When Your Child Can't Have Children

You've wanted to be a grandparent forever, but have struggled mightily to zip your lip and not ask when or if it's going to happen. Your friends are flashing baby pictures of adorable grandkids, and you wonder, "When will it be my turn?"

One day a phone call comes, but not the one you were hoping for. It's your daughter sobbing, saying "Mom, I can't stand it anymore. We've been trying to get pregnant forever, and nothing is working. I hate it so much!"

National Infertility Awareness Week, hosted by RESOLVE: The National Infertility Association and now celebrating its 51st anniversary, is April 20-26. The week is dedicated to reducing the stigma around infertility and educating the public about reproductive health and its challenges.

Lynnette Lyons, 58, of Katy, Texas, a former high school English teacher and now a freelance writer, remembers the pain of being unable to conceive. When she and her husband decided to start a family, they found that, as a result of a ruptured appendix at age 15, she had numerous pelvic adhesions, a twisted fallopian tube and an irregular ovulation cycle.

Her gynecologist started her on Clomid, a medication used to stimulate the development and release of eggs, and she was finally able to conceive. Unfortunately, she had two miscarriages. She then had difficulty getting pregnant again, and saw a reproductive endocrinologist, who performed several procedures using assisted reproductive technology (ART).

"Eventually," she says, "I produced enough eggs that some were able to be frozen," and she finally had her oldest daughter, now 28, and a second daughter, 25, now in medical school. At 37, she had a natural, very welcome surprise pregnancy, and gave birth to her youngest daughter, now 20.

"My mother tried very hard to be supportive throughout my fertility journey, and we spoke on the phone almost every day," she says. "I can't imagine having gone through it without her." Still, she adds, at times it was not easy dealing with her mom, who was anxious and emotional about the many ups and downs her daughter was experiencing. "I'm her only daughter and she very much wanted to see me have a child, which she knew I desperately wanted. I often felt that I needed to console her, at a time when I was needing to be comforted myself."

Infertility, defined as being unable to become pregnant after one year or longer of unprotected sex, is more common than most people realize. The U.S. Centers for Disease Control and Prevention states that, in the United States, one in five (19%) married women age 15 to 49 with no prior births are unable to conceive after one year of trying.

According to the American Society for Reproductive Medicine, approximately one third of infertility is attributed to the female partner, one third to the male partner and one third is caused either by combined problems in both partners or to unknown factors.

"People think of infertility as a female problem, even though this is not always the reality," says Pauline Walfisch, a Long Island, New York, clinical social worker, psychotherapist and director of Helping Hands Psychotherapy, who had her own challenges building her family but is now the proud mother of sons ages 15 and 22. "Infertility can be a shame-laden experience and there are often feelings of guilt about not being able to give a partner what they want so badly," she says.

The diagnosis and treatment of infertility is time consuming, physically and emotionally draining and prohibitively expensive even when partially covered by health insurance. IVF treatment requires women to be injected with medications that can cause mood swings and some physical symptoms and, at certain points during their cycle, necessitates daily early morning medical appointments.

Going to baby showers or seeing newborn babies can be excruciating, at times deliberately avoided, causing family disappointment and sometimes discord. Not being a grandparent can be difficult for some people, too.

How can you support the people in your life who might be experiencing fertility challenges, even if it has not been brought out in the open? Educating yourself about infertility, including the many initials used when it is being discussed, and the many ways that families can be created today can be helpful because you don't want to bombard your "child" with too many questions.

Understanding the complex processes also will help you to be more empathic with the stresses and struggles associated with fertility challenges and to be patient if the person or people going through them are at times short-tempered or dismissive of you and your feelings.

RESOLVE's website provides information on diagnosis, causes and treatment of infertility, along with subjects ranging from insurance concerns to alternate roads to building a family that do not involve ART.

According to the Centers for Disease Control, some ART procedures include:

• In vitro fertilization (IVF) or in vitro maturation (IVM)
• Intracytoplasmic sperm injection (ISCI)
• Gamete intrafallopian transfer (GIFT)
• Zygote intrafallopian transfer (ZIFT)
• Frozen embryo transfer (FET)

Additional ways to become parents include intrauterine insemination, the use of donor eggs or sperm, gestational surrogacy, egg cryopreservation (freezing), embryo donation and adoption. Sometimes, after trying different things with no success, there may be a decision to remain childless. Additionally, same-sex couples trying to conceive have their own challenges.

Once you've been told that pregnancy is desired but not happening, Walfisch says, it is important to verbalize that you are honored and grateful that the struggle is being shared with you. "Let the individual or couple know that you will respect their privacy and not share the news with anyone unless the prospective parents have specifically given the OK," she says. "Some people have good hearts but loose lips," she adds, pointing out that the infertility experience is very personal and not something that should be bandied about.

It's also important to ask how you can be helpful. Should you be checking in frequently and asking how things are going, or is it better that you wait until information is volunteered? It's also fine to say things like, "I don't know what to say or do but I wish I could help make this easier for you."

It is also important have your own support system, preferably a trusted confidante who is in a different circle, and to not expect your child to take care of your feelings.

Things not to say include:

• "I knew you waited too long!"
• "Do you know whose fault it is that you can’t get pregnant?"
• "You need to take a vacation and relax."
• "You should stop trying to get pregnant and just adopt a baby."
• "My friend’s daughter from church adopted an adorable little boy. Do you want her phone number?"

"I think it must be incredibly difficult not to have parents involved, but you have to think about how they would handle hearing about your medical issues and if that knowledge would be beneficial or detrimental to them or to you," Lyons says. "Infertility is an emotionally harrowing experience, and the more supportive people you have to fall back on, the better it is."

Barbra Williams Cosentino RN, LCSW, is a New York-based psychotherapist and writer whose specialties include chronic illness, health, aging and parenting. Bylines include HealthCentral, the New York Times, Today's Geriatric Medicine, Forward Magazine (Fox Chase Cancer Center), BabyCenter and many others. Read More