Teaching with Infertility: An Inside Look

Episode Transcript

Welcome to episode 15 of Teaching with Jillian Starr.   This episode is a tough one, and one that I actually tried to record it almost 3 months ago, but it was too raw at the time.  I cried several times while trying to record it, and in the end, realized I wasn’t ready to give it the clear focus needed to make this a meaningful episode for those listening.

Before we dive into today’s episode, I want to make sure it’s clear that this episode is for EVERYONE.  Whether you are a teacher or not, whether you are struggling with infertility or not, this episode is for you.  I hope to leave those of you who have never experienced infertility yourself to have a better understanding of the complicated, highly individual journey through miscarriage, fertility treatments and IVF.  I want to help make you a better friend, family member, and colleague to those struggling with infertility (many which you will probably never know are struggling).  For those with whom I share the struggles with infertility, I hope to leave you with the feeling of being seen, loved, and to know that you are not alone.  With all my heart, thank you for being here for today’s episode.

My own journey with infertility has been an emotional rollercoaster.  Like many, it has been a road through hope, sorrow, loss, grief, anticipation, shame, and until a few years ago, isolation and invisibility.

Four years ago this week, was the first time I shared about our struggles.  I wrote a blog post entitled: Our Story: A Teacher’s Silent Struggle with Infertility.  I had only JUST opened up to our immediate families about our struggles, and then I went ahead, clicked “publish” and shared it with the world.  It was the hardest post I’ve ever written, but it was also, by far, the most rewarding.  In opening up about our struggles, I discovered so many close friends, family, and complete strangers who were going through the same pain and heartache that comes with infertility and loss, and they too had been going through it SILENTLY, and alone. In the days that followed that post, I realized that this was a topic that NEEDED to be discussed… it needed to be discussed out in the open, and it needed to be discussed often.

Let’s talk numbers:  You may or may not know that 1:5 women experience a miscarriage, and 1:10 couples struggle with infertility.  The statistics tell us that several people you know have struggled, or are struggling with infertility and/or have experienced the trauma of a miscarriage. Most of these people will suffer in silence.  There are no visual markings to distinguish those who struggle with infertility or who have had a miscarriage from anyone else.

Therefore, it is important that we engage in conversations with the assumption that the person we are speaking with has experienced fertility issues.  I cannot tell you how many well-intentioned comments have broken my heart because they began with the assumption that I wasn’t struggling.

I want to use today to help shed light on the infertility journey.  Whenever I share the details of what IVF actually includes, I am always met with, “Wow! I had no idea it was that intense!”  Just last week, my brother came over and saw that multiple “hazardous waste” receptacles on top of my fridge.  When I showed him that each one was filled to the top with syringe needles, I could see in his eyes that he had not realized the level of my treatments.  I want to let you in.  When we acquire knowledge, we gain understanding, and when we gain understanding, we can begin to develop empathy.

If you’re a teacher, you know the power of storytelling and how we can use stories to build empathy with our students.  The same is true of adults, so I figured I’d start by sharing our story, and then excerpts from others experiences as well, as infertility is not a one-size-fits-all journey.

My husband and I were married 8 years ago.  We started actively trying two years into marriage.  Since I had spent most of my life trying hard NOT to get pregnant, I assumed it would be super easy once I started trying.  The first few months of negative pregnancy tests were disappointing, but I was comforted by the data.  It takes the average couple 6 months to get pregnant.  I’m an overachiever, but I was okay with prospect of being average.

However, “average” came and went.  We went a year without getting pregnant.  I resorted to every marketed strategy out there.  I used an ovulation kit for months on end, which means I peed on a stick every day for the first two weeks of every month to find out when the “optimal time” to get pregnant would be… and then peed on a stick for the last week of every month to find out if it worked.  It’s not a very healthy way to start your day 3/4 days a month, but it was my life.  It was consuming.

