Hello angel,

How are you this beautiful day, our baby? Although the day doesn't seem as beautiful without you in it. Daddy and I are still waiting for you to come to us. There have been some signs that this may be the month that you come to live with Mommy and Daddy, but we have had these signs before, and are trying not to get our hopes up too high. We know when God is ready to give you to us, you will be here. Although Mommy is getting really impatient and tired of waiting and tired of hurting so badly each month.

Daddy and I were talking about you yesterday and were trying to figure out what we would name you when you come. It will be fun--because Mommy and Daddy can't agree on a name for you. So don't be mad at us if you don't have a name for a couple of days after you get here :o).

Last night Mommy dreamed that she heard you crying and woke up to get you, and you weren't there. Mommy hears your cries all day long and wishes she could just hold you in her arms and kiss all those tears away.

Are you as anxious to come see us as we are to see you? Do you miss your Mommy and Daddy as much as we miss you? We wonder about you all the time. What color your hair will be, your eyes, will you have your Mommy's nose (we hope not), will you have your daddy's appetite (we will spend a fortune on groceries).

Well, Mommy has to be going now, honey. Daddy says he loves you and missed you and hopes you get here soon.

Love you baby,

Mommy and Daddy

November 5, 1998 Hello Angel, How are you tonight my baby? Mommy is very depressed tonight and has been since last Tuesday. After we had so many good signs that you may be coming to us this month, we found out you are not. Mommy was having very bad pains last week, and she had to go see her Dr. right away. The Dr. gave me a pregnancy test and it was negative. It was all I could do not to start crying right then. Since we found out that you are not going to come to us, I have not been able to think of anything else. All I do is lay and bed and cry and sleep. I hate going out anywhere, because everywhere I turn there are babies. It's hurts so bad to see those little ones. My arms ache to hold you so bad. Your daddy is so worried about me, because I am so depressed. I just miss you and want you here so I can hold you and cuddle you. Daddy and I have decided to take a 6 month break from trying. With Daddy's back and all, it is just getting to stressful for him right now. Mommy hates it that the holidays are coming. I told myself last year at this time, that you would be here, or on your way to us. The holidays are going to be really hard on us this year baby. We will think of you everyday. Please say you will wait for us to start trying again, angel. Mommy is trying to lose alot of weight, so maybe that will help me bring you here. I am trying to eat healthier and to remeber to take my medicine. Daddy says to say hello and he misses you so very much. Well, I think I am going to go for now angel, I am starting to cry. I love you. Love,

Mommy and Daddy

November 25, 1998 Dear sweetheart, How are you doing my darling? Mommy and Daddy are OK. Daddy's surgery got denied, so he has to have some more therapy and then go back to work. He is still in a lot pain. He is making chocolate chip cookies right now, and they are sooo good. Mommy has been having terrible stomach and back pains for a while now and that is why she hasn't written you back lately. I found out that I have endometriosis which is going to make it a bit harder for us to bring you here. I hope you will wait for us. We weren't going to try again this year, but a wonderful woman just donated the Fertinex to mommy, so Daddy said that we could try again. Please let this be the month that you get here. Daddy says that mommy is being a psycho because of the medicine I am on. He says that he's going to go stay with your grandma for a couple of days. :o) Mommy and Daddy are going to take your great-grandma out to lunch tomorrow, because your grandma went to Mississippi to see family. Then we will be going to see your daddy's family. I hope you have a Happy Thanksgiving darling, and I will be thinking of you all day tomorrow. Please come to us this time baby. I would love to tell your daddy that you were going to be his Christmas present.

Love you, Mommy

Side Effects of Some Infertility Medications

Pergonal and Humegon (Combination of FSH and LH) Irritation at injection site nausea, vomiting, diarrhea, abdominal cramps and bloating Ovarian enlargement Very rare--Ovarian Hyperstimulation Syndrome

Metrodin (FSH) Irritation at injection site nausea, vomiting, diarrhea, abdominal cramps and bloating Ovarian enlargement Greater risk of Ovarian Hyperstimulation Syndrome

Profasi, Pregnyl, APL (Human Chorionic Gonadotropin) Pain at injection site Fluid retention Headache, Fatigue, irritability, and restlessness

Lupron (Leuprolide Acetate) hot flashes, sweating irritability, nervousness blurred vision, joint pain pain at injection site **If you experience pain in the chest, groin, or shortness of breath--notify your Dr. immediately

Clomid (Serophene) breast tenderness moodiness mild ovarian enlargement hot flashes headaches

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To:__________


Because you care about ___________ and her happiness.

