After years of infertility, I was finally pregnant. Then doctors said there was a problem.

After years of infertility, I was finally pregnant. Then doctors said there was a problem.

Friction is needed for expansion.

For the past three and a half years, that’s been my guiding principle: *Friction* is needed for expansion.

When the pills and the shots and the timing and the evaluations didn’t work. When it felt like my body was failing me ― again. When the test showed a single line, and another confirmed the same result, and another, and another, and another. A failure. Not pregnant.

I told myself: *Friction* is needed for expansion.

When friends announced new additions. When despite true joy for their growing households, my own disappointment and heartache throbbed like an open wound. A guttural longing rising. Why not me?

Don’t answer. Just put the cage back around your heart. Just let the hurt fade into the background like a predator returned to its cave, biding time, waiting until hunger strikes again.

*Friction* is needed for expansion.

When the fertility clinic’s ultrasound showed something … off. This appointment, the nine-week check-in, was optional. My choice, they said. Two weeks earlier my scans were the picture of health. No problems. The heartbeat so, so strong. Hearing the rhythmic pulsing for the first time felt celestial, otherworldly.

I held the black-and-white screenshots by their edges, with an archivist’s tenderness. Could this be true?

A collection of fertility treatments surrounds a onesie.
A collection of fertility treatments surrounds a onesie.

I wanted to celebrate with the nurses one more time. After months of treatments, they felt like friends. Callie had danced ― that sort of arms pumping wildly, jumping up and down bop that is happiness manifested ― when delivering my results.

Pregnant ― finally.

But now we spoke haltingly, the lumps in our throats too much of an obstacle for more than a few words at a time. The exam room seemed colder, the angles and instruments sharper than before. *Friction* is needed for expansion.

When the diagnoses piled up in the appointments that followed. So, so many for someone so, so small. At first I was told the baby might just have a short stature. Maybe have a wide neck. Might have vision issues. Maybe high blood pressure.

Fatality wasn’t inevitable. And we were left to wrestle: Do you bring a life into this world that doesn’t have every chance? Do you start your child off with less? *Friction* is needed for expansion.

When the ultrasound specialist pushed and pressed her wand, jostling and dragging it forcefully across my belly, in a final attempt to find a healthy heartbeat. Ultimately, a vain attempt. Staring at the dusty vent on the ceiling, I was thankful for that pain, that wand’s sting. The physical ache gave shape, finally, to the misery that had taken up residence in my heart.

The magic inside me was a mirage ― just as I had feared. How could I have let myself dream that this might be true? How could I have let myself hope? *Friction* is needed for expansion.

When the doctor said, “She’s very sick.” The “she” landed on my ears like a thud. A girl. A daughter. I took notes, unsure I’d retain the horrific realities: Malformed heart. Halo around brain. Fluid under skin. Swollen. Won’t make it to live birth. *Friction* is needed for expansion.

I 'survived' infertility. But not before it shaped my perspective on everything.

Courtney Crowder and her husband, Scott Graca, on their wedding day in 2018. Two years later, Crowder and Graca decided to start a family and began trying to conceive their first child. Little did they know the difficult journey that lay ahead.
Courtney Crowder and her husband, Scott Graca, on their wedding day in 2018. Two years later, Crowder and Graca decided to start a family and began trying to conceive their first child. Little did they know the difficult journey that lay ahead.

When the doctor told me that the baby in my womb ― the baby we prayed for nightly, the baby we so desperately wanted ― was “incompatible with life.” How clinical that language. How emotionless. *Friction* is needed for expansion.

Was there anything I could have done? Or shouldn’t have done? Was this because of me?

“You are not powerful enough to have caused this problem,” the doctor said.

At home, I hung a Post-it emblazoned with this new psalm on my wall: “You are not powerful enough to have caused this problem.” *Friction* is needed for expansion.

When we took the medical advice to schedule an “evacuation” lest we wait an undetermined amount of time on a sure miscarriage. I could be showing by the time that finally happened. Obvious enough for people to comment, to assume I was planning for new life.

What are the right words to tell someone, no, I am planning for young death.

Courtney Crowder in recovery from dilation and evacuation surgery. After undergoing IVF, the fetus she was carrying was determined to be incompatible with life.
Courtney Crowder in recovery from dilation and evacuation surgery. After undergoing IVF, the fetus she was carrying was determined to be incompatible with life.

I wanted our story to end with peace, hers and mine. Or to at least a patina of peace ― a papier-mâché calm that betrayed the storm of despair, of anger, of jealousy, of wanting raging inside.

When the nurses at the outpatient clinic ― where people usually go to get better, to get a new knee, to fix a tendon, to patch up a shoulder  ― paused, stumbling for the right words, as they read my chart. I’m so sorry you’re here… *Friction* is needed for expansion.

When I climbed into Scott’s arms and cried. Sobbed. Until my cheeks were raw from the wetness. How this became our routine throughout the winter, like having dinner or brushing teeth. The suddenness and completeness of the emptiness was itself a presence. A gaping maw, created to devour spirit. *Friction* is needed for expansion.

When we made the choice to try it all again. The pills. The shots. The early morning appointments. The surgeries… The hope. *Friction* is needed for expansion.

