Chapter 15
Reaching Resolution

Resolution is a gradual process that occurs on many levels over a period of years. In a sense, all of life is an ongoing quest for resolution, as we strive to resolve the issues at each stage of life in our passage to the next set of life tasks.

There is no formula for how long it takes to reach resolution. Everyone is different. Not only that, each individual goes through the different phases that lead up to resolution at a different pace. The longer it takes to recognize a sense of loss and begin mourning the loss, the longer the entire process will take. If medical treatment has been undertaken, the nature and length of treatment affect whether, and how, loss is perceived.

Other life events intervene in this process, as well. These events may help in the final process of resolution, as they did for Sandra, in confronting her own and her mother's aging process. Or they may be a distraction from the work of resolution, and retard the process.

Women and men often worry because they feel unresolved and long for resolution to occur so they can go on with their life. They are tired of their inner struggle. Sometimes it seems endless. When a person feels this way, he is usually in the midst of the resolution process already, doing the work necessary for resolution to occur. Grieving, exploring other options, constructing the life story, finding new outlets for self-expression and creativity—all go on in the midst of the inner dialogue that retools identity.

Resolution as a Couple

Couples often reach resolution at about the same time. The amount of change they are processing simultaneously may feel exhausting, as Jenny and Matt found out:

JENNY : It turns out we're just not going to have children in our relationship, and that has been something that has taken seven or eight years now to roll around to. It's just what turns out to be.

MATT : That's what happened. I think Jenny and I would be good parents. But this is what we've got, and this is how it is.

JENNY : At a certain point I just had to decide that this has taken up too much of my life. I'm going to go on with life. I can't devote any more special time to the situation. We just don't want to do it anymore. We don't want any more strings. It's too exhausting.

It was such an upheaval. The whole time was. We don't want any more of that. Now we sort of want to sit around and be peaceful, and have friends over for dinner, and walk on the beach. It feels like we have to heal up from what was a tremendously emotional time.

Jenny and Matt were experiencing reintegration as individuals at the same time that their relationship was taking off in new directions. The possibilities seemed limitless.

MATT : I'm changing careers. I've got applications in all over the country. I'm thinking over all the possibilities.

JENNY : It took a long time to get past the fertility stuff, but

that's just how it goes. I figure I gave it my best shot, and that's all I can do. It really interrupted my career. So I'm getting on with my life. I have other things to do.

I ask myself which direction I should take? I look out there at the sky, and there's a lot of space. That's sort of how I feel. Like I'm surrounded by all this empty space. I love having all this space. It's an incredible feeling. I feel like my life's ahead of me. I can fill up as much of the space as I want, or not. It's up to me.

In their struggle with infertility, Jenny and Matt have discovered something critical about themselves: They have learned that the meaning of life lies within the self. It is up to us to create our own meaning—to discover that we have meaning in and of ourselves. No one else can do it for us. Only we can unlock it, only we can recognize it. But once we have, we can enjoy it to the full. We can embellish it, deepen it, and watch it grow.

This is the mid-life search for the self.

Resolution is not a straight path. It may feel like a forced march over windy and crooked roads, through dark forests and deep rivers, across dry stretches and over high mountain peaks. But eventually, the burden you carry will lighten and the answer will come.

It was wonderful to see in the Resolve group, couple by couple, people coming to a resolution, and what a difference it made. Even if the resolution was not what they had hoped for, it mattered. You could see people become transformed just by deciding not to pursue something anymore. That was really something to watch.
—Celia

What the answer will be for you depends on you and your partner. No one else can predict what it will be. In the pages ahead I give examples of different kinds of answers—answers that worked for people in this book. Perhaps they will help you to find your own answer.

Adoption

The big issue for most couples who face infertility is whether to adopt. Men are usually ready to contemplate adoption before women are. Adoption means a woman loses the experience of pregnancy and childbirth. And in addition, it removes her sense of bodily control over the process. Adoption becomes the Great Unknown, and women, especially, may be very fearful of it. Most women must resolve these issues before they are freed to seriously consider adoption.

Couples may remain out of step for a long time because women approach this alternative slowly, while men, who see a plausible solution, often become impatient. They want to get on with their lives. Adoption usually becomes more attractive to women if time passes and the likelihood of a biological child diminishes.

Adoption itself is not hurdle-free. Both partners must contend with the lack of control they may feel over the process, and with the shortage of available children. The prospect of the significant efforts they must make to acquire a child, whether through agency-sponsored or private adoption, may be daunting.

