Interview with Amy Klein on Infant Loss and Baby Envy

I sat down with Amy Klein, infertility advocate and author of "The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind”, to discuss infant loss, baby envy, and struggling with infertility in the time of the novel coronavirus.

BH: “Thanks for taking time to talk today. I know it's been forever since, well, seemingly forever since we've talked. We talked in February before the pandemic struck and now, we're all the way in September which is crazy and hard to believe. When we talked, we were talking all about how your book launch was about to happen and the impact that it was going to have and what your plans were to do a book tour, and then everything changed, all plans for everybody. So, what have your last few months been like? Since the plans for the book changed, what have you been up to?”

AK: “I think some days it felt like I was just rolling out of bed, throwing on makeup, and doing a Zoom call. A lot of the fertility in March and April, especially in New York, a lot of the fertility clinics closed down in March, April, and early May. And that was really, you know, forget my book. I mean, I can't even imagine going through fertility at a time like this. We have to talk about the actual people who not only had to put their fertility plans on hold and their baby-making plans on hold but had to be stuck at home watching everyone complaining about their kids and complaining how their kids are going to drive them crazy. It's like sometimes you could say, ‘Oh, ignore social media.’ It's really hard to ignore social media when that's the only thing you're allowed to do.”

BH: “When it's the only thing you can do, right, right.”

AK: “So, you can't even say ‘Oh, ignore social media’ and everyone's complaining about their kids, and meanwhile, there are people who couldn't get to their fertility clinics. There are people who couldn't get to their babies if they had a surrogate. A lot of people's surrogates were stuck. They couldn't even travel to pick up their own kids.”

BH: “Crazy, I never really thought about that. You're right, everybody on social media has been complaining about their kids, and that's got to be gut-wrenching for people, for sure.”

AK: “And then when you're going through fertility, you're like, ‘Okay, if I get pregnant in February, then I'll have a baby and then I'll be 39 years old.’ And then all of a sudden it's like, ‘Oh, you can't even go back to your clinic.’ I mean, thankfully most clinics have opened up with more rigorous health protocols. Someone said something funny, because we were talking about at-home testing, so someone told me, ‘Oh, all these things they could do at home now,’ and they were like, ‘Hello, why couldn't I do this before? Why do I have to go 10 times in a month to my clinic? It would be great.’

“So, I think that definitely are some improvements that the virus has, you know, for fertility patients who had to go every other day to the clinic. Maybe now they don't. One of the good things for me was that there were a lot of doctors who were not working, so I did spend time on a lot of people, different social media accounts, whether it was Zoom or Facebook or Instagram Live. I did something with Dr. Chang from Generation Next. I did something with Anate Brauer from Shady Grove, Aimee Eyvazzadeh in San Francisco, from Fertility Center Clinics of Illinois. So, I got to share directly. I would never normally have this much access to a doctor but in March and April, they were home. So, we did a lot of at home talking to patients, and one of the things we definitely had to talk about then was how hard it was to be home not doing fertility treatments.

“But now, I see people are going back to it, people who were waiting and people who were nervous. I think a lot of people, especially on the East Coast, I know the Midwest and the West Coast have higher numbers. California has pretty high number, but I think everything's back to what's called ‘the new normal’. So, I did have to cancel most of my book tour. Some of it was moved online, and I don't know what it's going to be with books. I think people are maybe a little bit back to reading, especially people without kids. People without kids, there's this whole divide my husband and I joke about. You have all these people like, ‘Oh, I have nothing left to watch on TV. I have nothing left to read.’ That's one side, and then the other side is like, ‘How do people have time to read when your kids are at home all the time?’”

BH: “Yes, I can attest to that.”

AK: “But I think I read a few books. I read the prequel to the Hunger Games.”

BH: “I didn't even know that was a thing.”

AK: “You didn't know the biggest franchise, so if you didn't know about the Hunger Games prequel, could you imagine how people don't know about my book? But I think people will get there eventually. People are finding it. It was really hard to get press coverage during the pandemic, but I did have some great excerpts run from my book. Glamour Magazine ran something on marriage. Religion News Wire Service just ran a piece about the religious part of my book. Refinery 29 ran something about baby envy. There's been snippets out and about, about the book, and I think anyone looking something up always finds me.”

