Written by Ashley Hunt, LCSW

“It only takes one”

It only takes one egg, one sperm, one embryo, one positive to move from trying to conceive, to being pregnant. “It only takes one” is the default response that nearly every member of the trying-to-conceive community has heard. It is intended to soothe the hearts of those who are feeling doubtful about the outcome of their process. It is a phrase that is repeated incessantly to those undergoing various methods of assisted reproduction. It is stated by nurses in fertility clinics, members of the IVF community, and Reproductive Endocrinologists alike. And each time it is repeated, it is a metaphorical gut punch to those for whom one is not enough, to those who have had one and lost, and to those who are afraid to pour all their hopes and dreams into just one.

This “comforting” statement assumes that the journey ends with that one and disregards several factors that make having just one terrifying. Studies have shown that 10% – 20% of pregnancies result in miscarriage; what if miscarriage is the ending result of that one? What if a parent wants more than one child, but can only afford a single IVF cycle? What of the woman with low ovarian reserve who has had that one embryo degenerate before there was the opportunity to transfer? What of the couple, or individual, who are down to their last embryo after multiple failed transfers? For those who have been down to one, the reality is that having just one, is heartbreaking.

Assisted reproduction, more specifically IVF, is a numbers game. The more follicles your body produces, the more eggs you potentially start out with, the greater the likelihood of multiple fertilizations, the higher the odds of multiple embryos, the more opportunity for transfer attempts, and the more options you have in growing your family. Thus, when numbers are not plentiful, although pregnancy does not become impossible, the possibility of pregnancy does become rather slim; and it is that reality that this four-word statement attempts to distract the heartbroken away from.

The one may be possible, it may get someone to their dreams, it may result in a baby; but it is OK to acknowledge that those outcomes do not feel probable. Each stage of IVF is riddled with anxiety and fear, and although decreased anxiety can improve fertility outcomes, completely disregarding and invalidating someone’s genuine fear does not. Demanding that those entering into these treacherous waters remain absentmindedly hopeful is insensitive. We must remember that having hope can feel dangerous. The more hope we have as individuals, the more we feel we have to lose, and the more pain we experience when that bubble of hope bursts. Hope in IVF is fragile and fleeting, and the individual afraid to take hold of it is not sprinkling bad juju onto their journey; they are merely protecting their heart from an outcome that may feel inevitable. The support they need is for that fear of the perceived inevitable to be acknowledged, not chastised or minimized. Because should this not be the one, should that bubble of hope burst, it will be them, not you, left to pick the pieces of their heart off the floor.

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