Stopping the blame game while trying to get pregnant
March 12, 2014 11:26 AM   Subscribe

Took doctor's advice and it made me worse. How do I cope with making a mistake that may prevent me from getting pregnant?

I'm a 34 (almost 35) year-old woman who has been trying to get pregnant for the last 1.5 years. Prior to trying to conceive, I decided to try and fix my chronic IBS issues. I went to a couple of doctors who put me on restrictive diets to see if that helped. It didn't, but it did result in my losing my period for 3 months. It came back for a month. Then it didn't return until 2 months later, when I had gained back all the weight I had lost. Unfortunately when it did come back, it was longer, more painful and just different. Prior to this, my periods had always been regular and pretty pain-free.

I decided to ignore the IBS issues and go ahead with trying to have a baby. I was under a lot of stress: not sleeping, crying, depression during this time. After trying naturally, being on Clomid and doing IUIs, a reproductive endocrinologist discovered endometriosis on my ovary via a ultrasound a few weeks ago.

I'm pretty devastated, and it looks like IVF is in my future (with low probability of success). But the main thing I'm having trouble with is blaming myself for causing the endometriosis in the first place by losing weight and losing my period. I can't shake the idea that if I hadn't listened to those doctors, I would now be pregnant.

Anybody gone through something similar? How did you go about forgiving yourself for making a mistake that had a huge effect on your life?
posted by purple24 to Human Relations (26 answers total) 5 users marked this as a favorite
Well, first of all, what basis do you have for thinking that your IBS-fighting diets caused endometriosis? Is that something your doctor said? Are you possibly simply falling prey to the ancient "after, therefore because" logical fallacy?

Second, suppose you are right about the first thing. You were attempting, in a responsible way, and under the supervision of doctors, to find relief for a health condition. There is no blame in that.
posted by thelonius at 11:34 AM on March 12, 2014 [22 favorites]

I have stage 4 endo, which wasn't discovered until a laproscopy (I was asymptomatic -- they were going in to take care of a cyst). I was under the impression that it just appears in your body, and that nothing you could do would make it appear or disappear -- you've probably had it since puberty. What did your gyno say about this?

I sympathize with you. My endo is apparently terrible and I'd also need IVF if I were to want to become pregnant. In fact, since one of my fallopian tubes is blocked up by it, it would be very dangerous to even try to conceive naturally. It sucks. You're allowed to grieve over this. I don't think you should blame yourself, though.
posted by chowflap at 11:34 AM on March 12, 2014

Forgive yourself. You didn't know. If you had known, you wouldn't have done it.

Also, what makes you think that losing weight and gaining it back caused the endometriosis? Doesn't it make a LOT more sense that you've had it all along and perhaps that's why you've had trouble conceiving?

You are looking for cause and effect relationships, "if I do this, then that will happen," and frankly, it's indulging in superstition or magical thinking. The human body isn't something we can control. We can do a lot, but most of it works/doesn't work, without any intervention on our part.

Some folks easily get pregnant, some need technological intervention and it may never happen for others.

Accept that for now, this is out of your hands.

Also, hie thee to counseling, because you're not right in the head about this process and it's crushing your spirit.
posted by Ruthless Bunny at 11:35 AM on March 12, 2014 [4 favorites]

Endometriosis can be caused by a lot of things. Losing weight and treating your IBS may not have been a factor at all. In fact, treating your IBS was probably better than not because bodies do weird shit during pregnancy, and IBS is likely to be extra messy to handle during pregnancy, especially if there's a significant flare up.

There is also a possibility that the IBS was a symptom of endometriosis, rather than the cause of it, too.

Short of it is, nothing in here says you made any mistakes. Nothing you did was a mistake. Nothing you did is anything you deserve blame for. You are not responsible.

I am so very sorry that this is happening. It is really unfair and unkind, and it happens to too many people who would be or through one set of means or another eventually become good parents.
posted by zizzle at 11:35 AM on March 12, 2014 [3 favorites]

Isn't it possible that the IBS was caused by the endometriosis? If anyone is to be blamed it should be your doctors for not being clear and thorough with you.
posted by bleep at 11:37 AM on March 12, 2014 [6 favorites]

You didn't cause it, you just finally figured out what was going on the whole time. Everything here seems to be pretty consistent with this being the trouble from the beginning. Now that you know, you can be taking appropriate action.
posted by Sequence at 11:42 AM on March 12, 2014 [4 favorites]

Agreeing with zizzle in that you have no way of knowing whether the weight loss or dietary restrictions are what actually caused the endometriosis. The absence of your period was a direct result of losing too much weight and allowing your body fat to drop below a healthy level needed for reproduction (hence your body diverting that energy into more vital, basic functions). A woman's period is one of the first things that disappears when faced with malnutrition or starvation - even healthy but exercise-obsessed girls will lose their period. I have not seen any studies which have linked it with reproductive issues later in life. My understanding about endometriosis (which runs in the female side of my family) is that it is partially genetic and partially luck of the draw.

