"How are you?" is a tricky question to field when you're responding to someone who doesn't already kind of know the answer. And when you're going through infertility treatment, not many people already kind of know the answer.
There's no shortcut to explaining the physical and emotional state of infertility treatment to the uninitiated. There's no quick way to work through the sea of acronyms, the IUIs, and the SETs and the PGDs, that clutter your existence. There's also no one-liner that adequately captures the feeling of being simultaneously captive and adrift, an existence beleaguered by a long list of instructions to follow but no discernible end in sight.
This is what makes Private Life, a new film by Tamara Jenkins recently released on Netflix and in theaters, so invaluable. In addition to being a crackling and touching story, it's a much-needed reference point for the fertiles of the world to understand the particulars, and particular madness, of infertility treatment.
Private Life is about Rachel and Richard (Kathryn Hahn and Paul Giamatti), two middle-aged New York literary types who can't get pregnant. Their diagnosis is a combination of advanced maternal age on Rachel's part and low sperm count on his. In short, they waited too long.
The film walks us through their process of trying to become parents "by any means necessary" with such a delicate accuracy that there were moments I, an IVF-veteran, wasn't sure I could keep watching. My heart accelerated through all the scenes of waiting, by the phone and at the doctor's office, the shots, the treatment plans, the maybe, maybe, maybes, and sorry, sorry, sorrys. I recognized the marriage that's been put in service of fertility treatment at the cost of nearly everything else. I also recognized Rachel's largely unacknowledged resilience. It didn't surprise me to learn that Jenkins had been through much of this herself.
My story. At age 35, I got diagnosed with secondary unexplained infertility. It's a diagnosis that means I was able to have a baby without any assistance, and then, for reasons they couldn't understand, was not able to get pregnant with another. The madness I experienced was void of the existential quality that I suspect is faced by many other infertile women who don't already have a child. The question of whether or not I would other get to experience motherhood was not at stake.
Still, like everyone else going through infertility treatment, I really wanted a baby. So often women feel like they need to mute or hedge that desire. Maybe someone has it harder, or babies ruin feminism, or it's selfish because of global warming or poverty (better to help needy children elsewhere) and, well, you name it. The list can go on and on but the desire remains. We long to have kids.
Here's what I did to get one: I had two IUIs (they squirt sperm in the uterus during your peak ovulation window), one with Clomid (a pill I took that made my ovaries mature 2 eggs at once); an IVF retrieval (a few weeks of many, many needles filling me with hormones that made my ovaries mature 21 eggs at once, followed by a surgical procedure in which the eggs were removed and then fertilized); a four-month wait while the resultant embryos were tested for chromosomal and genetic abnormalities; a medicated transfer (many more needles filled with hormones that shut down my natural cycle so they could control my body—and my mind, making me batshit crazy—followed by the placement of a single embryo in my uterus); a pregnancy!; a miscarriage!; a three-month wait before another transfer, this time medication-free; 11 months after it all began, another pregnancy; 9 months later, a baby boy.
Many people have lists that are much longer, and credit card bills that are much higher. According to FertilityIQ, the average IVF patient goes through more than one cycle of IVF and spends around $50,000 on infertility treatment, and insurance coverage is rare.
Here's how it felt: It's like making your way through an obstacle course located inside an eccentric billionaire's lawn maze. You climb up the walls, you paddle through the streams, you swing on the ropes. You are working so hard! You are giving it your all! You have absolutely no idea where you are going.
It's like being a low-ranking spy on a important mission. You are busy, regularly receiving and executing lots of instructions, while understanding that the stakes are high. You are a good servant, you follow orders, but never are you clued in to the master plan. You start to wonder if there is a master plan, or if your overlords (your doctors) are more susceptible to the forces of fate that you realized. You soon understand it's the latter.
It's knowing there is always one more thing to try.
Research shows that I am far from the only woman who found it emotionally intense. One study of 200 couples found that half the women and 15 percent of the men said infertility was the most upsetting experience of their lives. Another found that women dealing with infertility felt as anxious or depressed as those diagnosed with cancer or recovering from a heart attack. Also, infertility is really common. One in eight couples struggle to get or stay pregnant, and yet we rarely hear their stories, or witness their pain.
In addition to being a good movie, Private Life shows us how to tell these stories and convinces us that they matter too. Rachel's distant focus in the passenger seat of the car, her beating her husband's chest when he fails to consider bad news from her side, her determination despite being called a junky, all come together to flesh out a side of womanhood that often remains under covers.
May the film help infertile women, past, present, and future, respond to "how are you?" honestly, with the hope that whoever's listening might understand their answers.
Elissa Strauss lives in Oakland, California; she has written for The New York Times and Slate and is a contributing writer for cnn.com.
