Excerpt of Navigating the Land of If

A small taste of Navigating the Land of If. Click on the pages below to enlarge and read the introduction or scroll down the page to read the same text.

Welcome to the land of If.

I know, those are probably six words you never particularly wanted to hear. You don’t want to be here on this strange island. And if you’ve just disembarked, you’re probably a tad confused. Even if you’ve long known you were destined to show up here, you probably are surprised by the atmosphere. It’s not really a little-umbrella-in-your-drink sort of island. It smells of rubbing alcohol. It’s littered with garbage cans packed to the brim with sanitary napkins. And it’s
populated with tense-looking men and anxious-looking women. It’s hard to ignore one of the worst parts about this island: It’s situated so close to the mainland—you can see it over the horizon on a clear day. But even though there are daily departures, and even though it’s easy enough to end up here, it takes plenty of effort to get out.

The Land of If got its name not only because IF is the abbreviation for “infertility” in the online world but also because there are so many ifs inherent in being here. There are what ifs and if onlys and if this, then thats. If (there’s that word again!) you are accustomed to having a pretty tight rein on your life—accustomed to working hard and seeing the desired outcome, or being able to predict what comes next—the Land of If is going to be a particularly difficult stopover for you. Being here is all about living in uncertainty and doubt and wonder and hope: If only I had gone to the doctor earlier. What if I hadn’t bought my husband that package of tight briefs from Costco? What if my wife hadn’t laid out our adoption profile to look like a scrapbooking-store explosion? If I go past the baby aisle at Target, then I will have a nervous breakdown between the onesies and binkies.

I, for one, was shocked—shocked!—when I ended up here. Why was I shocked? I have no idea: My mother experienced eleven years of infertility while building her family. But, strangely, I believed that I would be fertile, and for much of my life, I knew next to nothing about infertility and pregnancy loss. I had absolutely no understanding of assisted reproductive technology (ART), either. In fact, the first time I met a child born through IVF (in vitro fertilization), I pitied him for what he had to go through as a fetus, pressing his tiny face up against the glass of his test tube, just to get the attention of the man in the white lab coat.

When my husband, Josh, and I decided, in the merry month of June, to conceive, I was so giddy that I started right away with plans for a February baby. But instead, February brought my husband and me the first diagnostic piece of our infertility puzzle: My progesterone was low. So we started treating that (with progesterone suppositories), but then other problems cropped up, until we had a final, but vague, diagnosis: “female-factor infertility.”

Vague though it may sound, we’re some of the lucky ones, because we actually have an understanding of what brought us to this island. There are plenty of inhabitants—maybe even you—who will never know what brought them to the Land of If. And that is just another one of the frustrating aspects of this place (along with the fact that there are no drinks with umbrellas): the lack of answers, or how the answers can lead to more questions.

With so many unknowns, your stay in the Land of If will probably be rife with uneasiness, but you can rest assured about one thing: For better or worse, your tour guide (that is, me) knows
this territory very, very well. I’ve done my time here. I have experienced early loss, treatments, pregnancy, and preterm childbirth.

That said . . . one or two experiences cannot possibly be enough to get you through all of the nooks and crannies of this island. There are plenty of aspects of infertility and loss that I haven’t experienced firsthand. But the inhabitants of the Land of If are a helpful bunch, and, like a giant pot of stone soup, this book came together based on the experiences of numerous men and women. They gave me the kind of invaluable information this book is packed with—the kind of
information that comes from tons and tons of personal experience.

Sure, the medical professionals I dealt with were all very helpful in giving me a basic understanding of my medications and the procedures I would eventually undergo. But it was information posted by others like me, on bulletin boards and blogs, that really provided me with a higher education in infertility. Sure, it was a nurse who taught me how to give myself an injection. But it was a fellow Iffer who taught me how to make that injection less painful. Sure, my reproductive endocrinologist made decisions based on my test results, but it was a fellow stirrup queen who gave me a list of what kind of questions to ask, and which tests to request.

Now, don’t get me wrong: Doctors have those initials after their name for a reason. They know their stuff, and before you act on any advice (including the advice found here), you should always check with your doctor. In fact, all medical information in this book was reviewed by a doctor.

There are plenty of guides out there that focus on treading the four paths leading out of the Land of If—books on adoption, treatments, third-party reproduction, and choosing to live child-free.
And although this book definitely covers those four paths, its focus is not on how to leave this island, but on how to live on it . . . at least for now.

In addition to providing you with tons of insider information, Navigating the Land of If will give you the words to explain your crazy, complex emotions to people who’ve never been here before. It will give you the practical tools and confidence you need to be your own advocate and make decisions that work for you.

And in between those tough choices is the waiting: waiting to cycle, waiting to see the reproductive endocrinologist (RE), waiting to see if you’re pregnant, waiting to be chosen, waiting for a referral. All of that waiting could drive you insane, or at least could make you obsessive, spending hours Googling early pregnancy symptoms. Lucky for you, there’s this book to coax you back into living life while waiting in limbo.

It will give you great excuses—both fake and real—for dodging other people’s baby showers or leaving work for a 10:00 am insemination. It will help you respond to pregnancy announcements with feigned or real happiness. It will help you gauge how much of your
infertility news to spread, and to whom. Mercifully, it will give you plenty of great advice on staving off unsolicited or bad advice, and tons of tips on how to nip rude remarks in the bud. It will help you keep track of your own hormone levels, introduce you to the online and offline hangouts of other Iffers, and teach you the ins and outs of Iffish—that strange language composed of multisyllabic, impossible-to-pronounce medical terms and mysterious abbreviations.

But I can see that you’re getting overwhelmed. That happens to people when they first get here—hell, it happens even if you’ve lived here for five years. Let’s grab our backpacks and get started on moving around the island in a methodical manner. I’ll take you around each neighborhood until you start figuring out the roads on your own. My hope is that you never get too familiar with this land, that your stay here is as brief and painless as possible. But while you’re here, you should know that you have a friend, in book form, to turn to in the middle of the night, when the sea monsters offshore start howling and you just wish you were home.