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Infertility affects one in eight American couples. We should talk about it.

A few years ago, Rachel Elliott felt like she spent all of her time at other people’s baby showers.

 A few years ago, Rachel Elliott felt like she spent all of her time at other people’s baby showers. She doesn’t remember what she bought each friend—onesies, pacifiers, blankets—but she remembers shelving her feelings just to be able to show up and smile. Sometimes, she couldn’t go inside at all. She’d stand on the doorstep, pink and blue gift bag in hand, unable to bring herself to knock. Eventually, she’d hang the bag on the doorknob and quietly return to her car. Sometimes, yearning for a child she didn’t have grew so overwhelming, she couldn’t get out from under her pain. “It’s hard to grieve over something you can’t hold; you’re actually grieving over having nothing to hold,” she explains.

Rachel was adopted from Korea when she was a little over a year old. Her parents also had two biological kids and another adopted child. “My adoption is very special to me, but I realized when I was young that I didn’t look like my parents.” Rachel recalls being around five, and looking at herself and her mother in a mirror, her mother holding her from behind. She compared them, her mother’s pale complexion and blue eyes, and her own black hair and dark eyes, and realized that they didn’t look the same. It never particularly bothered Rachel. But once she got married—“He’s white; I have a type,” she admits—she dwelled on the fact that there was no one in the world who looked like her. While she had always wanted to adopt, she also yearned for a biological child.

“After a few years of marriage, we were ready for a baby,” she says. But as months went by, nothing happened. At first, it was confusing. She and Paul both had siblings who could, as she puts it, “look at their spouses and get pregnant.” Rachel and her best friend had made a pact to get married and build their families together, but suddenly, Rachel was being outstripped. Her friend had a baby and then another. Finally, a third. Everyone in the world had a stork visiting their front door except the Elliotts.

“We lived in Flower Mound and there’s a playground on every corner,” Rachel cuts in. “In the suburbs we’re all soccer moms with minivans. And there’s me, trying month after month and it’s not working out. It became heartbreaking quickly. No one told me this might happen. No one talked about infertility.”

According to the CDC, one in eight American couples will struggle with infertility at some point. But many men and women who struggle with infertility aren’t comfortable talking about it, sometimes not even with their partner. Twenty percent of the time, no actual cause for infertility can be identified. Many people never know why they can’t conceive.

With no genetic history to act as a guide, Rachel was partially diagnosed with unexplained infertility and partially with polycystic ovarian syndrome (PCOS). Immediately, she and Paul started undergoing various treatments and simultaneously talking to adoption agencies.

“My doctors were on speed dial. I was optimistic and motivated. It took—for me personally—probably two or three [failed treatments] to realize that it was going to be hard. I needed to talk to someone. But I had no one to talk to.” They had a loving marriage and a strong circle of friends and family, an ever-growing collection of nieces and nephews too, but she felt alone with her pain. “My feeling was, I’m due [for a baby].”

When she did talk about it to friends and family, often it backfired. “Oh, the advice,” Rachel sighs and rolls her eyes. “It comes from family members, your spouse, strangers, women rubbing their third-trimester bellies: ‘You’ve been married that long? Why don’t you have someone on your hip?’ There’s the great aunt that says something at Thanksgiving. ‘Just keep trying.’ Or, ‘Do you know how to have sex?’ I wonder, do you hear yourself?”

After a few years of monthly doctor visits and failed treatments, Rachel and Paul had lost 15 pregnancies, including a pair of twin girls, and two failed adoptions.

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Rachel joined a support group for women who are struggling to conceive called Hopeful Hearts Women’s Ministry. “It’s so easy to point at yourself and say it’s my fault. You know, Mommy guilt.” One night, Rachel and Paul sat up late together while the shame was brimming over. “He said, ‘I love you for you. I don’t love you because of your organs.’ Infertility can be really hard on a marriage. There are five stages of grief. When are you ever on the same stage of grief with your spouse? But we fell in love with each other all over again.”

