Single Women Go to Fertility Clinics Too
It’s becoming more and more commonplace for single women in their thirties to research their options — regardless of whether they want children
With last month being PCOS Awareness Month, and this month being Pregnancy and Infant Loss Month, and while I try to put off going to bed, it seems like as good a time as ever to talk about my trip to the fertility clinic.
(This is long. My suggestion is that you go curl up with your blanket and some hot cocoa while you read about my womb. You’re welcome.)
It’s not a recent trip. I went about two years ago (and I have sat on this post since then because of #vulnerability). But recently a close friend visited a fertility clinic and it immediately took me down memory lane.
More and more and unbeknownst to many, especially the “marrieds,” this is what many of us single women do in our 30s. Besides my own lived experience, I have enough single female friends and have read enough blog posts to know that this is a fairly common and widespread occurrence. The fertility clinic is not just for couples having trouble conceiving and for those trying to have a baby. It’s also for those (me!) who want greater insight and want to do some investigation into their reproductive health in order to make well-informed choices for their future. Between living our best lives and cursing out Bumble (the app and the men on it), we start to think about what family planning may mean for us. Everyone loves to say, “you can always freeze your eggs!” as if we all have thousands of dollars laying around (especially after law school and while living in Toronto. Big LOL.). But at the time I wanted to know what this egg freezing was all about before discounting it outright.
In previous years, I’ve vacillated between “of course I’ll be a mother! There is no greater honour! It’ll just happen. It’s happenstance,” and “Hell no. HELL TO THE NO. There is nothing about motherhood that is remotely appealing to me. NOT A THING. And your vagina can tear? From front to back? And hyperemesis gravidarum is a thing? Only for the little bugger to grow older and talk back to you and put you in a nursing home? This cannot be the will of the Lord for my life. Babies aren’t that cute when they cry all night.”
To be fair, at the time I went I was thirty-years-old and I thought that I may want to have a baby someday. (Emphasis on someday. Not tomorrow. Not next week. Not even next year, or the year after that. But someday in the vague, far-off, distant future). I had, at the time, believed that I would like to take part in the human experience that entails bringing forth life.
As biology would have it, however, not having a partner complicates the whole “have a baby” thing. Apparently, I would need sperm (because I’m not hermaphroditic, unfortunately. If only self-insemination were possible).
Easier said than done though. I have eggs (allegedly), but there is no sperm in sight. Sperm is not hard to “come” by (no pun intended), but I don’t want just any random sperm. I would preferably like to use the sperm from a committed long-term partner who would help me raise the child resulting from our copulation (that last bit is of primordial importance). It’s fine not to have kids for now, but I reasoned that it may not be “fine” in two years or five years or ten years. Years do have a way of passing by quickly.
I also have polycystic ovarian syndrome (PCOS) and Hashimoto’s thyroiditis — two conditions which can sometimes complicate fertility, let alone if I were to be of — how do they say it? — “advanced maternal age” or having a “geriatric pregnancy”. I always want to keep my options open. So I started to wonder if there were things I could do to help me in the future and if there is anything that can be done to preserve and enhance my fertility until my personal life catches up. I figured that it wouldn’t hurt to know my options and plan or prepare accordingly. (As if life honours our plans. Lol. #2020. Anyways, I wanted to do my research).
Side note (and slight vent):
I don’t think people really realize or think about (or have to think about) how hard it is to be a Black, single woman in your 30s. How alienating it can be — not just for a day but for decades. How many private mini funerals you have for your life plans. How oversexualized and overlooked you can be. How you sometimes feel like no one’s standard of beauty. How people peg all Black women as existing within the “angry Black female stereotype.” How you must manage the tension between the possibility of everything changing in a moment and a possible life of longterm, endless singleness stretched ahead of you. How you must be resigned but hopeful. How you somehow have to live full but make space. This is currently my hard. I acknowledge that other hards exist. While it makes no sense to engage in the challenge Olympics, compared to the other hards that exist, this is a hard that I accept.
I Don’t Know How to Feel While Single
How do I find the middle ground between despair and hope?
For now, I am firmly in the “I don’t want to have children any time soon” camp. I don’t want to have children in the year of our Lord 2020, what with its plagues, pandemic, homeschooling, orange skies, orange president and people who look like me being killed for existing — besides the regular, age-old challenges of rearing a child. When I have to tell my nephew to stop doing something for the seventeenth time, I question whether I even have a desire to have children. If I were pregnant tomorrow I would not be happy. I felt strongly enough about this that it was an issue in my last relationship. But I’ve always been afraid that by the time I meet the “right person” who would magically make me want to procreate and “change my mind” (which may never happen, but it could) that it would be too late. My womb and my love life are not necessarily on the same schedule. People love to flippantly say, “you can always adopt!” as if adoption is cheap. And not equally as difficult. Or complicated. And while it is not something that I am absolutely dead set upon, people are allowed to want biological children.