But I digress... I know you mentioned IVFs having a low probability of success, but I wanted to share a more positive (albeit anecdotal) story that may offer some optimism.

My sister had difficulty conceiving. She miscarried - twice. She too suffered from endometriosis (and a slightly retroverted uterus) and had to resort to IVF.

She now has 4 children - the first one was because of IVF (in her early 30s), but the remaining 3 were conceived naturally (in her mid-30s).
posted by stubbehtail at 11:44 AM on March 12, 2014

My period would disappear for 6+ months and once even for nearly an entire year because of untreated PCOS, and before getting diagnosed, I thought the weirdness was because of bouts of "ketosis dieting" (aka "starving") I'd committed in earlier years. But, no. So, I personally think you're having a similar gap in identifying the true source.

Endometriosis was likely there beforehand (I've had friends who had it for a couple of decades and didn't know until they went in to find out what was up with their fertility, so I don't think this is all that uncommon). Treating your IBS or even mistreating yourself are likely not related at all to the situation.

But, regardless: do let go of any blame. If you need to grieve the idea of an easier time with conception, do that. It sure helped me when I finally let myself do it. Just follow the usual guidelines for healthy grieving and then keep taking the steps you need/desire for trying to achieve the outcome you want.

If you want to talk about fertility challenges and all of that in more depth, feel free to MeMail me. I'm always glad to share experience with that whole thing, if it'll help someone else.
posted by batmonkey at 11:51 AM on March 12, 2014

I've been dealing with infertility myself, in a situation similar to yours. One of the worst things about it is that it's a stark, in-your-face reminder of how little control we have over our own bodies. I doubt very much that anything you did caused your endometriosis; you are sad and you are grieving, and your brain is trying to make sense of it all and come up with reasons--that's normal human nature.

I'm very sorry you are dealing with this. I can definitely, definitely relate. I won't tell you it gets easier, but one thing you can do is be gentle with yourself. You're already going through something very difficult. If you have any close friends whom you think would be understanding, I urge you to talk about this with them--this is private pain, so not everyone needs to know, but it can be a relief to talk about it with close, loving friends.
posted by Secret Sockdentity at 11:54 AM on March 12, 2014

Are you SUUUUURE you didn't already have endometriosis? I have it and the symptoms it causes me are VERY similar to the symptoms of IBS - so maybe what you thought was IBS was actually endometriosis? In which case your IBS treatment most certainly did not cause you to have difficulty conceiving.

Also, I have been seeing a obgyn who specializes in fertility issues caused by endometriosis and she assured me that it's not impossible to get pregnant just because you have it. More difficult, yes, but there are many options for making it happen.
posted by joan_holloway at 11:54 AM on March 12, 2014 [6 favorites]

Gastrointestinal symptoms are supposed to be a fairly common (but unrealized) result of endometriosis.
posted by Blitz at 11:59 AM on March 12, 2014 [7 favorites]

Above and beyond what people are saying about it being quite possible you've had endometriosis prior to the IBS, or that the IBS is only tangentially related I hope you are finding ways to treat your issues of depression and emotional roller-coaster ride. I'd tentatively suggest getting the physical and emotional difficulties sorted out and be in a stable space before pursuing the next stage of trying to become pregnant.
posted by edgeways at 12:05 PM on March 12, 2014

purple24, I'm a doctor (though not an OB/GYN) and I also struggled with infertility. I have been there with Clomid. I have done the IUIs. I have been there with the self-recriminations and guilt.

Please believe me. You did not cause the endometriosis. You don't need to have symptoms of painful periods to have endometriosis. The fact that you have been dealing with infertility is very suggestive that you have had endometriosis all along. Medical science does not understand what actually causes endometriosis but I have never heard anyone say it's caused by diets or weight loss.

Trying the diets was a completely reasonable thing to do. There is nothing to blame yourself for or forgive yourself for here.

