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"I never dreamed I'd have trouble getting pregnant," said Carolyn, 38, a fund-raiser who's been married for four years. "Barry and I have spent three years trying to conceive -- first naturally and then with assisted reproductive technology. But it's always the same sad story: We're optimistic when treatment begins and devastated when it fails. Recently a blood test showed that my eggs aren't healthy, so our last remaining options are in vitro fertilization (IVF) using a donor egg and Barry's sperm (with me carrying the baby) or adoption. I'm open to either, but Barry won't discuss it. Every time I broach the subject he cuts me off and says I'm a nag. We're so mad at each other that we've stopped having sex.
"I met Barry, then 29, six years ago at the indoor gym he managed in Vermont. I was visiting a friend, and as I headed to the facility's climbing wall I noticed Barry -- tall and lean with thick brown hair -- across the room. 'He's so hot!' I said, grabbing my friend's arm. I was thrilled when he approached me after my first climb. We quickly discovered that we both liked alternative rock music, so Barry invited me to hear a local band that night. The next day we climbed together at the gym.
"A day later, when I left to catch my flight back to New York, Barry said he couldn't wait to see me again. Our romance began slowly, with visits every other weekend. Our temperaments are different -- I'm outgoing but anxious; he's reserved but mellow -- but we fell in love and got married two years later.
"The adjustment period was difficult. On weekend visits we were on our best behavior, but once we began living together in New York City, our bad sides emerged. We tripped over each other in my tiny apartment. It didn't help that he missed New England and the health club job market was tight.
"Since Barry couldn't find a job, my dad asked him to manage one of his restaurants. Once he was earning a steady paycheck we moved to a larger apartment, which helped a lot. We enjoyed rock climbing and Rollerblading in Central Park, and loved going to restaurants and clubs.
"We'd been married 18 months when we decided to start a family. After a year with no luck I consulted my gynecologist, who prescribed a fertility drug and intrauterine insemination (IUI) to increase the chances of conception. We tried this treatment twice, but both cycles failed. From there, I saw a fertility specialist, who discovered that the eggs produced weren't consistently healthy. The next step was IVF, with stronger fertility drugs and a cost of $15,000. My health insurance didn't cover it, but my parents offered to contribute and we gladly accepted."
"The doctor told me to abstain from exercise and sex while I was taking the medication to prepare my body for IVF. Meanwhile, my emotions ran the gamut from excitement that I'd get pregnant to despair that I wouldn't. Imagining a childless life, I'd dissolve into tears. I expected Barry to console me, but to my disappointment, he was silent.
"The two weeks between the procedure and the pregnancy test were an eternity. When the test came back positive I sobbed to Barry, 'Our nightmare is finally over.' Then, nine weeks later, I suffered a miscarriage -- the most wrenching experience of my life.
"I wanted to try again immediately, but had to wait several months for my body to recover. I became very anxious. Barry called me a broken record, saying I obsessed endlessly about all this. Well, I didn't conceive the second time and on the third my doctor canceled the procedure, because my hormone levels were so high that my eggs were no longer healthy enough to create an embryo. That's when he said I'd need a donor egg if I wanted to try again.
"Throughout this three-year ordeal I've felt perpetually sad. I've become a hermit because I don't want to hear friends who got pregnant easily say, 'Just adopt.' I want to watch my belly grow, feel my baby kick and give birth. Normally, my mom would be my support, but she keeps telling me supposedly inspiring stories about women who went through multiple IVF tries before conceiving naturally.
"To complicate things, Barry was profoundly unhappy working for my dad. He complained bitterly and incessantly about Dad's erratic management style. When I tried to stay neutral Barry accused me of being unsupportive. At that point I urged him to look for a new job, but he felt he couldn't quit because my parents were helping us pay for IVF. 'They'll support us no matter where you work,' I assured him.
"Even after all we've been through, I still want a child and am willing to consider egg donation -- and then adoption. But Barry just tunes me out, which makes me feel more alone than ever. Recently, he's begun staying out late with his single buddies, drinking too much and not calling. He's trying to spite me for pressuring him to make a decision. 'If you can't be happy with just me, then maybe I should leave,' Barry snapped the other day.
"I was crushed. I can't imagine life without Barry -- any more than I can imagine not being a mother. 'I love you and want a family with you,' I said. 'Let's work this out.'"
"I didn't mean it when I told Carolyn I should leave," said Barry, 35, his voice laced with regret. "I still love her. I lashed out because I didn't want to talk about infertility again. This is the only subject my wife wants to discuss, and it breaks my heart even to think about it.
"Fatherhood has always been one of my greatest desires, and I feel a tremendous void in my life without a child. But dissecting our problem ad nauseam won't make me feel better. Truthfully, I'm not sure how I feel about egg donation or adoption. I just know I'm too emotionally wiped out to explore either option right now.
"Baby making has dominated our lives for too long. Our discretionary income goes to IVF, so we can't afford to eat out, attend concerts or go away for the weekend. Rock climbing and Rollerblading are out, too, because they're too dangerous while Carolyn's going through IVF. Even our sex life has gone south. Forget spontaneity; as soon as we started trying to conceive, sex revolved around Carolyn's ovulation. Then, during treatment, we abstained on doctor's orders. Now we're so upset with each other we're not interested.