The support group meets once a month to encourage women struggling with the pain of infertility, miscarriage, and early infant death. Though Rachel started attending years ago to find support, today she leads the group. Paul also meets with the guys, sometimes not even to talk, just to watch football.

“So much healing starts with: ‘We’ve been trying for a long time.’ ‘Yeah, us too.’ Just knowing that someone else gets it,” she says. “If your friend is going through this, let her tell you what support she needs. If she likes flowers, buy her flowers. If she wants to just sit around watching Netflix, watch Netflix with her. Don’t try to say the right thing because there isn’t always a ‘right thing’ to say. Just listen.”

According to Dr. Sara Mucowski, a physician at Dallas IVF, stories like Rachel’s are common. But there’s plenty of hope.

“Fertility is a relatively new field,” she explains. “The technological boom we’re in has also affected reproductive medicine. Things that were theoretical 10 years ago are now possible like uterine transplants and egg freezing.”

Still, most of her patients are surprised when they have trouble conceiving. “It’s important to assure every patient that no two people are the same, no two pregnancies are the same. You need to find a physician who sees you as an individual. There are so many reasons a couple might have trouble conceiving: issues with ovulation, issues of sperm count or shape, issues with the fallopian tubes. Roughly a third of the time it’s on the male side of things, a third of the time it’s female, and a third of the time it’s both.”

When Dr. Sara first begins working with a patient, she lays out all the treatment options, starting with the least aggressive ones. Usually a couple has been trying for at least a year by the time they come to her.

“Even if all your tests say everything is normal, statistically, you stand a four percent chance of conceiving each month,” Dr. Mucowski explains. “There are a lot of potential things in our overall lifestyle that affect things, like chemical exposure or fat tissue, or men’s use of testosterone supplements. Patients get on testosterone to increase their libedos, thinking it’ll help them concieve. But they’re literally taking birth control.” Overall, she wishes more people knew how common infertility actually is and how many treatment options are available, to help them keep the faith.

Dr. Sara hopes that in the future, fertility might be a more open conversation as more technological advancements make it easier than ever for couples to have children. In December 2017, Baylor University Medical Center in Dallas welcomed a baby successfully carried to term in a transplanted uterus, a first in the U.S. Scientists are studying how to stratify DNA in embryos to eliminate genetic disorders such as Parkinson’s or Huntington’s Disease.

“People get bogged down with the idea of infertility and how expensive it can be. They get ahead of themselves without being informed,” she assures me. “We have all kinds of treatment out there that are individualized and advancing at a phenomenal pace. There is absolutely hope.”

Dee Singleton loving angel babies infertility fertility plano texas women motherhood
Courtesy of Dee Singleton


“I had my first miscarriage in 2011,” Dareisha “Dee” Singleton recalls. “I didn’t even know I was pregnant until I ended up in the ER and they told me. But doctors tell you the first is a fluke and not to worry.” Dee runs a personal blog called Loving Angel Babies (LAB). Summarizing her mission with the title of one of her favorite posts, LAB speaks “the truth about being young, black and infertile.” Dee explores everything from the science of pregnancy to the heartbreak that comes from years of longing for a child: “When everyone you love has the one thing you want.”

Before long, Dee had a second miscarriage. She went to see a fertility doctor. Usually, it isn’t recommended that a woman sees a fertility doctor until after three miscarriages, but Dee didn’t want to go through another. However, it was too early to know if anything was seriously wrong, so Dee went home. They kept trying. It wasn’t long before she had her bad omen: a third miscarriage and soon, a fourth.

Dee’s fourth pregnancy was ectopic, meaning the embryo attached itself outside of the uterus to the wall of a fallopian tube. Ectopic pregnancies are very dangerous and though Dee survived, she miscarried again and this time lost one of her fallopian tubes.

