Wednesday, August 6, 2008

Infertility vs. Recurrent Miscarriage

Here I go again with another somewhat controversial subject. And please know right off the bat, I do not mean to offend ANYONE, and I will try to use the most gentle, positive language possible.

Recently, on the online message boards where I'm a member, a topic was breeched about primary infertility (TTC the first child for over 1 yr with no success... or if using the Creighton Model, 6 months with no success), and how it is tougher than secondary infertility. Of course, I'd have to agree with this statement, since a) I can't relate to secondary, but I know from personal experience that primary is a bitch, and b) logistically, if you walk away from secondary IF never conceiving, at least you still have a child to love in your future.

But then the comment was made (not meant to be offensive) that TTC with recurrent m/cs is much different from TTC with no losses, because with losses, you are grieving the actual death of a child. There is NO DEBATE in my mind, on this point. The 2 are absolutely different, and if I had to pick which is "worse" to experience, definitely the recurrent m/cs. However, it got me thinking. Which is more despairing? Which is more hopeless?

Now of course, having never suffered a m/c, I will be taking the angle of an infertile who has never conceived. I just can't relate to the m/c side of this argument, so I won't try. But I can CERTAINLY relate to TTC with no pregnancies. Ever. Never. Nottaone. So that's what I'll do:

In NaPro Technology, they actually consider Infertility as a separate thing altogether from TTC with history of m/c. One of the Drs who lead a discussion in my Creighton Model training class came right out and said, "Having recurrent miscarriages is not infertility. They can get pregnant. Infertility is when you can't get pregnant at all." What I, and other infertiles experience every single month is a series of grieving emotions, over the loss of what "could have been." We actually do MOURN the death of our dream for that cycle. And in many ways, that mourning is similar to mourning over someone's death... except that it is a recurring death. With each passing month, and each failed cycle, something else continues to die, and that is our hope. The longer and longer we try to achieve a pregnancy, and fail, the more we wonder, "will I ever carry a baby in my womb?" "Will I ever be able to get pregnant?"

Another added level of despair for infertility with no losses is that we suffer alone. If an infertile shows up to work, or to an outing with friends, on the 1st day of her new cycle (aka, period started, no pregnancy... again), no one can really sympathize with her or understand how sad she is. Often, it is a silent suffering, because most infertiles realize that no one but other infertiles can relate to what they are going through. But in the rare case that an infertile DOES share their misery with co-workers or friends, the usual response is a puzzled look and a well-intended comment along the lines of "you're trying too hard, just relax!" or "I'm sorry, maybe next time." After many months of the same, though, outsiders tend to run out of things to say to you.

Conversely, if you have just suffered a miscarriage, I can guarantee that everyone (ignorant, heartless people aside) who hears about it will be there with open arms and an empathetic apology for your loss. A true loss people can relate to. But start talking about abstract losses like infertility and the inability to get pregnant, and people don't know what to do or say.

Another added bonus of infertility, and the monthly mourning (note sarcasm), is that deep down we also feel guilty for mourning! We realize that as MUCH as we would die to bring new life into this world, and have a soul growing inside of us, we DID NOT conceive. There was no life. Therefore there was no death. Why are we so upset? We didn't really lose anything! It's a horrible, viscious cycle, which continues to eat away at that hope I mentioned earlier.

Finally, in infertility, we don't even have the divine consolation that we will be with our children in heaven. We were never able to create a life with our husband and with God here on Earth, so that soul does not exist. Now obviously, there is no heartache or sadness in Heaven... so God must have something else, something very special planned for those of us who may never conceive children, for our time in Heaven. But as we spend the remainder of our years here on Earth, there is a fear of constant regret.

Add to this now the Infertile woman who uses NaPro Technology:

NaPro has a particular strength in helping women who have had previous m/cs to carry a pg to term. Why? Because NaPro treats and "fixes" the abnormalities in the woman's body, and helps it become the optimum environment for a growing baby. But NaPro cannot force a sperm to fertilize an egg. So often, upon hearing of a friend's miscarriage, I will think- "Oh, with NaPro she has such a good chance of getting pregnant again and carrying to term!" And while I know that NaPro has already brought me so far in correcting my PCOS, endometriosis, blocked fallopian tubes, thyroid system, beta-endorphin levels, and DH's morphology, there is no guarantee that I will ever achieve a pregnancy. I have the UTMOST hope that if I do achieve pregnancy, I will be able to carry to term, because of the NaPro treatment I will continue to receive in early pg. But getting to that stage? The hope continues to die.