After a year, we were recommended to a specialist.  My husband and I were both put through medical examinations.  Mine were far more invasive, and often painful.  Shortly after one procedure, where they insert contrast dye into your uterus and fallopian tubes to check for blockages and scar tissue, we got pregnant.  Who knows if the dye had dislodged a blockage or if it was just meant to happen, but I had finally received our first positive pregnancy test.

Unfortunately, that pregnancy didn’t last long, and we were now back at square one with a very heavy heart.

The next month we actually got pregnant again, but again, we lost it only a few weeks later.

Within a few more months we were surprised to find out that we were pregnant for a third time.  As the milestone of outliving the first pregnancy and second pregnancy came and went, we found ourselves hopeful that this might be the one!  We closed on our new home which would give us room for our growing family.  I remember sitting and signing the papers and the lawyer commenting what a perfect home it was to raise a family.  My heart was so happy to think it was all really happening.   A week later, we lost that pregnancy too.

Our fertility specialists recommended we try an IUI with a stimulant.  For those of you who are not familiar with fertility terminology, I am going to try and provide a bit of a crash-course in this episode.  I hope that you will use this information to be an educated listener to anyone who is willing to open up to you about their treatments.  PLEASE do not use this information to offer advice to anyone struggling.  I will elaborate more on that later in the episode.

An IUI is basically where doctors collect a sperm sample, with the purpose of inseminating you when you are about to ovulate.  What folks often don’t know about this procedure is that’s it’s not just coming in for that one appointment to have the insemination.  Actually, that’s the easiest part.  Prior to that, you come in for appointments every day or every other day to get your blood drawn (to monitor hormone levels) and then have an internal ultrasound (yes, they insert a wand inside of you) to monitor if your body is naturally producing an egg that cycle.  There’s nothing like starting your day being stuck with needles and wands, and hoping you can still make it to work on time (and that’s IF you’re lucky enough to live near your fertility clinic.  If you don’t, then you get to wrestle with sharing your struggles in order to explain your tardiness/absences to your admin and colleagues so it doesn’t appear as if you don’t care about your job.  FUN!

Well, we went through that process and were so grateful to find out that it worked! We were pregnant.  We had follow up blood draws which showed our hormone levels were increasing properly, which gave us so much hope.  Every test and ultrasound appointment were all positive… until they weren’t.  The ultrasound technician couldn’t find a heartbeat.  They had us come back for a follow-up.  There was still no heartbeat.  We sat across from our doctor as he explained that we were experiencing our fourth loss.  I had never cried about our struggles in public before, but I openly sobbed in the doctor’s office.  I just couldn’t hold it in anymore.  I was devastated.  It felt so horribly unfair. almost targeted… like for some reason I was not being allowed to have children.

I know that

After our fourth loss, we were given the options to go through the process of a miscarriage naturally, or surgically.  We opted to have it surgically removed, because this offered us the opportunity to have chromosomal testing done.  It was a really difficult decision, but one I would make again.

Despite a rough recovery, both emotionally and physically, we got what we asked for!  We finally had a reason for our struggle.  All signs pointed to a chromosomal issue.  We didn’t know quite what that meant, but it finally had a name!  To us that meant that we could get off our circular orbit, and perhaps start moving into uncharted territory.

The doctors recommended using InVitro Fertilization, in combination with a chromosomal screening.  This screening would help identify embryos that could not survive a complete pregnancy, significantly reducing our risk of loss.  SIGN US UP!

At the time, I knew nothing about IVF and what that journey really entailed.  At the time I couldn’t FATHOM the emotional, physical and financial stress it would put on us.  All I knew was that this was what it was going to take for us to have the family we so desperately wanted.

Here is the part of the episode where you get a crash course in what IVF actually looks like.  Please remember that everyone’s treatment is unique to them and how their body responds.  I will be describing MY treatment and mine alone:

Many folks think that IVF is simply a procedure and then you find out if it worked.  I actually thought that too, until I had to go through it.  IVF is a complex treatment that involves dozens of appointments, surgeries, blood draws, injections, medications, phone calls, and more.