Dorene did see adoption as the ultimate alternative, but she expected to get pregnant. She never thought she would reach the point of actually adopting. She and Kenny began to seriously consider adoption when their medical options dwindled. They made an appointment and visited an attorney who handled private adoption.

It was a real interesting experience going to that interview. I remember feeling that I didn't think it was going to happen. I had gone through so many disappointments that by this time, even though I thought I was going to get pregnant, I also didn't think I would be so lucky to do it. So I thought after all the infertility, adoption would never happen, either.

They started the private adoption process, which begins with sending out letters to various parts of the country in search of a child. Four days later, they got their first response, which didn't work out, and then a few days after that, an aunt in another state called to say she knew someone.

We ended up contacting them. They were teenagers. They wanted to give the baby up. Private adoption wasn't legal in their state, so she decided she wanted to come live with us for the last few months and have her baby here. We decided fine. Before that, whenever we talked about it, we had decided there was no way we could even meet a birth mother—that it would be too traumatic. But as time went on we got more and more desperate and accepting of the process. We thought we had to jump at anything that came along. We got more phone calls after that, but we had made a commitment.

So she came to live with us. And that was real stressful. She was very homesick, very young. She was breaking up with her boyfriend. It was mass hysteria. She wasn't eating the right kind of food. It drove me crazy. It was a wild experience. I don't know if we would do it again—we do have this gorgeous little girl here. But it was really hard.

It got harder when the birth mother changed her mind.

We were right outside the door when she was born, and we heard her say, 'Give her to Dorene.' There was no hesitation. From the outset she said, 'I don't want to see the baby. As soon as it is born, I want her taken out of the room.'

Two days later she went back home, and then she decided she didn't want to give her up. But she didn't do anything about it. She kept putting off signing the relinquishment papers. That went on for six months. I was just terrified they were going to come get her. Finally, she signed.

Dorene and Kenny wanted more than one child. They decided to adopt again in about three years. When their daughter was about eighteen months old, they got a call from their original letter. This adoption experience was very different.

When we got the call, I said, 'We are interested in adopting again, but we have this baby,' and the social worker said, 'Oh, that's great because the birth mother wants her child placed with someone who has an adopted child.' So she put us in touch with the birth mother. She had already picked out a couple, but it wasn't working out. She had decided to interview some more couples. She decided we were the ones.

She was absolutely wonderful. An entirely different experience. We felt really good about her. She had gone through counseling. It was a beautiful experience with her. She said when the baby was born she would want a few days with her. But the day she was born, she said, the heck with waiting. Come down and see her, so we did. And the birth father was there, and his mother. It was a little bit crazy. The grandmother was crying. She didn't want them to give her up. But they did. They are still together.

It was a neat experience. We all sat around naming her together. And when we left, the birth father came up to Kenny and was saying, 'You are going to be the father of my child.' It was just such energy—real positive.

And off they went. We heard from them a couple of times after that for business kinds of reasons, like 'I want you to know I signed the papers yesterday.' No fooling around. We did that adoption ourselves, without a lawyer. Now both of them are final.

Now that both adoptions are final, how do they view it?

Before we adopted, I wanted for us to have a child of our own together, even if we adopted. Now I feel these two are the children of our spiritual making, the children of our

heart. I believe we produced these children through our love rather than through sex. So to me it's the same thing—they are children produced from us.

Life Without Children

Another option, although a more difficult one for many women to contemplate, is going through life without children of one's own. Remaining childless, however, is a viable option for most—though not all—men. Somehow, remaining childless may seem like a very different way of going through life than what women and men have been contemplating for their future, although that is the way they have been living their lives until now.

Theresa was seriously considering being childless. She had given it a lot of thought, and spent much time talking to Paul about it.

The leader in Resolve really wanted to talk about child free. She wanted everyone to say one positive thing—just try it on—what would be good about it? One woman really couldn't do it.

Maybe I'm someone that needs to not put all my eggs in one basket as a way of salvation or protecting myself, saying, 'Well, this is a possibility.' So I had some experience toying with that idea. I have a husband who thinks like that, too. You have time to do other things, travel. My sister will tell me a million things—why I wouldn't want it.

That doesn't mean I'm unloving, I think. That was something that came out in the group. Like maybe you don't really want kids, you're not really maternal. But it doesn't mean that, I don't think. It's just another part of me.

Theresa came from a big family, and had a lot of children in her life already. She planned to build on these already-existing relationships with her nieces and nephews.

