Some people consider adoption as the only responsible way to approach the issue of parenting a child on an already crowded planet. They want to have the experience of parenting a child without adding to the population burden already weighing down our planet. For these people, fertility (or the lack of fertility) never enters the equation.

Others, however, approach adoption only after they fail to conceive a genetically-linked child. Infertility is insidious. In addition to preventing you from conceiving and bearing a child “like everyone else,” infertility can lower your self esteem. No matter how accomplished you may be in other areas, once you begin to battle the specter of infertility it is easy to see yourself as a failure. And even after you “move on” with your life, the fact of infertility can still rankle.

A mom of two children adopted from Guatemala, “When the doctors told me I would probably never conceive a child, I felt like such a failure as a woman. I mean, I worked hard all my life to accomplish what I wanted. I was tops in my college class, I own my own company, I succeed at whatever I put my mind to. But the one thing that I wasn’t supposed to have to work at [conceiving and bearing a child] is impossible for me. Coming to grips with that was very hard. It’s still a sore spot for me.”

Many adoption agencies say they want adoptive couples who have infertility in their history to “resolve” their infertility “issues” before proceeding with adoption. Indeed, one of the most common questions social workers ask when beginning a homestudy is, “Have you resolved your feelings about infertility?” It’s as if they see dealing with infertility as a one-time thing, and then the topic is never to be revisited.

To be sure, some people do approach their infertility in this manner, although many more people view their infertility as a continuing journey. Although the initial grief wanes over time the very fact of their infertility is like a dormant irritant, waiting silently just below the surface. The path from pursuing fertility treatment to admitting infertility to pursuing adoption involves many difficult questions, none of which have hard-and-fast right answers. Among these questions are:

• How long do you pursue infertility treatments? How far do you allow technology to enter into the business of conceiving a child?
• If you choose to adopt a child after failed fertility treatments, how much do you tell the child you adopt about your attempts at conceiving a genetic child?
• Will your adopted child see himself as your second choice, as second best?

If you or your spouse are infertile, you owe it to yourself – and to any children you may adopt – to come to terms with the issues raised by infertility before you pursue adoption.

Let’s address the questions in order: At what point do you stop pursuing fertility treatments and begin pursuing adoption? How far do you allow technology to enter into the business of conceiving a child? The answers to these questions depend on the people involved. For some, it will come down to a matter of money: Treating infertility can be outrageously expensive, and these treatments usually are not covered by health insurance. Others will say, “We’ll try X and if it doesn’t work, that’s it.” Although some people may view halting fertility treatments as “giving up,” others will see it as the push needed to move on to another chapter of life. When they stop fertility treatments and begin actively pursuing adoption, many couples report feeling unburdened, as if by focusing on adoption they are once again focused on the positive instead of constantly ruminating on the negative outcome of their fertility treatments.

How much should you tell your adopted child about any failed fertility treatments in your past? Will telling your adopted child make her feel like she is second best – like she is not your first choice? If you handle the situation with love, tact, and sensitivity your child will understand that you love her unconditionally. Above all, you should be honest. . At some point the child you adopted will ask  why you wanted to adopt her? All children of adoption want to know their story – what makes them special, how their journey ended in this particular family. Your struggles with infertility played a role in bringing this child into your life.

Ask any parents who built a family through adoption and they will say they couldn’t imagine their lives without the children they adopted. When you meet your child for the first time, when you finally bring her home and get to know her, you will feel this way, too – guaranteed. So, what should you tell your child about your fertility treatments? Tell her the truth – that these obstacles were put in your life’s path to make sure you and your child would find each other.