Early in an academic career, when job instability, long hours and high pressure are part of the experience, many people understandably choose to delay having children or not to have them at all. But delays can increase the risk of infertility, forcing people to face the prospect of having to change their view of the future entirely.
Infertility affects an estimated 15% of couples, with age being the single most prominent factor affecting conception and birth, according to the US Centers for Disease Control and Prevention. It is an experience that leaves many people feeling lonely and exhausted, and often invisible. If you are facing this situation, irrespective of your career stage, you are not alone.
C.M. was in her mid-twenties and about to start her PhD when she got pregnant but then had a miscarriage. After more than a year of trying to conceive again, she began in vitro fertilization (IVF), and she went through multiple unsuccessful rounds during her second and third years of graduate school. Struggling to reconcile her infertility journey with her role as a PhD candidate, she was relatively silent about her experience with colleagues. It wasn’t until she had ceased fertility treatments and entered a new phase personally and professionally — gaining a contract position as a lecturer in biological anthropology and accessing the research opportunities that academic employment provides — that she found the network she needed to open up about her infertility. This helped her to process the end of her IVF journey and to adapt her goals to a life without biological children.
A.B. conceived her first child naturally when she was in her mid-thirties. She assumed the same would be true for her second. But as she approached 40, she ended up having multiple rounds of IVF, and experiencing cancelled cycles, a failed implantation and a miscarriage. This left her emotionally and physically exhausted. Although she eventually gave birth to another child, the journey through infertility took a significant toll at home and at work.
Thankfully, she had a supportive network of colleagues, who knew about her experiences and encouraged her to stop apologizing and feel her lived experience. This gave her the motivation she needed to speak freely about her experience and not to feel ashamed if she became emotional at work. This was essential for her to carry on.
Our respective experiences of infertility also changed the focus of our research. C.M. shifted more towards desk-based work using accessible published data sets, ultimately leading her to focus on population fertility. In the process of trying to humanize the narratives of people in the deep past, C.M. was often reminded of her own emotional and physical burden. Although the research was emotionally challenging, having her experience made C.M. more aware of the sensitivities and social aspects of infertility.
A.B. switched her work on stress and health from non-human primates to people, with a special focus on prenatal stress and birth outcomes. As she was going through her infertility journey, she was interviewing women about their pregnancies and resultant births. Although this was painful at times, she also felt it was cathartic to hear about the different ways people experience conception, pregnancy and birth. It made her a more empathetic researcher and better equipped her to understand what some of her participants had experienced.
Here we share how we came to terms with the challenges of infertility and academia.
An aptitude for research is a blessing and a curse
As researchers, we both felt that we could decide on treatment strategies and understand statistics without the input of fertility specialists. We read the literature, checked out numbers, decided on our own plans and sometimes predicted outcomes.
As a relatively young person with unexplained infertility (that is, no identifiable cause), C.M. trawled through medical studies for conditions that might explain her inability to maintain a pregnancy and to identify seemingly suitable treatments. Often, she was crushed to learn that neither the condition nor the treatment were applicable to her, which further fed the uncertainty and anxiety of her reproductive journey. A.B. spent hours reading statistics and research papers on how biological and lifestyle profiles affected IVF success rates, and would decide well before a cycle had concluded what her chances of success were.
This is what good researchers do: interpret data and make rational, emotion-free conclusions. But it was not an emotion-free process. Research skills can help you to feel some sense of understanding and even control over the situation you are in, but letting it go too far can lead to disappointment when your ‘treatment plan’ turns out to be unsuitable. It is important to remember that it is ok to feel all your emotions and to maintain trust in your physicians and their plan for your reproductive success.
Although unwillingly, and unpleasantly, you are cultivating valuable skills in resilience
People with infertility are often left with many unanswered questions. There is a large literature base on how to deal with uncertain futures (we recommend the 2017 book Option B: Facing Adversity, Building Resilience and Finding Joy by Sheryl Sandberg and Adam Grant), but whatever strategy works for you, it is helpful to remember that rejecting or accepting uncertainty has no bearing on what will eventually happen.
Both of us also found that seeking professional counselling helped us to gain perspective and focus less on our infertility and more on the other joys in our lives, including our careers and support networks. This helped us to come to terms with the lives we were living, rather than the ones we thought we were going to live. For our academic careers, this was crucial for making research plans and pursuing opportunities for intellectual growth and career progression. In our personal lives, it gave rise to greater optimism and gratitude for the experiences within reach. This also helped us to deal with, and even celebrate, the reality of colleagues and friends getting pregnant.
Facing up to such challenges helped us to cultivate resilience by actively accepting the uncertainty. Academia is an occupation fraught with uncertainty. With the rarity of tenured jobs and the impact of the COVID-19 pandemic on the sector, many of us are either perpetually looking for jobs or coping with the stresses of a precarious future. Accepting uncertainty is grounding, and encourages us to have greater fluidity and adaptability to challenges and opportunities.
Your infertility does not define you, and neither does your job
Despite our divergent experiences, we both concluded that success can be defined in many ways. C.M. aspired to be one of the fantastic parents we see all across academia: working tirelessly to juggle their academic career with being the parent that they want to be. When her future as a biological parent disappeared, she felt she was left with only her academic career. For a while, this was a great coping strategy: she threw herself into her work to feel as though she was excelling at one thing when the other let her down. But with the uncertainty and pressures of early-career academia, she quickly learnt that she needed to place weight on both personal and professional achievements. She found balance in disarticulating her passion for research from a tenured academic job, and pursuing personal goals that had been put on hold during fertility treatments.
We both learnt that we did not need to define ourselves only by our fertility journeys and careers. Rather, ‘success’ can be defined collectively across the many facets of our lives, to allow us to change what it looks like as we encounter insurmountable hurdles.
Be gentle with yourself about the challenges you can face and the ones you choose not to
Both of us had to give up funded fieldwork and conferences to undergo treatment, which was hard to explain and justify to colleagues who did not know about our situations and who could not fathom why we would want to miss these career opportunities. This added more pressure to an already difficult situation.
Going through such a struggle pushed us. It made us more innovative, identifying research questions and approaches that were meaningful to us and did not rely on fieldwork, and using technology to maintain our networks and conference presences. At times, we decided not to attend events on childhood and motherhood because we found them triggering, and that is OK, too.
By sharing our infertility stories, we hope to normalize the variety of choices that academics might make for their research careers on the basis of their personal health and well-being. Decisions relating to the fieldwork, conferences and research topics you choose to participate in should be made courageously and with your own best interests at heart, and the ability to do that should be at the core of our academic freedom.
These lessons might do little to relieve the pain of infertility, but we hope that they help people going through these struggles to become more resilient, more adaptable and perhaps even a happier academic.
https://www.nature.com/articles/d41586-022-00399-7