Two Years or Not Two Years; and, Stress Revisited

One recurring question we’ve been asked is: why seek help at one year?

Other parts of the world use two years as a benchmark. In Britain, I wonder if the 2 year wait is influenced by the fact that the NHS can cover fertility treatment (behind a massive wait list*). (Treatment is alternatively offered privately.*) (*Source: British expat in my support group.)

But the way I’ve always thought of it is: why would I wait to get checked out? We haven’t stopped trying in the mean time. Is there something else to gain from waiting I haven’t considered? Urgency easily outranks financial considerations in our priorities.

After I quit my job and we both started working from home (not to mention the vacation we took then as well), we ruled out the stress** and lack of dedication factors. Why wouldn’t I want to rule out a medical reason while we continued to try?  If something is wrong, we’ll get treated or know that we have to look in to adoption. If nothing is wrong, we’ll know that too and decide where to go from there.

Considering we wanted a large family while we were young, if optional testing were available at any time like some kind of science fiction plot point, I would have gotten checked out when we decided to wait a few years after we got married to start trying. It’s too important for me to leave to chance, just like not getting pregnant was too important for me to leave to chance at one time (whether from lack of birth control or choice of less-reliable birth control).

As a result of delays, we have to change our expectations for our family — either we’ll have fewer kids or be older when we have them. The math stopped working any other way. If we had known this factor, maybe we would have reprioritized earlier. If you knew you could lose something so important, would you be able to wait longer?

The best analogy I can think of is planning ahead a few years to buy a house. If you think you’ll want to buy a house in three years, are you going to assume that everything will work out? Or are you going to look at some mortgage calculators and figure out if you are putting away enough for a down payment, or maybe need to reevaluate what your price range is? You know interest rates will be different but you want to know if your plan is even remotely feasible. How I feel about one is the same I feel about the other.

Also, older couples, whose chances are naturally lower, are allowed to seek help after only six months. If they were expected to try until statistics definitely pointed to a problem, wouldn’t they have to try longer than a younger couple, because their chances are naturally lower? Isn’t it more suspect that a couple in their twenties couldn’t conceive? What’s actually at play is that urgency trumps statistics; they don’t have as much time to recover from setbacks. And that’s where we stand because I am seeing the long game and watching my family shrink while I wait. (By the way, I always sucked at statistics, so I know I could have this all wrong. But it feels like a statistical contradiction: we’re young so we have a high chance so just keep trying… but if we have a high chance and don’t conceive naturally, doesn’t that mean a higher chance we have a medical problem?)

**About stress and circumstances: The best thing I’ve taken away from support group: in the opinion of the two therapists who mediate our sessions (based on three studies linked below), infertility causes stress but stress does not cause infertility. While it’s true that there can be a physiological link between stress and factors including ovulation and cycles, the truth is that over the course of many cycles, there’s no statistical link between stress and actually becoming pregnant. Managing the stress that results from treatment is important for physical and mental health and for relationship management, but stress does not reduce your
chances of conceiving.,

Why all the anecdotal evidence about relaxing and then getting pregnant? I’m not a researcher and I couldn’t tell you, but I bet the fact that more time has elapsed is the major factor. Also, stories about people who get pregnant immediately after adopting have more retell value than the couple who got pregnant after 20 cycles of trying.

If you want to believe anecdotes over data, I can still argue on that premise. After 3 months I was terrified of what might be wrong and how long we’d have to wait to find out. Putting myself in a physicians care relieved me of a lot of stress. Plus, I quit my job and now I study from home; it’s a pretty laid back environment.

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