Again, sorry if this blog was offensive in any way. But since this is a blog about my infertility, my journey, and my emotions, I thought I should shed some light on this subject, from my perspective.


Reproductively Challenged said...

That was beautifully said Amy, no offense taken here - you express yourself so well, I understand exactly where you are coming from on this subject, even though I am on the other side - you have such a great understanding of the issues and I can tell you are truly compassionate person, you are completely correct in everything you said

Karey said...

I've often wondered what I'll be doing in Heaven when everyone else will have their children with them. I know that is a human way of looking at it, but I can't help it. Anyway, I really liked the way you said God must have something special planned for us.

The Apostolate of Hannah's Tears said...

God bless you!!!

LifeHopes said...

I am with you 100%.

I cannot say which is worse- miscarriage or infertility, since pain is relative. BUT I CAN say that I cannot at this time imagine anything worse than primary, never had a BFP after years of trying, infertility. And while we're at it, I'll go out on a limb and say that CATHOLIC infertility might be worst. It is a cross almost too heavy to carry sometimes. Secretly I have envied those who can conceive but miscarry. Is this twisted? I don't know. But they are mothers and I am not, and that is that.

Jodi said...

I'm with lolo...I don't take any offense to your stance on this. I think each one has it's drawback and to try to compare the two is like comparing apples to oranges. You're such an amazing women to be this empathetic and willing to realize the difference and still relate to both sides.

andnotbysight said...

No offense taken! I think it is a good thing to hear other people's perspectives and experiences (which is a big reason why I read blogs in the first place!). Lately, I have to keep reminding myself that everyone has their cross to bear--especially when I see people who have what I want (like, oh, for instance, just to pick a random example, babies). I really hope and pray that you have good news soon! And it was really interesting to read some of the distinctions. I had never heard that about placing infertility and miscarriage in two categories from a technical point of view, though it makes sense.

Faithful Infertile said...

Well said, Ames! You are such an amazing woman! :) That's why I love ya!

Beth said...

Primary infertility is worse. At least that's what I think. Recurrent miscarriage is hard too though.

WheelbarrowRider said...

No offense taken. Well put. Insightful. Interesting points to ponder. :) I often wonder where I fit in? I mean, I couldn't get pregnant without my arsenal, but my arsenal works pretty effectively...and came into the picture early, even if the infection issue wasn't "fixed" until later on.

Anonymous said...

Part #1
Your post is from 2008 but I came across it googling info on what I am dealing with and I just had to set the record straight.

You are very wrong about recurrent miscarriage. I have had two miscarriages, both at 9 weeks, and people have NOT been supportive at all. As a matter of fact everyone (both my large of circle of what I thought were friends and my family) have done nothing but minimize our losses.

My husband and I found out we were expecting the first time on New Years day while on a romantic getaway to Paris, France. We were so excited and, having never miscarried before, the minute we got back to the states and all the pertinent people (parents) were told in person we shouted the wonderful news from the rooftops right away (like most people who have never experienced miscarriage do) rather than waiting until we were past the first trimester to tell everyone. Because of that, that miscarriage was very “public” and people were still insensitive jerks about. With the second miscarriage we only told our parents we were expecting and we planned to wait until I was passed the first trimester to tell anybody else but as luck would have it I miscarried again. I did need support (and still do although I don’t get it) so I told everyone I had miscarried and they were more insensitive than they had been the first time.

Anonymous said...

Part #2
The most insulting insensitivity has come from the people who consider themselves to be pro-life though. I guess to them it’s only a baby when they are trying to force their will on a woman. When the baby is wanted and it’s lost at 9 weeks it’s suddenly just a painful period. Anybody who considers themselves to be pro-life and has the latter attitude towards a miscarriage is just a pathetic hypocrite.
The only things people have offered me in the way of “support” are useless platitudes that do nothing to comfort. The only purpose of these platitudes is to shut me up from talking about my grief. Everyone should research and learn about platitudes and how hurtful they are. Platitudes blame the victim, make the situation the victims fault and they stop the victim from discussing their feelings when that is what the victim needs the most. The most helpful thing people can do to help someone who is grieving is shut up and listen without interrupting, without offering advice (unless the victim specifically asks for advice,) without passing judgment and without getting upset if the victim says something about God that offends the listener. The victim is coming from a place of hurt and anger and if God is really the all loving powerful being that Christians claim he is then he can handle the victim being angry at them and he does not need some useless peon like the listener to speak for him or come to his defense.

