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Dear woman struggling with infertility,

This might be a difficult letter for you. Partly because life feels challenging right now, and partly because I may tell you things you don’t want to hear.

Everything you do is centered around this: you want a baby— no ifs, ands, or buts about it. You’ve been experiencing a deep craving to have a child for a long time now. You feel ashamed and heartbroken that you can’t.

Other women around you are having babies. Other women around you proclaim how easy it was to get pregnant. Other women around you are glowing and growing, and you just can’t deal with any of it. You’re jealous, sad, hopeful, regretful, misunderstood.

I get it. I’ve been there.

Photo of couple, man comforting the woman, a silhouette

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When I was in my mid-thirties, partnered, and with an amazing stepson, I often asked myself why that wasn’t enough for me. Why did I want a baby so badly despite my partner’s blatant refusal to even consider having one? He already had a son, he said. That son loved me like a second mom. I loved him right back. Yet I craved what I couldn’t have— the memory of a tiny being growing inside me, the tactile remembrance of skin on skin with someone I helped bring to life, the shared stories with other moms of breastfeeding and late nights and what it means to be a real parent. The desire to get pregnant and have a child was intensely primal.

To add insult to injury, I couldn’t have gotten pregnant no matter how much I wanted it. My ovarian reserves are too low.

You’re likely going through your own version of this experience: craving, denial, anger. Hope, fear, despondency. The good news is that in spite of the roller coaster of emotions you’re on right now, there are some practical areas of your life to look at before giving up the baby dream.

Microscopic photo of female egg fertilized

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First thing is to get your eggs checked. Do you have enough? Are they healthy?  A simple blood draw at your OB/GYN’s office can determine this by measuring your FSH (follicle stimulating hormone) level. Once you’ve determined what that level is, you can start to look at other things that might need attention.

Often, symptoms of infertility can be masked by something else. Your inability to lose weight, menstrual issues, and acne are all possible signs of Polycystic Ovary Syndrome (PCOS). PCOS can wreak havoc on your body and can lead to infertility. Do you have high blood sugar and high blood pressure? The dismay you feel every time your doctor tsk-tsks at you for your unhealthy cholesterol levels or your weight might be misplaced. Feeling like a failure because of a stubborn belly pooch that won’t go away no matter how much you exercise isn’t going to solve what’s going on metabolically for you.

Common symptoms of PCOS are decreased glucose metabolism and insulin resistance. A lifestyle change that entails cutting out grains and dairy and adding in lean grass-fed organic meats, wild caught fish, lots of organic veggies, and plenty of healthy fats can do wonders for reversing metabolic syndrome.

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And while we’re on the subject of lifestyle re-dos, let me get preachy, but only for a second. Those glasses of wine you have at book club, or to mask the sadness you feel, or because you figure “I’m not getting pregnant, what the hell” aren’t doing you any favors, my dear. Consuming alcohol is associated with premenstrual anxiety, mood problems, and headaches. Once that adult beverage is in your system, your liver has to metabolize alcohol rather than burning fat. Downing more than three servings of alcohol each week also increases the risk of breast cancer.

You can protest all you want, but I know— I used to like a generous pour or three. Sometimes because it tasted good and sometimes because it seemed like the one thing that helped me relax. When I cut my friend Cab Franc out of my life (I now only see her on rare occasions), my hips got smaller, my belly tauter, and my crazy periods have stabilized.

Photo of oral contraceptive pill strip

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Progesterone deficiency, also known as estrogen dominance, can be a cause of agitation. It can cause or PMS, breasts that are swollen or tender, irregular, heavy or painful periods, bloating, clumsiness, restless legs, ovarian/breast cysts, headaches that keep pace with your cycle, and the two biggies: infertility and miscarriage. Getting your hormones balanced can be a big step toward fighting depression, decreased metabolism, and lack of energy as well.

“But,” you say, “I’m healthy! I don’t drink alcohol or coffee. I cut out grains and processed sugars. I manage my stress. And I still can’t get pregnant.” It’s time to head back to your OB/GYN and ask for options that can put you on the path to pregnancy. Boosting hormone levels, naturally or with the help of medications, can help. We’re already living in a science-rich era; egg retrieval, ovulation induction, and boosts to fertility are all commonplace these days.

Photo of happy couple waiting child

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Falling short of that, as is my case, there are still options to consider. Eggs donors are becoming increasingly common, and so are surrogates. I’m acquainted with many people who have adopted both from domestic and international agencies.  A couple I know has recently completed training to be foster parents. They’re spending their time offering their home and love as an interim stop for babies on their way to a longer-term situation.

The point being, there are alternatives. And sometimes they may not look like what you thought they would.

A few years ago, I chose to give up the specifics of my dream. When I did, I could swear I saw pale ribbons fluttering in the wind, a tiny daughter with light eyes who looked back only once as I let her go.

It was difficult to give up that hope. But I know that my life is rich and full of nurturing. I’m fortunate to work in a field where I care for people and I get to spend time with both pregnant women and little ones. Given the chance, I would have a baby tomorrow, but the way that happens for me might not be what I originally imagined. Instead, I’m focusing on self-care, good eating, exercise, and joy. I’m okay with whatever happens next.

Keep this letter, but not because it’s some sage advice being bestowed upon you. Keep it so you can remind yourself that there are solutions to what can feel like an insurmountable problem. Keep it so you remember that you have choices even when it feels like all avenues are closed. Keep it so you remember to take care of yourself and continue to move forward. Keep it so that even in your darkest times, you know you’re not alone.

We’ve got this, girl.