I’ve been asking myself this question a lot lately. Intellectually, I know the answer is: NOTHING, GIRL! You are perfect and worthy and GOOD ENOUGH, exactly as you are!

And I do try to tell myself this. But the thing about infertility is that it has many more dimensions than just the intellectual. There is, of course, a medical aspect to it, as well as an emotional one. It affects your relationships, your financial decisions, even your spirituality. But the hardest thing to overcome is its relentless assault on your sense of self. You’re a good person, you’ve tried your best to be kind and selfless. You’ve always wanted kids. You’d be a great mom. But as you watch your family, friends, colleagues and seemingly every other woman of child-bearing age on the planet get pregnant and have children, you can’t escape the plague of questions – why not me? When’s it my turn?

What’s Wrong With Me?

I first became aware that something was definitely not right when I found myself fleeing a lunchtime performance of “Let It Go” from Frozen by my 4-year-old niece. There is something so purely innocent and beautiful about a child singing, and I was so impressed that she knew all the lyrics by heart. Suddenly, tears welled in my eyes and I had to leave the room. Her thin little voice had called forth some haunting, inexpressible sorrow in me and I rushed to the bathroom, where I stood at the vanity, looking into my splotchy, tear-streaked face, wondering what they all must be thinking of me. Surely something like, “Jeez, what’s wrong with her?”

This was about five years ago, shortly after I’d been diagnosed with Unexplained Infertility. Medically, infertility is determined when a couple fails to become or remain pregnant after trying (or not not-trying) for a period of a year or more. About 1 in 8 U.S. couples experiences some form of infertility at some point. Causes range from ovulation disorders (like PCOS), to endometriosis, to uterine or cervical abnormalities. In approximately 20-30% of cases, the cause is simply unknown. In an attempt to unravel the mystery of our struggle to conceive, I underwent the full battery of diagnostics. The pelvic ultrasound to check for cysts, tumors, or fibroids (mildly uncomfortable). The one where they pass a catheter through your cervix and shoot dye up into your fallopian tubes to make sure there are no blockages (OUCH). More ultrasounds to count and measure my follicles before ovulation, and blood tests, so many blood tests. They tested my FSH and AMH to check the number and quality of my eggs. They tested my progesterone to confirm that I was ovulating. They even tested my thyroid stimulating hormone to make sure I didn’t have hypothyroidism, which has been shown to interfere with ovulation and conception. All of these tests came back “within range for a woman [my] age” (which is 39, by the way). My husband’s semen analysis yielded the same results. So I’m left with a lot of information and zero answers. Essentially, my OBGYN has told me that he’s unable to find a single, earthly reason why we can’t conceive. The conditions are perfect. The time is more than right. So why the hell can’t I get pregnant?

Seriously, What’s Wrong With Me?

I suspect the answer has something to do with my period. I’ve been charting it for years now, and from studying it with my acupuncturist, Molly, I’ve learned that there are features about it that are definitely not normal. My basal body temperature, for example. It’s supposed to be lower during your period and follicular phase and then rise after you ovulate. Mine doesn’t do that; it’s closer to the opposite. You’re supposed to ovulate on day 13 or 14, but for me, it’s more like day 20. And then your luteal phase, the period after ovulation when the fertilized egg, if there is one, implants in the uterus, is far too short. I’ve told all this to my doctor and asked if he agrees that my irregular menstrual cycle has been the culprit all along. His answer basically amounts to a shrug. “Yeah, could be,” he said. His lack of interest in the strange particularities of my period both frustrates and worries me. Does “Unexplained” encompass all those miracles of nature we’ll just never fully understand? Should I take heart that nothing is seriously wrong with me? Or have they just not looked closely enough? Maybe the real reason I can’t get pregnant is deep up in there, skulking around my uterus as it slowly kills me with some undetectable endometrial cancer. Not getting pregnant is the least of my concerns! I might actually be dying!

Dear God, What the Fuck is Wrong With Me?

Sometimes I have trouble recognizing the person I’ve become during the course of this reproductive crucible. The maelstrom of emotions spinning around inside of me leaves me feeling twisted and shaky, like I’m constantly trying to steady myself so I can walk without falling. I try to control the feelings, to gently release them in deep, audible exhales. I manage to calm myself for a few minutes this way, only to be ambushed again moments later. That’s one of the hardest things about infertility; everything is a trigger. A dear friend I hadn’t spoken to in months texted me shortly after Christmas to ask for my address so she could send me a birth announcement, and I thought: Jesus, what did I ever do to you? When my sister – with whom I share a connection that is even deeper than biology, I swear we’re linked on some psycho-cellular level, that’s how close we are – told me that she was pregnant, I thought: What? How – ? But we were supposed to do this together, like chicken pox and losing our dad… Even when my fellow infertility warriors finally become pregnant, I can’t help feeling this pervading sense of betrayal, you mean to tell me you’re leaving me here to fight this hellbeast ALONE? How COULD you?

Of course I’m happy for them. No, I’m ecstatic for them. I bear no grudge; I wish them safe, uneventful pregnancies and deliveries and every happiness under heaven. But I can’t deny that it’s made me feel more isolated than ever, like they’re all floating away from me on a cloud of their own well-deserved happiness and as I watch them slowly disappear, all I’m left with is that old devil question:

Please… What’s Wrong With Me?

But I know the answer. Chronic infertility is what’s wrong with me. The sense of failure as a woman and a human that has spread like a shadow over my entire life. Its gradual and insidious campaign to chip away at my self-worth until I crumble like sand. I’ve tried support groups and leaning on my friends; I’ve become more open with my family and honest with my husband about how difficult this is. But the burden is so heavy and I’m barely holding it together as it is.

So I’ve made a decision.

I’m going back to therapy. We start on Tuesday.