“People weren’t helpful. They’re like, ‘Oh, don’t worry about it. Just relax. Don’t think about it and it’ll happen.’” She scoffs. “Well, that’s easier said than done. I’m thinking about it every month. I tried all kinds of crazy stuff. The measures you’ll go when you really really want a family—I just never saw any of it coming.”

Dee’s worries weren’t unfounded. Once a woman has had one ectopic pregnancy, it becomes more likely that she’ll have another. Sure enough, the fifth time Dee was pregnant, she lost her other fallopian tube.

“At that point, you’re considered infertile,” she explains. “I never really got an answer either. Even with tubal pregnancies they don’t always know why it happens. I thought maybe I’m not supposed to have kids. I prayed, ‘God, take the desire out of my heart because I don’t want to want kids I can’t have.’”

Dee had no one to talk to about it and it all started bottling up inside her. “I could feel myself being envious of other pregnant women, of my friends. I wanted to cry all the time and I didn’t understand why. If you keep something bottled up, it’ll come out but it’ll come out bad,” she says. She started seeing a counselor after the fourth miscarriage and though it was out of her comfort zone, in 2016 she started her blog.

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Dee is a private person, embarrassed and ashamed by her body’s failure to do something everyone else seemed able to manage with ease. But her blog gave her a place to vent and work through her own story. On her first post, she encourages readers to comment with their own experiences. Strangers responded, filling her inbox with their own stories of miscarriage, infertility, shame and the stupid advice from strangers in grocery stores.

“It gave me a sense of support,” she explains. “I didn’t have to cry by myself. Remember,” Dee reminds her community on her blog, “you aren’t alone.” She encourages women to listen to each other and get to know each other’s struggles.

Modern medicine has its miracles. When we spoke in the spring of this year, Dee sported a modest baby bump. She was precariously, joyously, four months pregnant after an In Vitro Fertilization (IVF) treatment.

For IVF, doctors extract eggs and fertilize each one in a petri dish, which acts as an artificial fallopian tube for Dee. There, doctors watch the embryo begin to grow and divide itself. Though parents can take their pick of the embryos, Dee didn’t want to choose. “I just said to put the best looking embryo in. I’ve been through too much to be picky.” Viable embryos that aren’t chosen right away can be frozen or even donated to couple for whom IVF isn’t an option—the latter is called snowflake adoption. Dee’s are frozen. She thinks she might want more kids later on.

Dee Singleton loving angel babies infertility fertility plano texas women motherhood
A recent sonogram of Dee’s child | Courtesy of Dee Singleton

“At this point I have a normal, boring pregnancy,” Dee says, practically glowing. Though her doctor warned her not to say anything about it until she was in the “safe zone,” about 12 weeks, Dee went Facebook official at nine weeks. “There’s no safe zone. I’m pregnant. Either way it goes I’ll need support.” Dee documents every single moment. She takes weekly bump pictures and even appreciates her morning sickness.

For Rachel and Paul Elliott, it took ten tries at IVF before it worked. “It’s the practice of medicine, not the slamdunk of medicine,” Rachel says wryly. She was on bedrest for seven out of the nine months of her pregnancy. “But Pinterest had just come out and we started our subscription to Netflix at that time, so I was good,” she laughs. Rachel spent her days watching movies and picking out DIY projects, eating the lunches Paul packed her and left on her bedside table.

Rachel Elliott Hopeful Hearts Ministry infertility fertility plano texas women motherhood
Rachel and Lucy Elliott on Lucy’s first day of school in 2017 | Courtesy of Rachel Elliott

She only had one hour a day out of bed, but one of her friends was also pregnant and on bedrest. They’d met through their husbands who worked together. Over time and a few lunch breaks, the men realized, bare bones, their stories were the same: empty cribs, painful treatments, years of disappointment and finally, fragile hope. Once a week, either Rachel or her friend would use their single hour out of bed to drive to the other’s house so they could spend the day together and “talk, dream and hope.” Their daughters were born seven days apart.

Originally published in Plano Profile’s July 2018 issue.