Sometimes sweet childhood fantasies about the future turn into nightmares when adulthood’s realities set in. That’s what happened for Shari DeGraff Stewart, an Anchorage psychotherapist, when she began trying to have a baby but couldn’t.
"I had been fantasizing about motherhood since I was a girl playing with my dolls," says Stewart, 45. She says she had picked out names for the children she imagined she‘d have — twin boys, Michael and Matthew — long before she was even old enough to be interested in boys. "My life has always been filled with dreams about my babies," she says.
When she and her husband, 55-year-old psychiatrist Dr. Robert Stewart, married in 1994, he brought four kids from a previous marriage, but DeGraff Stewart says that helping raise those children didn’t replace her determination to give birth to children of her own. They immediately began trying to conceive, but month after month the result was the same. When doctors told her she was infertile, she says she felt as if she had been told she was dying — only worse, since no one else seemed to be able to understand her grief.
"If I had been told that I had cancer, the outpouring of sympathy and concern from my friends would have been overwhelming," DeGraff Stewart recalls. "But instead, there was largely just misunderstanding."
Over the next three-plus years, as she and her husband tried everything they could to conceive a baby, they both sank into a lingering depression. DeGraff Stewart says her sense of isolation, and a sort of grieving for a child she feared she would never have, only grew worse as each new attempt to make a baby failed.
Memories of those dark days, and the knowledge that other couples were experiencing similar anguish, motivated the Stewarts to produce a DVD called Infertility: Holding & Healing Yourself & Your Marriage. Released earlier this year, the disc aims to remove the stigma from infertility, focusing specifically on the special challenges they say couples who pursue in vitro fertilization will face. That was where their own path led them, after about a year of trying to conceive in other ways.
In vitro fertilization is a process most people have heard of, but few realize the costs — emotional, financial, and health-related — of pursuing it, the Stewarts say. To conceive a baby in vitro, a woman’s ovaries must be stimulated to produce an abnormally large number of eggs, which are then harvested. They can be frozen for future use, or immediately matched with a man’s sperm sample in hopes of fertilization. If the sperm fertilizes the egg, the tiny embryo is grown in a lab until doctors can predict whether it would have a chance to survive in the mother.
If the embryo shows signs of strength and begins to grow, it is placed back into the womb, where the mother can carry the baby to term. Typically several embryos are placed in the womb at once, bettering the chances that a birth will occur. 
Shari and Robert Stewart and their in vitro-conceived sons, Connor (left) and Noah.
The first baby conceived in a laboratory was born in England in 1968. Since then the process — which some religious groups, including the Catholic Church, oppose — has been responsible for more than 20,000 births. But the process, while sounding straightforward, is anything but, the Stewart say. It’s an invasive and expensive process — costing an average of $12,000 each cycle — and often has to be repeated many times before an embryo is produced that is strong enough to be placed back into the mother’s womb.
It’s also a very long process, DeGraff Stewart says, and one that comes with no guarantee of success. "You have just gone through so much, and you are geared up to have a baby," she says. "So when the time is right and you are going through one of the fertilization cycles, you start believing you are going to be a mother. Emotionally, you are preparing yourself."
Under those circumstances, when a woman’s menstrual flow arrives, it can be devastating for her, DeGraff Stewart says. "I literally felt like I was having a miscarriage every time I had a period," she says. "It was impossible to explain, and some of my friends just felt I should get over it. But for me, I was grieving."
For husbands, the process can be just as disorienting, Robert Stewart says. To begin with, any romantic idea of how to conceive a child is tossed out the window almost immediately. Years later, he might be able to chuckle at the memory of being told he had to produce a sperm sample within a half hour or so, with his wife’s eggs at prime readiness, and being shown the door to a fertility lab’s washroom, with a line of men waiting their turn already sitting just outside the door.
"It can be a lot of pressure," he says, laughing, but stresses that it didn’t seem funny then.
Their ordeal came to a close in 1998, when their first son, Connor, was born. Now eight, he has added more to their family life than even she anticipated, DeGraff Stewart says. They would eventually retrieve an unused frozen embryo to give birth to another son, Noah, who turns three in late November.
"Motherhood was absolutely everything I expected it to be," she says. "I loved it, everything about it."
Their current happy household aside, Robert Stewart says that not even a lifetime practicing psychiatry had prepared him for the impact his wife’s inability to conceive would have on their mental health. While they were first struggling to conceive, his biggest frustration was how to cope with his wife’s misery.
"Her distress was my distress, and it was very discomforting to see her in such pain. It felt absolutely horrible to her, and I was making it worse because I wasn’t hearing what her pain was," Stewart says.
Michael J. Tucker, a clinical embryologist and medical director at Georgia Reproductive Specialists in Atlanta, says that as the science of fertility has improved, attention to its human and medical dimensions has not always kept up. "There is always the potential, when technology is involved in medicine, for the technology to take the front seat," Tucker says, even as the field has begun to do a better job understanding the mental-health stresses associated with the process.
Happier, informed clients, he says, are usually more successful getting pregnant. "There is a major connection between the state of mind and potential success of fertility," says Tucker, who did not work with the Stewarts. "This has been recognized more in the very recent past than it had been previously."
DeGraff Stewart says that’s a big reason why she and her husband created the new DVD. "We want other couples out there to know that they are not alone, and that they can take steps to prepare themselves for what is going to be a very emotionally trying experience," she says.
The DVD, which is available for $30 through Amazon.com, is composed primarily of interviews with four couples, including the Stewarts, who have had successful pregnancies using in vitro fertilization. It deals with typical feelings couples will most likely experience — from fear to anxiety to loneliness — and also gives practical advice about how to handle the IVF procedures themselves.
So far, DeGraff Stewart says, the response they’ve received after showing it to doctors, therapists and infertility support groups has been positive. "(Other couples) only wish someone had done the video before they had gone through it," she says. "You just feel so alone, and yet everyone goes through the same thing."
