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Sunday, February 25, 2007

Infertile Enough

There are a few different branches of our library system and I go to each one for a different reason. One has the best selection of cookbooks and new DVDs. Another is close in location. And my favourite contains the medical library which is where I get all of my light reading on PCOS or recurrent pregnancy loss. The medical library also happens to be situated in an orthodox Jewish neighbourhood, therefore many of the patrons are orthodox and enter the library with the obvious signs and symbols: long skirts, hats or wigs, tzitzit hanging out.

And this probably speaks more about my own insecurities, but when I see orthodox women walking through the library, I have an urge to tell them that I'm Jewish too. My method of choice is to position myself near them and then begin speaking loudly about the challah I have to complete at home or how I'm going to the kosher butcher after this stop at the library (saying these things to another person--not just shouting them out to the library in general. Er...). I feel this need to do this because my observance isn't outwardly obvious. Yet even though I'm wearing brown cords and a sweater and my hair isn't covered, I do many of the same Jewish traditions as these women. In function, our houses probably don't operate that differently. But in form, they differ greatly. But at the end of the day, function and action win out over form in my world--I have mezuzot on every door of the house, I keep Shabbat, I keep a kosher home.

Sounds pretty observant, right?

But sometimes when I'm having a low-self-esteem day and I'm standing next to the orthodox women, I don't feel Jewish enough. I know in my heart that I'm still Jewish even if I choose to wear pants. The fact that they choose not to wear pants doesn't make them more Jewish. Their overt signs of Judaism don't detract from my observance of Judaism. Right? Yet I still feel this need to let them know that I'm Jewish, perhaps because I am waiting to see if they accept me as Jewish.

And I'm not the only person who plays the am-I-Jewish-enough game. I was standing in the library Friday morning, speaking with a friend about how I had to get a move-on with making hamantaschen for Purim, a holiday coming up in another week or so. An older woman next to me leans into our conversation and says, "I used to make hamantaschen every year, but now I just buy them. Too much work."

She doesn't really give a crap about hamantaschen (at least, this is my assumption since how many of us actually give a crap about jam-filled cookies?), but what she wanted me to know from overhearing my conversation is that she's Jewish too. And on the sliding scale of observance, I'm looking more observant than she is in this moment. Because I'm speaking about the upcoming holiday whereas she's talking with her friends about the latest romance novel that she read. If this were the old version of the SATs and they still had analogies in the verbal section, I would be to this woman what the orthodox women are to me.

We rank.

That's what humans do.

And we do it in infertility too. The driving force behind the pomegranate-coloured thread was to establish our commonality. We all go through our journey differently, but we all have this common thread of infertility or pregnancy loss. That's the other thing that humans do: we make connections, we let people know that we belong. But once you establish community, it feels like our inner insecurities automatically kick in and people begin wondering: "do I really belong?" as well as "do other people think I belong?"

Some of it comes from the same place as comparative Jewishness: while there are some general guidelines for establishing whether someone is Jewish, there are other factors that are more fluid. In Conservative Judaism, it's completely acceptable to wear pants. In Orthodox Judaism, not so much so. Therefore, someone Orthodox may look at me and say, "damn, she isn't that observant." Whereas someone in Conservative Judaism may look at me and say, "damn, the chickie makes her own challah every Friday? She's pretty observant."

You see what I mean?

I write this because this topic keeps coming round in many forms with the common refrain being, "I don't know if I belong." I've written about this before, but it really saddens me when I see people second-guessing. Infertility and loss is difficult enough without people wondering if it's appropriate to ask for emotional support.

Like Judaism, there is a definition for infertility. According to RESOLVE, "Infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages." For women over 35, the accepted time frame is six months and "multiple" miscarriages generally refers to three, though there are doctors who begin testing after two (or even one depending on the circumstances).

Which would follow that if you have had a year of earnest bonking or home inseminations, you are infertile. It doesn't matter if you've decided to continue trying on your own or if you've decided to go to the RE: you are still infertile. And it doesn't matter if you've been told to go directly to IVF and do not pass go, or if you're first trying some lower impact solutions such as Clomid: you are still infertile. A person who has chosen a different route is not more infertile just as those women I see at the library are not more Jewish. In both cases, the two people belong to the same group and it's simply the chosen path and the fine details that differ.

