When enough is enough? This is a question I have felt having the answer for many, many times. An answer I felt conviction in giving, even though I sensed a painful guilt in admitting it. An answer I felt logic, even though I knew it was not rational. An answer I felt right, even though it did not seemed so.

And the answer was always simple, it was always the same: Now! When enough is enough? It is now! At the very moment we’ve got the news that once again our efforts were in vain. At the time my wife and I were both lying in bed after being told unsuccessful. At the time when it hurt in ways I felt no recovery possible.

But such answer was scary. An answer that I felt was definitive and, as such, would imply my defeat. It would imply I had given-up. It would imply I had lost faith. Yes it gave me a strange sense of comfort in knowing that somehow I was gaining control of the situation, but a control that was coming at too high of a price tag. No, it was not a rational answer. It was a “reactional” one. One resulting of my emotional tiredness and my mental exhaustion. One that I could not tell if it was right or wrong.

I however, as presumably most human beings, like to think that I have the ability to differentiate from other less evolved species by presenting two simple characteristics: forgetfulness and hope.

It is remarkable how quickly I forget about the challenges of the previous treatments when embarking in new ones… Like many fellow humans, I have had countless hurting, non-fertility related experiences in life. Therefore, the simple recollection of them, made me not look forward to repeat the mistakes that led me to feel that pain in the first place. And my logic behind such feeling was simple: I had the understanding of such mistakes and had little hope that I could change the outcome, therefore the pain would be inevitable. So the conclusion was easy: I knew it would burn me, so I was not going to put my unprotected finger on the fire. Pretty much a male-type, straight-forward and rational way of thinking, correct? Yes. Consequently, the “now” answer would be acceptable at the end of yet another unsuccessful pregnancy attempt, right? Well, no. Not quite…

And that was because I felt that logic did not applied to fertility treatments, as it was missing a key component: hope.

At every new fertility treatment we did, I had hope. Since we do not have a “definitive” diagnose for what is causing our affliction, Doctors could not pin-point the steps in our path that caused our pain, so, in theory, all new treatments were new ones.  Ones that would learn from its predecessors and project a different outcome. Ones that would not oversight potential flaws made in the past. Ones that learned how to make a positive impact on the final result. So, at every new cycle, I had the conviction that it would work. At every new two-week period I was sure it would be the last. And that made me forget about the pain. And that made me focus on the positive result to come and not on the negatives of the past. And that made me believe a different outcome was possible. A positive one! Yes, hope most definitely made me forget.

So I think that the real answer to the “when enough is enough” question is: it depends.

Really, it depends. Is there hope that the fertility treatment this time would be different? Is there hope that the Doctor have found something new in the many clinical exams we did? If yes, then my answer would probably be “let’s see” when enough is enough… I have tried to put definitive milestones to help me with the decision making, but all fell apart when hope came to play. Were we having financial difficulties to keep-up with the cost of the treatment? Well, if there was hope I for sure found ways to come-up with the money. Was I reaching a “key age” to become a father? Well, if there was hope I reassured myself that an extra year or two would not be too much of a problem in the long run. Yes, all milestones were demolished by my hope bulldozer!

Our journey through couple’s infertility definitely made me grow conscious about the odds, but not discouraged. If I Mother Nature has a formula for procreation, I am convinced that I have uncovered the most important empirical element of it all: Hope. And I for sure continue to have it!

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Common Wisdom

I must have been looking for couple’s infertility treatment in the wrong places, as my logic for deciphering common wisdom recommendations led me to believe that the best spot for us to get pregnant should have been a SPA.

Tranquil music, peaceful surroundings and massage, all calling for relaxation, unwinding and letting it go… Nice propositions for someone overburden with the anxieties of many infertility treatments and tired from all the emotional drainage it commanded. Yes, SPA for sure equals relaxation. Since relax is indeed the top ranked advice I have been given over the years; it should make sense, right? Common wisdom should prevail, correct? Not quite…

Just relax. Really? Is that easy? Why have I not tried that before… How many times, during the course of this journey, have I not heard words of wisdom such as “you two are too stressed, you need to relax.” Or, better yet: “my friend tried to have a baby for a long time. But it was only when she relaxed that she got pregnant. You should tell your wife that!”. Seriously, if relaxing was the “secret ingredient” for pregnancy, Yoga practitioners would be the single most important group responsible for overpopulating the world. (And my wife and I like Yoga, so not the case…)

Of course that I understand those comments came, most of the times, from a very good place. A place of good intentions. A place of sincere cluelessness of what we really have been going through. A place of sympathy for our suffering. A place of love. But that understanding alone did not made me feel any better about it… Relax. Seriously. When my wife was going through many emotionally draining treatments and I was dealing with my own insecurities; when I was trying to protect her while bracing myself for the storm of feelings that would come should the result be negative; when I was frustrated for not being in control, the last thing I could think of was bamboo wallpaper, eucalypt oil scent and sun salutation. Relax was simply not an option.