BH: “Yeah, no, that's awesome. So, in the midst of all of that, I mean, I'm sure with these articles and the snippets that have been published, there have certainly been people that have been impacted by your book. What's some of the feedback you've received so far, some of the stories you've heard from people up to this point that stand out to you, ways that they've been impacted by your work?”

AK: “I got a really interesting letter on Twitter, and she said, ‘Oh, this is going to sound surprising, but your book really helped me, but maybe not in the way that you thought it was.’ She said, ‘We've been going back and forth between IVF and adoption, and after I read your book and saw what people went through to have their baby, it finalized my decision to adopt.’ And that's a wonderful impact.

“There's so many good books about adoption and I've never been down that path. In my book, in like chapter 24, in the penultimate chapter, I talk about the end of the road and how different people reach the end of the road. And for some people, it's all about what decision resonates with you. I used donor eggs. For some people, they even said it to my face ‘Donor eggs? I will not have donor eggs.’ Some people said ‘I would feel terrible if my husband got to use his genetics and I don't get to use mine’ which I personally think is crazy, because you get to carry the baby and you have so much influence over its epigenetics, but that's what some women say. Some women say, ‘I won't use donor eggs, but I'd use donor embryos, because neither of our genetics is going to be there.’ And then some people say, ‘You know what? I always wanted to adopt, and if I can't use my own eggs, I'm just going to adopt.’

“So, in that chapter, in chapter 24, the end of the road, some people say ‘I tried. I only want to do it if it's going work with our own genetics, and if it's not going to work, we're stopping.’ Some people say, ‘We're stopping, and we're going to try adoption.’ So, it's all about what choice resonates with you.

“Some people, they stop, and then they start again a little bit later on. I mean, one interesting thing, this is not about the reader's letter, but one interesting thing about stopping, a lot of people say ‘Oh, I really just want to stop IVF.’ Of course you want to stop IVF because it's so many hormones, it's so many appointments, whether it's at home. It's such a toll on your life.

“But the thing about stopping is, it's another thing to come to terms with never having children. And that's something that I wanted to address for people who have stopped and who didn't continue, and it's not all wrapped up in a happy bell. For some people who stopped, it was fine, and some people who said, ‘This is the decision I have to reckon with for a long time.’ But the woman who wrote me on Twitter, she just said, ‘I saw what people went through, and I just know that I didn't have that in me. It wasn't that important to me. It's really solidified my intention to adopt.’ I thought that was really beautiful.

“Another woman that I quoted in the book actually who was talking about adoption— so this is a woman who, because people's stories don't end after the book happens, some of the people in my book had babies— told me, ‘It has to resonate with you.’ So, she had one biological baby and was not allowed to carry again due to health risks, which happens to a lot of people with secondary infertility. She decided to adopt, and we talked about that in my book. She said it was something she always wanted to do. She always felt drawn to adoption, so it wasn't important enough for her to do surrogacy for her second child. That was what we talked about in my book, but the coda to that is, she had been through like three failed adoptions and it just wasn't working for her. People always say, ‘Oh, why don't you just adopt? Why don't you just adopt?’”

BH: “Right, you don't hear that side, that there's failed adoptions too, and that's heartbreaking as well.”

AK: “This was way after my book was closed, but she's moved back to surrogacy, but only because adoption was so hard and heartbreaking... I think one chapter that resonates with a lot of people because, you and I both know that the technology is changing every day. Maybe one day PGT will work 100% and people will get pregnant with IVF on their first try. So, the technology is going to change, and hopefully it's going to always improve, and doctors will be more informed but the one thing that doesn't change is the emotional journey. I think what's really resonated with a lot of people, and this was the article that was excerpted in Refinery 29, is ‘baby envy’, how to deal with other people in your life because people don't understand why you're not happy for them being pregnant.

“You know, today I think I saw an article, Jenna Bush Hager, who's on the Today Show, she just wrote in her book that she got pregnant accidentally with her third, and she was afraid to tell her sister because she knew her sister had fertility struggles. And that's the hardest thing to deal with. I'm glad that Jenna Bush was sensitive to her sister, but a lot of people who are pregnant don't understand what people who are infertile are going through.”

