At the end of “The Year That Did Not Go as Planned,” we needed some cheering up. Lots of it. We decided to take a two-week road trip around the United Kingdom. We wanted to enjoy the freedom of childlessness while we still could, but also to distract ourselves from the obvious. To be honest, we were in desperate need of a change of scenery and some fun. Lots of it.
It was summer break for me, and Carter had some vacation time. The stars had aligned. We headed across the pond for some adventure, culture, and carefree fun. At each little inn or bed-and-breakfast, the innkeeper or host always asked about our travel agenda. Without fail, we were told how ambitious our plans were, how very American. We were too embarrassed to tell them we had eliminated half of our original itinerary. We went to the theater to see Shakespeare’s Richard III and Ibsen’s Brand. We played croquet on a picturesque lawn while drinking Pimm’s cups. We strolled over rolling green fields with grazing sheep. We “took the waters” at the tearoom in Bath, hoping that drinking the mineral water would help us conceive. (It tasted disgusting, and it did not work.) We visited Stonehenge, had a cream tea in the Lake District, and walked from village to village in the Cotswolds. We enjoyed London’s restaurants and nightlife like “normal” twenty-somethings. We even bought a pregnancy test at a Boots Pharmacy in Cambridge (it was negative).
It was all very lovely—save the Bath mineral water and the negative pregnancy test—and that trip remains among our favorite memories. We really needed that time together, time away. Upon returning home, however, we had to face one big question that still needed answering: What comes next?
We knew that, at our ages, most couples would conceive a child within a year of trying. After that, it was likely that something was wrong with one or both of us. (Doctors recommend that women over the age of thirty-five consider six months the typical time frame for trying to conceive since time is of the essence.) Over the previous year, along with trying to start our family, Carter had been the lead author of a government report about infertility and the regulation of artificial reproductive technologies. Between Carter’s research, my studies in Catholic bioethics, and all the anecdotes picked up from books, websites, and friends, we considered ourselves amateur experts in “what might be wrong.” And so, we decided it was time to actually see a doctor to find out.
At the time, we had a diverse social circle—a diverse social circle made up of singles, married couples, a couple new parents, Catholics and non-Catholics. We probably were not known socially for being über-Catholics; our faith, marriage, and sex life were, for us, more of a private matter at this point in our young lives. We knew vaguely that there were Catholic fertility doctors out there, primarily Dr. Thomas Hilgers at Creighton University in Omaha, Nebraska, the pioneer of Natural Procreative Technology, or NaPro. A large part of his protocol involved using the fertility tracking model he had developed, which could be taught to individual couples by a trained practitioner. The guidance required that you track three cycles before seeing him. And remember, our Catholic marriage preparation course had been iffy at best. The nun who ran it is most memorable for crying about being unable to be a priest, rather than for teaching us anything useful at our weekly meetings. We had taught ourselves Natural Family Planning (NFP) using the Couple-to-Couple League Manual. At this point, we were not feeling patient enough to take the time required to learn another fertility awareness method and then sit and wait to get an appointment with Dr. Hilgers—all the way in Nebraska!
We just could not wait. We were desperate for a baby now! Yesterday! So, we decided to see a well-regarded local reproductive endocrinologist. Carter’s work provided him a familiarity with the top reproductive endocrinologists in the D.C. area. We had heard that this specific practitioner was “very good” and had high success rates. Unfortunately, as we found out, what that meant was that he was very good at selling couples on in vitro fertilization (IVF).
At our young ages, and with what appeared to my self-trained eye to be a reliable cycle (menstruation, follicular phase, ovulation, and luteal phase), we assumed we would be an easy fix, something that could be treated right now! Why should we have to wait any longer than we already had? We were sure we could handle this if the right doctor just pointed us in the right direction. Thus, armed with our “Catholic Fertility Playbook,” we were looking forward to getting a diagnosis and an easy, effective, and doctrinally licit treatment. Right in our own backyard.
Well, that did not happen. What our “very good” endocrinologist doctor delivered was a very unsatisfactory diagnosis of “Unexplained Infertility.” So much for that easy fix.
The diagnosis served up a weird emotional cocktail of hope and frustration. No one was saying, “X is wrong with you, you will never bear children.” The doctor and his team were only saying, “We do not know why you are not getting pregnant.” And the truth was that we had been at this for over a year and were really not pregnant—and, on some level, it kind of did not matter why. Even a few months under the “let’s try this” care of the endocrinologist had delivered no results.
