Adapted from Practical Guide: Adoption After Infertility
By Dr. Anna Koehle, EdD, HS-BCP, CCTP
"Well IVF for you!" the doctor shouted after the very painful HSG test. I had regular periods, normal pap smears, nothing indicating any problems. Yet there I was on the examining table looking at the screen reflecting dye pooled in my uterus, a collapsed tube on the left and blocked and knotted tube on the right.
Shock and shame washed over me as the doctor told me I had no chance of getting pregnant naturally. NONE.
I didn't want to know how or why. Instead, I wanted to hide. I didn't want my husband to think that I was flawed. I felt like the only woman, and certainly the only Black woman, with this invisible, asymptomatic infertility.
One in four women receiving fertility treatment have tubal related infertility like me yet, at that moment, I felt so alone. There in that moment, everything changed. Who I was, how I saw myself and how I showed up in the world all shifted in an instant. My body felt foreign to me, and I knew I would never be the same version of myself that I was before that fateful day in the fall of 2018.
Stopping treatment isn't giving up
We started IVF right away. From more than 50 eggs, we created 15 embryos and I was confident that IVF would work the first time and we’d be on our way to parenthood.
At the end of the two week wait our nurse called. My husband answered the call and I overheard her say, "Todd, it's negative. I'm so sorry." After 18 months and more than $25,000 out of pocket, none of it worked.
The months that followed were the hardest of my life. My husband feared he had lost the vibrant, quirky girl he married. We had promised each other at least two rounds of IVF. Instead, we ended all treatment. The depression was so dark that we had to stop IVF to save my life.
Deciding to stop is deeply personal. There is no right or wrong answer.
I've since walked alongside hundreds of families facing that same crossroads. What I tell them is what I needed to hear: the grief is real, even when the loss is invisible. Mine looked like numbness, then embarrassment and jealousy, then bargaining with God, then years of depression.
Knowing about adoption isn't the same as being ready to adopt
So, what did we do next? We began searching for adoption agencies with the shortest wait time. We had waited long enough! As we started reaching out to agencies, doors started closing. One agency excluded anyone previously divorced. Another required five years of marriage. Another had an age cutoff we'd soon pass.
Every "no" felt like more proof that I was flawed and that maybe I would never be a mother.
After so much disappointment, we weren't ready to hear "no" again so we stepped back from the adoption process four times over before fully committing. Each time, we'd reach out to an agency, fill out the forms, start imagining a child's face, and then pull back. We knew we weren't completely happy, but we also weren't sure if we were completely ready.
"Why don't you just adopt?"
Meanwhile, everyone had advice. "Why don't you just adopt?" "Why don't you become a foster parent?"
We knew there was no such thing as “just” adopting. Adoption is a lifelong commitment not a second choice or a quick fix to infertility. We also knew fostering wasn't right for us at that stage. We knew the goal of foster care is reunification, and as much as I believed in that goal from my work in child welfare, I didn't have the emotional reserves after infertility to love a child and let them go.
We began to see adoption as a different and completely separate path to parenthood and soon realized that that perspective was critical to our healing and our ability to move forward with adoption in a healthy way.
"What are we ready for?"
Over time, I realized we'd been asking the wrong question. It wasn't "Are we ready to pursue adoption?" It was "What are we ready for?" Being ready for IVF doesn't mean you're ready for adoption, and we had to spend some real time with that question.
It wasn't until September 2019 that something shifted. We were no longer searching for the shortest wait time. As we worked with our agency on our adoption preferences, we remained open to most circumstances, including substance exposure, sibling groups, older children, and children with physical health needs. We understood that birth parents are the priority. We would not choose them; they would choose us.
That's when I knew we were ready. It wasn't because the process felt easier, but because it had stopped being about us. We were not saviors or saints, simply a family who was unable to have biological children and who had the capacity to love any child regardless of relation.
"She's here!"
March 2020. The world shut down, and our adoption agency stopped matching across state lines and we took that to mean that the wait would be even longer than the estimated 18 months we’d been given. Heartbroken, we decided to put our adoption on hold. We'd call our caseworker Monday and stop the process.
At 8:00 AM on Monday, March 23rd, my phone rang. It was our caseworker. "Soooo, there's a birth mother who just had a baby. It's a girl. She's waiting for you."
I crumbled to the floor. My husband crumbled to the floor with me, and we wept.
What infertility and adoption taught me
In October, our adoption finalized and on that exact day our daughter smiled for the first time and it was like someone flipped a switch. We felt so much peace about our journey and so much gratitude that all the pain led us to her. Also, for the first time in years, I was gentle with myself. My journey had nothing to do with my worthiness and everything to do with my daughter.
Our journey to parenthood wasn't perfect, and it looked nothing like what we expected. But adoption completed our family in a way I never could have imagined. We still feel joy and grief when we think about how our family came to be. The difference is that we no longer carry them with shame, guilt, or anger. We hold them side by side, as equal parts of a more perfect whole.
If you're standing where I once stood, your heart may still be tender. Open it anyway. So much love is coming.
My Journaling Prompts If you’re also on this path:
If you're moving from fertility treatment toward adoption, take some quiet time with these. There are no wrong answers.
How do you define yourself? Everyone uses a different language to describe their journey. I chose to use the word “infertility” because I feel that my journey was about what my body could not do and that feels empowering to name it in that way. What language honors your story?
In a perfect world. Describe family building as you first imagined it. Then describe where you hope to be a year from now. What's changed?
What are you ready for? Do you see adoption as your path or as your "Plan B"? Where do you still need time or support?
If, then. Write down your "if, then" fears, like "If I adopt, then I'll never have a biological child." Rewrite each one to name what's hard and leave room for hope.
A letter to your future self. What excites you? What scares you? What are you proud of? Save it and consider sharing it with your child one day.
Adapted from Practical Guide: Adoption After Infertility
Dr. Anna Koehle, EdD, HS-BCP, CCTP, is a child welfare expert, Human Services Board-Certified Practitioner, and Certified Clinical Trauma Professional with more than 20 years of experience supporting children and families. Honored as a distinguished Black child welfare leader by the National Adoption Association Ujima Think Tank for Black Family Connection, Dr. Koehle remains committed to ensuring every child has a place to call home. She lives in Richmond, Virginia, with her husband, daughter, and furbabies.