Beyond that, I think that the emotions of infertility are broader than the medical diagnosis. Under the standard definition of infertility, a lesbian couple who is undergoing IVF in order to transfer the eggs of one woman into the womb of another may be going through the emotions of infertility after the first or second failed cycle even if they haven't been trying for over a year. Fertility treatments are a roller coaster and other factors come into play in that situation. Therefore, in my opinion, they belong. Secondary infertility where the woman conceived her first child on the first try, but has now been trying for over a year to have another? She belongs. A woman who has tried for four months and is currently stressing out because her friends all became pregnant on the first try? Not so much so. It's a flexible definition, but even flexible definitions break if you bend them too far.

I guess what I'm trying to say in apparently the longest way possible is that if one considers the emotional journey to be just as valid and important as the medical journey, many more people can fit comfortably into the world of infertility and draw necessary support. And subsequently, if there is a diagnosis written on a medical chart somewhere, you are infertile enough--even if you look at other infertile women walking around the lobby of the clinic and wonder if their journey is ten times more terrible than your own. Regardless of the decisions you make and the choices that are influenced by outside factors, you are infertile. Therefore, in my definition, you belong. And you can ask for emotional support. And you can receive it.

I am having a difficult time ending this post. I know this is my personal opinion and I can't speak for the entire community. But I'd like to believe that as a whole, we are empathetic and inclusive. Right?


Larisa said...

I tried to allude to this in a recent post of mine ("it all sucks"). You've done a better job of more clearly stating it. I think, for the most part, we are an inclusive and welcoming community. But there is comparison sometimes - and though I don't think people mean to hurt each other - sometimes things are written that are dismissive.

It all sucks.

pamela said...

I'm in the process of writing a post that touches on this same issue. It's a sensitive one, no doubt about it. Thank you for raising it once before and's something that needs to be raised, I'm guessing, on a regular basis as new people enter and circumstances change for others. Life is anything but static and we all need reminders.

Tanner said...

It's great to learn about the string. Did you go with 814? I'll have to find it! Thank you for sharing and organizing these things. It's really good to know that you are not alone.

Frances said...


May said...

Damn, but this post made me cry. Excuse me, must get a tissue.

OK. H and I have been 'trying' officially for 16 months now, but I was diagnosed with PCOS when I was 21, and lost an ovary when I was 18, and have always, always known I would so not get pregnant as soon as I came off BCP (which I was taking to control the rampant PCOS mustachios in the first place). I got a very negative response from several women on the first trying-for-babies message-board I joined. I wasn't infertile, I'd only been trying six months. I hadn't had Clomid or IVF or IUI yet. I basically ran away from that board and hid.

After a year, and with added persistant bleeding, I still occasionally feel some people don't see me as a 'real' infertile (well, my family, for a start, seem to think I'm 'doing it on purpose' and 'exaggerating'). So what if I've ovulated once in an entire year? So what if I bleed for weeks on end? I haven't tried IVF or Clomid. I don't count.

The blogs, however, oh, thank heaven for the blogs. Yes, there are indeed as many different meaningful types of infertility situations as there are women.And though some people prefer to create heirarchies of suffering and validity, most don't.

And that helped me feel less fraudulent.

decemberbaby said...


You're one of the ones who initially made me feel like I had a right to consider myself an infertility blogger.

And BTW, anytime I've actually talked to Orthodox women about feeling like a fraud or feeling out of place anytime I shop at Kosher City or the frum (religious) lingerie store, they all say something like, "don't be silly! We're all Jewish, we're just on different places on this path. And I think a shabbos robe looks lovely on you."

Thanks for posting this... it really made me think, on both counts.

Cathy said...
This comment has been removed by the author.
Cathy said...

Thank you for this post.

Even now, I'm still struggling with if I belong to this community. I read so many blogs, but never comment, and I'm even having trouble commenting here. Afraid that maybe I don't belong.

Who, me, infertile? Nah. We barely even started ttc. But why then were we sent to the RE so soon, and why is the RE saying IVF is our only chance?