But before even suggesting other treatments, this mainstream doctor wanted to “enroll me” in his IVF program. We finally managed to get our position on IVF through to him (or so we thought), and he agreed to let me try Clomid and progesterone supplementation. Clomid is often used to treat Polycystic Ovarian Disease (PCOS). About one in ten women suffer from PCOS, but lifestyle changes (weight loss, controlling blood sugar) and these medical interventions can promote regular periods and ovulation and allow many women with PCOS to achieve pregnancy. I did not have PCOS, though. To be honest, I actually wished I had, since I knew several women with a diagnosis of PCOS who had been able to successfully manage the condition and become pregnant through lifestyle changes—some with additional help from Clomid. If only I could just have PCOS, it would be something the doctors could “fix.”
I was told there could be some side effects with Clomid—mood swings and hot flashes. But, I told myself, not for me, of course. I was absolutely convinced I was immune to these side effects, and I was sure that I was definitely not experiencing mood swings or hot flashes. Man, was I wrong. I did not realize this until one day when I was chatting on the phone with a girlfriend who had taken Clomid for PCOS and had recently become pregnant. Erin was also a nurse-midwife, and I often ran things medical—gynecological or not—by her, so she knew all about my current prescriptions and treatment plan. We were chatting about this and that when I suddenly became so hot and sweaty, I could not help but mention it to her. “Welcome to your first Clomid hot flash!” she said, chuckling. I finally understood what my previously cold-all-the-time mom had been going through in her forties and fifties. (And I got a sneak peek at what would happen to me in my perimenopausal years.)
As for those mood swings that I swore I was not having, well . . . One day, Carter said something to me while we were at a gas station in D.C.’s Dupont Circle. I cannot even remember exactly what it was, after all these years. Something tells me he suggested that I was overreacting to whatever he had said, due to the medication. I immediately got out of the car, slammed the door, and pounded my fist on the hood of our beat-up old Honda Accord, screaming that I was not experiencing Clomid mood swings. While we laugh about it all now, I also still cringe when I remember that day.
What soon followed was both one of our darkest and brightest moments—and exactly the push that Carter and I needed to finally admit we were not in control.
We should have seen it coming. For starters, our doctor and others in his practice had repeatedly mocked us for following the licit but also awkward and embarrassing method of testing Carter’s fertility. A little background: According to Catholic teaching, sex is meant to be unitive and procreative. Masturbation is neither, even when it is in the service of testing male fertility. The natural question then becomes: How do we test male fertility? Lucky for practicing Catholics, the Couple-to-Couple League provides a licit method for those of us who choose to remain faithful to the teachings of our Church: the perforated condom. The husband sports this while engaged with his wife in the normal marital way (unitive!), and the condom’s perforation allows the act to still be procreative. And there is a sample left in the condom to take to the lab for testing. Just to add to all the fun, you will likely have to carry it under your shirt or in your armpit to keep it warm! The only way to get through all this is with a sense of humor and a real appreciation for the twists and turns of married life. Our doctor and others in his practice thought all this was eminently mockable.
Our doctor also reminded us at every visit that he himself was “a cradle Catholic,” as if that should lead us to change our minds on the issue. And then, after a few months of our trying different medications, he grew so frustrated—not that I was still not pregnant, but that he had not yet convinced me, a young twenty-something with good eggs, to acquiesce to his IVF entreaties—that he lost his composure. “I’m creating life back there,” he yelled, pointing in the direction of his surgical rooms, “not destroying it!”
That was it. I looked at Carter in shock, horror, and disbelief. He immediately grabbed my hand and led me safely out the door. We never went back.
Though in retrospect it all happened just like that, it was not so cut-and-dried emotionally while it was actually happening. Far from it. Even before the doctor started pushing it, the IVF temptation was everywhere in his office. I suspect it is in all reproductive endocrinologists’ offices: the walls plastered with pictures of gorgeous babies, and the special financial guarantee—having a baby through IVF is so likely in your case (your case, Leigh!) that if it does not happen, you will not be charged a dime. When you have been sad for so long, and your heart aches and your arms remain empty, it is very easy to think, “We could do it only once, maybe twice. Just two embryos. And then we will have a baby (or two) and never, ever have to think about any of this again. We can almost pretend it did not happen.”
