If you are reading this article, you do not need to be told how devastating the diagnosis of infertility is. I’ve met a few people who had feared that they would have a difficult time conceiving. But for the most part, even if you are approaching 40, the possibility of waning or non-existent fertility is often the furthest thing from your mind. So when the boon is lowered, the shock and disbelief is likely to throw the most stress-hardy into a tailspin. Infertility is an enormous blow to the ego and sense of well-being.

Despite the miracles of modern medicine, treatment is no picnic. Sifting through the treatment options and making decisions in the face of an emotional free-fall is an endurance test, which makes keeping your balance feel like trying to walk normally when the laws of gravity seem to have changed.

In addition to needing the stamina to endure, another difficult aspect of dealing with this crisis is that it is so all-consuming. Females live in their underwear (I should be bleeding but I’m not; I should not be bleeding but I am). Should I buy clothes which won’t fit me if I’m pregnant? Should we plan a vacation when I may need to be at the clinic? How are we going to afford this?

Happily married couples may have gotten away with different or less than optimum coping and communication skills up until now, but needing more emotional resources, and maybe not realizing that you need more resources, can seem like looking up at Mt. Everest. How do we learn what we need to know about coping in ten minutes or less? What if we never have satisfying sex again? Your social world leaves you in a place where other people’s happiness makes you feel sad. You cannot think about the future in a normal way, thereby merging limbo with hell. A highly charged emotional situation is made worse by the typically ongoing nature of the problem and the fact that you must really work at escaping from it from time to time so as not to explode or implode from the pressure.

For most people, the dust settles, and some process of sifting through the rubble begins, with or without psychological guidance but usually with medical guidance. I believe it is part of the human condition for us to find within us even that tiny spark of hope which drives the process toward parenthood. Whether clumsily, or with determination and direction, whether consciously or unconsciously, that hope is accessed and, in a way that is usually not neat, couples make their way. Hope usually looms larger than vulnerability and despair at this difficult time. Even if you do not feel it strongly, hope is what keeps you going. And with the advances in medical technology these days, the majority of couples have reason to be hopeful that they will produce a baby that is either 100% or 50% genetically theirs.

Besides hope, the other factor that drives the engine of the infertility nightmare, is the anticipated rewards despite the trials and tribulations and enormous responsibility of parenthood. For most, those anticipated rewards are sincere and meaningful.

But for some, maybe you, the hope of a pregnancy runs out. Then what? Resolving the infertility crisis demands navigating one dilemma after another. But, the final decision has to do with moving on to adoption or choosing to live child-free. Arriving at which of these two choices to make is the last decision which, while it does not end the life-long process of maturation and facing choices, it does resolve, logistically at least, the ordeal of whether to build a family or not. Once you have made the last decision, you can expect that the emotional residue will linger like the tail of a comet, and will never fully disappear. We cannot unhave our history. But we can work it through and live fully in the present moment of the new reality that your decision yields.

The key to moving on is metabolizing grief and loss. There is much that is attached to this process. There is loss of sharing the process of pregnancy, birth and breast-feeding. There is the loss of the feeling of physical normality. There is the loss of reproducing if you check out physically, but your spouse does not. And what if your spouse is opposed to sperm, ovum or gamete donation but that is your hard-won choice? There is the loss of dreams and the loss of feeling the power to be in control of life choices.

It is hard to see these discrepancies as a problem that belongs to both of you, but it is. It might be hard to navigate your own grief, never mind your partner’s. Whether adoption or child-free living becomes your choice, grieving the loss of reproductive potential is important. But grieving cannot be legislated. It has its own time, space and way for each person. Life gets complicated if spouses grieve at different paces and with different styles. But grieving is healthy and will free you to go to your final choice with an unburdened heart.

Traversing and transforming grief does not mean that you will never have sad moments again about not carrying and birthing an infant. It does mean that you have moved through the grief to acceptance, where new possibilities and new blessings abound. Navigating grief necessitates giving up one kind of hope, but accessing another.