When I made the active choice to let myself hope again. *Friction* is needed for expansion.

When Scott and I called the answering service, holding hands and our breath, and the nurse said in a bright singsong that we were pregnant. When the memories of what happened before snuffed out any joy fast, like wind to a flame. How hard it was to hang onto happiness when anxiety stood sentry in its shadow. How I wondered if the fear would swallow me up. *Friction* is needed for expansion.

An ultrasound of Courtney Crowder's son, Clark Graca. Clark was conceived using in vitro fertilization.
An ultrasound of Courtney Crowder's son, Clark Graca. Clark was conceived using in vitro fertilization.

And when expansion finally came. The love when we told our families at Christmas. The love as, one by one, I told my dearests. The love made evident in texts and calls and showers and good tidings ― how that love expanded from me to the baby. *Friction* is needed for expansion.

When I realized just how loved my baby was already. *Friction* is needed for expansion.

How could I have let myself forget: Love is a higher force. Love will always be a higher force. And love will forever guide you home ― physically and figuratively.

In May, Scott and I welcomed Clark Graca into the world and into the tribe that helped me weather the friction and welcome the expansion.

The doctor who delivered the news that shattered me was the same one who delivered the baby that put the pieces back together, which felt like a cosmic righting, a course correction away from choppy waters for the first time in years.

Des Moines Register Iowa Columnist Courtney Crowder holds her son, Clark, at her home in West Des Moines, Friday, Oct. 11, 2024.
Des Moines Register Iowa Columnist Courtney Crowder holds her son, Clark, at her home in West Des Moines, Friday, Oct. 11, 2024.

Clark was two weeks early, charging in with all of the Taurus energy. He’s so curious. Eyes searching inquisitively, arms seeking in a way that ignites and inspires and, yes, exhausts. And he’s a dreamer ― moving and mewing as he sleeps.

Sometimes I cry just looking at him because I’m sure the warmth in my heart is powerful enough to burst a hole right through my chest. Most of the time I let those tears fall and fall ― until my cheeks are raw with wetness.

The fear didn’t swallow me. I bore the fear with longanimity ― with the understanding that I won’t just tolerate difficulties and delays and setbacks, I will know they’re coming, I will see them on the horizon, and I will hold the burden of their pain as I wait. And wait. And wait.

I know now that fear is like the tension on the string of an archer’s bow. Fear pushes back with equal force. Harder force even. But the pressure is needed, its build steady before the snap, to make the arrow’s path straighter, to make the release that much swifter.

Fear is a prerequisite to bravery.

Don’t back away. Hold on long enough to see what all the unrest reveals.

Clark Graca plays with his grandmother.
Clark Graca plays with his grandmother.

The fear strengthened me. It clung to my bones like a metal skeleton. Preparing me. Allowing me to grow into the person I am now. The mother that I am now.

It revealed to me that having a baby is an act of hope — a deep belief in the tenets of optimism, the tenet that tomorrow will be better because we will make it better. The fear didn’t steal my hope, as I once worried. The will to survive what was fearful restored it, stronger and more powerful than before.

I still lean on my principle: Friction is needed for expansion.

When my eyes burn with fatigue. When deciding whether to let Clark sleep or get him up for a bottle feels like life-or-death stakes. When I overnight that fourth pacifier brand because he keeps figuring out how to spit them out.

Friction is needed for expansion.

But there are two other mantras I find myself saying now: What’s meant for you will not pass.

And: The win is coming.

Clark is proof.

Courtney Crowder is a columnist for the Register.

Infertility facts and figures

Infertility affects millions of Americans every year, leaving many seeking assisted reproductive technologies, including in vitro fertilization, commonly known as IVF, to expand their families.

  • 86,146 infants born in the U.S., or 2.3 percent, were conceived using assisted reproductive technologies in 2021, the latest year for which data was published.

  • Approximately 413,776 assisted reproductive procedures were performed at 453 reporting clinics in 2021, resulting in 112,088 pregnancies.

  • In Iowa, 823 babies born in 2021 were conceived through fertility treatments, representing about 2.2 percent of the state’s 36,835 total births.

  • Nearly 10 percent of married women ages 15 to 49 experience some form of infertility.

  • Nearly 10 percent of men ages 15 to 44 experience some form of infertility.

  • An estimated 1 in 8 women ages 15 to 49 have received some infertility services in their lifetime.

  • The average number of cycles needed to become pregnant through IVF is 2.5.

  • Costs for a single cycle of IVF can range from $15,000 to more than $30,000.

  • Two clinics in Iowa offer these services — Mid-Iowa Fertility Treatment Center and the University of Iowa, which has multiple locations across the state.

  • More than 69 percent of the 120,000 individuals of reproductive age diagnosed with cancer in 2018 required fertility preservation procedures, which are now considered a standard of care.

  • The use of assisted reproductive technologies has doubled and the number of infants born who were conceived using these treatments has increased by 50 percent from 2012 to 2021.

Data and statistics as reported by the U.S. Department of Health and Human Services

This article originally appeared on Des Moines Register: Infertility: IVF, a baby incompatible with life. And then joy.