I'm loaded with nieces and nephews, and I find that really helpful. My sister is real concerned about me in kind of a neat way. She is a good support. She is worried about me in a real loving way. And her kids are great. For some people I hear them talking nieces and nephews … it makes them sad. But for me, I really love my nieces and nephews. I could be this great aunt.

Theresa envisioned other kinds of generativity that went beyond her involvement with other children and her interests.

Another reason I'm open to being childless: I don't think about it in terms of who is going to be there when I'm old. I assume, watching my grandmother and Paul's grandfather, I will get involved with other people and be a doer, and just be active.

Donor Insemination

When a man has an infertility factor but his partner appears to have no fertility problems herself, donor insemination (DI) becomes another option. Most often, it is men who balk at this possibility—the idea of another man's sperm being used to create a pregnancy. Most, though not all, women find DI an acceptable alternative. If men are able to get past the idea that DI is an insult to their masculinity, this option may contribute to a highly satisfactory resolution of the problem for both partners.

Celia and Ron joined Resolve after a crisis when Ron lost his job and learned about his low sperm count almost simultaneously. They began to explore different options.

After I'd been in Resolve a while, adoption seemed like an alternative. It was a different point of view, like we could

have a baby instead of maybe we will. I don't think I pushed for donor insemination. I wasn't sure how I felt about it, either. I told Ron I would like to be pregnant, but I didn't really push it at all. I backed off.

I don't know how he came around to it, but one day he said to me, 'I'd like for you to have a baby. I'd like for you to be pregnant. It's okay with me.' So we contacted the doctor who does artificial insemination and we had to wait to see him. They wanted us to bring pictures.

So we brought a picture of a camel and a rhinoceros, and we gave those to him. We all sat there and laughed together. It was pretty easy after that. It only took three inseminations.

When couples choose DI, women worry that their partner will feel distant from the child, and that this distance will impede total acceptance of a child as a man's own. Celia was no exception.

I worried because I was on bedrest before the baby was born. I had nothing else to do. But he has always seemed to love him. He has seemed very much his baby from the first. He always held him more and was very watchful. Yesterday he said, 'Who could deprive anybody of having Jimmy as a sibling?' So I think he is wild about him.

People have said that Jimmy looks like him. I think those are the most awkward times, but actually, I think he does look like him. If he had any trouble getting attached to him, I think it is gone.

What does having a baby by DI mean for the future of their family?

A few days ago Ron said, 'Now the only thing to consider is if we will have a donor next time, or if there is anything that can be done about me.' In a way that makes me a little

nervous because I am worried that he would love a baby who is biologically his more than Jimmy, but in my heart of hearts I don't think so.

So I'd love it if I could have Ron's baby, but as far as I know, I can't—we can't. It doesn't mean we can't have a wonderful baby, and a wonderful family. And we do.

Advanced Reproductive Technologies

Most people start considering advanced reproductive technologies only when they have exhausted other, less expensive medical treatments. Eileen and Roy had been married for ten years and trying to conceive for five years before they seriously considered trying in vitro fertilization (IVF).^[*] About the same time, they began looking into adoption. Eileen said,

We started going to Resolve's adoption seminars, thinking that the IVF percentages were low, anyway. But because our insurance paid part of the IVF, we decided to try that. Otherwise, we didn't think we could afford to do both. What if the IVF failed and we had spent all our money? We thought we would do one, and see how it went. The decision to do IVF was mine, because he really didn't care. He could have done adoption first. He said, 'It's you taking the drugs. You decide.'

Roy interjected, 'Well, she was going to go through most of the grief, so I left it up to her."

[*] In vitro fertilization (IVF) is an advanced multi-step procedure in which multiple eggs are stimulated by the use of combinations of fertility drugs, removed from the ovaries transvaginally by an ultrasound-guided needle, then mixed outside the woman's body with her partner's sperm. The fertilized eggs are allowed to incubate and if developing normally, are then transferred transvaginally into the uterus for implantation and an ongoing pregnancy (Robert D. Nachtigall and Elizabeth Mehren, Overcoming Infertility (New York: Doubleday, 1991).

Eileen said,

So we did three IVFs, and then we got really serious about adoption and started working on our letter. But meanwhile, we were sort of a textbook case. Every time they would say, 'You're having absolutely the right reaction, you're producing this many eggs, you fertilized this many, and this is like a textbook.' We didn't have any other odd medical problems to cloud the issue.

But it didn't work.