I think if there are feelings of exclusion, some of it may be born of jealousy. Jealous that treatment seems so "simple" for some couples. Jealous that a diagnosis was given so "easily" or quickly to others. Jealous that someone else is moving forwards, while you yourself cannot.

But overall this does seem like a supportive community to be in, and if you've gotta be stuck in this boat, at least there's good company.

Elizabeth said...

I think that definitions and ranking are general human proclivities, but find particular potency in our culture. From the time we're in pre-school we're taught to sort and rank things in groups and hierarchies (first by shape and color, then successively into more complex arrangements). I applaud the inclusivity of your approach as it validates the subjectivity of our individual journeys. And creates a safe place where we can just feel our own hurting.

On a lighter note - I married into a progressive Mennonite family, and have found that whenever my husband and I see conservative or "old order" Mennonites in public places I always want to run up to them and "identify" myself as "Mennonite too," even though I'm not wearing a head covering or other visible marker of identity. So I could relate to that part of your story too :-)

Jess said...

I agree, and I really think that our community here, the blogging community, does a WONDERFUL job of being inclusive to all women (and men!) suffering from IF in all its forms.


Sunny said...

Oh I so love this. I have been dealing with these same thoughts lately. I know that I am an infertile but I wonder what others think since I haven't started IUIs or IVF yet and it has been 4 years. I feel judged but it is me judging myself.

I am starting a small group for infertility. I want the group not to be a place to one up one another but to take each others journey with love and compassion and understanding. It sure is hard though.


Samantha said...

I think you have so aptly described it because everyone's experiences of infertility are so individual, from how long we've been ttc, to diagnoses and doctor's visits, to treatment decisions, to how we respond to treatment. It's not a straightforward path. What we do all share is a wish to have children and a problem obtaining that wish.

I also sometimes feel guilty about things that perhaps I'm not trying "hard enough"--perhaps I haven't pursued every potential reason why I can't get pregnant, feeling guilty that I know I want to stop treatment regardless of outcome after three IVF cycles. Maybe my guilt over myself makes me more likely to try to judge and rank others. There are so many feelings around infertility, so many of them negative, that it can tempting to promote your own actions at the expense of others.

Overall, however, in the short time I've been in this community, I've really appreciated the support.

Natalie said...

I struggle with the insecurity a lot. I worry that we didn't try "enough". That it's "only been a year".

Stacie said...

Thank you!

This one really hits home for me. I often feel not infertile enough. I mean, I got pregnant on our first IVF cycle. It was (mostly) male factor. I never had to do an IUI. I have twins. I feel like an imposter next to infertile friends who are grimly starting a fourth cycle, or who watch their dreams of biological children disappear with the last BFN they can handle. How dare I presume to belong to this group of women.

(Not one of these women has ever suggested such a thing to me, by the way, this is all in my head.)

And yet, I am not a "fertile" either. When women in my "'we were all due in July" group talk about when they want to conceive their next baby, well, I don't have much to say. When the midwife tried to talk to me about birth control my laughter had the slightly hysterical tinge of someone who has figured out just how many high end handbags she could have purchased instead of wasting money on the pill.

Between, betwixt. Not fertile enough. Not infertile enough. As Larisa said, "It all sucks". So...thank you again for this post.

Oh, and though I'm certainly not Jewish enough (lapsed Unitarian) I have a great hamantaschen recipie. I care about jam-filled cookies. I care about ALL cookies.

Joselle@WilliamsTriplets said...

I have actually seen posts on forums where great debate has taken place about what "defined" infertile in the particular message board. Everyone seemed to want some strange "Most infertile" title. Point is, ANYONE suffering thru the emotional journey of IF should be welcomed, and not judged. It is sad that some lose sight of battle we all go through. I have even been judged because I was able successful thru IVF. Success does not come with a magic wand that erases the struggle to get to the end result, whether thru adoption, success with ART, or another path. Excellent post.

Anam_Kihaku said...

i think if you get to that point where youc ry when yous ee your period. you belong. end of story. when in that first flow od red, you lose all hope for even a split second you belong. becuase that point happens for all of us at different point on our jourmey - some people its 6 months and some people its 2 years, or 4 years, or the first drugs, the first doctor to give you a patient number, the first ivf blood test, the last one.. it doesnt make any difference - its defining where you have also lost that little slice fo heaven for a moment. none of us want to be infertile ever. just part of the journey.

pink said...

