Editor’s note: This story pairs with “No reason to fear adoption, couples say”
Walking into the home of Garrett and Kellie Bull, visitors are greeted with pictures of their three beautiful children on the walls. The boxes of toys in the living room and the Bull family’s smiling faces give no indication that for the first six years of their marriage, the dream of starting a family seemed like it may never become reality.
Kellie and Garrett both come from families with no history of infertility and didn’t have any reason to believe they would have a problem starting a family early in their marriage.
“My mom never had any problem having children, and my sister got married at 19 and had all her children right away. There was really no reason for us to think that infertility would ever be an issue,” Kellie said.
For the Bulls and many couples struggling with infertility, the hardest part is often the unseen emotional side effects and feeling alone and isolated when dealing with those emotions.
Diagnosing Infertility and Treatment Options
A recent study from the Kem C. Gardner institute at the University of Utah revealed that Utah’s fertility rate is at an all time low. Despite this, the state still has the highest birth rate in the nation, and nearly five percent of those births come with some form of fertility treatments, according the the Centers for Disease Control and Prevention.
After trying for over a year to conceive on their own, the couple decided it was time to visit a doctor and get some answers. Kellie was initially put on Clomid, a common infertility drug, but saw no improvement.
A couple or individual is officially diagnosed with infertility issues after one year of actively trying to conceive, according to Camille Hawkins, the executive director of the Utah Infertility Resource Center and a licensed clinical social worker.
“A lot of times there’s a reason for the diagnosis,” Hawkins said. “The reproductive systems in the male and female bodies are extremely complicated, and there’s so many parts to it. It’s actually a huge miracle that babies are conceived all the time because there’s so many things that could go wrong.”
After two years of testing and doctors, Kellie was eventually diagnosed with stage three endometriosis, an issue where tissue that typically grows on the inside of the uterus grows on the outside, according to the Mayo Clinic. They began to look at other options to start a family.
“We couldn’t afford IVF (in vitro fertilization) at the time and had exhausted all our medical efforts,” Kellie said. “We had friends that had adopted a baby privately the year before and it was extremely affordable. I told my husband that I didn’t want to miss the opportunity to get a baby if it presented itself to me, so we expanded our options and got our home study done.”
After a few possible leads, the Bulls were chosen to be the parents of a baby girl from Idaho five months later. They were notified when the birth mother was already in labor, rushed to Idaho, and returned with their new daughter.
The couple has since had success with IVF, and even a natural pregnancy that has resulted in two more children.
Angela and Phil Williams started trying to have children two years into their marriage.
“I knew something was wrong almost immediately and I took Clomid for three months and then pleaded to be referred to a fertility clinic right away,” Angela said.
It was on her second round of medication with timed intercourse that she became pregnant with her first child, a daughter born in January 2013. The Williams’ had a set of twins in 2015 after two more rounds of IVF and medication, and Angela will be undergoing her next transfer in December.
An infertility diagnosis can be overwhelming emotionally, but also financially, with the costs of an IVF treatment typically reaching over $10,000 in Utah. Many insurance companies don’t cover infertility treatments, and the cost can quickly become the biggest obstacle.
“I think that’s one thing that’s unfair, and a bit ironic,” Garrett Bull said. “Why are (insurance companies) willing to help with getting an abortion, but not with getting pregnant?”
For couples looking for answers, Hawkins recommends researching all options.
“Most of the time, it takes couples three to five years to get all their information,” Hawkins said. “(UIRC) can answer questions that are specific to their situation.”
UIRC offers educational consultations in person and over the phone where a staff member will sit down and talk through various options with the couple. All services are low or no cost. The center also provides couples with a booklet that gives the basic options for infertility.
For couples or individuals ready to start a family, the news that they may be unable to do so is crushing and brings strong emotional side effects.
“It’s not the situation, but it’s how the situation makes you feel,” Garrett said.
Myke and Amanda Emal have been trying to start their family since December 2015. When they found out that it would take up to 10 years for them to be able to conceive naturally, they were heartbroken.
“I had never experienced such sadness, and in that moment it took all of my being not to break down in front of the doctors and just sob,” Amanda said. “Discovering that we would deal with infertility for the rest of our lives was very challenging emotionally, spiritually, physically and mentally.”
Common feelings among couples and individuals struggling with infertility include isolation and inferiority.The amount of time required and dedicated to treating infertility only adds to the deeper emotional struggles.
“It’s countless doctor’s appointments,” Angela said. “Your whole life revolves around your monthly calendar. It consumes you. A lot of people pull away from their friends because it’s so consuming … It’s just so devastating and people who haven’t gone through it don’t always understand how heavy it is. It almost isn’t as serious to those on the outside as it is to the couple.”
Couples will sometimes hide their feelings while struggling with infertility because of embarrassment or fear of not being understood. Insensitive comments from family, friends or religious leaders can lead couples to remove themselves from their social circles even further.
“I honestly think that because infertility is not life-threatening and having kids comes so easily to most people that hardly anybody even considers it’s a problem others might be dealing with,” Myke said.
