(Editors note: This is the second installment of a two-part series. You can read the first installment here.)
While fertility issues may be increasingly common, the causes are not. Researchers speculate that approximately 10% of women aged 15-44 may be infertile, and that any number of factors can contribute, including the advanced maternal age of many working women. But infertility is equally linked to reproductive conditions that affect younger women, like polycystic ovarian syndrome (PCOS), endometriosis, uterine fibroids and adenomyosis.
While fertility issues aren’t always easy to diagnose, they’re also difficult to discuss, especially in the black community, where we have traditionally been conditioned not to “put our business in the streets.” So, when famous black women like actress Gabrielle Union and former first lady Michelle Obama (and Beyoncé, Halle Berry and Tyra Banks before them) are willing to be transparent about their struggles to conceive, they open the door to much-needed revelations about what is truly “normal.”
Mrs. Obama recently became the most famous black woman to date to discuss using in vitro fertilization when her memoir, Becoming, revealed a devastating miscarriage and that much-beloved first daughters Malia and Sasha were subsequently conceived via IVF. Speaking on the 2 Dope Queens podcast finale in November, Mrs. Obama explained why she felt that disclosure was so important.
The notion that I wouldn’t share things about my life and then call [Becoming] a memoir to me just seemed, like, disingenuous. ... I do believe that it’s important for us to share the highs and the lows, especially when you’re a role model and people are looking at you. ...
And miscarriages and challenges with pregnancy, especially as more young women are going to college, they’re postponing pregnancy, the biological clock is real. And no one told me that. When you start trying and then you go to the doctor and they’re like, ‘well at 35, this is your egg production,’ and I was like, ‘for everybody?’ … [W]hy didn’t they tell you about like, finite eggs? That seems like something people know, and you didn’t tell us? That’s wrong. … So I just don’t want some young person struggling with stuff that happens to everybody and going through that loneliness and that pain and that feeling of failure when this is how our bodies work.
Dwyane Wade, NBA star and husband of Gabrielle Union, agrees. The couple, along with Wade’s three sons, recently welcomed a baby girl via surrogate, after years of trying unsuccessfully to conceive. Continuing to share their birth journey with the public, Wade and Union recently addressed the need for open dialogue on Oprah’s Super Soul Conversations.
“We feel that we have a responsibility. In the African American community, we have a responsibility to educate through our life experiences,” Wade offered. “So, what Michelle did and what Barack did—for us, that was like, thank you. Another strong voice, another strong powerful voice in the African American community stepping up and educating … and standing up and saying, ‘You’re not the only one; look at us.”
As The Glow Up continues to explore what this conversation means to those not in the public eye, we interviewed two black women about their distinctly different experiences with IVF. This is the second of those two dialogues.
Naomi, 42, Communications Strategist, Brooklyn, N.Y.
Having entered a relationship with her now-husband more than two decades ago, Naomi was in a rare position to consider her reproductive options early. In fact, due to a genetic condition her husband carries, the couple first consulted a geneticist in 2003 to explore options. IVF is often identified as a method to filter out any unwanted conditions. (It’s worth noting that pre-genetic diagnosis is rare and not covered by insurance; pre-genetic screening, a separate procedure, is regularly recommended for any prospective mother over 35.)
But despite early planning, the couple didn’t start trying in earnest until 2012, when they were both settled into their careers, and had the added bonus of up to four cycles covered by insurance. After their third cycle of IVF and egg retrieval, Naomi experienced severe internal bleeding that ultimately required emergency surgery.
“I was told that if I’d waited a couple more hours [to go to the E.R.], I wouldn’t be here,” she said. “At that point, the decision, of course, was do we do this again?”
The couple opted to proceed in the summer of 2014, leaving the world-renowned hospital they’d been working with in favor of a small clinic called New Hope that specializes in natural (no injections) and “mini IVF,” which involves low dosage pills. Choosing the lower dose option, the cost was considerably lower (Naomi estimates half as low as their prior procedures). This time, the focus was on quality over quantity. New Hope theorizes that less drug exposure produces better eggs. In August of 2015, their healthy baby girl was born.
Eager to provide a sibling for their child, Naomi has done about 12 more cycles since her daughter’s birth. In fact, she was mid-cycle during our interview. She credits her ability to weather back-to-back procedures with the lower dosage of drugs, “but of course, you don’t know what the long term effects are; no one does,” she admits. “So, that’s like, a little teeny bit of a concern, when I start thinking about it.”
Naomi also admits that in her two-earner family, they are earning enough to devote her entire income to trying to have another child. “The odds are kind of stacked against us, so that is why we do so many cycles,” she said. Last summer, they had six fertilized embryos, but none were viable.
“I think honestly, that was the most devastating point,” she admitted.
In the months since, she’s taken a new approach to trying to expand her family. “Now, I kind of go with the flow in a way that I haven’t before, and I don’t quite know what brought that on,” she said. “I think I’m just done with being devastated.”
Still, Naomi admits that when it comes to infertility, “the stigma is real, and you feel it.”
“If I find out that a friend wants to have a kid, and they are coming close to that age where it becomes harder and harder, I always say really think about it, and if it’s something that you want to happen, consider freezing your eggs,” she advises. “IVF is an option, but that doesn’t necessarily mean it’s the easier option. ... In my mind, I feel like anytime we ask our bodies to do something they’re not meant to do, it’s never going to be easy.”
“So, I just feel like there needs to be more conversation, and more of a heads-up from folks who have gone through it, to say ‘this is how I was able to conceive,” Naomi adds. “Not all of us are able to have babies the way we thought we thought we were going to be able to. And having those options is a beautiful thing, but also, I want folks to know that it should be a last resort ... IVF is not an automatic solution.”
And that’s a reality not making headlines, even as more and more women are confronted with the limits of their fertility. But regardless of whether the journey ends in parenthood, or simply finding peace with what is, keeping the conversation around the realities of infertility open and alive is the most important component of removing the stigma of these increasingly common issues.
“You don’t have to suffer in silence,” Gabrielle Union told Oprah. “You don’t have to suffer alone.”