the story of how her boy/girl twins joined her family through international adoption, following years of failed attempts to conceive.
  • Triplets: Angela’s Story:  conceived triplets after 3 years of infertility and two miscarriages, only to lose her son Carter as a newborn.
  • On the Clock: compares the cyclical natures of infertility, pregnancy and parenting infants.

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.

Infertility Blog Link Up

Have you blogged about infertility on your own blog? Please share your links so others can know your story.

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Stories of infertility on How Do You Do It?

Infertility Link List

Infertility TalesThis post is part of Infertility Tales 2014, How Do You Do It?‘s series to raise awareness about infertility and its impact on families. Please take a moment to read through some of the personal stories of loss, pain, fertility treatments, and success.