BH: “So with that, with baby envy, what kind of guidance or advice do you give in your book? What do you discuss in your book surrounding that?”

AK: “I think there's a lot of ‘shoulds’ like, ‘You should be happy for this person. You should go to her baby shower. You should go to the birth circumcision ceremony’ and then even, ‘You should be grateful when you're finally pregnant. You should be enjoying your pregnancy.’ So I think my first thing is there's no ‘should’.”

BH: “That's great, that's a great summation. Yeah, absolutely, you're right. There are a lot of ‘shoulds’ that get put on people.”

AK: “And I think the first thing people have to do is just acknowledge their own suffering. Like, when my younger sister was pregnant, of course I should have been happy for her. Not only that, she had two miscarriages. So, what we call in the fertility world, she ‘deserved’ to be pregnant, because she had suffered those miscarriages. It wasn't like the accidental pregnancy. So, my mother said, ‘Oh, you should help her more. You should be there more for her.’ And you know, I looked at my mom thinking like, ‘Yes, I should’ but I wasn't.“I talk about this a lot, and my sister knows it. I wasn't there for her pregnancy. I couldn't, you know? I love my nephew and I'm the greatest aunt in the world, and our kids are now five months apart, so I wasn't that far behind her. You just have to acknowledge the pain of what you're going through, and you also have to know that other people are probably not going to understand.”

BH: “That's an interesting perspective. So, the guidance and the input that you give people isn't so much like telling people who are pregnant of how they should treat people who are struggling, but more that people who are struggling, who are going through this journey with infertility, that they need to recognize and admit the pain that they're going through and being able to handle how people treat them? Is that the approach?”

AK: “So, it's not only admit the pain, but also take care of yourself, you know? I say in my book, I went to all those parties. I went to all those baby showers. I went to them, and they didn't make me a better person. I spent my time crying in the bathroom stall. I went there, and like, I give some advice. It's basically, ‘If you can get out of it, get out of it.’ I also say, ‘Act happy, and do your voodoo at home.’ You know what I mean? Like, if you can act happy, and I give a list of things that you could say to other people, instead of, ‘I'm so happy for you’ you could say, ‘You must be so excited’ or the Southern way, ‘That must be such wonderful news’.”

BH: "Bless your heart."

AK: "'Bless your heart’, exactly. So that's in part, I have a letter in there, ‘Dear pregnant girlfriend’ a letter that you could just copy and say, ‘I'm happy for you, but this is such a hard time for me, and I'm definitely going to be there, but this is really hard what I'm going through’. But I do hope that if someone is suffering, whether it's because their mother-in-law just keeps saying, ‘When are you going to be pregnant already’ or your best friend says, ‘Why can't you throw me a baby shower?’, I do hope that they could just give this chapter to their friends and say, ‘Read this. I'm not the only one. Don't think that I'm the only one. I'm such a bad person because I can't be happy for you and I can't be there for you.’

“I mean, it's a weird thing. When you're pregnant, and I've been on both sides, so when you're pregnant, you have these, for the most part, happy hormones coursing through your body, and you want to share with the world. Then on the other hand, when you're infertile, you have these horrible hormones coursing through your body, and you might be depressed, or you might be anxious, and those two opposing forces are colliding. I do think the chapter is, like everything else in the book, directed to the women who are suffering, to just tell them, ‘It's okay to take care of yourself as best as you can.’ And it's hard to change other people. I don't know if I would have said.”

BH: “That's true, that's very true.”

AK: “There was a relative in my book, so not only was my sister pregnant, but then my brother announced he was having his fifth baby the same year. So, thank God my daughter has two cousins the same age. It's like a beautiful ending but in October and November, when I found out that I was pregnant, but I didn't know because I've already had four miscarriages, I didn't know if this pregnancy was going to work out.

“Nobody knew I was pregnant, but one of my relatives was talking to me about the blankets she was knitting the other two babies and she doesn't know I'm pregnant. I know I'm pregnant, but I was thinking, ‘Are you seriously telling me this? Like, I am not that strong.’ But was I going to say something to her? No, I didn't, because you know what, most people, for the most part, regardless of the world we live in and regardless of the politics you have, I still believe that most people mean well and most people don't want to harm other people. And the people who are hurting the infertile people are not doing it on purpose. You can't always change other people, but some people want to learn, and maybe they'll read this chapter on baby envy and maybe they'll understand what people are going through.

