The other day I ran into another one of those patients who always makes me smile when I see her.  She brought me up to date on what was happening in her life.  It was a story of debilitating pain and multiple surgeries to try and relieve pain.  Instead of relief she developed a tumor in the area that required more surgery.  In the end, she was still in just as much pain and on chronic pain medication.

I expressed my heartfelt sympathy for what she has had to go through.  She smiled and said she’s fine and that she is almost off of the pain medications because she is planning to see me soon to try to have another baby.  She was coming off of the medications not because she didn’t have pain, but because she wanted to have another baby.  I looked into her eyes – and her smile, and realized I am a better person for knowing her.

Mother’s Day is upon us.  It is not the most welcome holiday for my patients.  Gifts passed out at church or given by a well-meaning spouse do little to fill the void of yearning that brings patients to my office.  We hear stories about the great love, sacrifice, and courage that mothers have for their children, but little is said about the incredible love, sacrifice and courage of “mothers-to-be.”

It takes incredible courage to acknowledge that there is even a problem.  We all want to believe that we are in control of our lives. Just to acknowledge there is a fertility problem is to internalize a lack of control over this incredibly sensitive part of their lives.

It takes courage to seek medical attention.  No one likes to see doctors (I’m over a year late for my own colonoscopy), and the trip to the fertility doctor is a particularly difficult journey.

It takes courage to undergo procedures that are not comfortable in an area where discomfort is particularly unwanted.

It takes courage to face the possibility of disappointment.  Studies have shown that when a woman experiencing infertility has her period, indicating that once again she is not pregnant, she experiences the same degree of grief as if her brother or sister had just died.  Most of us go through that only once or twice in our lifetime. Imagine going through that every month for years.  Then imagine going through a specific procedure to get pregnant and having it not work.

It takes courage to hope that it will work the first time and proceed, and even greater courage to experience a failed attempt and then turn around and have the courage to hope again.

These women undergo great sacrifices.

They sacrifice the intimacy of what was supposed to be a wonderful and intensely personal experience with their partner for a doctor’s office.

They sacrifice time on repetitive visits for monitoring and procedures.

They sacrifice financial resources to have something that everyone around them seems to receive without thought and sometimes with disdain.

They sacrifice personal comfort, sometimes thinking that if they experience pain, they will be more worthy of the “gain” they so desperately seek.

Why do they do this?  For the same reason a mother gives her bread and goes without.  For love.  The only difference is they do it for a deep abiding love for a child that they have not yet held, a voice they have not yet heard, a smile they have not yet seen, and a touch they have not yet felt.

My smiling patient had experienced infertility for 10 months when she first came to see me.  It was clear that each passing month was difficult.  She had endometriosis and her husband had a sperm problem.  Unfortunately her biological clock was more advanced than it should have been.  When two months of inseminations failed, she tried IVF.  She required high doses of medication to produce nine eggs but only made four embryos, one of whom became her beautiful baby boy.

Sixteen months after delivery, she was back for his brother or sister.  She tried IVF again, which resulted in a positive pregnancy test but the pregnancy hormone dropped, leaving her with a “biochemical pregnancy.” The pain from her medical condition reached a peak and she had to stop infertility treatment to manage the pain.

She returned two years later after many surgeries and no pain relief with the intent to continue but could not.  She returned again, two years, later having experienced a tumor where her pain surgeries had been and having had an additional seven biochemical pregnancies – and she still wears a smile.  She is the epitome of the courage, sacrifice, and love that characterizes mothers in general and the “mothers-to-be” that I have the privilege of associating with every day.

To each of them and to mothers everywhere, Happy Mother’s Day!