Struggling with infertility can impact not just relationships with family and friends, but the relationship between spouses. It was during those years of intense emotion that strengthened their relationship the most, Kellie said.
“We had five and a half years of just us, but that’s not to say that we didn’t have our rough moments when dealing with infertility,” she said. “There were times when our relationship was strained, but not giving up on each other has brought us closer together through it all.”
Garrett said he felt pressure to always be positive and be the one to tell his wife that everything was going to be okay, but that wasn’t always the best option. It was in those tender moments when they cried that strengthened their relationship the most, Kellie said.
“Sometimes, as the guy, you’re just going to want to cry. And that’s okay,” Garrett said.
Utah has the highest fertility rate in the nation and is known for the family-focus culture among Latter-day Saints, with its teachings about the importance of family. Couples said that focus can make dealing with infertility in Utah especially difficult.
The number of children here makes it hard for couples or individuals to escape their pain, Hawkins said. It only makes them feel more isolated and abnormal, when that’s the last thing they want.
“With that family focus culture comes a lot of desire to have children, and not just one but two or more children,” Hawkins said. “So when it doesn’t work out, that can be more devastating for couples because family is everywhere in Utah… you can’t escape it. ”
For the Emals, seeing so many newborns and young children became almost toxic.
“(In) Utah culture having kids is a gigantic status symbol,” Myke said. “Many of our friends were having kids by accident and occasionally complaining about it, where we would have given anything to be in their shoes. We eventually stopped going to church for a while because there was a new baby being born every two weeks and we felt out of place and unwelcome.”
Mormons believe that being mother is a sacred and a worthy calling, and not being able to fulfill that calling brings a tremendous sense of guilt, Garrett said. Attending church becomes awkward because women tend to talk about their children a lot, Kellie said.
Hawkins’ professional background allowed her to realize that she would need to find support from others who could empathize with her situation in order to help cope with the difficult emotions of her own infertility.
“I’m a counselor, and after I went through a failed IVF and had a miscarriage, I just was completely broken down emotionally,” Hawkins said. “I knew as a counselor it was time for me to get support.”
The resources for infertility support groups or counseling were extremely limited. So she started her own support group in the living room of her home.
This eventually led to the establishment of the Utah Infertility Resource Center, a non-profit whose mission is to provide “education and emotional support to those who are struggling to grow their families so that they are empowered, strengthened and equipped to move forward on their respective journeys.”
The center currently has five counselors that have personal experience with infertility and receive ongoing training for infertility counseling. They also hold several support groups for both men and women.
Kellie Bull agrees with Hawkins about the importance of finding support and said opening up and finding support through others who were in similar situations was extremely helpful for her.
“For a long time I never talked to anyone about my feelings revolving around my infertility and because of that I felt very alone,” Kellie said. “I think it’s so important to have female support as well as your husband.”
Since her mother and sisters had no problems with infertility, Kellie believed they couldn’t understand and it wasn’t a topic they could discuss.
Once she opened up to her mom, however, Kellie realized found that getting support was healing. Her connections with family and friends are far stronger now than they were before opening up.
“I decided at that point to be open with anyone and everyone about my situation and through that I’ve been able to help and assist close friends who are going through similar struggles with infertility.”
How to Help
Trying to understand what it’s like being unable to have children when wanting them so desperately can be difficult to comprehend, Garrett said.
It’s easy become offended or hurt by insensitive comments or questions, even if they are well-meaning, Kellie said. Over time, she’s learned to take questions graciously and ignore the hurt that may come with certain remarks.
“I would get questions like ‘are you sure you’re doing it right?’, and honestly, I just took that comment as them being uncomfortable with the situation and trying to make light of it because they don’t know how else to respond,” Kellie said. “People who have never had to suffer through infertility don’t know the amount of time, effort, medical procedure, blood, sweat and tears that have gone into trying to achieve what they already have.”
For those who have family or friends struggling with infertility, Hawkins advises the the best thing to do is simply listen and avoid trying to give advice. She said it’s better to just listen and love them.
“People who struggle with infertility have tried everything,” Hawkins said. “They’ve tried all the magical potions… and so a lot of the advice is well-meaning but it isn’t helpful. Tell them you love them and ask ‘how can I support you?'”
It can take time for couples or individuals to feel comfortable sharing information about their situation with loved ones. Myke said part of that hesitation is because he dislikes being outside “the norm.”
Certain comments meant to be loving can seem shallow and be hurtful to those struggling to have children. Angela said there are certain phrases that don’t help the situation in any way.
“I hate when people say that people with infertility should just have more faith. It’s out of our control if we have infertility … People tell stories about other couples who just stopped worrying about it so much and then they got pregnant when they least expected it; (those) are more hurtful than they realize,” she said.
Dealing with these emotions and struggles of infertility in Utah can lead to something of a paradox, Myke said.
“I would appreciate not having my nose rubbed in the fact that I can’t have my own children,” he said. “I want to be treated like everybody else, but I don’t want them to constantly remind me about fertility issues by talking about children – the most common and normal thing for married adults in Utah to deal with. A paradox.”