I couldn't decide if I wanted to do the fourth IVF. I was very ambivalent about the whole thing. I just kept thinking, 'I can stop anytime. I'm really not commited to this until the actual transfer.' So we composed our letters. Did the pictures. Ran around having people take pictures of us. Went to an adoption symposium. We sent out our letters, talked to an attorney, then we started with an adoption agency. Then I did the IVF. And once I did it, I said, 'I'm glad I did it.' Because now it's out of my system. I don't want to do it, anymore. I don't care anymore, it's not that important.

When I was having second thoughts about doing another IVF, I started to think, 'This is just too much of a hassle. I need something that will produce a baby at the end, and adoption will.' It helped that neither of us was dead set on a biological child. We had had a plan in mind if that IVF didn't work, how we'd proceed with adoption. So we did that, and now we're taking infant care classes, even though we don't have a child in the picture yet.

Similarly, after a great many other medical procedures, Cyra and Geoff decided to try advanced reproductive technologies.

Their physician suggested gamete intrafallopian transfer, or GIFT,^[*] as it is commonly known. They had one adopted child but they wanted more children, and Cyra wanted to experience pregnancy. She said.

I went through a lot of things. I had years of taking my temperature. I did maybe a year of clomiphene, I had a laparoscopy. I had unexplained infertility. Then we decided to do GIFT. They extracted a bunch of eggs and they just fertilized some of them, froze the others, put these little guys together in a dish, and plugged them back in. But meanwhile, we started to think about adoption. We were moving towards GIFT and adoption almost simultaneously, but we were still hoping that GIFT would work. It was a lot of energy and a lot of money, and we felt we weren't getting anywhere. I didn't know I would go through with it until the day that they did the egg retrieval. I really wasn't sure. I was very ambivalent about it. I wasn't ready for another disappointment. And I was very frightened of the procedure. I had had somewhat of a traumatic experience with treatment a year before that. I was really sure it wouldn't work. But the insurance covered it, and that pushed us over the edge. So we did it. They extracted the eggs. They got a lot of eggs, they fertilized the eggs.

But it didn't work the first time. So we did it again.

Geoff interjected, "Everything was working out very well the second time. I was optimistic. I had no pessimistic feelings at all. I mean, I didn't necessarily feel it was going to work, but everything was going according to plan."

[*] Gamete intrafallopian transfer (GIFT) is an advanced infertility treatment that involves the placement of a mixture of eggs (oocytes) and sperm directly into the fallopian tubes. The procedure involves a number of steps, including medications to induce many eggs to develop, the preparation of sperm, the retrieval of eggs and the placement of a mixture of eggs and sperm into the fallopian tubes, usually through a laparoscope (a microsurgical tool) (Nachtigall and Mehren, Overcoming Infertility ).

Cyra said, "I was doing it to get control over my life. I didn't believe it was going to work. And then it turned out I was pregnant with triplets, and I lost one. One dissolved or was absorbed. One didn't make it. So we have twins!"

Reflecting back on this experience, Geoff said,

When you go through this process, where you go through adoption first, you realize that it doesn't matter whether this child is linked to you biologically, because in all other respects it's your child. Then when you have your own children biologically, you realize, who knows, they could be serial killers, or God knows what. You don't really have that much control. It just blurs that distinction entirely.

Donor Egg

I interviewed Clara and Connor after they conceived by going through a donor egg program, using an egg donated by another woman.^[*] They had been going through infertility treatment for a number of years. Clara recounted how things had started:

Fifteen years ago I got pregnant through an IUD when I was 21, and I had an abortion. So I thought I could always get pregnant. Then five years ago I developed pelvic inflammatory disease, and I had a right ovarian abscess and they took the ovary out and the tube out and the left tube was completely

[*] Egg (Oocyte) Donation allows women whose ovaries are unable to produce fertile eggs to become pregnant. This includes women born without ovaries; women whose ovaries have been damaged or removed because of endometriosis, infection, or tumors; women whose eggs did not fertilize after undergoing in vitro fertilization (IVF); and women whose age precludes treatment with their own oocytes. A young egg donor is given injections of a combination of fertility drugs to increase the number of available oocytes, these oocytes are removed by transvaginal needle aspiration, and the oocytes are fertilized with the sperm of the recipient's partner. The fertilized eggs are then transferred transvaginally into the uterus of the recipient for implantation and an ongoing pregnancy.

blocked. And there was a lot of scar tissue. So that was that. That started our fertility quest.