It’s hard to summarize it all, but I will put on my teaching hat for a moment and give it a try.  IVF is performed in terms of cycles.  Day one of a cycle begins with your period.  The goal of the first cycle is to get your body to produce as many eggs as possible without putting your body at risk.  Since your body usually only produces one egg per cycle, you need the help of extensive medications to increase the amount.  Every morning and evening I was giving myself three injections in the abdomen.  One of them was a smaller needle, about the size of an insulin injection.  The other two however, were large and left me bruised and swollen.

These injections go on for however long your body takes to respond to them.  For me, it went on for about fifteen days.  Within those 15 days, I had to go to my fertility clinic every other morning to have my blood drawn and have an ultrasound (the super fun ones I described before).  When your clinic’s first appointment is at 6:45, and your students arrive at 8:00am, you keep your fingers crossed you get one of the first three appointments, that you get a parking spot, and that traffic is light.  Again, the stress of making it to these appointments alone is a lot, but the added stress that happens if you haven’t been able to talk about your struggles with your colleagues or admin makes it SO much more stressful.

Another stressor is not knowing when the appointments will be.  It’s not like your cycle starts and you are given a calendar of which days you can have appointments scheduled.  No.  You go in for your appointment, and you get a phone call in the middle of the school day giving you the results of your tests that morning, and then with instructions for when your next appointment will be and what dosage of medicine to be taking until then.  Then you go home and watch an video tutorial that teaches you how to mix the next round of medications on your kitchen counter, and you just hope that your hands don’t shake too much because that medication is liquid gold and cost you your last paycheck.

It’s really hard to schedule IEP meetings, parent meetings, meetings with service providers, or any other type of meeting in advance when you truly have no idea what your appointment schedule is going to look like for the next month.  This, on top of not being able to plan any kind of a social life because you don’t know which days you have to be home, and what times you have to do your injections until 24-48 hours before.  It became easier to just not engage in making plans with friends, because I didn’t want to have to explain why I kept canceling.

What you also don’t know, is when your egg retrieval surgery will take place.  This surgery is when the doctors go in and remove all of the eggs your body was able to produce that cycle.  You have to give yourself a final injection 36 hours prior to your surgery, which last time meant waking up at 1:30 in the morning to do.  I truly don’t know how they trust us to inject ourselves while we’re half asleep, but they do!

An egg retrieval surgery is usually completed under total anesthesia, which means that you need someone with you to drive you home afterwards.  It’s also very painful, so you wouldn’t want to be driving anyway.  The recovery depends on the person, and sometimes even on the cycle.  For my first retrieval, I was okay to work the next day.  My most recent retrieval left me vomiting for the rest of the day and then took me several days to recover.

When you get out of surgery, they tell you how many eggs they were able to retrieve.  Those eggs are then mixed with a sperm sample and you hope they fertilize. Depending on your circumstances, several different next steps could take place.

• You could have one of those eggs transferred a few days later (which means they put a catheter inside you, put the embryo inside the tube, and then send it up into the uterus and hope it implants itself into the lining- there is no guarantee it will).

• You could have more than one of those eggs transferred if your doctor’s determine that is the best course.

• If you’re like us, you might have to wait.  First, we wait to see how many eggs fertilized.  Then we wait to see how many grow to a healthy day 5 blastocyst, and then we have any of those that have made it to day 5 biopsied and tested for any chromosomal abnormalities.

To give you an idea of numbers, the first time we retrieved 15 eggs.  11 fertilized.  3 passed the chromosomal screening.  Our second time, we retrieved 4 eggs, 3 fertilized, one passed the chromosomal screening.  Our third time, we retrieved 13 eggs, 11 fertilized, one passed the chromosomal screening.  In all, we’ve had 32 eggs, 25 embryos, and only 5 that have passed the chromosomal screening.  It’s crushing to know that our chromosomal issues are THAT severe, but we are also so grateful we live in a time where IVF is even an option.