________ knows that you love her and want her to be happy, to be her "old self" again. But lately she seems isolated, depressed, and obsessed with the idea of having a baby.

You probably have difficulty understanding why getting pregnant has colored virtually every aspect of her daily life. _________ hopes that by reading this booklet, written by counselors with both personal and professional experience with infertility, you will better understand the pain she is feeling. This booklet also will tell you how to help her.

SOME FACTS ABOUT INFERTILITY
It may surprise you to know that one out of six women who wants to have a baby cannot conceive. There are many possible reasons for this dismal statistic: blocked fallopian tubes, ovarian failure, hormonal imbalances, husband's low sperm count, to namy just a few. Moreover, after a woman turns thirty-five, it becomes difficult to have a baby primarily because many of the eggs she has left are defective and old.

All these barriers to pregnancy are physical or physiological, not psychological. Tubes don't become blocked because a woman is "trying too hard" to get pregnant. Antibodies that kill sperm will not disappear if a woman simply relaxes. And a man cannot make his sperm swim faster by developing a more optimistic outlook.

WELL-MEANING ADVICE
When someone we care about has a problem, it is natural to try to help. If there's nothing specific that we can do, we try to give helpful advice. Often we draw on our personal experiences or on anecdotes incolving other people we know. Perhaps you recall a friend who had trouble getting pregnant until she and her husband went to a tropical island. So you suggest that _______ and her husband take a vacation, too. ______ appreciates your advice, but she cannot use it because of the physical nature of her problem. Not only can't she use your advice, the sound of it upsets her greatly. Indeed, she's probably inundated with this sort of advice at every turn. Imagine how frustrating it must be for her to hear about other couples who "magically" become pregnant during a vacation simply by making love. To ______, who is undergoing infertility treatment, making love and conceiving are unrelated now. You can't imagine how hard she's been trying to have this baby and how crushed she feels every month she learns that she's failed again. Your well-meaning advice is an attempt to transform an extremely complicated predicament into a simplistic little problem. By simplifying her problem in this manner, you've diminished the validity of her emotions, making her feel psychologically undervalued. Naturally, she will feel angry and upset with you under these circumstances.

The truth is: There's practically nothing concrete you can do to help ______. The best help you can provide is to be understanding and supportive. It's easier to be supportive if you can appreciate how being unable to have a baby can be such a devastating blow.

WHY NOT HAVING A BABY IS SO UPSETTING
Women are reared with the expectation that they will have a baby someday. They've thought about themselves in a motherhood role ever since they played with dolls. A woman may not even consider herself a part of the adult world unless she is a parent. When ______ thinks that she cannot have a baby, she feels like "defective merchandise." Not having a baby is literally a matter of life and death. In the bible, Rachel was barren. She said to Jacob "Give me children or I die..". Commenting on this some sages said, "One who is childless is considered dead." So powerful are the feelings connected with barrenness that the person feels dead or wants to die.

Worse, _______ is not even certain that that she will never have a baby. One of the cruelest things one can do to a person is give them hope and then not come through. Modern medicine has created a double-edged sword. It offers hope where there previously was none---but at the price of slim odds.

WHAT MODERN MEDICINE HAS TO OFFER THE INFERTILE WOMAN
In the past decade, reproductive medicine has made major break-throughs that enable women who in the past were unable to have children to now conceive. The use of drugs such as Pergonal can increase the number and size of eggs that a woman produces, thereby increasing her chances of fertilitzation. IVF techniques extract a woman's eggs and mix them with sperm in a test tube and allow them to fertilize in a laboratory. The embryo can then be transferred back to the woman's uterus. There are many other options as well.

Despite the hope these technologies offer, they are a hard row to hoe. Some high-tech procedures are offered only at a few places, which may force _____to travel great distances. Even if the treatment is available locally, the patient must endure repeated doctor's visits, take various procedures, and lay out considerable sums of money--money that may or may not be reimbursed by insurance. All of this is preceded by a battery of diagnostic tests that can be both embarrassing and painful.

