Infertility: Where uncertainty is the only thing that is certain

Physicians love to feel in control. We thrive in environments where we feel we can predict the outcome.

Do well in medical school and on boards—you will get into a residency.

Take the statin—it will improve your cholesterol.

Do the screening colonoscopy—it will improve your chances of catching cancer early.

I think most of us can agree we would give these recommendations. But certainty, the foundation of predictability, is not a given.  We know the chances of good outcomes are likely, but not 100 percent.

This is why we discuss risks and benefits with our patients.

As physicians, we are able to take a step back and help guide our patients through their uncertain times.  We can comfort them with statistics, experience, and expert opinions; while at the same time acknowledging that we cannot guarantee every result.

How did I forget that when I started my infertility journey?

How did I forget that uncertainty is part of the package?

How did I forget that I cannot control the outcome?

How easy it is to forget, when you become the patient.

I was anxious and overwhelmed.  And I didn’t have the control I had become accustomed to.

I had successfully predicted and achieved most of my life goals: College degree, medical school and board certification, marriage, a good job at a good hospital.

What I could never have predicted was how difficult it would be to get pregnant.

I couldn’t guarantee that I would ever have a biological child.

I couldn’t control how I would respond to medications that were recommended.

I couldn’t predict how I would become a mother: Give birth? Have a surrogate? Adopt?

I was desperate, to restore a sense of predictability, some sense—any sense—of control over the things that promised help.

Researching every diagnostic test, medication, procedure. Surely there was something I missed.

Arranging additional consultations. There had to be a doctor or clinic with answers.

Changing my diet and exercise routine. Maybe that would improve my fertility.

But the more I tried to control, the more I actually felt out of control.

I was searching for something that didn’t exist—a guarantee of a certain outcome.

I was arguing with a reality that I couldn’t change.

Lightbulb: I didn’t have control.

Using my mental energy to try to exercise control was exhausting.

I finally saw clearly that once I stopped trying to control everything, I was able to open space in my mind for so much more.  I could focus on thoughts that re-energized me. I could choose how to feel as each obstacle approached.

Old thought: If I research the data, get five consultations, eat the “fertility” diet—I will get pregnant.  What an immense amount of pressure.

New thought:  I trust myself to make the best decisions with the information I have.  I don’t need to know the how, I just need to know that I have the strength to get there.

The freedom this created in my mind was transformative.

What I’ve learned: I may not have control over how I become a mom.

But I do have control over my mind, which will help me get there.

You have control over the quality of life you’re living moment to moment.

If there is any certainty to be found on this journey, it will be found inside yourself.

Kate Hoppock is an internal medicine physician.

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