So, if not true or accurate, why is that I have heard it so many times, from so many people, that I should relax? The answer is easy: Common wisdom. Just like common sense, common wisdom is everything but “common”. It is simply a support, a crutch one can lean on when feeling the need to provide insight or counsel to unknown situations. It is a conversation starter. It is a conversation stopper. It is kind. It is empty. It is everything but advice. It is something I am too to be blamed for, as I have recited many of such tales myself. Who hasn’t? Therefore, right or wrong, common wisdom was telling everyone that the secret to infertility was relaxation. And I was being advised accordingly… But, if I logically knew that common wisdom was to be taken lightly, why was that this particular piece of advice was bothering me so much?

Because those words went directly where it hurts the most: my soul.

It is no news that the one thing that has been a constant throughout our infertility journey is my high level of stress and anxiety. And these feelings were deep, coming from my inability to gain control over our situation, no matter what I did. They came from my soul. Since I believe relaxation begins with loosing-up on the things that are immediately bothering you and ends with your complete emotional surrender, being told to relax often made feel challenged. How could I rest when I had no control over what was emotionally stressing me out? How could I calm down when I could not visualize the source of my pain? How could I simply turn off my emotional switch? Well, I couldn’t. And that realization made me cringe. That realization made me suffer. That realization made my soul heavier.

So here goes my logic regarding the relax advice: If common wisdom was right, relaxation for pregnancy would work, fertility clinics would be SPAs, I would be a Yogi Master and we would be parents by now.

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Pain Scales

On a scale from 1 to 10, how much does it hurts? This is a typical question, and a very valid one, Doctors, Nurses and Health Practitioners would ask anytime one is in pain. Physical pain.

According to the fictitious mybrainspedia.com, physical pain is a pain that is material and makes you visible, noticeable. It is a corporal pain that one can actually point to and describe about. It is a pain that can be measured and understood using the simple, empirical scale from 1 to 10. Throughout our years dealing with couple’s infertility, my wife and I have been asked to measure physical pain many, many times. In our case, my wife is the one that braves into the specific physical, and sometimes hurtful, aspects of the treatments that unfortunately only she can perform. So she was indeed asked the “pain question” numerous times…

But every time the question was being asked to her, I was secretly, quietly, responding to myself: 11.

Yes, 11. On my 1 to 10 scale, the pain I felt during our treatments was off the charts. It was not the physical pain she was being asked to report on, but the emotional hurt the infertility process caused me. And it was a self-inflicted, lonely and selfish feeling. The emotional pain I was in was normally kept to myself while I pretended to be all strong, supportive and optimistic about the infertility treatment we would be experiencing at the time. It was a positioning towards male expectations so ingrained in me that it took me a long while to figure it out what it was. But it was there. So much so that the secrecy I had imposed on myself made it even worse, as the emotional pain would made me feel wounded yet completely invisible during the entire process. So make that a 12 on a scale from 1 to 10…

As I look back, I see I was in constant emotional pain. I realize that I was always measuring it against all sorts of inquiries and not only those directed to my wife. A simple “How are you doing?” would trigger my hurting, as my unspoken answer would be “Do you really, really want to know?” I understand now that my emotional pain was latent, pulsing through my heart every step of the way. It was making me sink in a quick sand of emotions without noticing I was even on it. I was so absorbed by the need to show control and support that I had chosen to simply accept my emotional pain as part of the treatment, not even sharing it with the one person I love the most: my wife. For a long time I have kept my emotional pain away from her, and I now know that in doing so I was too causing her suffering I could not understand.

The same feeling on “invisibleness” that was bothering me so much was afflicting my wife every time I kept my emotional pain for myself. How could I hold her during rough times when I was not allowing anyone to support me? How could I ask her to look at the positive side of things when I was not being honest to own feelings? Difficult questions for a guy to find answers for… I had coded on my Latin soul that “feelings” could be perceived as weaknesses. And I was not made for being weak. I could not afford to be weak. She would not love me if I was weak. So yes, understanding and dealing with my feelings was challenging, confusing and stressful. But it made me realize that my secrecy was in fact causing more harm than good to our relationship, even though all I was trying to do was to protect her by not showing my true self.

