My whole body stiffened at the question I knew was coming. The question that sends me spiraling for hours, days, or weeks after it is asked. The question that is asked too frequently without regard to what is actually being asked.

“So, are you one and done?”

The manicurist looked at me, innocently, having no idea what I was feeling. My sister, sitting next to me, also tensed. She knows what this question does to me. I was having a pretty good Sunday, so I responded lightly, “Actually, we have two children; our five-year-old son and our son from my husband’s first marriage.” And that was it; we went back to mindless chatting, scheduled our appointments for next month, and I am sure the manicurist never gave a second thought to our conversation. But I thought about it all day, as I do each time, I am asked some version of this awful question. The real answer is complex and painful.

No, we never expected to have only one child together; we always wanted two more children. But we also never expected to be diagnosed with infertility and we certainly never expected in vitro fertilization (IVF) would be our only option to have a biological child. The road to having our youngest son was long (so, so long) and very difficult, but it did not deter us from deciding to have another child. We had not let infertility derail us the first time why should the second time be any different?

But trying to conceive again? It was different and much harder. We started our trying to conceive again (referred to as TTCA among infertility veterans) journey by transferring the one frozen embryo we had left from the cycle that resulted in our youngest son. We were so confident; we had previous success, so we were expecting nothing less this time around. In hindsight, this assuredness seems so naïve, especially since we had experienced failure; our first cycle had resulted in a loss.

Our frozen embryo did not implant.

“Receiving a negative pregnancy test result never gets easier, even when you know it is coming.”

Even when you have had more negative results than you can count, or care to remember. This setback shook us, but it did not deter us; we were determined to have another child.

After some time passed, we embarked on a new cycle of IVF; our third fresh cycle. According to our doctors, that cycle was “perfect on paper;” I stimulated well, had 16 eggs retrieved, and had good fertilization. Then I received the call that none of them survived to be transferred. I was distraught. My husband, as he has been through this entire journey, was my rock. He let me react without judgment and when I was ready, we decided to try again. We embarked on our fourth fresh cycle of IVF feeling far less confident. This cycle was also unsuccessful; I did not stimulate as well and had far fewer eggs retrieved. Not surprisingly, we had no embryos for transfer. At the end of this cycle, our doctor asked us to come in to review the details of my two cycles and decide the best approach for cycle number five.

My tearful response? “Thank you, but we have decided our family is complete. We will not be pursuing another cycle of IVF.”

No one was more surprised by my answer than me. When we started down the path of having another child, I thought the only endpoint was success. It turns out, I was wrong. There are so many reasons why we decided not to continue to try to conceive another child, but ultimately it was this: the thought of one more failed attempt was more unbearable than the thought of our family being complete. I could not imagine recovering from another failed cycle, but I could imagine a way forward without another child. And so, we stopped. Our decision was not made easily. We are still not in a place of full acceptance, but there are now more good days than bad days.

Having been on this fertility journey for so long, I know how it shakes you to your core. How it challenges your relationship in ways you never imagined. How it isolates you from friends and family, even those who may be well-meaning. And I know it ends differently, and not always happily, for everyone. As you navigate your path, take each day as it comes, be kind to yourself, and know you are never alone. Wherever you are – just learning of your diagnosis, beginning treatment, a seasoned IVF warrior, pursuing adoption, choosing to live childfree, or anywhere else, I am walking with you always.


At CooperGenomics, we also understand the importance of understanding what your options are during your journey to help you better make informed decisions.  This may include understanding how endometrial receptivity impacts your pregnancy odds, parent of origin testing which better helps you determine if a chromosomal abnormality detected came the sperm or the egg, the importance of working with an REI who is a good match for you and your journey, and how to be a good advocate for your own personal health and needs.

Sheila JohalSheila Johal

Sheila Johal is a lead laboratory genetic counselor at CooperGenomics; she counsels patients seeking preimplantation genetic testing. She came to CooperGenomics after nine and one-half years at MetroHealth Medical Center in Cleveland, Ohio, where she provided prenatal, general, and cardiovascular genetic counseling. Sheila graduated with a master’s degree in Medical and Molecular Genetics with a focus in Genetic Counseling from Indiana University – Purdue University Indianapolis in 2006.

Prior to attending graduate school, she also received a Bachelor of Science in Biology and a Bachelor of Arts in Psychology from Kent State University. She has a specific interest in disorders of hemoglobin, CFTR-related infertility, and is passionate about educating genetic counseling students. She currently serves as co-chair of the OAGC Web Design Subcommittee. When she is not working, Sheila enjoys being with her husband and children, listening to baseball on the radio, baking, and reading.