We are now unable to conceive so unlike you have I have been on both sides of the fence. I can say without a doubt that I would much rather have never been able to get pregnant in the first place than I would have been able to get pregnant only to have my babies so cruelly taken away from me. At least when you are infertile (unable to conceive) you don’t have to deal with pregnancy hormones like you do when you are pregnant and you miscarry.
At least when you are unable to conceive you can throw caution to the wind and not worry about getting pregnant and not taking your meds on time and miscarrying. It has been discovered that I have a blood clotting disorder and that my body does not make adequate amounts of progesterone so I have to start taking progesterone right after ovulation. That requires me to chart every single cycle so I can’t very well just push TTC out my mind, relax and not worry about. Being required to chart, so I can take my meds on time, so I won’t miscarry in the event I get pregnant makes that’s impossible. I also have a blood clotting disorder and will have to inject myself daily with blood thinner if I am ever able to conceive again. Since I have been unable to conceive since these issues were discovered it is unclear if any of this will stop me from miscarrying. If I don’t do these things it is a guarantee that I’ll miscarry again though. Progesterone gives me false pregnancy symptoms so that makes the big fat negative pregnancy test at the end of my cycle even more of a letdown. Progesterone also impacts my hormones, another false pregnancy symptom, which makes me more of a basket case dealing with infertility than I would be if my hormones were not being tinkered with.

At least when you are unable to conceive and have never miscarried you will be able to be blissful about a pregnancy if it ever happens. When you have had repeated miscarriages like I have pregnancy is not a positive experience because you live in constant fear that you will just miscarry again.

People who suffer recurrent miscarriages also deal with grieving over the loss of hopes and dreams of the future just like you mentioned you deal with. The added layer of grief is that people who suffer recurrent miscarriage are not only grieving the loss of hopes and dreams but the loss of a baby that they were actually pregnant with.

Anonymous said...

I agree with the Anonymous comment. I have experienced Primary Infertility, Secondary Infertility, and then Undiagnosed Recurrent Miscarriage. They are all awful and unbearable. I think that each person has very different experiences with each issue because we are all so different. However, for me, recurrent miscarriage was the worst of the three. ALL were hell, but recurrent miscarriage has by far been the worst experience for me and my husband.

Anonymous said...

Hi, Thought I would add my two cents. It sounds like everyone's experience is different so we should be caref not to judge & be good listeners. I have experienced 5yrs ttc in my 20's & recently miscarried 1st pg at 10wks. At the moment, I feel the pain, dispair and hopelessness during infertility has been much worse than the miscarriage. Now the glimmer of hope is there that I can get pregnant. With infertility you take all your drugs every day & mourn 'nothing', alone. With nmiscarriage I had something to tell people, & they responded with support & offers of meals.

Anonymous said...

Different kinds of hopelessness. One the build up of hope each month is dashed and is relatively short lived but it's acculmaltive. The other hope and dreams are realised , plans are made, relief is felt , there are scans and then in an instant it's gone. If that isn't enough there is the physical trauma to go through when all the products are passed and the lengthy emotional recovery after. I wonder what a neutral outsider would say was worse?

Amy @ This Cross I Embrace said...

Anonymous (the most recent commenter), I've had some readers recently mis-read and misinterpret this post. Please again see these words I originally wrote in 2008, which I echo again today in 2014, still having never conceived:

"The 2 are absolutely different, and if I had to pick which is "worse" to experience, definitely the recurrent m/cs."

I am not an unbiased outsider. But I STILL think miscarriage is worse. The point of this post from my first few months of blogging :) was to show the hopelessness in primary infertility, which of course is also present in a woman experiencing miscarriage (or several), but not the same *kind* of hopelessness of never being reunited in heaven.

