Editorial

Heidi K. Leftwich, DO

Infertility is more common than people acknowledge, with some data reporting as high as one in eight women struggling with infertility in the United States. As important as it is to acknowledge the medical causes of infertility and the stress on the health care system, it is just as important , if not more so, to acknowledge the physical and emotional toll on patients and couples struggling with infertility. The title of this issue reflects the struggle patients feel when they, too often, sit in silence. We are fortunate to have authors from many aspects of health care sharing their stories and expertise in this field, with some sharing deeply personal stories. I feel very fortunate to be the editor of such a powerful volume of Worcester Medicine.

My own intimate encounter with infertility began in residency. I married relatively young, in my first year of medical school, and while children were in the plan for us as a couple, we were happy to wait until things were “more stable,” whatever that meant. This was a common theme in residency, as our work hours were long and unpredictable, and it seemed there would always be a better time to have kids. However, in residency, a few of my colleagues had children and I watched intently as they navigated these long, unpredictable hours and parenthood. I was longing for the same. My husband and I had decided there would never be a “good time” and decided pregnancy during residency would work for us, especially as I was planning a three-year fellowship. As an obstetrics and gynecology resident, I had the distinct pleasure and privilege of delivering many babies, which I will admit became harder and harder as the reality of infertility set in. I longed for the ability to have that moment as well. While sitting with colleagues in break rooms and on the labor floor, many would ask when I was going to have children and when I said we were trying but I had not yet conceived, many reassured me my time would come when I was “less stressed” and “working less.” For a while, I believed them. After years of not conceiving, I decided to reach out to my colleagues in infertility for a work-up. I was conflicted when I heard the news that we would need in vitro fertilization, or IVF, to conceive. However, I was arguably a little relieved it was not my career choice that had landed us childless.

Fast-forward to the time of multiple appointments and blood draws during an 80-hour work week in your own department, all while trying to be secretive as I did not want to share this journey with all of my colleagues. What I know now and did not know then was how vastly important it was to share this journey. With someone. With anyone. I felt so alone. The title of this issue expresses my own silence as well as the many others who experience this journey – openly or in silence. My first IVF cycle ended in a miscarriage at seven weeks, which presented itself with a significant bleed while I was operating. This was emotionally difficult as I was certain I was losing the pregnancy and had an additional component of having to tell my male attending and find coverage for the case while I lost the pregnancy otherwise in silence. It was my 30th birthday and not the way I had planned to celebrate. I had friends over that night and aside from my husband, told no one.

My next two cycles of IVF were much happier times. They each were successful and I now have two daughters, Harper (9) and Hailey (6) , due to the wonderful technology, hard work, robust research and dedication from those who work in the field of reproductive endocrinology, or REI, and infertility. I could not be more grateful every day for this opportunity. As a maternal-fetal medicine specialist, caring for patients with high-risk pregnancies, I feel I can share a more personal connection with those struggling with infertility and those who have made the journey through IVF. I try to ensure others do not endure this in the silence I once did. I am fortunate to have an article from the head of our own IVF center at UMASS to provide information on infertility care in Central Massachusetts. I was thrilled to hear from the former chair of the Department of Obstetrics and Gynecology, an REI physician, for this issue, as she was instrumental in the creation of this IVF center. This issue is also filled with stories regarding the struggle women in medicine face delaying starting a family, and often choosing a career that would allow them flexibility to start a family. As you read these articles, some quite intimate and personal, it is my hope you gain a better understanding to the condition of infertility and how it may impact your patients, family and friends. Thank you for the opportunity to serve as the editor of this very important volume. +

Heidi K. Leftwich, DO Assistant Professor, Obstetrics and Gynecology Associate Fellowship Director Division of Maternal-Fetal Medicine University of Massachusetts/UMMC