“But for the most part, like you just have to build this, maybe we learned this during coronavirus, you have to build this wall around yourself. How can I get through this? In coronavirus, you ask yourself, ‘How am I going to get through this? What am I going to do?’. Sometimes for me it means hiding in my car and taking a drive to nowhere. I suggest you take all your Zoom meetings in your car. Get a virtual background.”

BH: “Yeah, yeah, I've done that. I've actually done that a lot, just driving around feeling like I'm like going to a meeting, when in reality I'm not. I'm just like on a phone call and pretending I'm in a meeting, yeah.”

AK: “So I think we need to build this when you're doing infertility, and if you're doing infertility during COVID, you have to just, that's my main message to people. I can't get them pregnant, but I can help them take care of themselves and put themselves first and put their marriage first and hunker down until they get pregnant.”

BH: “So with that, what was the turning point for you? Was it when you were able to conceive? Well, lemme rephrase that. So, in struggling with that with baby envy and not being able to attend the parties and having to struggle with your brother having his fifth baby, was there a specific point at which you became okay with that that you can remember, or was it more of like a gradual change?”

AK: “Okay with other people having babies?”

BH: “Yeah.”

AK: “I think I started off okay, because I was sure that I was going to be pregnant and I kept getting pregnant. So, I think for me, it was like I started off not caring about other people's pregnancy. I remember, back when you could take the subway, I was on the subway with a friend and this homeless woman got on, and she said, ‘Help, I'm homeless, I'm hungry, and I'm pregnant.’ And I said, ‘You too? Even you? I can't believe it.’ My friend was like, ‘That's not nice’. She didn't appreciate the humor, but I'm sure most people could.

“Someone said something to me after one of my miscarriages that really helped me and that I wrote about. She just said, ‘Nobody's going to ever say the right thing.’ I think today, people are more and more, just from that Jenna Bush tweet, I think people are more and more aware of fertility issues and aware of people who are suffering. I think people are not always going to say the right thing, and for me, it helped just to realize that nobody was being malicious. My mother wasn't being malicious. That relative wasn't being malicious. Even my sister, she was happy for her pregnancy and she wants my help.

“One of the nicest things, and this is how I end the chapter on baby envy, it always makes me cry, one of my best friends—I’ve known her since I'm three years old— when I was going through infertility, she was also pregnant with her fifth child because people I know have crazy amounts of children. She said to me, ‘Amy, I have to tell you something’. I think I was in the middle of complaining about someone else who was pregnant to her, because I thought she wasn't having any more kids because her youngest was eight years old. I was complaining to her about someone else who was pregnant, and she said, ‘Amy, I have to tell you something,’ which is always a bad thing, but this was so beautiful, the way she said it. She said, ‘I just want to let you know that I'm pregnant. You don't have to be happy for me, I'm just letting you know.’ And I was like, ‘That is the nicest thing that anyone has ever said to me’. It was such a blessing, because, I don't know if you could understand it, but it's such a sigh of relief, like, ‘I'm allowing you the space to have your own feelings, and it's not going to impact me personally’.”

BH: “Yeah, that's a beautiful way to approach it for sure.”

AK: “I don't expect that from most people, but I do give advice, like tell people by email. Thankfully, you don't have to do the face-to-face anymore or even the Zoom call, but like, don't do the face-to-face, and for other people who want to know about it, just allow the other person to have their feelings and maybe take some more space. I think for most people who are going through infertility, once the kid is born, once the baby is there, it's not hard anymore.”

BH: “Yeah, because that concept of seeing somebody who's pregnant, that's the goal that you're trying to get to, right? So, yeah, I can see that. It's interesting you say that, that there's an increased recognition of infertility and realization that there's a lot of people struggling with it. There was an article on CNN, I think it was on CNN, this morning. It was somewhere on Apple News that I saw it, about how gender reveal parties need to stop because of all of the wildfires that are happening in California, and I thought, ‘That's strange that they put this in the article, but then I read it further, and it was actually talking about how people need to be more sensitive to all of the people struggling who can't get pregnant and yet this is all being flaunted and burning down acres. It was really interesting that that was mentioned, ‘be more sensitive to people who can't get pregnant, and don't make it such a big deal, because it could offend, it could hurt a lot of people, especially during this time of COVID where people are already struggling with depression.’ I just read that like 30 minutes before you and I talked this morning.”

