A Doctor Turned Patient: Proactively Coping with Secondary Infertility
By Dr. Flora Sinha
Negative. My pregnancy test was negative. My first IVF cycle didn’t work.
I have a beautiful three year old daughter. We got pregnant naturally so quickly with her that I took my fertility for granted. Being a primary care physician, I quickly figured IVF was in the near future after I wasn’t able to conceive baby #2 after a year. Even with my medical training, I could not have prepared for the emotional and time commitments of IVF.
From the start of the IVF process I confidently started the myriad of oral, vaginal, and injectable hormones, meticulously timing them according to the calendar. Blood work and ultrasound appointments were booked every two to three days. I soon found myself running on a hamster wheel. I would juggle my Los Angeles commute, seeing patients in clinic, work projects, fertility appointments, scheduled meds, and home life with a physician husband and a strong minded toddler (like her mama). I was constantly moving patients around my own appointments so I didn’t have to cancel seeing them. When I did have to cancel a set of patients, I felt so overwhelmingly guilty that I would work extra hours to accommodate them. Sound overwhelming? That’s because it was. I was over-extending myself, and it was nonstop.
After receiving the negative pregnancy test from my first IVF cycle, I felt an overwhelmingly amount of doubt mixed with guilt. Did I start a family too late because I was studying through medical school and training in residency? Was I in the wrong for waiting “too long” after having my daughter because I went through post-partum depression and had a difficult time juggling my career and family life? Was this a sign that I wasn’t meant to give my daughter a sibling?
I was uncharacteristically unable to clearly verbalize my feelings. I felt isolated, even though I was surrounded by endless love. I have a supportive husband who helped keep balance. I have my “mom tribe” who said all of the right things. I have an excellent fertility doctor, accommodating colleagues, and funds to support this decision. I reminded myself daily of how lucky I was.
Simply thinking positive wasn’t working. I would receive unsolicited advice from friends, family, and strangers: “Your daughter needs a sibling.” “What are you waiting for?” “Just be positive. Don’t be stressed.” And, my favorite, “Have you stopped your birth control yet?” I was surrounded by others my age (and not my age) getting pregnant. I was unprepared for the constant roller coaster of feeling pure joy then immediate devastation when they would share the exciting news. These repetitive stings became open wounds. I became angry and resentful. Why me? Why her? Why the uninvited questions? Why the excessive positivity? IVF failed me. I failed IVF. I failed myself, my husband, and my daughter. I was in a downward spiral. Eventually the pain became a part of me. It was affecting all aspects of my life. Hundreds of women go through IVF, so why did my situation feel different?
Because it IS different. Everyone’s fertility journey is their own.
It took seeing a new patient who was having fertility issues of her own for me to get insight. In her pain, I saw resilience. In my pain, I began to see the same. Her journey was completely different than mine, yet something resonated with me. I hugged her at the end of the visit. She cried. I cried. Neither of us knew why. We were just two women in uncontrollable situations, who needed to cry and hug it out with a complete stranger. As an internist, I am often counseling patients on how to reduce stress, anxiety, depressed mood, and increase their productivity, value, and happiness. Regardless of the situation or trigger, the foundation for change is the same. So, it was time to take my own advice and here is how I approached my situation:
I stopped the guilt.
I do not regret my 20s. That is when I decided to devote my life to practicing medicine. In that decade, I met the love of my life, went to medical school, got married, moved to California, and started residency. I am now a practicing internist giving a piece of myself to every patient I see. “I” didn’t fail the IVF cycle. This is not an exam that I studied for. This is a process of probability. We do not inherently control our menstrual cycles, ovarian egg count, or our egg quality. We just have statistics. How was I to predict that I would have fertility issues in my early 30s? It’s not my fault. And it’s not yours.
I acknowledged my feelings.
Good and bad. I didn’t feel the need to seek therapy, but I always bring this up with patients as an option. I chose to feel my pain, recognize my obstacles, and learn from them. My pain plus my self reflections led to changing my focus. I started journaling my pain, verbalizing my confused feelings, and concentrating on my achievements. YOUR feelings are real. The hormones you are swallowing, injecting, and shoving up your vagina may even exacerbate these feelings. Take those feelings, ask yourself why you are feeling them, and move forward. No need to linger.
I showed vulnerability.
This one is difficult. I had been transparent with my closest friends and family from the beginning. However, to those strangers (Yes, strangers: MANY patients, friends of friends of friends, that one woman in the park that one time…) who would ask, “So, JUST the one? She needs a friend!” or “When are you going to give your daughter a sibling?” to which I would angrily (and sarcastically) reply, “I made her. I’m her friend,” or “Oh yea. Let me go buy a human and GIVE my daughter a sibling,” I’m not angry at you now. I’m actually flattered that I made you feel comfortable enough to ask me such a personal question. I started to answer these questions honestly. My response invited the most empathetic and open conversations: Moments that I cherish. Alternatively, if my response made them feel uncomfortable, we’d politely move away from the topic. I’d hope in the future they would think twice before asking such a personal question to which they were not ready to hear an honest answer to. Openness is a sign of courage and strength. And, this journey, my friend, takes all of that and more. You don’t need to suffer in silence to prove your strength.
I focused on gratitude.
I am blessed to have a beautiful little soul call me mom. My husband, who already gives his all to his patients, recognized I was falling. I am thankful that he listened to me when my feelings didn’t make sense to him. He stepped up and took care of our little family. I am thankful for my in laws for being so open with me and recognizing how overwhelming this process is. I am grateful for my parents simply holding me while I cried uncontrollably after the first unsuccessful cycle. I have appreciation for my beautiful friends who gave me superwoman Band-Aids when I started injections, who gave me space to be angry, who were honest with me about their own pregnancy journeys, who checked in with me, and who simply listened to me without judgement or advice. I recognize how lucky I am to have supportive coworkers. I have accomplished so much. You have great people in your life. You have achieved a lot. Don’t ignore your current obstacles, but don’t let them outshine all of the things that are going right.
I started trusting MY process.
Not one fertility journey is the same. It took breaking my negative cycle and putting myself in a new space to change my perspective. Is it perfect? No. Do I see myself sometimes spiraling? Absolutely. Is IVF still difficult? Um, YES. But, I have come this far.
So, let’s go round two.
Dr. Flora Sinha is a board certified internist practicing in Beverly Hills, California. She is passionate about preventative care medicine and takes great joy in counseling patients on how to keep physically and mentally healthy among treating a variety of medical concerns. Recently, she found writing as an aide to help her effectively deal with her secondary infertility hardships. Dr. Sinha lives with her husband, Dr. Sanjay Sinha, and their beautiful three year old daughter, Gia. You can follow her on Instagram @dr_flosinha