I can totally relate. I'm culturally, but not religiously, Jewish and send my child to the JCC for preschool. I occasionally pull out the "member of the tribe" card when someone is looking at my blonde-haired, blue-eyed child (and her really Aryan-looking father).

At the same time, I'm squarely in the middle of the IF crowd--lucky enough to just need Follistim the first time. But among most of my friends here in Cleveland, I'm the ONLY one who had problems, so I'm the IF expert. I try and educate my friends so they have a sense of the range of what people might be going through--just call me the ambassador to the land of fertile gals. ;) Hopefully everyone, whatever the state of their hoos, can be inclusive and supportive. This site definitely helps that goal along.

sharah said...

Thanks for such an insightful post -- I think what you said is a great corollary to the "pain olympics". I often feel like I'm not "infertile enough" just because I'm young and I ovulate on my own. Those don't really matter, as they don't seem to make a difference in getting me pg, but I still feel like an outsider sometimes because I'm doing IUI/IVF.

sharah said...

Gah - I need more coffee this am. I meant to say that I feel like I'm an outsider because I'm not doing IUI/IVF right now.

Karaoke Diva said...

I REALLY felt this when I got pregnant with my son on the very first IUI and an online friend was in her ~8th year of IF treatment and had 7 angels taken away from her too soon. How could I call myself infertile when she has gone through so much more than me?

I feel it now too because I am trying for #2 and recently suffered a heartbreaking miscarriage, and I NEED the support of the IF online community, but how can I ask for their support when so many have never even been able to get pregnant the first time, let alone had a child?

I think for the most part, the online IF community has been wonderful to everyone, from all "levels" of IF. However, (and I know I am guilty of it too) sometimes we get so caught up in our grief and feelings of "Why her and not me?" that we dismiss the pain of others because they don't have it "as bad". We can't afford to do that to any of us.

Aurelia said...

I've felt this a lot lately. Mostly in real life, because friends who have done IVF have pointedly acted like I'm not really one of them.
Of course, the fact that I don't qualify for IVF because of my high FSH, well, they don't count that. And my miscarriages? Again, I get the line about "But you can GET pregnant..." even though I can't...geez I have to get some better friends.
Online in the blogworld it's a bit better, but sometimes, I do feel like a squarepeg in a round hole.
As for the definition, around here, they amend it to infertile automatically if you already have a problem diagnosed, like endometriosis, or POF, or PCOS, or whatever, so that you can get referred right away.
And for any loss after 12 weeks gestation, they will start investigations right away, sicne those are rarer losses.

TeamWinks said...

This is a well stated post Mel! I couldn't agree with you more.

Piccinigirl said...

I deal with this question very often, mostly because even though I am 37, and trying for 3 1/2 yrs and never been PG despite yrs of unprotected bonking. I think that many times I don't put myself in the box of a "real infertile" not because I don't believe I am one, but because I don't feel like (until recently) I decided to be so aggressive about it. Even when we were doing IUI's I didn't consider myself a "good or real" infertile since I hadn't taken a step toward an RE yet. It was a lonely place to be, because I was doing what I needed to do these past few yrs to make this journey ok for me, but it wasn't a planned attack, it wasn't calculated and I felt like if it wasn' wasn't the same.
You are right, Infertility is Infertility. My journey and your journey might be different in many ways, but in the ones that really count...being PG or not being PG it's exactly the same.

thanks for post, you said it wonderfully.

sarah said...

I agree with some of what Anam_Kihaku said -- crying at your period is a sign that you are joining a club no one wants to be in. Having said that, I would have been the exception -- I sobbed harder the first time AF showed after timed bding on our first cycle than I did a year later when I had a miscarriage after our first BFP. Seriously. I am a freak.

Anyway, I had a long talk with a friend last year about infertility. She'd been trying for a good while but just wasn't upset about not getting pregnant yet. I was concerned for her, as were others, but she wasn't. And I said fine, that is fantastic for you (and I meant it). I told her that when she cries at the first sight of AF, she'll know it's time to go to the next step, whatever that means for her.