But why was it so easy for me to understand the physical scale of pain when being inquired by Doctors, and it was so hard to quantify emotional pain? Simple: because the physical one was “visible”. The simple acts of talking about it and empirically quantifying it made it real and easy to understand. So, the logical conclusion was that the emotional scale had to be seen for it to work.

And there it was. In my face. Bright and shiny. The light bulb that turned on and made things all much clearer for me. The realization that the emotional scale had to be shared with my wife was simple yet fantastic! That by sharing with her how I felt was not admitting defeat, but instead an invitation to truly walk together on the path to deal with our infertility.  And that it was a scale after all, a somewhat measurable thing my male brain could relate to… A wise man once said that for one to be courageous, he has to fear his challenges. And that saying never felt more appropriate than the time I saw my emotional scale at a bright light.

Have my emotional pain disappeared since I admitted my feelings and plotted them on an imaginary chart? No, of course not. It is still there and it still hurts. But in making it visible to my wife and me, it made my journey more bearable, as I felt more connected and more empowered to deal with our pain every time the scale blows pass 10.

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Confusing Unique Bunch

When it comes to couples infertility, I feel that yes: we are unique. Oddly unique. Hopelessly unique. Confusingly unique.

I was taught at school, and got reassured through life, that all humans are different, unique individuals. Good? Bad? Indifferent? Until a certain point in my upbringing, I really did not care much as such notion had little practical impact on me… That was only until reality made me focus on how unique we really were. And reality came in the form of the many treatments my wife and I had to do to overcome couple’s infertility, the longest medical condition we both had to endeavor thus far in our lives. This experience has given me a new perspective, making me realize that the notion of human singularity is hard to accept when it comes to understanding the outcome of medical treatments.

If we are all unique, why is that I always felt as if my wife and I were being labeled and then treated with “alike” infertility cases? Why is that I felt that we became a number and not a person when our fate led us to the wrong side of the statistic charts? Why is that I felt that we were on the pages not yet fully written by the Academia?

In short, if we are all unique, why is that I felt being treated as a herd?

Of course that logically I knew, and agreed, that health studies rely on statistics to validate its findings and procedures. Of course that my pragmatic self knew that a medical treatment is not an exact science so I was not to expect a 100% success rate. Of course that the male I am knew to trust numbers and rational thinking as means to gain control. But the emotional me was painfully learning that rational thinking did not really helped when there was no explanation for my wife and I not getting pregnant…

So I felt odd. I felt confused. I felt hopeless. When doing such an emotionally draining process as an infertility treatment is, the least thing I wanted to hear from a Doctor was “I am not quite sure why this is not happening to you two, as everything looked great”… That statement, which unfortunately I have heard more times than I would like to remember, always gave me no confidence that the treatment we just did was correct nor that the Doctor was in control… All I wanted to hear was a clear explanation about why we were not successful. All I wanted was enough information to make a decision, whatever it was, so we could move on. All I wanted was a bit of guidance without any “but” in the middle of the sentence. But we were unique… And that sucked!

My “new rational” became to go back to basics and look for ways to be treated as a single entity. We have done all the tests. We have done all the exams. We have tried all types of treatment. It did not work out so far. So we needed to be treated as the unique individuals we really were. Was this a “new concept” to fertility clinics? Perhaps, but the one that felt right to me. After all, we had learned through our journey that the principles of infertility treatment were the same, but the investigation of the causes for couple’s infertility, the interpretation of the findings and the prescribed treatment could be completely different if we were not to be treated as a bundle.

And that new rational has been driving my intimate search. Search to be placed outside the herd. Search to have our condition seen as unique and treated as such. Search for the one who will be The One! Has this search been successful? Not yet. But ironically, at least I think I know why: I have to be bundled as one, to generate one.

Confusing? You bet! But I believe that statement holds the unique irony behind couple’s infertility, where I have to recognize our singularity while accepting that the treatments are made for the pack, trusting that a single Doctor will be able to bring it all together and give us our so expected little person… Yes, ironically we are a confusing bunch of unique individuals.