This, of course, being a sinful and intrinsically evil act. By entering that doctor’s office, by becoming his patients, we had essentially set a plate for the devil himself at our dinner table. We opened ourselves to all his empty promises. In hindsight, that “very good” doctor’s interventions were only ever intended as a gateway drug to the hard stuff: IVF. In the end, we were disappointed, but not so much in the diagnosis itself. No, we were disappointed in ourselves. We had made a huge mistake trying to take a shortcut with the mainstream doctor. We had used up months of our potentially fecund youth and had nothing to show for it—no clear diagnosis, no baby. Only by the grace of God did we finally find our way out of that office and find the strength to never go back.
And we knew better. So many Catholic couples, to say nothing of non-Catholic couples, do not know any better. They are victims of poor—or nonexistent—instruction in the culture of life. They are prisoners of our secular “science-y” culture. And they are left, suffering and alone, to face this temptation, surrounded by the walls of beautiful baby pictures and the special financial guarantees.
But, as it turns out, the Church’s teaching on IVF and other assisted reproductive technologies (ART) is beautiful, compelling, and resonates with our intuitions about health, wholeness, love, and family. First of all, the Church loves children and families. And she attends carefully to the beautiful way babies come into the world—ideally, engendered by and emerging from the conjugal act of loving spouses. The child is the fruit of the love spouses have for each other—a gift from God that is begotten and not made, equal in dignity and worth to the parents who will welcome her into life. In this way, the spouses’ loving embrace of one another becomes the conduit through which God creates a new, unrepeatable life destined to know and love him on earth and be with him in eternity. The child is a gift—not a product of the parents’ wills or the result of their rationally mastering the world of nature. This is why the Church teaches that husbands and wives, in their conjugal union, should always be open to the transmission of life, and hold together the procreative and unitive dimensions of the marital act. They are not the authors of life. Only God is. And he gives us the gift of sex as a means of giving us the gift of children.
But our Church also understands that, in reality, some people are unable to conceive or carry their babies to term. And as she made clear in the 1987 instruction Donum Vitae, there are many wonderful medical interventions that serve as an aid to procreation, rightly understood and ordered to the notion that a child is, fundamentally, a gift from God. But the Church rejects those forms of assisted reproduction that eliminate and replace the conjugal act, whereby the child becomes a product of will and technical expertise, made outside the loving embrace of husband and wife by clinicians in a laboratory.
It goes without saying that the Church loves all babies, whether conceived through IVF or natural procreation, just as she loves their parents. And, of course, parents who choose IVF love their babies. But our Church asks us to conform our lives to the truth that all human beings are made by God in his image and likeness, and because children are gifts from God, they should be conceived through the mutual, self-giving love of spouses, through which God can accomplish his life-giving work, rather than by the actions and technical expertise of persons in a laboratory, outside the marital union.
Moreover, IVF routinely involves the destruction of many human beings at the embryonic stage of development. They are discarded when they are unwanted, or they are frozen indefinitely. (There are over a million embryonic human beings in cryo-storage in the United States.) They are sometimes even destroyed when they fail to meet genetic testing specifications of practitioners. An overwhelming number of U.S. IVF clinics practice sex selection, and there is a burgeoning industry for “polygenic risk scores” for non-medical traits such as height and IQ. One entrepreneur selling this service quipped, “Sex is for fun; IVF is for making babies.” The IVF industry is famously unregulated (called the “Wild West” by observers across the ideological spectrum). Experimental procedures make their way into routine practice without meaningful oversight. And there are serious health and safety questions for mothers and babies alike, including ovarian hyperstimulation syndrome for women, an increased rate of premature births, and even, some studies suggest, an increase in birth defects. There are still no longitudinal studies on maternal or baby health and safety, forty-seven years after the birth of the first “test tube baby.” So, there are good reasons for anyone of goodwill—not just Catholics—to turn away from IVF.
We spent the next few months in limbo. Perhaps we were recovering from the dramatic end to our care under the endocrinologist. Or perhaps we were just weary after nearly two years of trying to get pregnant and failing miserably. It did not help that the day we walked out of that office was just before Mother’s Day. Yes, another Mother’s Day, when I was still not a mother.