"I grew up in a blue-collar family in a small New England town. As a child, I loved smelling fresh-cut grass, watching the leaves change colors each fall and seeing the stars twinkle in the clear night sky -- stuff I miss living in New York. Because I lacked the grades and money for college, I worked in several fields after high school before I found my niche in health club management.
"Carolyn was not only the most beautiful woman I'd ever met, she was warm, adventurous and honest. I was excited to meet someone in her 30s who shared my interests. If we disagreed about something, she'd defend her opinion and then challenge mine, a quality I found intellectually stimulating.
"Unfortunately, I had serious acclimation problems when I moved to New York. I hated the noise, traffic, fast pace and throngs of people. Worse yet, I hated working for my father-in-law, a gruff manager who's a poor listener and never praises. I'd love to move back to New England, but I feel trapped because of my job and our ties to the fertility clinic. If we pursue egg donation, it would be foolish to start all over again with new doctors. So for the short term at least, I'm stuck.
"Yes, I'm guilty of staying out late and not phoning. Yes, I've drunk too much. I'm not proud of this behavior, but I'm so miserable about everything that hanging out with friends has become a respite.
"I'm sorry Carolyn feels I'm being insensitive when I refuse to discuss our options. I know I can't avoid a decision forever, but I don't like being pushed. Maybe counseling can get our marriage back on track."
"Infertility, which affects some 6 million Americans, is a major life crisis that puts enormous stress on a marriage," said the counselor. "In the best-case scenario, it can make a couple stronger, because they discover they can support each other through a traumatic experience. But often, it drives them apart, as it did with Carolyn and Barry.
"Infertility can trigger overwhelming feelings of loss, which each partner must be allowed to grieve in his or her own way. A couple's sex life also suffers. The pressure to perform and have timed intercourse takes the romance out of lovemaking. And many couples have collateral damage, becoming estranged from friends and family who make inappropriate remarks or ask intrusive questions.
"Carolyn and Barry had experienced all of these emotions. Moreover, their relationship had been further strained by Barry's unhappiness working for Carolyn's father and living in the city. Still, they remained deeply in love, so I was hopeful their marriage could be repaired. My three-part goal was to help them see the solid relationship beneath the infertility issue, guide them to make a decision, and help them stay emotionally strong if they decided to pursue either of their options.
"First, each needed to understand the other's coping style. Barry's silence didn't mean he was insensitive to Carolyn's feelings; it meant the situation was too painful for him to discuss. And Carolyn's anxiety wasn't intended to drive Barry crazy; it was linked to the uncertainty of whether she'd ever be a mother. As Barry became more tolerant of her need to vent, she stopped pounding the subject. Since Carolyn felt uncomfortable talking with her mother, I encouraged her to seek support from friends. As she reached out, she relied less on her husband. Barry, in turn, stayed home more and cut back on the drinking.
"Since both egg donation and adoption are stressful and time-consuming, I agreed with Carolyn that they couldn't delay their decision much longer. Their medical center sponsored forums on egg donation, which I encouraged them to attend. Inspired by what they heard, Carolyn and Barry decided they'd come too far to give up on their dream of parenthood. As Barry said in one session, 'I don't care about genetics. Being a parent is about caring for your child.' Carolyn agreed: 'The baby will have the genetic link to Barry, but I will be the mother.'"
"Since Carolyn and Barry had put much of their life on hold for three years, I urged them to reclaim control during the six-month wait for a donor. Barry started job hunting in both New York and New England, and together they visited areas where they'd be able to work, live and pursue their outdoor interests. Meanwhile, I advised him to stop complaining about work to his wife. She was powerless to change her father's management style and was caught in the middle.
"Like many couples caught up in infertility, Carolyn and Barry had forgotten how to have fun. By going out to eat, attending concerts and doing sports together, they not only had something else to focus on, but also were reminded of the common interests that had drawn them together in the first place.
"Most couples seeking egg donation have many requirements for selecting a donor -- everything from religion to academic credentials -- but Carolyn and Barry asked only that the woman be healthy. Typically, fertility clinics try to match clients with donors who bear some physical resemblance to them, so the first donor had brown hair and hazel eyes like Carolyn. Sadly, Carolyn didn't get pregnant, but the doctors had no medical explanation for the failure. 'We agreed that a second try would be our last, because we'd both reached our breaking point,' Carolyn said. Happily, Carolyn conceived and gave birth to Sara, now 19 months old. Although their immediate family knows the circumstances of Sara's conception and they plan to tell Sara someday, Carolyn and Barry haven't shared the details with friends or coworkers.
"Barry still works for Carolyn's father, but the situation has improved, largely because his happiness as a dad has made him less annoyed. For now, the couple has agreed not to relocate until they both can find the right jobs.
"Today, Carolyn and Barry's marriage, as well as their sex life, is back on track. They're communicating effectively and spending time alone together to keep their marital bond strong. 'Parenthood has brought out the best in both of us,' Carolyn exulted in a recent phone call. 'When I see my husband with our daughter, my heart melts and I cry tears of joy.'
"Barry agreed: 'I never thought I'd say this, but the bumpy road we traveled drew us closer. Carolyn is a fantastic mother and the love of my life.'"
Originally published in Ladies' Home Journal, March 2008.