Kasmirah Scarbrough wants people to know that infertility is not a dirty word.
The Montgomery resident has been on a journey to have a baby with her husband, Derick, since 2010.
“It’s a roller coaster of emotions,” she said. “It’s hope, it’s fear, it’s loss. It’s a constant barrage of ‘I feel really good about this’ to ‘it didn’t work.’ ‘I feel really sucky about this,’ to ‘maybe there’s hope.’ ‘We can try it again’ to ‘it didn’t work again.’”
While infertility is stressful emotionally and physically (i.e., the pain associated with in vitro fertilization), Dr. Tarun Jain, reproductive endocrinologist and infertility specialist at Northwestern Medicine, wants to reassure those going through it that there is no established link between emotional stress and infertility.
Having frequently fielded questions about how stress factors into fertility treatments and miscarriages, Jain conducted a study, published in the Journal of Assisted Reproduction and Genetics. Of the 1,460 women who participated in the survey:
Additionally, studies have shown that Black women are almost twice as likely to experience infertility as white women, but about 8% of Black women between the ages of 25 and 44 seek medical help to get pregnant, compared with 15% of white women.
“It’s really one of the most challenging times of people’s lives, and then sometimes people are given the message of ‘Oh, just relax and you’ll get pregnant. Don’t work so hard; you’ll get pregnant,’ Jain said. “It leads to this feeling of self-blame, self-doubt and guilt, that, ‘Hey, I’m doing something to cause this situation.’
“I see this all the time in my patients,” he said, “people asking: ‘Is it because of all the stress at work that I can’t get pregnant?’ The reality is that studies don’t support that emotional stress causes infertility or miscarriages.”
Jain said there are many reasons for women’s infertility that are unrelated to stress — fewer eggs, eggs of lower quality, no ovulation and release of an egg from a condition called polycystic ovary syndrome, endometriosis, blocked fallopian tubes or scarring in the uterus. In men, quality of sperm is often the problem.
“There is a lot of stigma, unfortunately, that exists with fertility and misinformation. And it leads to women not seeking care soon enough. It leads to self-blame and guilt, or shame or not wanting to talk about it,” Jain said.
“We see that a lot in our field,” he said, “where many women are delaying coming to see us, thinking they can solve it all by themselves. We’ve got medical reasons why they’re struggling, and we’ll help them overcome those medical reasons. But at the same time, we don’t want you to feel helpless or feel like your own emotions are getting in the way.”
Dr. Charles Miller, reproductive endocrinologist and director of minimally invasive gynecologic surgery at Advocate Lutheran General Hospital in Park Ridge, agrees with Jain, saying stress isn’t the root cause of miscarriages and trouble conceiving. Miller said there is not enough fertility information for the lay population to fight these myths.
“Just chill? That is perhaps the worst thing you can say to someone going through this very stressful situation,” Miller said. “Dr. Jain outlines that you have to have the dialogue, support services for the patients who feel this stress is just so overwhelming, to help them with this.
“We (doctors) have to emphasize that no matter if you’re white, Black or brown, there’s a lot of misinformation on the Internet,” he said, “and knowledge is not always power, unless it’s good knowledge.”
Fertility for Colored Girls, an Olympia Fields-based nonprofit that empowers women to take charge of their reproductive health by providing education, awareness, support and encouragement to women and couples of color experiencing infertility, is doing its part to share that good knowledge. The organization will be opening its 16th location (in Jacksonville, Florida) in July.
The organization was founded in 2013 by the Rev. Stacey Edwards-Dunn, who went through her own infertility journey, portrayed in the NOVA documentary “Fighting For Fertility.” The hourlong film shows the complex, realistic path to parenthood, including systemic racism and how it contributes to infertility rates. It aims to de-stigmatize the topic of infertility, including falling sperm counts, egg freezing and IVF.
“Many of us are not taught that Black women struggle with infertility,” Edwards-Dunn said. “We know that we’re less likely to seek access for many reasons — medical mistrust, lack of education around this, sometimes it’s even financial (gestational carriers, adoption and IVF costs range in the thousands of dollars). We don’t have the health care or the insurance to be able to access it.”
“We have to keep this conversation going,” she said. “Normalize the conversation just as we did about breast cancer, so people will begin to move beyond the walls of shame.”
Scarbrough said knowing about a community of women who understood what she was going through would have made a big difference in dealing with her infertility. She felt isolated and helpless, even with the great support of her husband.
As it turned out, endometriosis was the cause of her infertility and IVF medication was having a negative impact. After several surgeries, an embryo transfer was successful.
“I didn’t know whether or not this little embryo was going to take. I just knew that I was grateful because there are so many women who don’t even get to the place where they can try and get that close to success,” Scarbrough said. “Two weeks later, I get a phone call, and they told me that I was pregnant. I was just so thankful.
“The moral of the story,” she said, “is perseverance, I think, is what makes the difference. I’m happy to say that I am 18 weeks pregnant. … And we know we’re having a boy, so we’re excited.”
Jain said it’s up to medical professionals to get the correct information about infertility out to the public. He hopes other physicians will make it a priority to alleviate women’s fears about stress and infertility, and encourage them to find healthy ways to manage the stress. He said that was the impetus for his study: to show a lot of misperceptions exist and are potentially damaging. Now that the information is out, Jain said, something can be done about it.
“If you had high blood pressure, diabetes or broke a bone, you’re not going to be like: ‘Oh, it’s my fault.’” Jain said. “Those things are very easy to get treatment for, and there’s no shame associated with it. Those are considered medical. But if I can’t get pregnant, that’s like, ‘Oh, I must be doing something wrong.’”
The Rev. Stacey Edwards-Dunn will participate in a panel discussion, “Overcoming Fertility Challenges,” 6-7:30 p.m. Monday. The conversation will feature NOVA documentary director Larkin McPhee and other infertility advocates. Viewers need to RSVP for the event.
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