We all compare ourselves to others. It's what we do. Heck, it took me a long time to admit we were infertile. I thought we just needed a little tweaking. Turns out that a little tweaking wasn't enough and we need major tweeking. But I'm a bad infertile -- I've only done one cycle of treatment in the last six months and it was a clomid cycle, even though I know I need IVF. We've been working on this for two years and I've decided that I like being on a break. Does that mean my membership gets revoked?

C said...

This is something I've been thinking about quite a bit, especially since getting pregnant myself. I've never had anyone say (or even imply) that I no longer belong on infertility boards or that I'm no longer a member of the infertility community because I didn't end up having to do ART, but I sometimes place that judgment on myself. Am I infertile enough? I'd love to know how to get out of this space in my head (and my heart) but don't know how. It's frustrating, and reading all of these responses have made me feel better about how conflicted I currently am. I'm not the only one who feels this way--in my book, that's huge.

Lindsey said...

This is an excellent point. Thank you for expressing it so eloquently and with such compassion.
In a way, it seems infertility itself is comprable to one of it's culprits, endometriosis (which I have). The extent to which you have it is not necessarily coorelated in one way or another to the amount of pain you may feel as a result. And regardless of the stage of endo, none of it is good news.
It's been said before, "it all sucks."

Tina said...

Thank you for such an insightful post - not necessarily easy to end, I agree. But very touching.

I am very greatful for the blogosphere I entered a year ago - it has given me such a strength of community that I never had before. No one in my real life understood our journey when we were TTC #1 - and others eventually came out of the woodwork after we finally succeeded in conceiving. But now that I am dealing with IF yet again and also recurrent loss, I am back in that unchartered boat when it comes to people in real life I know. The blogs have been an amazing support that I never had the first time around - and I am forever grateful.

I have been all over the IF spectrum - primary IF, secondary IF and recurrent loss. My means of getting PG (Clomid and IUI) are not as difficult as others - but, some of the feelings are the same. Although, now I have the added guilt of feeling sad even though I do have a child - and I try not to offend those who have not yet reached the precious goal of a first child.

The blogs are amazing - and it saddens me when we are "attacked" occasion for how we feel, and occasionally sites have to get password protected. We should be able to be open about our feelings and be validated for them - not cursed out and told we are wrong.

Dianne/Flutter said...

I find that I don't comment (as much) on people's blogs who are talking about procedures that I haven't done or for my own religious/personal reasons know that I can't do.

But, I think that is a in my head not infertile enough - these people have been thru more than you are willign - and you are a fraud because you know in your heart of hearts that you won't be able to do as much as they have.

Jen said...

Thank you. Just Thank You.

Karen said...

I really enjoyed reading this post. I've struggled with both issues that you so cleverly tied together in this post... not feeling authentically Jewish enough and not feeling authentically infertile enough.

It's ridiculous, really. I am an orthodox woman. I only wear skirts, I wear a sheitel. My necklines aren't perfect, but they're close. I keep shabbos. I keep kosher. But I never ever feel Jewish "enough" around Jewish people... secular, religous, or in between. The thing is this... don't ever let your pants make you feel less Jewish around a skirt-wearing frummy. (there is, in fact, a valid halachic argument to be made regarding pants wearing) If anyone is judging you by your pants, then they aren't acting as a Torah-observant Jew anyway.

I find the same is true for me and infertility. I've been playing this game for 4 1/2 years. I've had six IUIs and one, possibly two pregnancies. A miscarriage at three months after the first pregnancy. I'm probably/possibly/maybe/whotheheckknows in the middle of a second miscarriage. But I never feel "infertile enough" around people who've really been through the ringer with IVF and other assorted bits of fun. Yet when people tell me that they feel badly about complaining about the TTC efforts since I've had it "so much worse" than them... I always remind them that trying to conceive sucks. Badly. At any stage of the game. Any time a woman decides she wants to be pregnant RIGHT NOW... any sort of wait or frustration becomes instantly painful. It is not a contest, and if it is, it is not a contest I want to win.