What if you were no longer fertile and could not otherwise have your own biological child?

This week’s question from Gregory Stock’s The Book of Questions follows naturally from last week’s exploration of loss, identity, and genetic connections. While last week we grappled with the devastating reality of losing a child and the temptation to recreate what was lost through cloning, this week we confront a different but related challenge: the discovery that the biological children we might have imagined will never exist at all.

Infertility affects roughly one in eight couples, making this hypothetical scenario a painful reality for millions. Yet the question goes beyond medical statistics to probe something fundamental about human nature: What do we really want when we want children? Is it the genetic connection, the experience of pregnancy and birth, the continuity of our biological lineage, or something else entirely? And when that particular path is closed to us, how do we navigate the complex landscape of alternatives while maintaining our sense of meaning and purpose?

The Mythology of Biological Destiny

Before examining the practical and emotional responses to infertility, we must first understand what we’re really losing when we lose the possibility of biological children. Modern society has constructed powerful mythologies around genetic parenthood that go far beyond the simple biological act of reproduction.

We speak of “our own” children in ways that subtly diminish other forms of family creation. We obsess over whose eyes the baby has, whose temperament they’ve inherited, whose talents they might display. We frame adoption as a “backup plan” rather than a primary choice, and we invest assisted reproductive technology with almost magical properties—as if the specific combination of our particular genetic material represents something irreplaceable and essential.

But what if this entire framework is fundamentally flawed? What if our attachment to biological reproduction reflects not some deep truth about family and meaning, but rather a collection of evolutionary impulses and cultural assumptions that don’t necessarily serve our actual wellbeing or our capacity for meaningful relationships?

Consider the absurdity of our genetic obsessions from a slightly different perspective. We share roughly 99.9% of our DNA with every other human being. The genetic differences between you and your biological child are, in cosmic terms, vanishingly small. Yet we invest those tiny variations with enormous significance, as if they represent some essential continuity of self that cannot be achieved through any other means.

My Response: Acceptance Over Intervention

If I discovered that biological children were impossible, my response would be guided by a simple principle: if it’s not meant to be, then it’s not meant to be. This isn’t fatalism or resignation—it’s recognition that our deepest fulfillment often comes not from getting what we think we want, but from learning to find meaning within the constraints we’re given.

The phrase “not meant to be” might sound like spiritual bypassing, but I mean it in a more practical sense. Life presents us with certain realities—some beautiful, some disappointing, some simply neutral. Our choice lies not in whether to accept these realities, but in how we respond to them. We can exhaust ourselves fighting against what is, or we can redirect our energy toward creating meaning within what’s possible.

This doesn’t mean I would be indifferent to my partner’s feelings. If my wife were deeply committed to pursuing biological children through whatever means available, I would support that journey. But my own preference would be to either pursue adoption or embrace a child-free life, rather than subject ourselves to the emotional and financial roller coaster of fertility treatments.

This preference comes from observing how the pursuit of biological children can become an all-consuming quest that overshadows other forms of meaning and connection. When we invest too heavily in any single outcome—especially one largely outside our control—we risk losing sight of the many other ways life can be rich and purposeful.

The Economics of Hope

One of the most troubling aspects of modern fertility treatment is how it commercializes hope itself. The industry has created a marketplace where desperate couples spend tens of thousands of dollars chasing possibilities that may never materialize, often with little transparency about actual success rates or the cumulative physical and emotional toll.

Dr. Eli Adashi, a reproductive endocrinologist at Brown University, has written extensively about what he calls the “fertility treatment treadmill”—the psychological and economic pressure that keeps couples pursuing increasingly expensive and invasive procedures despite diminishing returns. The average cost of IVF cycles can range from $15,000 to $30,000, rarely covered by insurance, with success rates that vary dramatically based on age and specific fertility issues.

What troubles me most about this system isn’t the expense itself, but how it preys on the vulnerability of people facing one of life’s most profound disappointments. Medical professionals, however well-intentioned, have financial incentives to encourage continued treatment. They offer hope in measured doses—just enough to justify the next procedure, the next cycle, the next experimental protocol.

This creates a cruel dynamic where stopping treatment feels like giving up on your dreams, while continuing treatment means accepting an indefinite period of emotional and financial strain with no guarantee of success. Couples find themselves trapped in a cycle where each failed attempt increases their investment in future attempts, making it psychologically harder to step away.

The ethics of this system become even more questionable when we consider the opportunity costs. The money spent on multiple failed IVF cycles could fund adoption proceedings, could be invested in creating a different kind of meaningful life, or could be donated to causes that help existing children who need homes and resources.