After every medical attempt at making her pregnant, ______ must play a waiting game that is peppered with spurts of optimism and pessimism. It is an emotional roller coaster. She doesn't know if her swollen breasts are a sign of pregnancy or a side effect of the fertility drugs. If she see a spot of blood on her underwear, she doesn't know if an embryo is tring to implant or her period is about to begin. If she is not pregnant after and IVF procedure, she may feel as though her baby died. How can a person grieve for a life that existed only in her mind?

While trying to cope with this emotional turmoil, she gets invited to a baby shower or christening, learns that a friend or colleague is pregnant, or she reads about a one-day old infant found abandoned in a dumpster. Can you try to imagine her envy, her rage over the inequities of life? Given that infertility permeates practically every facet of her existence, is it any wonder why she is obsessed with her quest?

Every month, _____ wonders whether this will finally be her month. If it isn't, she wonders if she can muster the energy to try again. Will she be able to afford another procedure? How much longer will her husband continue to be supportive? Will she be forced to give up her dream?

So when you speak with ______, try to empathize with the burdens on her mind and on her heart. She knows you care about her, and she may need to talk with you about her ordeal. But she knows that there is nothing you can say or do to make her pregnant. And she fears that you will offer a suggestion that will trigger even more despair.

WHAT CAN YOU DO FOR _______?
You can give her support and not criticize her for any steps she may be taking--such as not attending a nephew's party--to protect herself from emotional trauma. you can say something like this: I care about you. After reading this letter, I have a better idea about how hard this must be for you. I wish I could help. I'm here to listen to you and cry with you, if you feel like crying. I'm here to cheer you on when you feel as though there is no hope. You can talk to me, I care."

The most important thing to remember is that ______ is distraught and very worried. Listen to what she has to say, but do not judge. Do not belittle her feelings. Don't try to pretend that everything will be okay. Don't sell her on fatalism with statements like "What will be will be." If that were truly the case, what's the point of using medical technology to try to accomplish what nature cannot?

Your willingness to listen can of great help. Infertile women feel cut off from other people. Your ability to listen and support her will help her handle the stress she's experiencing. Her infertility is one of the most difficult situations she will ever have to deal with.

PROBLEM SITUATIONS
Just as an ordinary room can be an obstacle course for a blind person, so can the everyday world be full of hazards for an infertile woman--hazards that do not exist for women with children.
She goes to her sister-in-law's house for Thanksgiving. Her cousin is breast-feeding. The men are watching the football game while the women talk about problems with their kids. She feels left out, to say the least.

Thanksgiving is an example of the many holidays that are particularly difficult for her. They mark the passsage of time. She remembers what came to mind last Thanksgiving--that the next year, she would have a new son or daughter to show off to her family.
Each holiday presents it's own unique burden to the infertile woman. Valentine's Day reminds her of her romance, love, marriage - and the family she may never be able to create. Mother's Day and Father's Day? Their difficulties are obvious.

Mundane activities like a walk down the street or going to the shopping mall are packed with land mines. Seeing women pushing baby carriages and strollers strikes a raw nerve. While watching TV, ______ is bombarded by commercials for diapers, baby food, and early pregnancy tests.

At a party, someone asks how long she's been married and whether she has any kids. She feels like running out of the room, but she can't. If she talks about being infertile, she's likely to get well-intentioned advice--just the thing she doesn't need: "Just relax. Don't worry. It will happen soon." Or, "You're lucky. I've had it with my kids. I wish I had your freedom." These are the kinds of comments that make her want to crawl under the nearest sofa and die.

THE BOTTOM LINE
Because she is infertile, life is extremely stressful for _______. She's doing her best to cope. Please be understanding. Sometimes she will be depressed. Sometimes she will be angry. Sometimes she will be physically and emotionally exhausted. She's not going to be the "same old ______" she used to be. She won't do many of the things she used to do.

She has no idea when, or if, her problem will be solved. She's engaged in an emotionally and financially taxing venture with a low probability of success. The longer she perseveres, however, the greater her chances of pregnancy become.

Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a child-free life. At present, though, she has no idea what will happen. It's all she can do to keep going from one day to the next. She does not know why this is her lot. Nobody does. All she knows is the horrible anguish that she lives with every day.

Please care about her. Please be sensitive to her situation. Give her support--she needs and wants it.

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