If anecdotes help, I've known many friends and family members who have dealt with endometriosis and successfully gotten pregnant multiple times - it is a treatable problem and infertility treatments are very effective these days for many people, even though going through the treatments is emotionally very hard. Best of luck and feel free to MeMail me about anything related to this. I'm sorry you're going through such a difficult thing.
posted by treehorn+bunny at 12:07 PM on March 12, 2014 [21 favorites]

To more directly answer your question about "how did you forgive yourself?" I will tell you - when I was going through infertility I found going to yoga classes several times a week and focusing on forgiving myself as the purpose of my practice to be very helpful. I have never met a woman going through infertility who did not find some way to blame herself for it, and I was no exception. Yoga saved my mental health.

I also enjoy running as stress relief, but I quit running because I read studies that running could impact fertility (yes, I blamed myself - maybe if I hadn't been running a few miles here and there while I was trying to get pregnant, I'd already be pregnant by now!) When the day would come that I would realize another cycle had failed, sometimes I would go out and just run, as fast as I could, as hard as I could and as long as I could until I had to stop. Somehow after I had run my frustrations into pain, it felt a lot easier to tell myself that I was doing my best, that I was going to make it through this hard experience because I was strong, and that I was going to be happy again someday (and I was right).

If you do something that has a similar effect on you, I'd highly recommend trying to make time for that, especially on days that you know are going to be hard.
posted by treehorn+bunny at 12:15 PM on March 12, 2014

I also noticed that you mentioned "I was under a lot of stress". I wonder if you are also blaming yourself for being stressed. Telling people who suffer from infertility to "just relax and you'll get pregnant" is so common it is a cliche.

Studies on the psychological impact of infertility have shown that it is similarly stressful to other serious diseases such as cancer. People don't tell cancer patients to just relax. Recognizing that this is a very stressful experience to go through and that you may need help and support to make it through (such as therapy, etc) may help you avoid the thoughts of "oh no, I am stressed, I am making it worse! Why can't I just relax?!"
posted by treehorn+bunny at 12:29 PM on March 12, 2014 [2 favorites]

It's entirely possible that the endo is causing the IBS, not the other way around. I have endo too and my periods remained super regular (except for when I went on the Mirena to help with the pain by stopping my period and that messed up my cycle for a year after I went off it). Don't take it as a death sentence for your fertility, either, as soon as my cycle normalized (and I started consistently ovulating again - which I charted by taking my basal body temperature every morning) I got pregnant right away. With treatment (have you considered ablation?) it can be a very surmountable obstacle.

There is nothing to forgive, it is highly, highly unlikely that anything you did diet-wise "caused" endometriosis. That is not how endometriosis works. It is pretty much certain that you just had it all along and that's what was causing your digestive issues.

You should find a therapist that specializes in difficulty trying to conceive, your doctor's office should be able to recommend someone. Our bodies sometimes just don't cooperate and do what we desperately want them to do. It is no one's fault. Talk it through with a therapist and let the grief go, there is no reason to focus on the negatives until you have exhausted all fertility paths you want to undertake.
posted by lydhre at 12:34 PM on March 12, 2014

Also, in case you are stressing about stressing, stress has been shown to not impede fertility. Depression, however, does. So take care of yourself and put your oxygen mask on first.
posted by lydhre at 12:36 PM on March 12, 2014 [2 favorites]

purple24, dealing with infertility is so, so hard and it's completely normal to blame yourself. But do you have any actual evidence that your weight changes caused the endometriosis? I've never seen any.

I'm also wondering why you think IVF has a low probability of success. Did a doctor tell you this and show you some specific studies to back it up? On average IVF works better when you're younger, and 34-35 is still pretty young. Average pregnancy rates for IVF at that age are around 40-50% per cycle.

One other thing I wanted to mention is that if you feel like more online support would be useful, there is a good infertility community in the forums at altdotlife.
posted by medusa at 1:00 PM on March 12, 2014

At the risk of going too off tangent, it might be helpful for you to seek out infertility support, whether it be online, through a counselor, or a support group. I've had many friends who have dealt with infertility, and many of them went through a stage where they blamed themselves for it - "If only I had eaten better as a teenager!" "If only I had figured out who to settle down with by the time I was 20!" "If only my parents hadn't lived in a town with an incinerator!" Infertility is so heartbreaking, and it would hurt my heart to see how they tear themselves up over something that so often has no known cause. (Although I would never tell them that - support in (to them), sadness and stress out (to unrelated support people like my husband). They didn't do anything wrong, didn't do anything to cause this. I think sometimes our brains want to find a reason, even when there is no reason to be found. It's the lack of reason, I think, that sometimes makes this sort of pain so awful.