The absence of my periods remind me that I am not working at peak fertility, that something is “wrong” with my body, that I may not be able to have children if (big “if”) and when (even bigger “when”) I want to and my helplessness in it all.
It is in that spirit that I broached the conversation with my doctor, and it was those fears (and curiosity) that landed me at the Ottawa Fertility Clinic.
I literally told my family physician what I’ve just told you all: “So, I’m single and I have no marital prospects…”
My doctor stopped dead in his tracks. The expression on his face said, “Where is this going?”
“I want to know when I should start being concerned about having a child.”
“Well, a woman’s fertility decreases after the age of 35…” he told me. Okay, I knew that (and that “fact” is disputable. See also here and here.). But I wanted to know how PCOS and Hashimoto’s would affect my chance at conceiving.
“How does me having PCOS and Hashimoto’s come into play?” I asked him.
“There are fertility drugs we can give you when the time comes, but if you want to know your options, I can definitely give you a referral to the Ottawa Fertility Clinic.”
So off I went to the Ottawa Fertility Clinic. It was fun! I bounded through the doors and said, “I’m here. INSEMINATE ME!”
On a dreary September day, I took the bus for over an hour to the outskirts of the city and sat in the waiting room all by my lonesome with a pit in my stomach and a feeling of failure gnawing at me while I was surrounded by a sea of hopeful couples. I remember being so sad. I was sad that I even felt like I had to consider a fertility clinic (what is this life where so many women go to fertility clinics like this is commonplace and so many people have trouble doing the seemingly most natural and straightforward thing in the world — have babies?). Sad that I was unpartnered. Sad that I was considering these decisions by myself. Sad that my life hadn’t worked out as streamlined and normal like all of my peers. Frustrated by the circuity and meandering of my life. Failed the bar four times. Not practicing law. No discernable career path. Government job I hate. Nowhere close to being married. Eight menstrual cycles a year at best. There were a couple of times I had to keep myself from bawling. I was already in a clinic to discuss subfertility — I didn’t want to transform into a pathetic public spectacle as well.
When I finally got to see the specialist, I basically learned that I was too poor for egg freezing and IVF and too fat and infirm to conceive naturally or with drugs. Well, I mean, the specialist didn’t quite say it like that.
I didn’t know that freezing my eggs would cost $20 000 (and that might be USD because the eggs are housed somewhere in the States) and wouldn’t be covered by insurance. I also didn’t know that there is no guarantee that your eggs will survive the freeze-thaw cycle (i.e. there is no guarantee that there will be a return on your hefty several-thousand dollar investment).
I also didn’t know that OHIP (provincial health insurance for my non-Canadian readers) covers one round of IVF (after 35 I think?) but this also costs just as much as egg freezing.
Then of course there is the possibility that as soon as I leave the fertility clinic I bump into my future husband or get knocked up during a one-night-stand and don’t need those frozen eggs after all and thus I just flushed $20 000 down the drain which could have been a downpayment on my house or paid my school debt because I wanted to be prepared and “take precautions.”
So, issa no for freezing my eggs. And all those people who love to say, “jUsT FReeZe YoUr EgS,” can shush now. It’s not that simple.
She told me that, “Typically we would say a couple is infertile after a year of trying [under age 35 — it’s after six months if over age 35], but for you, I wouldn’t suggest waiting a year. As soon as you realize you want to have a baby, I suggest you come in and we start you on drugs immediately.” Good to know. Glad I went. Because I could have wasted a year trying fruitlessly and in futility, and when it comes to fertility, depending on the age I am trying to conceive, I may not have a year to waste. Time is of the essence.
My doctor asked me how much I weighed. I told her. She said, “Mind if we weigh you when we get into the room?”
“Your blood pressure is a little high, but then again you were talking.” I’ve never had high blood pressure… I have it checked regularly. I still don’t have high blood pressure.
“You should try to get to a BMI of under 35,” she said. Anytime a doctor comes at me with that BMI B.S. my eyes literally glaze over and roll to the side of my head. It is a well-known fact that BMI is an inaccurate measure to test the health of a person. But doctors seem to insist on some kind of objective measurement — however flawed — in order to be able to say that their patient is fat and tell them to lose weight. I suppose that’s why so many still insist on using it.
I told her that I have a muscular build —I’ve done body composition analyses and my body composition disallows me to have a BMI of under 35 and still be alive (I’d have to lose over 100 lbs). She shook her head. Even a “5 to 10 percent body weight will help. It will reduce complications during labour and it will allow the fertility drugs to work better…”
I protested. My periods have never been regular — not when I weighed less, not when I was vegan. Never. But she waved my protestation away.