The Superiority of Chosen Love

If I were to become a parent under these circumstances, I believe adoption would not only be equal to biological parenthood—it might actually be superior in some fundamental ways. This isn’t a consolation prize perspective, but a recognition of what makes family relationships truly meaningful.

Biological parenthood, however much we romanticize it, begins with accident and instinct. Two people have sex, genetic material combines in ways beyond their control, and nine months later they’re handed a person they didn’t choose and don’t yet know. We call this natural and beautiful, and in many ways it is. But there’s nothing inherently more meaningful about this process than the deliberate choice to create family through adoption.

Adoptive parents, by contrast, actively choose to love a specific child who needs a family. This choice represents an act of conscious compassion rather than biological inevitability. The child benefits from being genuinely wanted and chosen, rather than simply resulting from their parents’ reproductive activities.

Research consistently shows that adopted children, when placed in loving homes, develop attachment bonds just as strong and secure as those formed with biological parents. Dr. David Brodzinsky, a leading researcher in adoption psychology, has demonstrated that the key factors in healthy child development are consistent care, emotional availability, and secure attachment—none of which require genetic connections.

Moreover, adoptive families often develop particular strengths that biological families may lack. They tend to be more intentional about creating inclusive environments, more conscious of issues around identity and belonging, and more skilled at navigating difference and diversity. These skills benefit not just the adopted child but the entire family system.

The genetic connection we prize so highly in biological families is largely illusory anyway. Yes, children inherit certain physical traits and predispositions from their biological parents. But personality, values, worldview, and most of the characteristics we actually care about in our relationships develop through environment, culture, and choice rather than genetics.

The Grief of Imagined Children

One aspect of infertility that deserves particular attention is the unique nature of the grief it produces. Unlike other forms of loss, infertility requires mourning people who never existed—the imagined biological children who will now never be born.

This grief is complicated by its abstract nature. There’s no funeral, no memorial service, no tangible person to remember and honor. Instead, couples must somehow process the loss of possibilities, of genetic continuation, of pregnancy experiences, of seeing their features reflected in their children’s faces.

Dr. Janet Jaffe, a clinical psychologist specializing in reproductive trauma, describes this as “ambiguous loss”—grief for something that was hoped for but never actually existed. This type of loss can be particularly difficult to process because it lacks the social recognition and support structures we provide for other forms of bereavement.

Society offers sympathy for couples struggling with infertility, but often accompanies that sympathy with pressure to “keep trying” or suggestions that they “just adopt” as if switching paths were simple and emotionally uncomplicated. Well-meaning friends and family may minimize the loss (“at least you know you can love any child”) without understanding that the grief isn’t just about wanting children—it’s about mourning a specific vision of family that will never come to pass.

The healthy processing of this grief requires acknowledging its validity while also recognizing its limitations. Yes, it’s natural and appropriate to mourn the loss of imagined biological children. But this mourning becomes problematic when it prevents us from embracing alternative paths to fulfillment or when it convinces us that no other form of family can be as meaningful.

Societal Pressures and Pronatalist Assumptions

Our responses to infertility are shaped not just by personal desires but by powerful societal pressures that treat parenthood as a fundamental life requirement rather than one meaningful choice among many. These “pronatalist” assumptions—the belief that everyone should want and have children—create additional suffering for those dealing with fertility challenges.

From childhood, we’re socialized to assume that having children is part of the normal life trajectory. We ask young people what they want to be when they grow up, but we rarely ask whether they want to have children—we simply assume they do. We frame childlessness as something that happens to people rather than something they might actively choose.

These assumptions create a cultural context where infertility feels like failure rather than simply a biological reality. Couples struggling with fertility often report feeling broken, defective, or somehow less than complete. They face intrusive questions about their reproductive plans and unwanted advice about medical treatments or alternative options.

The pressure is particularly intense for women, who face the additional burden of feeling that their bodies have “failed” them in some fundamental way. Dr. Alice Domar, a psychologist who specializes in mind-body medicine and fertility, has documented how infertility can trigger symptoms similar to those seen in depression and anxiety disorders, largely due to the intense social stigma and sense of personal failure.

These societal pressures make it harder for individuals and couples to make clear-headed decisions about their fertility journey. When the culture around you treats childlessness as inherently tragic and parenthood as inherently fulfilling, it becomes difficult to honestly assess whether pursuing biological children aligns with your actual values and desires, or whether you’re simply responding to external expectations.