Again, to repeat myself, I do wholeheartedly feel that going through a miscarriage is a pain like nothing else on this world. I am so sorry that it seems like you are intimate with that type of pain, and I will pray for you.

Dawn said...

I've never experienced infertility - I get pregnant quite easily & am very lucky to have one beautiful daughter who is almost five.

I'm also under the care of a reproductive endocrinologist & currently experiencing miscarriage #4, my third this year. I'm not exaggerating when I say I'm starting to crack psychologically. I have become a bitter, angry person who cannot tolerate pregnant women or the sight of families with multiple young children.

I think comparing infertility vs. Recurrent miscarriage is like comparing a crap sandwich with mayo to a crap sandwich with mustard. Would you really want to eat either one of them?

Jo Ann said...

I don't want to judge anyone or say my pain was worse than someone else's, but I will say that going through multiple miscarriages was one of the most horrific experiences in my life. I had 6 miscarriages in a row, in a matter of 4 years. The worst part is they could never really explain why. I did all the testing, took progesterone every month, was on heprin self injected shots, on baby aspirin and nothing worked. They finally diagnosed me with SNAPS, which to this day I don't really understand what that is. In my experience people were not supportive of my losses. Everyone took it so lightly and like it was no big deal to lose 6 babies. I will tell you with the 6th pregnancy I was a basket case. I was barely able to function. My depression was so severe.
As with another lady who blogged, I too got pregnant so easily but my body would just not hold on to the baby.
The part that was so hard is that I had had a daughter with my first pregnancy. So my 6 miscarriages came after her. So what I got all the time was "well at least you have one", or "be happy with her". Secondary, infertility is hard because you really don't get sympathy because people think you should feel lucky to have the one. This is true, I was blessed with having a child and I don't take that lightly but it still doesn't mean a women shouldn't want for another child or that she is selfish for wanting another child. This is how people made my husband and I feel with each passing miscarriage.
I will tell you after my 6th miscarriage, we stopped trying, I could not bare losing another baby. It is heart breaking. Especially, because they did genetic testing on 2 of my babies and determined both of them to be healthy baby girls. They could still never give me any real reason or true diagnosis for all my miscarriages.

justonemore said...

Experiencing Recurrent Miscarriage has been an awful but necessary gateway for me to empathize with friends suffering with infertility. I know that my actions after loss changed - I truly started to think before I speak and try to approach people with sensitivity about children and pregnancy.

But I really do need to emphasize that both are silent struggles. Every single pregnancy I have lost - including the one at 14 weeks - was hidden from the outside world. Most people were completely terrible when I shared my losses, offering platitudes ("you can try again!" "God had other plans") or worse, dismissive ("they weren't babies"). Well, they were babies. Each one of them was a hope and dream and promise of life, snuffed out. Imagine losing a relative and having no forum of grieve. No funeral. No bereavment leave. No cards. No nothing. Both infertility and RPL are terribly, awfully isolating.

Anonymous said...

Thank you! Every situation is different and this is not a competition. I have been ttc for over 3 years without a single BFP and thousands upon thousands of dollars spent in fertility treatment. Since I have never had a miscarriage, insurance will not pay for any of the fertility treatment. Every single month is a roller coaster of the 2 week wait hopefulness only to be followed by gut wrenching depression and denial. Maybe it's implantation bleeding, maybe this, maybe that. I am 39 years old and am having to give up on my dream of ever carrying a baby. I do not know what it is like to miscarry and I will never know. Stop comparing your pain and support one another.

Sezpez said...

Against contrary belief I suffer both infertility and recurrent miscarriage. I can't say one is worse than the other as they are both debilitating and soul destroying. For many years I could not concieve and the specialist was at a lost as to why. I am one of the 'unexplained' due to the fact tests say I should get pregnant. In more recent years I have with many moths of trying and monthly breakdowns found myself pregnant 3 times and each time within 2 weeks of finding out our dreams have come true had them pulled away from us my recurrent miscarriage. Each time as hard as the first. Never knowing if I will get another chance. My heart goes out to all women who for whatever reason grieve for want of a child or in memory of a baby they never got the chance to meet.

Jackie B. said...

I lost twins at 15w3d due to incompetent cervix after 11 years of TTC. All the years of infertility are no match to the grief I experienced with my loss.

Unknown said...

Nice post