I don’t expect doctors to coddle me and tiptoe around solutions. I have read and have come to understand that body fat (not weight!) can and does play a role in conception, pregnancy, labour, delivery and postpartum recovery. But given my experiences with medical practitioners, I can’t help but wonder if her counsel was steeped in fatphobia. Afterall, fatphobia in fertility counselling and medicine in general is a real problem (luckily there are people trying to buck this trend).
I was handed a business card for their reproductive fertility psychologist (I didn’t know that was a thing) and told me to come back on day three of my period to get my blood drawn to test for some hormone (AMH?) that would let them know about my ovarian reserve.
Thing is, when you have PCOS, you don’t know when your next period will be. So that’s always fun.
So I left the Ottawa Fertility Clinic feeling rather defeated. And sad. And like crap.
I thought of this when my fellow single friend relayed her experience at the fertility clinic to me. While she was not fat-shamed (she is not fat), neither of us left the clinic encouraged or hopeful.
I didn’t end up getting my blood test because it was months before I had my period. But I later had a conversation with my naturopathic physician at the time, explaining to her how defeated and torn and upset the whole process made me. And she asked me, “do you need to get that blood test done? If you had that piece of information, would it help you? How would it help you?”
“Well, I would know how many eggs I have left,” I replied.
“But how would you use that information?” she asked.
I was silent.
I couldn’t really do much with that information, to be honest. She made a good point — even if I knew what my ovarian reserve was, I’d still be missing a complete other half of the picture — the potential father’s fertility information. And I don’t know who that person would be. I could only go so far with the information I had, and it may not prove helpful (and could be stress and desperation inducing depending on what they discovered).
This is the part where readers, feeling empathetic and helpless and wanting very much to help are tempted to comment such things as, “You’re so young! You still have time! I had an ectopic pregnancy! I had my baby when I was 39! Just lose weight!”✌🏾 That’s nice. I’m not looking for advice (but thank you). I know it is really touch-and-go to solicit advice from strangers on the internet so I do not invite it.
And with all due respect I don’t think I need it because I slowly came to the following conclusion:
I think a combination of all of the above — the PCOS, the (possible) uphill battle to conceive after the years-long battle to find a mate, not to mention my lack of desire to raise a child makes the decision to not try to have children a valid one. For now. I mean, I concede — anything can happen. Surprises happen. Surprise marriages. Surprise pregnancies. Miraculous pregnancies. I always challenge myself to leave space for possibility.
But the lack of desire is key. I suppose if I had the desire then I would find a way to work through all of the other “challenges” I mentioned. But I don’t have the desire. I don’t think I’ve ever had the desire. I don’t know if there will ever be a situation that conspires to stoke that desire. I don’t know. That’s the hardest part. You never really know.
I always took for granted that I would become a mother and thus I felt like I had to do my research and be prepared. But I need to want it.
Over the years, and definitely since my excursion to the fertility clinic, I have had to really ask myself if this is something I really want and want to work for — barring PCOS or weight or marital status. And I had to admit to myself that I don’t want it that badly (or maybe at all). I am not inspired to siphon away money for egg freezing. I am not inspired to go on dates in the hopes of finding a father for my children. I know what it is to long for something, or someone. I deeply desire a partner. The thought of remaining partnerless into the yawning future is torture. The thought of not having biological children does not fill me with similar dread — questions perhaps (about who will visit me in my nursing home) but not dread. I don’t stare at strollers longingly like I do at the couples gazing at canteloupe in the grocery store. I don’t think of cute baby names or dream of the outfits in which I’d like to see my child, the way that I think of travels around the world and stolen kisses on sunkissed beaches with the love of my life. I don’t long for children, and it’s too great a responsibility to procreate out of it being a rite of passage as opposed to out of a deep desire to raise a good human being.
Going to the fertility clinic, though, gave me a sense of what conception may look like for me, giving me a piece, however unfixed, of the puzzle in figuring out how I ought to approach my relationships and the rest of my childbearing years.
I say all of that to say this: whether you are planning to have a child or not, I think it is still a wise idea to do some investigation into your reproductive health as early as possible so that there are few(er) (if any) surprises for when you actually do want to conceive (if that is what you want. If you know that you will never care about conception, feel free to disregard this advice). Unfortunately, there is only one fertility clinic that serves both Ottawa and Kingston (which is the one I mentioned), but I would ask your doctor to refer you to a clinic that has good reviews for its care and treatment of patients — not to mention positive outcomes for those who want to have children of their own.
Knowledge is power, and if having children is a battle you want to have, I think you will want to go in armed, ready, and with all of the information at your disposal.