The Validity of Choosing Child-Free Life

Perhaps the most important recognition in confronting infertility is that choosing to remain child-free is not only valid but may actually represent the wisest response for many people. This choice challenges some of our deepest cultural assumptions, but it reflects a mature understanding of what creates a meaningful life.

The assumption that everyone should want children is relatively recent in human history and far from universal across cultures. It also contradicts a great deal of research about what actually contributes to life satisfaction and wellbeing. Studies consistently show that while parents report finding meaning in their relationships with their children, they also report lower levels of day-to-day happiness, higher stress levels, and more restricted life choices.

This isn’t to suggest that parenthood is inherently negative—many people find it deeply rewarding despite its challenges. But it does suggest that the assumption that everyone will be happier as a parent is simply false. For some people, the constraints and responsibilities of parenthood would diminish rather than enhance their life satisfaction.

Choosing to remain child-free in response to infertility can represent a form of wisdom rather than resignation. It acknowledges that meaningful life doesn’t require reproduction, that adult relationships and pursuits can be just as fulfilling as parental ones, and that sometimes the most authentic response to life’s limitations is to embrace them rather than fight against them.

Child-free couples often develop particularly strong partnerships, pursue careers and interests with greater focus and energy, maintain more extensive social networks, and contribute to their communities in ways that might be more difficult for parents. They may travel more, take greater career risks, volunteer more extensively, or simply invest more deeply in their friendships and extended family relationships.

Redefining Legacy and Meaning

The choice to remain child-free also requires rethinking conventional notions of legacy and genetic continuity. We’re conditioned to think of children as our legacy—the way we ensure that something of ourselves continues after we die. But this genetic view of legacy may be both narcissistic and unnecessarily limiting.

True legacy might have less to do with passing on our genetic material and more to do with the impact we have on the world during our lifetime. The teacher who influences hundreds of students, the mentor who guides young professionals, the activist who works for social change, the artist who creates beauty—all of these people leave legacies that may be more meaningful and enduring than genetic reproduction.

Moreover, the genetic legacy we imagine passing to our children is largely illusory. Within a few generations, the specific combination of traits that makes us unique will be diluted beyond recognition. But the ideas we share, the kindness we model, the institutions we build, and the positive changes we create can influence the world for centuries.

This broader view of legacy can be particularly liberating for those facing infertility. It suggests that the meaning we seek through biological reproduction—the sense that our lives matter, that something of value will survive us—can be achieved through many different paths. The key is identifying what we actually want to contribute to the world and finding ways to make that contribution, regardless of whether we have biological children.

The Wisdom of Acceptance

Ultimately, the question of how to respond to infertility comes down to a fundamental choice about how we relate to life’s limitations. We can exhaust ourselves fighting against what is, investing tremendous energy and resources in trying to force outcomes beyond our control. Or we can practice what might be called the wisdom of acceptance—not passive resignation, but active engagement with the possibilities that remain available to us.

This wisdom doesn’t mean abandoning all effort or giving up on our dreams. It means distinguishing between the things we can meaningfully influence and the things we cannot, and investing our limited time and energy accordingly. It means recognizing that some of our most profound growth and fulfillment comes not from getting what we want, but from learning to want what we have.

In the context of infertility, this might mean grieving the loss of imagined biological children while simultaneously opening ourselves to other forms of family and meaning. It might mean supporting a partner’s desire to pursue fertility treatments while maintaining our own clarity about when enough is enough. It might mean choosing adoption not as a consolation prize but as a deliberate choice to create family through love rather than genetics.

Most importantly, it means recognizing that our worth as human beings and our capacity for meaningful life doesn’t depend on our reproductive success. We are not failures if we don’t have biological children. We are not incomplete if we remain child-free. We are simply people navigating life’s complexities as best we can, creating meaning and connection within whatever circumstances we encounter.

The deepest wisdom may lie in recognizing that the desire for biological children, however natural and understandable, is ultimately just one desire among many. When that particular desire cannot be fulfilled, we have the opportunity to discover what other desires might be equally or more meaningful—the desire to love and be loved, to contribute something valuable to the world, to create beauty and meaning in whatever forms are available to us.

In choosing acceptance over endless intervention, we model a different way of being human—one that finds peace within limitation, meaning within constraint, and fulfillment within what is rather than endless striving for what might be. This may be the most profound legacy of all: demonstrating that happiness and meaning are possible even when life doesn’t unfold according to our original plans.