Over the next few years I had several surgeries, and we did three IVFs. They failed. Meanwhile, we heard about donor egg at a symposium, and we asked our doctor about it but he wasn't set up to do it so he referred us.

Asked what their initial response was to using a donor, Connor responded,

It was a poor second choice, in my opinion. We were going through second choices and lining things up, and they became increasingly disagreeable. I really wanted to just remain a family. If it wasn't going to be Clara's, at least I wanted it to be her sister's egg so it would still be family. That was a major concern. That was our first choice.

Clara said,

But she didn't want to do it. She's very young, and she had never even had a pelvic exam. So she backed out. And I was starting to become resigned to doing donor egg. It became obvious it wasn't going to work with my egg, and so what we saw as possibilities were child-free, adoption, and donor egg. Actually, that was exciting for me because the success rate was a little higher than regular IVF.

So we went for an interview with this specialist and did a donor cycle and it failed. It was tough. We were devastated, and we didn't come up for months. Finally, I had more surgery. I had been putting it off, thinking I could get around it. But in order for me to do this fibroid surgery, we made a deal, the two of us. We had to do at least two more fresh cycles with a donor and we had to start working on adoption. We had to start working on a letter because I didn't want to get to the end of our fresh cycles, frozen, or whatever they were, and have to start from scratch.

Then we tried to use our frozen embryos and they didn't survive, which was difficult. Because most donor embryos are reused. That really threw us because it was like coming to the end. It's hard to keep going.

So finally we called our donor and asked her if she would do one more cycle with us. She had experienced a lot of pain with the last retrieval. So she agreed. And we went through with it.

And … I'm pregnant, 24 days.

Overwhelmed by her emotions, Clara burst into tears. Connor took up the story: "We're really excited. Apprehensive. We've hit the wall before, and it took me months to recover from the last one. But I'm fairly optimistic. Yeah, real up. I announced it to my entire class [of fellow graduate students]."

Recovering, Clara said,

We haven't been very private about this whole thing. We've been very open about using a donor. We want to educate people and we're not ashamed of it. This is an option for a lot of people. It's not cheap, and it's pretty emotionally wrenching, but it's another alternative. And until recently it didn't exist. So we like the educational part. We volunteered to talk to people through Resolve, and we get calls from all over the country. But the main thing is I really want it to work.

I went back to visit them when the baby was almost due and asked Clara how she felt about having the baby now. She responded, "I knew I was pregnant but it took me a long time to believe I was going to have a baby. It was probably not unti like the seventh month. I mean, long after the baby started to move. Now that the baby's almost here, I can finally get excited." Turning to Connor, I asked how he felt about becoming a father in a few weeks. He responded, "Its a mixture primarily of extreme excitement and total terror. It's something we haven't done before."

The Unknown Future

Sometimes things happen when we least expect them. Susan and Larry put a lot of work into resolution. They looked at their alternatives. One was remaining childless. Susan though this might work out for her, but it was Larry who was most enthusiastic about the possibilities.

We've thought about it a lot. So far it has been pretty good as a life, so not having children is sort of a continuation of that. We've talked about getting pilots' licenses, and getting a little airplane and start traveling around and doing things. There's a lot of things you can do and have freedom. It's not looking at life as being childless, but being very full in other respects.

They also considered adoption, about which they had been thinking off and on for several years.

SUSAN : We talked about adoption for a long time. We could have done it when we were working overseas. But we weren't ready. And lately, I have been feeling ready, but then I hang back.

LARRY : But now that I'm looking at jobs in different parts of the country, we think we will wait until we move and are settled down again.

Meanwhile, Susan decided to go to graduate school and finish her training as a psychologist.

I applied to all these different schools. We don't know where we will end up, but we decided it wouldn't be a good idea to adopt while I'm in my first year of graduate school. So we'll wait and see. We stopped feeling the time pressure we used to feel. Who knows what we will want to do in a couple of years?

Susan was accepted to the graduate school of her choice, and Larry was offered a challenging job nearby. They moved, and launched into their new life. To her complete surprise, Susan learned she was pregnant in her second year of school. Their daughter was born into a family life that had been regeared for adult living. By that time, Susan was immersed in her graduate studies, and Larry was deeply involved with his work. Neither was willing to give up the newfound interests to focus solely on parenting, as they had been in the past. What did they do?

We manage to fit everything in, but sometimes it's a struggle. It's been a challenge. Life is so unpredictable. You just never know what lies ahead.