A Doctor's Response to the "Fertility Crisis"

In a heartbreaking essay titled “My Fertility Crisis” published in last weekend's Wall Street Journal edition, writer Holly Finn gave a detailed account of her own struggles with fertility and trying for pregnancy after 40. Her story brings readers through the harrowing reality of infertility treatments and the pain experienced by couples who after years of hoping remain – childless.

Finn writes,

“IVF brings you to your knees and dares you to stagger to your feet again. Even as you steel yourself for more shots and setbacks, it forces you to remember the gentleness in you and the true reasons you want to bring another human into this world....

...Is this the punishment for romanticism: having to do the least romantic thing in the world [infertility treatment]? Like many, I trusted that marriage and children—my family—would happen. In the meantime, I lived my life. I fell in with some fascinating men, up close and unvarnished, and had conversations I can still quote. I didn't want to settle at 25. I wanted adventures. I just didn't imagine their cost, and how I would struggle to keep paying it....

...In the end, infertility can make you feel less human. As cultivated as we are, we hold on to a deep-rooted belief that our worth is tied to how well, and how much, we reproduce. I've seen women and men shrink like salted slugs during IVF treatment. I've done it myself, disappearing even as the hormones start to puff me up. The whole process makes you feel unlovable.”

This lengthy, heart wrenching essay by Finn is actually an excerpt from her book “The Baby Chase” in which she details every financial and emotional expenditure that her journey through infertility has cost her.

This one woman's emotional story caught the attention of a very prominent infertility expert, Dr. Norbert Gleicher, founder and medical director of the Center for Human Reproduction, President of the Foundation for Reproductive Medicine, and Visiting Professor at Yale University School of Medicine.

Holly Finn's essay so moved Dr. Gleicher that he sat down and wrote a lengthy response to Finn, and every woman out there like her. His own reproductive clinic specializes in pregnancy of the older woman and he says that it is women just like her that he and his colleagues try and bring miracles to every day. Dr. Gleicher acknowledges the sadness and guilt that Finn describes, but challenges the validity of her hopelessness. He writes:

“I see women like her (and often older) daily at our infertility center. None of them really has reason to be down on herself, because, as individuals, women are mostly powerless in overcoming the major evolutionary developments, radically changing how we live, and, therefore, reproduce. It is not their fault that they gave too much time to the wrong men....

...Ms. Finn concludes from her own experience that women should listen to their guts and their gynecologists rather than their bosses, and for all practical purposes, should choose early pregnancy over careers. Easier said than done in a rapidly evolving world, where women can no longer count on the safety of life-long marriage and support from strong family ties.

...[However,]women today are no longer limited by their own reproductive lifespan (i.e. their ovaries’ ability to produce viable eggs) because (anonymous) egg donation has become widely available. In the United States, egg donation now represents the most rapidly growing fertility treatment within IVF. At our infertility center, egg donation cycles have doubled and tripled respectively over the last two years.

Dr. Gleicher goes on to explain that with proper medical care and guidance women like Ms. Finn may still have a real chance at conceiving children. However, this is not his point, he concludes:

“What struck me in reading Ms. Finn’s essay was that she did not reflect the anger our profession often faces in publications describing failed IVF and infertility treatment experiences. Instead, she projects a degree of hopelessness and sadness in her message, which is almost harder to take.

What she is really telling us in her piece is that as a medical specialty, it is high time to recognize that we, to a large degree, are failing a rapidly growing patient population which urgently needs our help.”

Further reading: How Many Failed IVF Attempts Are Too Many?