We are also so grateful that our first two embryo transfers resulted in our son and daughter.  In an unlucky group of couples struggling with infertility, we are considered the lucky ones.  I know this.  I will never forget it.  What I will also never forget, is that when we originally looked to start our family, we had always talked about having 3.  It was the image of our family that we had created in our minds.

We tried for a third.  Our transfer failed.  We were crushed.  We went through all of the injections/appointments/blood draws/ultrasounds…etc. again, only to get the flu and have my egg retrieval canceled.  We were crushed again.  This past summer I went through the complete IVF process again to only get one healthy embryo.  We put all our hopes in that ONE, because we had no other choice.  Our transfer failed and we lost our embaby… again.  I got the news that our transfer failed the day before school started.  Instead of setting up my classroom, I spent most of that day crying in my car with no idea how I would face a classroom of children the next day.

I decided to take a risk and post about our experience on Instagram.  I was overwhelmed by the warmth and kindness shown in the comment section. To any of you who reached out with kind words of support, THANK YOU! I was even more overwhelmed by the hundreds of private messages I received over the next few days.  Friends and complete strangers poured their hearts out to me, sharing the grief, shame, and loneliness of their infertility journeys.  It was hard to be on the receiving end of so many heartbreaking messages, especially while I was trying to process my own grief simultaneously.  However, it actually proved to be the greatest blessing.  It was apparent that while infertility is a hard battle for anyone, there is something that makes it uniquely difficult as a teacher.

It was clear that teachers needed a place to have these conversations.  They needed a place to discuss strategies for being out of the classroom, or how to talk to your administrators.  They need to have the real talks about where the is best place to mix and administer shots at school.  They needed a place to come when you get the news that your colleagues are pregnant and how to deal with the comments “there must be something in the water.”.  They needed a place to talk about the heartbreaking reality that we spend our lives caring for other people’s children, while facing the possibility of never having your own.

I decided that instead of having 1:1 conversations with people in my DMs, I could invite them to create a community to support one another.  We formed a private Facebook group for teachers struggling with infertility and miscarriage.  It was the quickest couple hundred friends I ever made!  If you are a teacher struggling with infertility or loss, I am so sorry that we share this journey in common, but we would love to have you join us.

https://www.facebook.com/groups/TeachingWithInfertility

Last week, I asked the group to help me with the content of this podcast by asking three questions.  I would like to take a moment to add their voices to the conversation, as their experiences differ from mine, and therefore their responses will be different too.

I first asked what have been some of the hardest aspects of teaching while on your infertility journey.  I hope their responses can support empathy for certain issues:

• The stresses of “can I make a 7am appointment so I’m not late to school. Oh no – what if they don’t have those available? Then I need to find a sub and write plans to take a half day or a full day for the appointment. Oh my goodness”.

• [I live in a rural area} where the nearest clinic is an hour away on top of it. It’s also hard explaining to others why I’m missing so much. I’m not open about my struggles with most of my colleagues. Also the guilt of having a sub so often and feeling like I’m failing my students on top of everything.

• The need to continue teaching after hearing not-so-great news from your doctor or nurse (during the school day or before school). When I got my first negative pregnancy test results over the phone during my lunch break.  It was hard to keep teaching normally for the rest of the day.

• I got a there is nothing more we can do for you phone call at work last year and it was my lunch break. I texted my colleague to ask the secretary for a sub so I could go home. I was in inconsolable.

• The emotional roller coaster of hormones with the fertility treatment makes it harder to deal with the kids emotions/behaviors etc. It effects my whole day. I feel exhausted.

• The hardest thing for me is that with working with so many women, there is literally always someone pregnant at all times. While I’m sincerely happy for them, it’s hard.

• Being in a female-predominate profession and being around so many women who are pregnant or have young ones-not being able to relate to weekend family activities in the staff lunchroom, etc.