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Happy Ice Cube

A happy ice cube. That was me over 15 years ago. And I was living in Brazil, so no reference to the dreaded Canadian winter here… Shiny, squared with rounded edges, confident that no matter how full a glass was, I would always “add-up” to see it fuller. I was always ready to help cool down the hottest pot but, in being an ice cube, always kept my own emotions frozen, preserved from the outside word.

Of course I did not view myself that way at the time. I have always been a communicative person that loved to make new friends while cherishing all existing relationships. I was the guy who loved to host, from a soccer game at my place with whomever to a last-minute party, just to celebrate life. I was a good listener and I like to think I was a good friend as well. So yes, I was a pretty happy guy.

And “guy” here is the dominant word… I was a true guy, a pal, a dude. I was a man born and raised on the Latin society of the all powerful men. And, as such, I should keep my emotions hidden, frozen. No talking about it. No sharing it. But, if they were ever to come out, they should be expressed in a simple form: yes or no. Like it or don’t like it. Black or white. Well, life in the “real world” is not quite simple…

As I have grown wiser (OK, older…) I became aware not only of the need to break the ice, but also to understand that there was more between pure water and its frozen kind.  And that was, and still is, hard. What if what came out defrosted was not as great as I would expect? What if when I shared what was locked it would not be as pure as I would hope? What if I would be less loved by showing my true self? Hard questions to answer and to deal with, for a dude and even for a gal.

But I like to think I learn from my experiences. And the one thing I have learned through the infertility journey is that there was no point in keeping my emotions locked-in. The stress and anxiety were so great that, should I keep it frozen; it would break out of the pressure I was imposing on me. I have not done it alone and have not done it at once. Defrosting is a slow process, where I needed to take one step at the time and where I had to rely on my wife and my loved ones to give me support and understanding as I was discovering myself.

And what is my main “technique” for defrosting? Talk. Yes, talk. It was the only way to express my feelings. Even as I write these words, talking about it is what makes it relevant. I could write these and lock them in a drawer for nobody to see but, in doing so, I would only be transferring freezers… Talking and sharing of feelings has helped me tremendously during our many fertility treatments, and has kept me sane and true to myself and my wife during the processes. But I am still a guy, a pal, a dude. So talking is still hard. Talking is not yet “natural”. And talking for a guy has definitely a different timeline and schedule than for a girl. After all, right or wrong, it is not because I am stressed to my teeth that I would like to miss the game to talk about my feelings…

So, am I still a happy ice cube? I don’t think so but I as mentioned in the beginning, it has been 15 years in the making…. One of the first things my wife told me when we met in 98 was that she would help me find ways to melt my heart. At the time, it did not make sense … Fortunately she has kept her promise and, with her help, defrosting has indeed begun to happen for me! But it is far from being done or perfected.

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There is nothing like home…

I think I found where “home” is when it comes to our infertility treatment. But, before I reveal its address, let me put a few things in context…

I was born in Brazil and came to Canada when I was 30 years-old. Therefore, even today, I have lived most of my life accustomed to the Health system in my home country. Brazil has many social and economical imbalances but, when it comes to the Health system, the difference can feel like an invisible abyss. Private medicine is available and is fantastic! I could consult with specialists (including fertility ones) without a gigantic waiting list, I had access to labs that look like research facilities and I was treated in hospitals and clinics that looked like five-star hotels. The abyss, however, became clear at time of payment, as I could only afford such treatment for having private insurance. But that was the medical environment I was used to.

So it was only natural that my wife, who is also Brazilian, and I had a bit of trouble adapting to the publicly funded Health Care system in Canada. I am not arguing that one system is better than the other; I am just saying it is different…

And those differences were pretty evident when it came to our past medical history in Toronto, leading my wife and I to developed very strong feelings about the Heath system in Canada.  Those opinions were no mystery to our friends and family and, unfortunately, were not positive ones either… We have had several adverse experiences since our arrival in 2002, ranging from misdiagnose to poor human interaction to procedures done wrong at about every major hospital in the Greater Toronto Area, including having a terrible first experience with fertility treatment on a cash-grabbing clinic in Oakville, ON.

We had not yet looked at specialized IVF clinics in Canada, but we had very few hopes that they would be any different than those we had experienced thus far. Therefore, frustrated with our options locally, we’ve decided to try our home Country, where we were familiar with the system, where private medicine is in existence, where family would be close by and where we felt Doctors were personable and approachable (they even gave us their cell phone number to call at anytime!).