Despite the fact that there are questions to ponder which can funnel you in the direction of your answer, the ultimate answer lies deep within you. Considering these questions is very different from using a recipe. The profundity of this issue does not allow for cookbook answers. These questions will only point you in the direction of the mirror. Your truth will not stare back at you in the form of your face. Rather you must go inside your face, indeed, inside your very being to your inner world – the place where the rough and tumble of your life history and circumstances collides with the essence of who you were born to be. You may be at a loss if you’ve never gotten in touch with that place where your truth resides. Although it may seem like an oversimplification, this can best happen if you can quiet down the mental noise of every day living and listen to that inner whisper. It is important to breathe fully and deeply in an undistracted place – a park, an easy chair with the phone shut off – and be solidly in the NOW, the present moment.

Though only a starting point, these questions may get you past the outside layer of your confusion about adoption:
Am I giving up too soon?
Am I obsessing too long?
Am I stuck in grief?
Do I feel punished because I am not fertile?
Am I so driven that I cannot take a break from trying, and if I took a break,
would I feel renewed energy or would I know it’s time to stop?
Am I being influenced for or against by prejudices of my family or friends?

These are part of the mental noise that, once considered, needs to be put aside so your answer can emerge.

If becoming a parent is the real goal over becoming pregnant, then see if you connect with what a patient said to me many years ago about her adopted child: “We feel as if we could not have done better ourselves and we can’t wait to do it again.” For this couple, the ultimate resolution of adoption was the right one.

The only people I know who abandon their wish for a baby of their flesh and blood and move on to adoption, are those who have a genetically inheritable disease that they do not wish to perpetuate. It’s not that this decision is easy. It’s just that some people in this position feel that the decision is made for them. Almost everyone else who is trying to decide when enough is enough, flops around like a fish in the bottom of a row boat because of the magnitude of the question and the answer. As time goes by, a wrong decision cannot be reversed; one must adapt to it.

Although procreation is genetically driven for all species, human species have a choice. And it is not the right choice for everyone. My number one concern for those of you who choose to live child free, is that you confuse freedom from responsibility with freedom from having been burdened with too much responsibility when you were a child because your parents in one way or another abdicated their responsibility in caring for you. This does not mean that child-free living is wrong for you. It does mean that if you were to work the early trauma through, you might discover that you really do want children of your own.

If you are not in this category, then not becoming pregnant or not finding adoption acceptable could leave you with the conclusion that child-free living is the answer. If it is, it should not be a decision by default. The question that could help to narrow your concerns here is “What would make this a decision that you could choose to embrace?” There is surprisingly little social support for this choice, given that feminism has been around for more than a generation. So in many ways, to arrive at a place where you value this choice would truly feel like swimming upstream. And again, the freedom to embrace your choice depends upon getting past your face in the mirror, to your inner soul where you can really know that the answer is the right one for you.

Most important to gaining clarity about this choice is to realize that generativity comes in many forms, of which procreation is only one. To feel that your life has a purpose and maybe even a passion is the key. Perhaps yours would be the passion of travel and experiencing the broad horizons, intellectual stimulation and excitement that immersion in different cultures can provide.

Perhaps you have a dream that has lain dormant since your childhood, which having a family would preclude. Perhaps you come to realize that freedom to you is more important than responsibility to others.

There are two aspects to making the last decision of the infertility saga that you might not realize but you might find helpful:

First, some decisions never feel like they are 100% right. A decision that is 51% to 49% is still a decision for one thing and against something else. This could be the case with adoption or living child-free. It would be recommended that you honor the 49% or the 30% or even the 1% of you that wants the opposite of your choice and come to terms with it. This may require patience and kindness to yourself and perhaps even seeking out a skilled practitioner whom you can use to facilitate putting the issue to rest.

And second, you may not realize that the challenges of crises and the difficult decisions that go with them would appear in your marriage eventually in some form or another, even if you had been as fertile as a rabbit. In fact, the silver lining in the clouds is that because infertility is so huge an issue, traversing the emotional challenges, sets you in good stead later on in life when other crises strike. Infertility is an enormous opportunity for emotional growth.

The place within you from which hope has always sprung and will always spring is the place within you where the answer to your question resides.

Helen Adrienne MSW, ACSW, BCD specializes in therapy for infertility in the New York City Area . She is certified in the State of New York and licensed in the State of New Jersey. Helen works with a variety of therapies and will also do phone sessions and consultations.

Psychotherapist, Hypnotherapist, Practitioner of Mind/Body Medicine
420 East 64th Street – 1D (East), NY, NY 10021
Phone: 212-758-0125
Website: http://www.HelenAdrienne.com
Email: Helen Adrienne