• For me, it’s been the “just wait until you have kids” type of comments that parents say when I suggest a solution for their child that maybe isn’t easy, but essential. It’s like knives to the heart when I hear this.  [I would add that this type of language is constant from colleagues too, and it is devastating every time!]

The second question I asked was to share a way my listeners could support a fellow teacher struggling with infertility [whether they know they’re struggling or not].

• Many said that understanding common triggers for folks struggling with infertility and loss would be a HUGE help! Some of those triggers include:

• • Asking “when are you going to have kids?” or “when are you going to try for another?” Let me break this down: Never, no matter how close you are to a person, ask them when they plan to have kids.  First, it is wrong to assume that having a child is the default plan for any couple.   Second, regardless of your relationship to someone, it is wrong to assume that you are entitled to that level of personal information.  If a person wants to share, they will.  Finally, anything along this line of questions is incredibly triggering for someone struggling with infertility.  It looks different for everyone, but it is traumatic, and needs to be treated as trauma.
  • Words like miscarriage, pregnancy, children, and family can be potential triggers.
  • Baby announcements and pregnancy announcements.  Avoiding social media and the mailbox are often coping strategies for people experiencing infertility.
  • Seeing someone who’s pregnant.  The visceral reaction to another person’s pregnancy is real, and almost always uncontrollable, despite your relationship with them.
  • Places with small children.
  • When a pregnant person complains about their pregnancy, regardless of the merit of that complaint.

• Offer to listen, check in with your teacher friends but please don’t offer advice unless asked for it. While it might seem helpful, it often times comes across very hurtful. You can offer support without trying to solve the persons problem or give them reasoning.

• Listen. Keep your mouth shut and listen. Listen with your heart more than your ears. Give hugs, offer time, support, service, and patience. Honor their feelings and readily apologize if you learn comments you made were hurtful.

• For me, the best support has been those that just listen. I don’t want you to tell me, “everything happens for a reason,” or, “you will get there,” etc. I just want someone to talk to. This has been one of the most difficult journeys, and also the most lonely, so having someone that will just listen and offer silent support has been amazing.
• Ask if there’s anything you can do for them and let them know you’re thinking of them. Don’t ask about appts during the school day. I often have cried in the middle of the classroom and had to step out because my coteacher wanted to know how my morning appt went (didn’t go well) and my hormones did all the talking. They didn’t mean harm, but I would have rather waited until the end of the day when the students are gone to talk.

• Just say “it sucks and I am sorry. Is there any way I can help.” Don’t try to solve it. So many people told me to try IVF, I would have if I could.

Finally, I asked if you could offer one piece of advice to other teachers struggling with infertility, what would it be?

• If you feel comfortable with this is to have one person at school that knows exactly what is going on. I had one teacher friend in the building that I confided in completely and she would know when I was getting phone calls or going through treatments and could read my facial expression without me having to say anything. It was comforting to know I wasn’t alone at work and she wouldn’t ask questions but I knew she was always there, even if it was to just cry in her office.

• remember to protect yourself from hurt – maybe don’t go to baby showers unless you’re really close to the person. Support from afar!

• One piece of advice is to find someone at school you feel comfortable opening up to. I am not a very open person and struggle sharing my journey with people. I have found that once I opened up to a coworker, it made it much easier when I am out for appointments and to share news, both good and bad, with. It’s always nice because she will pop in and ask if I need a break, or always offer support, that I didn’t realize until I had it, how wonderful that is.

• Don’t feel guilty taking a day to either go to the doctor or simply a day for mental health. Your kids will be okay and you deserve to take care of yourself. I felt so guilty taking my due date off earlier this week but was so grateful for the time spent with my counselor and my husband. I needed that day.

• My advice to that would be to make sure you put YOU and you’re future family first!! As teachers we rarely do that. Nothing at work is more important than this…. I have to tell myself every time I feel guilt over getting another sub. Or missing another day etc.

There you have it.