We have definitely found what we were looking for in Brazil: a much welcoming clinic environment than we had ever experienced in Canada, a more personal relationship with the Doctor and the close support of our family. But we have also found that there is no magic to IVF. That the many elements that need alignment on Mother Nature’s formula for procreation do not change with country or language. That the basis for IVF treatment is the same, no matter where you are at in the globe.

We have done several IVF attempts in Brazil and unfortunately none was successful.

So, was the treatment received in Brazil better? Was it worse? Was it worth it? It is hard to find a simple answer to those questions… We have yet to have our dream of conceiving a child fulfilled so, from that perspective, I would say that going back to our home country was not a success. But, having said that, doing the treatment in Brazil was definitely necessary for us! For as expensive, frustrating and emotionally draining as it was, I am confident that we would have never rested our hearts should we have not tried it…

As I write these words, we are now back in Canada, continuing our journey with the help of a local IVF clinic. And it feels like a great one! Definitely there is no difference between Canada and Brazil when it comes to the IVF clinics we’ve experienced. And the approach and treatment of our local Doctor is, in my opinion, far superior to the one we received in our home country! He is approachable, more practical and scientific about the entire process and his staff is fantastic! So, have we found locally a solution to our infertility issue? I truly hope so, but only time will tell…

What is the lesson learned from this experience? Well, it is easy now to look back and point-out the hits and misses on our “home adventure”, but I believe I learned that “home” is where it feels right. That “home” is where our hearts are at ease and where my wife and I feel comfortable at the time. That the best Doctor will be the one who ultimately would lead us to a successful pregnancy. No matter where he or she is located…

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Couple’s infertility has made me a better person. Yes, I strongly believe in that.

As I also believe that the world is a gigantic strawberry…  My friends and family would normally say that in reference to my sometimes almost naïve optimism towards life. This is not an unshakable belief, of course, as I have gone through challenges at different times in my life that made me question if the world had not turned into a sour preserve…

So, was infertility one of these challenges that made we question the quality of the fruit I’ve chosen to define what’s good in the world? You bet it was!

It should go without saying that having the opportunity to write about how I feel on my wife’s and mine journey through infertility has given me a lot to think about… As I reflect back on our many attempts for pregnancy and on the impact it had our lives since we decided to start trying to have a kid, I do consider infertility the toughest challenge we had yet to overcome. It has been a difficult road to travel in, when most of the time I felt like driving on a curvy road, dueling cliffs by the sea with a thick fog above us. And I am terrified of heights, so such picture is a particularly bad one for me…

But every challenge offers an opportunity. And my opportunity is to learn from our difficulties and try to become a better person as the result of it. Naïve? Perhaps. Easy to accomplish? Definitely not. But a true feeling nevertheless…

Infertility has been hard on us, for sure, but it has not been unbearable. It has made us suffer in ways we never felt possible, but it also made us grow as a couple and as individuals. It has made us put things in perspective and, in doing so, has made us value what we have versus cry over what we don’t. It has thought us the true meaning of cultivating something, rather than expecting to be given everything effortlessly. Like many couples on the same situation as ours, we have inevitably put the many treatments we went through as the “driving forces” of everything we did, from business to pleasure. We have committed more financial resources than we have the courage to calculate. We have drained our emotional pool more times than we dare to remember.

But I like to think that I have also learned from every pregnancy attempt we did. That I have grown with every tear dropped on our many missteps on this road. That I have become a better person in this process. So I’ve decided to embrace our situation and, rather than fight it, live with it! Since then, my wife and I have taken some time-off to travel, to renovate, to study, to work, to workout, to dance (ok, ok, only my wife did, not me. I have the rhythm and the moves of, well, a strawberry…), to laugh, to party! Has “time-off” helped on the infertility treatment itself? No. But it made me live better!

I think what I want to say is: it has been hard, but not so hard that we could not enjoy our lives. The infertility issues, the potential upcoming treatments and the discussion of options will always be there and we will have to live with it. Some days will be better. Some days will be worse.

So yes, I do believe today that I am a better person than I was in 2006. I have learned to value what I have at the moment I have them. I have learned to feel pain and share my feelings without being afraid of judgment. I have learned to love my wife and our life together, unconditionally. I have also confirmed that the world is indeed a gigantic strawberry, but that strawberries are not perfect… And, in that case, all I have to do is to put some extra work, effort and love and perhaps I could end-up with a fantastic jam!

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