If you’ve watched the new Netflix film Private Life, released this month and starring Kathryn Hahn and Paul Giamatti as a couple in their 40s struggling to have a child, you’ll be at least a little bit familiar with the nitty-gritty of infertility. The TL;DR? It’s brutal. From unsuccessful IVF cycles to adoption scams, this pair—and their marriage—painfully endure it all, just as many real-life couples do.
Private Life is part of a recent wave of storytelling that embraces infertility narratives, shedding bright light on what has historically been a hush-hush, shamed-filled experience for many families, and opening up space for couples to tell their stories and find supportive communities. Part of that wave includes the acclaimed HuffPost podcast IVFML, hosted by husband-and-wife team Anna Almendrala, a senior HuffPost reporter, and Simon Ganz. The pair started on their family-making journey about five years ago and chronicled it on the first season of IVFML, which was released last year. Season 2 debuted this week with the announcement that—spoiler!—the couple’s last IVF cycle had produced a healthy baby girl, Marigold, and that this season would focus on other couples’ infertility stories.
I sat down with Almendrala (who, on a personal note, I have known for a number of years) and asked about the process of making this season post-baby, how infertility affected her sense of herself, and whether she thinks I should freeze my eggs.
HelloGiggles: You have a bunch of beautiful, heartfelt messages from your listeners at the beginning of the first episode about how Season 1 affected them. Have you gotten any feedback so far on the new season, and the fact that you’ve now had a baby?
Anna Almendrala: Yes, people are delighted that we have our Marigold now. People reached out about their own stories, as they often do with us. But people actually really responded to an accompanying HuffPost piece that I had written to debut the season. It wasn’t really about the creation of the podcast season so much as the impetus behind it, which was to shed light on the fact that there’s a certain narrative out there in the world about infertility. And what it takes for granted is the fact that the person or couple have their butts in the seats of a doctor’s clinic. And you either get the baby in the end or you don’t, or you find some other means to make a family, but what unites all these narratives is the presumption that you’re going to get help. But the best data that we have on this shows that people who have fertility issues, which either means having problems getting pregnant or having problems keeping a pregnancy, they are not seeing doctors about this issue. So I think people are responding to the inclusiveness of that message and about how we need to widen the picture of who needs these treatments and why.
HG: Why aren’t people seeking treatment? Is it a lack of access to medical care or information?
AA: There’s research out there—especially for sub-groups of the population that are especially not getting care, like Black women, Latina women, women that don’t have a bachelor’s degree or higher—and the surveys point to things like lack of social support for medical help for infertility, a stigma about infertility or a couple having a baby. But I think all of these things—obviously I’m not a researcher—but all of these different explorations are so secondary to the elephant in the room, which is that these treatments can cost hundreds, if not thousands or tens of thousands, of dollars. We’re acting like we’re surprised that people can’t afford $20,000 for a cycle of IVF. All of these socioeconomic and cultural factors that are barriers, yes, we should talk about them, but not prioritize them as the reason [people aren’t getting care]. Because that sort of puts the blame on the person for not seeking care in the appropriate way when we should be looking at the obvious reasons.
HG: What has it been like working on this second season now that you are parents, talking to couples that maybe aren’t parents yet or are really hurting?
AA: We set out to find people that were so different from us. We wanted to be able to capture the diverse reasons that people were using these treatments. But actually what we found over the course of making the season is actually how similar we all are in terms of our desire to make a family, the barriers that we face, our adult life not lining up with our childhood expectations, [and] the extra effort that we need to put into making our family the way that we want.
It’s also the second season of me working with my husband, which has been really difficult, obviously. So many late nights at the kitchen table really going back and forth passionately about why this should be included, why this shouldn’t be included. We’re both really concerned about how to represent these people who trusted us with their stories. We need couples counseling!
HG: I wanted to ask about that actually. In the first episode, there’s a part where Simon’s describing a time when Goldie was newly home from the hospital and you woke up in panic thinking you and she were covered in bugs. You weren’t, of course, but you were really upset. You’re both kind of laughing in the episode, and you’re laughing now, but I’m sure that was really hard at the time. How has the process of infertility and becoming parents—and of making this podcast—shaped your marriage?
AA: There isn’t research out there on how making a podcast affects your relationship. But is there is research on how infertility affects your relationship, and what’s interesting to note is that, generally, people who go through infertility together, they end up staying together. As Andrea Syrtash, the founder of Pregnantish.com, put it, if you break up about infertility or IVF treatments or that sort of stuff, you were always going to break up, but maybe for a different reason. So the research shows that this stuff can bring you together. And that’s how I felt about my marriage.
HG: So what were you like as a couple before you started trying to have a baby versus what are you like now?
AA: I would say that before we started trying to have a baby, of course we loved each other, we’d been married for five years. Of course we supported each other. But we were basically doing parallel play, which is this thing that toddlers do. You make playdates for them, and you sit them down on the carpet together, but they’re actually just playing with their own trucks, just doing whatever. They’re not interacting with each other.
Trying to make a baby was the first collaborative thing that I tried to do with my husband in a regular, serious way. And when it didn’t work out, that was the first time we started having conflicts related to that collaboration. Basically, before trying to make a baby, our marriage had been smooth. We get what we need from each other, we take care of ourselves, we’re mostly focused on our careers, having fun on the weekends. It isn’t until you start introducing the conception and the infertility stuff where you both have to put in equal—or maybe unequal, which may be part of the conflict—amounts of effort to try to achieve this common goal.
HG: So is the podcast kind of your other child?