AK: “I saw the headline. I mean, and people need to celebrate. I felt really guilty putting up a back to school picture, because on a normal year, back to school is super triggering for infertile people. They're like, ‘Oh no, I have to sift through all the back to school pictures.’ And this year it's like, ‘I'm super privileged to send my daughter back to school, because most people can't send their kids.’ Forget if you don't have kids. Most people can't even send their kids back to school... It's hard to know these days what you can say.”

BH: “Oh yeah, I think that anything that can be posted on social media can end up offending somebody for sure. But yeah, it's interesting to me to hear you say that there is, like with the Jenna Bush tweet, there is an increased recognition and then seeing this thing on CNN this morning. Infertility is something that more and more people are realizing, like, ‘Wow, there's a lot of people who struggle with this.’

“I had a meeting last week. I was talking to somebody, showing them how many people throughout the world struggle with infertility, and people were blown away. People who aren't exposed to it, who don't know that it's such an issue, think, ‘Oh, there's a few people who can't conceive’, but there's so many people who struggle with this, and then it continues.”

AK: “Right, especially even secondary infertility, and not even to mention LGBTQ, who often have to use fertility treatments just to have a baby.”

BH: “Yeah. So, what do you think the reason is that there is an increasing awareness of it?”

AK: “This is dating me, but celebrities used to never tweet about their kids in general. It wasn't a thing, I feel like. Maybe in the last 15 years, celebrity babies have become a thing. I think in the olden days, celebrities, women would keep their child aspirations private, not only for the privacy of their kids, but they didn't want to hurt their career. And then babies became the newest accessory, like with fashion and the Kardashians and everybody.

“I think first, motherhood became really chic, and then I think people started tweeting. People often tweet about their infertility only after it's over. Someone just had a baby and said after the whole thing how much fertility trouble [they had]. Amy Schumer just came out with all the fertility trouble she's having. I think a lot of people talk about it after the fact, and I think that also with reality television, the Kardashians are so upfront. Chrissy Tiegen just had her accidental third pregnancy, and I'm so happy for her, but that's so hard to hear also. She had two IVF babies, and then she had the accidental pregnancy and she knows what a miracle that is. I think Khloe Kardashian is freezing her eggs. Kim Kardashian had crazy pregnancy IVF stories. So, celebrities, whether they're upfront about it while they're doing it or after the fact, are making a difference.

“... It’s not only because women are getting married older. Women are getting married older, but also men’s sperm is declining. Men's sperm is taking a dive there in the health of the men's sperm. I think that there is more awareness about fertility, but the one thing that I really want to change in life is women taking charge of their own reproductive health, whether or not they want kids. That's definitely a big mission of mine.

“I was the same way. Like, I hear the word ‘fertility’ and I was like, ‘Oh, I'm not sure if I want kids yet. I don't even have a partner, I don't know. I'm not going to even think about it. I'm not going to even listen to this.’ I can't tell you how many women in my book had things that they found out about later in life— at 37, 38, 39— that had they known about it when they were 30, 29…”

BH: “It would have changed their entire trajectory, yeah.”

AK: “And I'm sure that you work in this field, but we women are woefully undereducated about our health. I don't even want to use the word ‘fertility’ because I know some people tune out when they hear the word but if you're a woman and you're 30, I would like you to know, do you have endometriosis? Do you have PCOS? Are you skipping periods? Shouldn't you look into that? What does that mean?

“I know someone, and this woman is in her 60s now, but I'm working with her on a fertility campaign, and she told me that when she was in high school, she would be home for a week because of the pain of her period. People would just say, ‘Oh, well that's normal.’ No, that's not normal, that you should be home for a week, and she didn't find out until it was too late that she had endometriosis. So, if there's one mission for me and women, I want us to know our bodies the same way that we know our careers. I want us to know our hormone levels. And you know, I'm not an egg freezing company. You want to freeze your eggs? You don't want to freeze your eggs? Doesn't matter to me. You want to have kids; you don't want to have kids. Do what's good for you, but I don't want you to get to the situation where you're 35 or 40 and you find that all these things that you could have known about when you were 25.”

