Because I work on the place of fertility in a historical culture, I spend a lot of time thinking about demography and statistics and averages. When you are dealing with an infant mortality rate of 50% of any birth cohort before they reach age 5, the hard truth is that women in their lifetimes have to give birth five or six times in order to maintain a stable (with five births) or very slowly growing (with six) population. It takes that many children, on average, to ensure that each woman will replace herself with a daughter who reaches child-bearing age. It’s manageable provided you have a earlyish (late teens to early twenties) age at first marriage for women, and no reliable methods of family limitation.
My field doesn’t have the sort of evidence that other historians of other periods do. We don’t have access to birth records from villages. We can’t track the rise and fall of individual families. Only very rarely can we piece together a coherent picture of any family at all.
As a result, we spend perhaps more time than we should with the statistics, the demographics, the averages.
And we forget that the averages can only tell us what the population does as a whole; they leave no room for the individual hiccups of fate and (mis)fortune that change the makeup of families.
A scholar in my field who does recognize this failing wrote recently that, “Diversity is perhaps the most striking feature of ‘natural fertility’…birth and death rates vary dramatically, from family to family (the childless lie next to families of eight or ten or more), from year to year…from region to region.”
Enormous variation lies underneath that computer-generated calculation of five or six births per woman, variation that can’t be quantified or reduced to statistical averages.
It’s the same, I feel, for infertility.
I haven’t gone and done the research, but I would imagine that the majority of women with primary infertility who succeed in having a baby eventually are able to go on and have a second baby. But whatever the percentage is, the bald number masks the individual stories. It will lump together the ones who managed to have their second baby naturally, without medical intervention, with the ones who still needed help but were successful on the first try, with the ones who lost baby after baby before they got to bring another one home, with the ones who ended up pregnant with twins on a last-ditch, final chance cycle, with the ones who saw two pink lines from a FET, with the ones whose fresh IVF led to a heartbeat on an ultrasound monitor.
Equally, the statistics make no distinction between those who are not so lucky, the ones who make up the smaller number. There is no room to distinguish the ones who exhausted current medical knowledge and technology to no avail from the ones who had to stop treatments because they couldn’t afford to continue, from the ones for whom time and biology ran out, from the ones who had the resources to continue but had to make the decision to stop for their own sanity, so they could build a life with the family they had, rather than continually engage in a (what-had-proven-to-be) futile chase for another baby.
Statistics don’t tell the whole story. They never tell anyone’s individual story.
The success rate for FETs among women who are under 35, using good quality blastocysts, is very close to 50%.
If everyone were average, one of the two FETs we did this fall should have worked.
One of those embryos should have become a baby.
I don’t know yet if we were just unlucky, or if there is another underlying problem.
I don’t know yet in which group I’m eventually going to belong.
I don’t know yet what the road will look like that will bring me there.
But I think we’ll do another IVF cycle.
We might have just ended up on the wrong side of the statistics this time around.
And ten years from now I don’t want to regret not having tried to change that.