AA: Oh yeah, definitely. We love to announce the podcast in a birth-announcement style. But I think in the same way, we both are coming from different points of view but trying to make one thing together. And whenever we’d hit a snag or a conflict, he’d be like, ‘Wow, we’re not good at working together.’ And I’d be like, ‘What are you talking about? You don’t think Beyoncé and Jay-Z have conflicts when they’re planning their tours together? You think everything is just so cool and chill up in their Beverly Hills mansion? No!’ If you both care about what you’re working on and what the product is going to be, of course you’re going to have conflict.
HG: I want to ask how gender plays into the infertility conversation. I think there’s a narrative in popular culture that infertility brings up gender-based insecurities—I’m not woman enough to get pregnant, I’m not man enough to get my wife pregnant. In your experience, is that true? How else does gender factor into this?
AA: Gender plays a huge role in this. I mean, frankly, conceiving a child is one of the most heterosexual, heternormative things you can possibly do in this world. On its face it’s not very queer at all. And I think that if you’re somebody who hews very closely to a gender norm or a gender role, which I didn’t think I was, when this stuff starts malfunctioning for you, you can be surprised at how it brings up feelings of fear that you’re not a real woman, or that you’re not woman enough.
For example, I had PCOS [polycystic ovary syndrome]. It’s a hormone disorder that sort of inhibits ovulation, and one of its unpleasant side effects that’s very superficial but still disturbing is coarse hair growth where women wouldn’t normally grow their hair, and severe acne. So those are things that women with PCOS, and me too, struggle with trying to tame or keep under control. Like, ‘Oh man, I’m growing a little mustache, I’m growing a little beard.’ People have told me they’ve gone through hell with electrolysis and shaving. It’s all in service of presenting in the way that you think other people think you should present.
We actually go into the gender stuff a little bit in the third episode. I managed to speak to Trystan Reese, who’s part of the Family Equality Council—that’s an organization that helps LGBTQ people create the families they want—and Trystan also agreed with me that holding tightly to gender roles can have unexpected consequences for people going through infertility. Like maybe this wouldn’t have been so hard for me if I hadn’t equated being a woman to the function or non-function of my reproductive organs. It’s just not something that you even think about, for me, as a straight woman, until you start having problems.
HG: You talk in the first episode a fair bit about the perfect, natural birth that you had in mind, and it doesn’t go that way at all. You have to be induced and eventually you have an epidural. First of all, how did you get that idea of the perfect birth in your mind? And where did that come from? Is it related to these gender questions?
AA: I think that because the creation of this baby was so highly medicalized—it didn’t involve sex at all, it involved multiple surgeries, lab stuff, lots of money, a doctor basically putting Goldie back inside me. It didn’t have anything to do with my husband and us having a loving experience and creating this child from our marriage. I think that a reaction to that had been to fixate on the natural childbirth experience. I didn’t put that realization in the podcast episode because I didn’t have it until after it had wrapped. But I think that that’s what I was rebelling against. I was wishing that something would go right in my body once.
HG: And so what were the psychological effects of not having that natural childbirth experience that you’d envisioned?
AA: I was embarrassed that I’d told so many people about my goal to have a childbirth that didn’t involve an epidural. But at the same time I felt defiant. I told Simon once, Simon was like, ‘Why are you making such a big deal [about natural childbirth], why do we have to go to this class? Why do you want to feel everything?’ And I said, ‘Because this might be my only time that I give birth to a child. I want to have the full range of experiences, whether it sucks or not. And I want to be able to say that I felt a labor pain, or that I felt a contraction.’ Turns out that it’s horrible.
HG: In the next episode of the podcast you’re tackling egg freezing. Here’s my question: As a science reporter, an infertility expert, and also my friend, if I told you that I, as a 31-year-old woman with no children, wanted to freeze my eggs, what would you tell me, based on your experience and all of your areas of expertise?
AA: First I would ask if someone else is paying for it. If someone else was paying for it I would say yeah, do it in a heartbeat.
AA: The research that we have to date on egg freezing shows that most women who freeze their eggs don’t even use them. They end up finding a partner, they end up having children naturally, they end not wanting children in the end. But I think that data point has made some people think that egg freezing is a scam, the technology is a scam. But I think that the emotional marketing thing—[the] fear-based marketing—that people use to get women to freeze their eggs, [that] might be a scam, might feel scam-y.
In the next episode we’re actually talking to a woman who has cancer, about to go through chemotherapy treatment that might actually leave her sterile. She said that when she was going through the worst chemotherapy that year and had to force herself to get out of bed and do her physical therapy, do her walks, she was always thinking about the eggs. She said she needed that to get up and comply with all the treatments and look forward to the future.
In talking to the people for this podcast who also froze their eggs, they said that the process of doing it has lifted a weight off their shoulders that enabled them to be free when it comes to dating, pursuing professional opportunities. Just this notion that they’ve done [everything] they possibly can to safeguard some kind of fertility future for themselves is a huge load off.
HG: So it’s almost like, if you have the money, or someone else is paying for it, it’s a worthwhile peace-of-mind thing to do.
AA: I think knowing now what I’ve gone through and what I know, if someone had paid for me to freeze my eggs at 25, I would have. I think it’s because of the miscarriages that I’ve had and the poor embryos we’ve made in the IVF process, the doctors are pretty strongly hinting that it is an egg-quality problem. So.
HG: How does that affect you, just hearing that?
AA: Oh it’s devastating, like it’s my fault that we don’t have a Simon Jr. That it’s my fault, through my reckless eating and letting myself get to obese levels of weight and eating too much sugar, or basically all the things that we know might have some affect on PCOS, that my love of desserts would be robbing my future family of the children in it—I just felt horrible. I went to counseling to get through those feelings, but in the IVF process you’re told to lose weight and be as healthy as possible, and I really feel like one of the only ways to start to feel better about the poor egg quality stuff is to try to do everything that the doctors are saying might improve it. So that’s one of the things that helped me.