Please know that you did the best you could with the information you had, and there are many people telling you that your IBS did not create your endometriosis, but may have actually been in part caused by it. You are not to blame for your infertility.
posted by RogueTech at 1:13 PM on March 12, 2014

Okay -- I'm going to share something here on the internets that I haven't shared with my friends or family. Because maybe it will save you some pain. I waited until about your age to try. And it just didn't work. I could go through the whole horrible story with a miscarriage and years of IVF but in the end my FSH was sky high and I have no quality eggs. This is not the case for many of my friends, but it is for me. I spent a lot of time beating myself and my husband up for this. For waiting too long. And caused us both much pain.

The thing is we have enough god damn pain. I don't need to cause more. What's done is done. The thing that helps me is the serenity prayer. Really. And I'm an atheist. But. God Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to tell the difference. Decisions in the past fall firmly in the things you cannot change camp.

If you reach a point (like I did), that it just won't work, there are other options (adoption, surrogacy, donor egg), and with time you can find a way to have a happy life within one of those. That's where the courage part comes in I think.

There are support groups and therapists for this and they can help. It's a fairly common thing for women to beat themselves up about, so a good therapist can help. Good luck.
posted by bananafish at 1:21 PM on March 12, 2014 [7 favorites]

The endometriosis is effecting your hormones - this is why you are depressed, anxiety ridden, and kinda not thinking straight.

I had endo, a laporoscopy surgey, and years later at the age of 38 and (finally!) happily married to the right guy, I had a baby at 40 with zero intervention. It took about a year and half to get pregnant. We decided to have fun trying and not stress about it.


But I am someone doctors convinced when I was younger it would be hard for me to get pregnant.

Find a doctor who can help you through these issues, including the very dramatic hormonal symptoms you are undoubtedly facing right now.

If your doctor did not tell you the hormones from endo would be a factor for you, then I suggest you find someone competent to guide you through treatment and conception. That's a big factor to skip over in discussing your diagnosis, IMHO.

Take a deep breath. Yo will get through this. Try to remember the worst of your catastrophizing will look different when you feel better, and that this moment right here and now is NOT the last word on how things will turn out for you, and that you WILL feel better about everything soon.
posted by jbenben at 1:24 PM on March 12, 2014 [1 favorite]

I likely have endo and (thankfully) mostly asymptomatic PCOS. I have NEVER heard of anything causing either of these other than luck of the draw and genes. If anything, it seems more likely that hormone fluctuations caused the IBS... I get IBS like symptoms on my period. My PMS has been getting noticeably worse and worse as I get into my thirties... including much of the IBS, anxiety, mood swings, etc you mention. You are definitely not alone. You didn't do anything wrong. Wanting to be healthy and feel good is OK!

I have an OB who is a fertility specialist, a urogynologist, and yes, a counselor - which I highly recommend.
posted by jrobin276 at 1:41 PM on March 12, 2014

Also this infertility subreddit is the best community on the internet for this:

The ladies there have all been through this. You may want to ask your question there. They are very sympathetic and helpful. And the avoid the stupid baby talk (Follies? Really people? Of other websites.
posted by bananafish at 1:42 PM on March 12, 2014

FWIW, my mother had endometriosis, about your age. Lost an ovary, but then gave birth to both my sister and I soon after, without any fertility treatment.

As for your diet 'causing' it, in the extremely unlikely scenario that this is correct, you had no way of knowing anyway. You really can't beat yourself up about that.
posted by derbs at 2:05 PM on March 12, 2014 [1 favorite]


It's astonishing for a condition that affects maybe 10% of the female reproductive aged population, but we have no idea what causes endometriosis. Scratch that, we have many ideas about what causes endometriosis, but no consensus. The deposit on your ovary could have been there for months and years, but it's only now that someone is looking that it has been found. Also, the relationship between fertility and endometriosis is not linear and it is very hard to say for any one person how endometriosis contributes to fertility.

That said, it is completely natural for you to seek something, or someone, to blame for the difficulties you have had conceiving. I do not think it should be you. One of the hardest things to deal with is the fact that sometimes life does not make straightforward, cause-and-effect sense. We want to find reasons for things, and sometimes there are no easy answers.

Your doctor may be able to refer you to a counsellor who has a lot of experience with your situation - not because you're crazy about this, but she may be able to help you process these conflicting feelings of guilt and self-blame about something that is ultimately not your fault.
posted by chiquitita at 6:14 PM on March 12, 2014 [2 favorites]

Response by poster: A big thank you to everyone who replied, particularly those folks who shared their own personal infertility stories. It is very comforting to read these posts. In fact, I keep coming back to them whenever I start heading into the "This is all my fault" thought pattern.
It's amazing how much better I feel because I posted this question, and got so many thoughtful answers. Thanks again, everyone!
posted by purple24 at 4:55 PM on March 17, 2014

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