Infertility feels like a punch, not a punchline

Suzy Evans, a lawyer and doctoral student in history at UC Berkeley, has a 7-month-old daughter who was conceived via artificial intrauterine insemination.

On May 1, the popular NBC sitcom “Friends” aired an episode in which Monica (Courtney Cox Arquette) and Chandler (Matthew Perry) learned that they might not be able to naturally conceive a child. Then, on the May 8 episode, Monica and Chandler decided, without any tears or expression of their fears, that they would simply adopt a child.

While NBC and the creative team behind “Friends” are in the business of entertaining a widely diverse audience, it would be refreshing if, when the series resumes this fall, they accurately portrayed some of the physical, emotional and financial heartache that the disease of infertility, and the process of adoption, can cause.

According to the American Society for Reproductive Medicine, infertility affects roughly 6.1 million people in the United States -- about 10% of the reproductive-age population. About one-third of infertility cases are due to problems with the woman (female factors) and one-third are due to problems with the man (male factors). Other cases are due to a combination of female and male factors or to unknown causes.

Some of the most common causes of female infertility include endometriosis, uterine scarring, blocked or damaged Fallopian tubes, hormonal imbalances and ovulatory problems.


Some common causes of male infertility include testicular failure, low sperm count, retrograde ejaculation, impotence and immunological disorders.

Monica was diagnosed as having a “hostile” cervical environment, a condition in which a woman’s cervical mucus is abnormally acidic, scarce or dense, thus preventing sperm from traveling through the cervix and into the uterine cavity and Fallopian tubes to fertilize a mature egg.

Chandler was diagnosed as having sperm “motility” problems, a condition whereby sperm are incapable, for a variety of reasons, of moving through the female reproductive tract. Or, as Chandler jokingly explained: His guys won’t get off the Barcalounger, and the ones that do, Monica’s uterus wants to kill them.

One can imagine other funny one-liners that the writers on “Friends” can pen for this story line. But despite the high laugh potential, writers of the series would do well to remember that infertility is not simply a temporary inconvenience. It is a serious, and sometimes permanent, disease of the reproductive system that impairs the body’s ability to perform the basic function of reproduction. And it is no doubt a source of great sadness and despair for many “Friends” viewers.


Although everyone’s experience with infertility is unique, there are some common emotions that people typically experience while struggling with the disease. During my seven-year struggle with infertility, those experiences included: withdrawing from family and friends; feeling jealous of my own friends who could get pregnant, naturally and easily; anger at my husband for not being able to get me pregnant; anger at my own body for not being able to get pregnant; losing interest -- and pleasure -- in sex; feeling sad, empty, lonely, ashamed, angry, helpless, irritable, depressed and pessimistic; and, during the darkest days, feeling like a childless life was not worth living.

For some people, these feelings may last for several weeks or months. For others, they may last for several years -- or even a lifetime.

Sadly, infertility can also create debilitating feelings of social and emotional isolation. This is due, in part, to the fact that people who have never experienced infertility typically do not know anything about it. And those who suffer from it often do not want to talk openly about it, which makes it that much harder to bear.

The process of adoption can also create major emotional and financial problems. Most people struggle with infertility for several years (not minutes) before finally deciding to pursue adoption. And once that difficult decision has been made, the process typically costs from $20,000 to $60,000. And it often takes more than three years to complete.


Whether the writers of “Friends” ultimately portray infertility and adoption facilely or in an accurate manner remains to be seen. But given the competitive pressures of Hollywood, perhaps the most we can hope for is that some pertinent information about these issues is interspersed between the jokes.