BH: “Yeah, because focusing on your reproductive health, that has implications for all of life, not just whether or not you're going to have babies. I mean, I think for guys, I look at that as there are things that you can do. Like you're saying, male sperm quality is taking a dive, and you look at the things that can affect that. You look at testosterone levels. Increasingly, there's guys who struggle with low testosterone, and that's not necessarily because they're not producing it, but because there's lifestyle factors that affect that. Like, if you're eating too much sugar or you have too high cortisol that binds to that testosterone and renders it unavailable. There are so many things that can affect that and it may not have anything to do with whether or not you're trying to have a baby, but if you could educate yourself from a young age on your hormones and your reproductive system and making sure you're caring for that now can change your life for the long run. It's super important. You bring up a really good point.”

AK: “I wish every college student had a health class, just about their bodies and everything.”

BH: “Yeah, I agree. I think college should change to teach people how to do things like caring for your health, what to do when you leave college. There's a lot of things I think that colleges should be doing, I agree.”

AK: “The college of life. Maybe we should start, the ‘life college.’”

BH: “Hey, I think that after all this COVID stuff, I think there's going to be all kinds of new education that takes place. Maybe it's the end of in-person higher education, who knows?”

AK: “That would be good, if you got it before your kids got to college.”

BH: “Yeah, crazy. I know that we're reaching the end of the time that we have together here this morning, but before we go, I just wanted to know: what's in the works for you next? Is there anything else that you are working on as far as books go or any other projects?”

AK: “Sure, well, first of all, next month, October is National Infant Awareness and Pregnancy Loss Month, so I definitely hope to be out there talking about miscarriage and how hard it is and how hard infant loss is and to be cognizant of those things for people because miscarriage is very little understood in the world. I'm working on a project about third-party reproduction and egg donors and sperm donors, and all the crazy stories that you hear in the news about people finding 30 siblings or this guy who has 80 children out there and what the future, the crazy future in the next five, 10 years is going to look like for people who are donor-conceived.

“And you know, when I started shopping this fertility book around, I actually started shopping it around while I was going through infertility, and a lot of people said, ‘Oh no,’… they didn't realize, and that was almost 10 years ago probably. So, I think this book is a little bit ahead of its time, but I think it's going to be super important. I think it's going to be super interesting to people, even if you're at home with your three kids.”

BH: “I agree.”

AK: “That you're going to want to know. I have to tell you a crazy statistic that I read. In 1987 or 1988, something like three percent of fertility doctors were using their own sperm.”

BH: “No way!”

AK: “Yes. That's crazy. There’s this guy Donald Cline. They didn't tell their patients. They told them that they were using donor sperm, and you think that's a crazy story until you look into how many doctors were using their own sperm, which is crazy.”

BH: “Wow, that is crazy. Is that this guy who has like 80 children whose sperm has been outlawed? That's more recently, right?”

AK: “No, that's not illegal. He's just donating his sperm to people, and his sperm was outlawed in Israel. I have a story coming out about that soon, but his sperm was outlawed in Israel because they said either sperm has to be anonymous or you have to be a father, and he clearly can't be a father. His point was, ‘I'm in touch with as many kids as the moms want me to be, and I'm not their father per se. I don't act as a parent per se, but I'm in touch.’ They all know who the genetic father is. He said, ‘Is that really worse than an anonymous donor?’ and he kind of has a point.”

BH: “That'd be a heck of a family reunion, yeah.”

AK: “Exactly, yeah, we have to get them all together.”

BH: “Crazy. But yeah, I'm excited to see what else you come out with here in the future and to see the continued that you have. I'm always intrigued by everything that you write. What I really love about everything that you're doing is that everything you write and everything you talk about is always geared towards helping people who are struggling with this. It's not just throwing information out there, but you really care, and it really comes across. It's always a privilege to talk to you, and I'm super excited to see the impact that you continue to have throughout the whole world.”

AK: “Great, and I'm excited for all the changes you're going to make in technology.”

BH: “I am equally excited.”

You can find her book "The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind" online or at a bookstore near you.