Additionally, I was not happy in my Ph.D. program. I did not want to be a philosophy professor. I was depressed. Like I said, the plan had always been that I would get pregnant at the beginning of my third and final year of coursework. When that third year went by without a pregnancy, I started to spend my days sleeping until late in the morning and sometimes past noon. I would change into my “nice robe” to make it seem like things with me were normal when Carter got home from his long days at work. Normal, things were absolutely not. Again, I was depressed. If you are reading this, you may know how that feels.
Eventually, I realized that this lifestyle was neither healthy nor sustainable, so I decided to seek some professional psychological counseling. Because my therapist was more of a listener than a dispenser of advice (she was trained in the psychoanalytic school), I knew things were bad when she gently suggested that soaking in the bathtub up to three times a day might be excessive. With her help, I learned a lot about the differences between self-care and self-medicating.
My self-esteem had taken a serious nosedive. I knew, deep down, that I would never finish my Ph.D., but that was a secret I kept from everyone, though surely Carter had his suspicions. I also experienced some deep insecurities about my essential femininity and attractiveness. I could not get the word “barren” out of my mind. And I felt so much guilt over whatever I must have done to make all of this (not) happen.
What kind of woman was I, what kind of wife was I, if I was incapable of having a child? Your whole teenage life is spent living in fear of spontaneous pregnancy, accidental pregnancy from a dirty toilet seat. Isn’t it supposed to be impossible not to get pregnant from sex? Was I not doing it right? Not often enough? What kind of woman—what kind of young, married, Catholic woman—does not get pregnant? Everyone else seemed to be getting pregnant, and for at least half the women I knew, those pregnancies were unplanned. I had anxiety dreams, nightmares really. Some common themes: Carter no longer wanting to be married to me; Carter having a baby with another woman; my own mother announcing she was suddenly pregnant at fifty. I invented a fictional character named Fertile Myrtle, my nemesis. She embodied all my neuroses and insecurities surrounding my fertility and my femininity. I do not remember her having much of a personality, but she was basically a super-fertile, super-devout Catholic supermodel. How could I ever compete with Fertile Myrtle?
As you might guess, therapy was clutch for me at this time. I was trying to work through my feelings while trying to conceive and to prepare, hopefully, to be a mother. It also helped me work through some of the sticky stuff most of us have in one way or another with our own parents and upbringing. An only child, and a child of divorce, I grew up having a hard time imagining the family life I knew I wanted. Oh, I could picture being a mother or a wife, but what that whole family picture looked like remained elusive. I had never really seen it.
Of course, when parents are no longer romantically involved with one another, they are likely to have social lives that have little or nothing to do with their children. That is not to say that happily married couples never spend evenings or even a week away from their children—heavens, no! Now that we do finally have children, my husband and I relish those times with just the two of us. But, from a child’s point of view (from any point of view, really), it is a very different animal when divorced single parents spend time away from their child dating others.
Being an only child was, for me anyway, very lonely. I do not even have any first cousins. I was dragged along to many events that, while fun for grown-ups, were torture for a kid left to entertain herself alone. While parents are people, too, and have lives of their own, and deserve them, we all know that having a loving, married mother and father is best for children, and that is the way we learn to be good spouses and parents ourselves.
Even as a teenager, I had a weird habit of sometimes asking a friend who resembled me to pretend, while we were out or on a school field trip, to be my sibling. Though slightly bewildered at the request, he always obliged. I do not think I even knew then exactly what I was asking for. But I think now that it was my nascent longing for family, for more family, asking for it in the best way I knew how. And now I was married to someone who wanted the exact same thing (Carter is also a child of divorce), and yet we could not seem to make it happen. Devastation is an understatement.
Looking back, we would have done things differently. For one, we should have never set foot in the mainstream endocrinologist’s office. What should we have done instead? We should have been patient enough to pursue treatment under Dr. Hilgers, or found good Catholic health care closer to home while continuing to keep trying the old-fashioned way. We should have doubled down in our prayers and trusted in God’s wisdom and plans for us. We were young, in a wonderful marriage. We should not have been in such a panic. Lastly, we should not have put off adoption.
We had always known we were open to it. Why wait? Yes, it is hard to give up the dream of having your own biological children. For some more than others. But conception and adoption are not mutually exclusive.
We remembered the advice of older friends who had also experienced infertility and then adopted their two children: Just start. Right away. Find a good social worker and start the adoption home study. Research and ask around for a reputable agency. Familiarize yourself with your state’s adoption laws. Learn about the different kinds of adoptions: private, domestic, open or closed, foreign, special-needs, foster-to-adopt. You do not have to stop trying to conceive in order to do this, and none of it is binding. Yet, when and if you are ready to adopt, you will be able to hit the ground running.
