The Infertility Hierarchy

There are a few things guaranteed to raise the blood pressure of a woman struggling with fertility issues.

There's the couple who "just fell pregnant, just like that", who giggle about how they "must just be like... really fertile". Then there's the couple who seem indifferent to the pregnancy and their baby, continuing to smoke and drink throughout who still manage to have a healthy baby (not that you would wish anything different, obviously, but when you're feeling guilty for that coffee you had just after ovulation it doesn't seem very fair). There are those who were just born lucky, who tell everyone the minute they fall pregnant and seem never to worry about it or imagine the worst. There are the people who assume you don't want a baby, and there are the people who not only assume they know what you want, but then have the cheek to question it and berate you for it.

But worse then any of those are the ones who confide that they too are struggling, who talk to you about "trying" and "waiting" and, when you are drawn in by the sense of shared suffering, tell you that it's been 3 months now and not even a sign...*screams a silent scream*

I am also one of "those women" - I have already been blessed with a beautiful, healthy child who, after years of trying, appeared by accident early in a relationship that luckily turned out to be stable. But I'm greedy and I want another. Not only that, I know that we don't have much time before Mr feels too old to care for a young child, so after 7 or 8 months I'm already impatient. The intensity of wanting hasn't changed, just because I am already lucky. If anything, the desire for a child is even stronger as I know time is running out.

I can't get over this feeling that I am a fake in the eyes of other women who have been trying for much longer, and that my pregnancy cancelled out the years of trying and that I now have to start from scratch and earn my right to post on the fertility forums again.

In the end I posted a poll on one of those forums asking how long into your TTC journey is it reasonable to say you have fertility issues. Just over 100 people voted, and the consensus was that if you have been trying for a year or more, then it is not unreasonable to describe yourself that way.

3-6 months		5%
1 year		80%
2-3 years		12%
4 years or more		0%
IUI/IVF/ICSI only		0%

Reading the answers gave me real comfort. I classed myself as having issues (never as infertile, as it feels too hopeless) after 2-3 years of TTC, at about the same point as I got referred for testing. While a lot of people agreed, someone shared the following medical advice:

"Reproductive endocrinologists, the doctors specializing in infertility, will consider a couple infertile and eligible for treatment if:

• a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.
• a woman over 35 has not conceived after 6 months of contraceptive-free sexual intercourse."

"Alternatively, the NICE guidelines define infertility as failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology" 

So many women posted that they were sure they had problems long before they felt they could approach their doctor - I would have had more confidence asking for a referral if I had been aware of these guidelines.

There is certainly a hierarchy of infertility. Even when you acknowledge each other as infertile, there is an understanding that the longer you have been trying, the worse it is. It's an understandable and often justifiable snobbery, but I think it does sometimes leave women who maybe haven't been trying so long, and who are afraid of offending, out in the cold.

Infertility has so many facets that you really can't know what someone else is dealing with unless you can walk in their shoes. A woman who wants children, thinks there may be an issue but is not in a position to start TTC, could feel just as desperate as someone who has already endured many unsuccessful cycles.

Either way, I'm giving myself a break. This is my space, and my life and I won't be wasting any more of my time feeling guilty or a fake. Infertility is not a badge anyone should have to or want to earn and while I will probably still grimace inwardly at the "trying" couples, I will try to remember that in their minds, the suffering is very real.