At long last, we listened to the good advice we remembered. But before I share what that looked like, I do want to take a moment to emphasize to you: Before you get to the point of debating and deciding which treatments you are willing to undergo in order to conceive, bear in mind that there are many medical tests for both husband and wife. You will need to go into the doctor’s office armed with all the information on the Church’s teachings relating to the treatment of infertility. Of course, if you are the patient of a faithful Catholic physician, this will not be too much of a concern. But you may decide to do some preliminary tests with your regular mainstream doctor before moving onto a Catholic physician if or when you need further fertility care, or maybe there are not any Catholic doctors practicing in the specialist care you need, and if so you will need to tell them how it will all go down.
The preliminary blood tests, pelvic exams, ultrasounds, and x-rays to assess female fertility are unproblematic, though not exactly a day at the beach. And I will say this again: If I had to do it all over again, I would have gone to see a NaPro or other faithful Catholic physician from the outset. Any medical professional or medical procedure that reduces your body, your marriage, your sex life, or your infertility to a battery of lab results will likely leave you unhappy and discouraged and empty. Opt instead for medical care that treats you as God’s beloved creation, your marriage as sacramental, and children as gifts to be received.
Now, what did adoption look like for us? At the point where we had decided to pursue it, we had still not shared any of our fertility struggles with our parents. I think we may have feared they were all still recovering from the shock of us marrying at such a young age (in their minds) and the idea of grandchildren might just send them over the edge. I also did not want constant questions or expectant looks every twenty-eight days. We were already stressed enough. Plus, I had fantasized so many holiday-themed reveals, my favorite being a framed ultrasound picture for the future grandparents for Christmas. I did not want to ruin the surprise.
A few months after we walked out of that “very good” endocrinologist’s office, my mom and I were on a walk through the leafy streets near my childhood home in West Virginia. Chatting and catching up, my mom caught me off guard when she asked when we thought we might have a baby. She asked in a way that made me think she had been expecting—maybe even hoping for—a pregnancy announcement from us. “Do you really want to know?” I sighed.
Of course she wanted to know; she is my mother! I filled her in on the ups and (mostly) downs of the last two years. The next, much harder step was explaining why IVF was not an option for us. My non-Catholic mother knew many of her friends’ adult children who had successfully conceived through IVF. She thought it an obvious option for anyone in our position. Without a full understanding of children, marriage, and sexuality through the Catholic lens (or even knowing what IVF actually entails), it can sometimes seem that someone is denying themselves something—something supremely good, a baby—for no good reason, and maybe even based on sheer superstition.
This can be hard to swallow, even for some Catholics, many of whom use IVF or know and love somebody conceived through IVF. They have never needed to learn about the Church’s teachings on artificial reproductive technologies. Parents want their children to be happy, to have everything their hearts desire. Today, as a parent myself, I have a newfound appreciation for the grief my parents felt when they learned that our dreams of a family were not coming true. When your child’s heart is broken, your heart is broken, too. And of course, parents likely have dreams of their own: grandchildren. They may also need to grieve for the biological grandchildren they may never have. Infertility really is a family affair.
It takes great generosity and patience to understand the “why nots” of IVF, if that is not familiar territory. Luckily, my mom had both in full measure, and she was able to accept what I told her and not try to convince me otherwise. And then, when Carter and I broached the idea of adoption, she and her husband, my stepfather, were 100 percent on board.
It was a few months later that Carter and I shared the story of our so-far-unsuccessful quest for a baby, and our current plans to adopt, with my dad. Even though he was a Catholic, he too wondered why not IVF. After all, he was a single man in his sixties. He had never had any occasion to question if these new fertility practices that were reportedly helping so many couples have a family were aligned with Church teaching. After listening to us and offering a few counterarguments (What if we created and used just one or two embryos?), he too wholeheartedly supported the idea of adoption. He was very eager to welcome his first grandchild. Sadly, Dad was diagnosed with an aggressive form of cancer soon after we shared this conversation with him. It is one of my most beloved blessings that he lived long enough to meet and hold his first grandson before he died.
EDITORIAL NOTE: This article is excerpted from Infertile But Fruitful: Finding Fulfillment When You Can’t Conceive (Sophia Institute Press, 2025). All rights reserved.
