Getting Pregnant the Hard Way: Our Struggle with Infertility
Submitted by Anonymous on Mon, 11/07/2005 - 05:00.
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by Stacy Hamilton
Forty
years ago my husband and I would have been unable to have children. We
eat well, we exercise, and neither of us has ever had any significant
medical problems—and yet for six years we couldn’t get pregnant and no
one could tell us why. We struggled for many years to have our first
child, and we have no real prospect of having any more. As the doctor’s
way of making a baby is fraught with emotional and physical peril,
often we felt lost, anxious, and frustrated, and my heart goes out to
those who find themselves in a similar situation. I hope our experience
might help others make their choices with open eyes and lots of hope.
Our experience began seven years ago when after two years of trying we
finally decided to go see a doctor. Most people don’t wait so long, but
we were young, we had our careers, and children were not absolutely
necessary to our lives at the time. Besides, after all the finger
wagging from health teachers who spent years explaining the dangers of
unprotected sex, we couldn’t really believe we were infertile
We discovered quickly that reproduction is mostly a mystery to Western
medicine, and the doctors take a purely mechanical approach—poke us
until they find out why sperm isn’t getting together with egg. First,
our doctor tested my husband in his one area that could be the trouble
(sperm), while I endured a battery of tests that ranged from the
mundane to the bizarre to the embarrassing. They checked my blood for
hormone levels, ran dye through my Fallopian tubes to check for
blockages (which caused unpleasant cramping), and took strips of my
uterine lining for examination under a microscope (which caused severe
pain). The strangest experience was the “postcoital” test; my husband
and I had to make love, and one hour later at the doctor’s office they
scraped my vaginal wall to see how the sperm were doing. Our doctor
never found anything amiss, and so scratching her head, she sent us to
a doctor who specializes in infertility.
During our first visit in January 2001, our new doctor told us that the
tests I had just endured were usually inconclusive, and the rest were
completely useless, but the insurance company insisted on all of them
before allowing a specialist to step in. In
they cover infertility in some fashion, but since full-blown in vitro
fertilization is so expensive, they require doctors to exhaust every
other avenue first.
The initial treatment plan included checking my hormones (again),
examining my uterus and ovaries via ultrasound, and performing
laproscopic surgery to search for endometriosis. The surgery was pretty
awful because a) they used a general anesthetic, and I am sensitive to
such drugs, and b) the doctor blew air into my peritoneum to get a
better view of my reproductive organs. The pressure of the gas against
the diaphragm caused “referred pain” in my shoulders and caused
significant discomfort for quite a while after the procedure. On the
plus side, now I have minimal cramping during my menstrual cycle
because they removed some lesions that were giving me monthly pain.
Unfortunately, those lesions were not the cause of my infertility; in
fact, no test came back as abnormal. Our official diagnosis is
“unexplained infertility”, and 15% of infertile couples are designated
as such.
This euphemism does not even begin to describe its emotional impact.
Infertility is one’s own body fundamentally betraying you. The
instinctual animal in us knows children should come from our bodies,
and when no children come, it is impossible not to feel anger,
resentment, and despair. While the doctors looked for something to fix,
we felt relatively hopeful. Pregnancy is so easy, shouldn’t something
be dreadfully wrong if we couldn’t do it? Western medicine is often
skilled at the big fix, but we didn’t have that as an option.
Therefore, our doctor outlined our next move, the only move: unite egg
and sperm artificially. The first month they had me check my ovulation
using those home hormone tests: pee on a stick, and if you get a dark
purple line you will likely ovulate in the next 24-36 hours. When I
determined I was close to ovulation, Ken gave the doctors a sperm
sample, they whirled it around in a centrifuge to concentrate it, and
performed an IUI—intrauterine insemination. In simple terms, they
inserted a catheter into my vagina and squirted in the sperm. It came
as no surprise to anyone when this did not work, but the insurance
company mandated that as the first step.
The next month they had me take Clomid, a commonly used fertility oral
drug that boosts the number of eggs you release during your ovulation.
This is a gentler version of earlier fertility drugs that resulted in
the ludicrous baby counts you read about on the news. Another IUI was
performed, and still no luck. The next month they added a new drug that
would force me to ovulate at a particular time. You may have noticed
the pattern. After incremental modifications each month, in a year’s
time we had exhausted every option but in vitro fertilization.
This slow progression in treatment during 2001 was wearing and
exhausting in multiple ways. Every month, we thought, “This could be
it!”… until my period arrived. Every month our desperation increased,
and our depression deepened each time I did not get pregnant. When we
initially began our IUI attempts a year earlier, we told each other we
would try everything up to but not including IVF—it seemed so invasive
and awful. But once our year of “training” had passed, we decided IVF
wasn’t a huge jump from what we had just done. More importantly, it had
become our last chance: if in vitro didn’t do it, we would probably
never have children. The two months spent on that first in vitro
attempt were probably some of the worst in my life. I was certain that
if anything was going to work, it would be in vitro, but after so many
months of failure, it was hard to imagine success.
In vitro protocols vary from person to person, and even from year to
year, but I will outline my own experience at the time. We began with
10 days of injected Lupron, a drug that keeps your body from
progressing through its monthly cycle, 7 to 10 days of Follistim, a
follicle stimulation hormone that forces the ovaries to produce as many
eggs as possible, and a final injection of Ovidrel, which ripens the
eggs for retrieval. The injections are subcutaneous, under the skin, as
opposed to intramuscular (ouch) and my husband injected in my stomach
under the belly button, but you can use your thighs and arms. We
visited the doctor regularly during this period so that they could take
blood tests to check hormone levels and perform ultrasounds to check
the size and number of the eggs. The IVF nurses handled this entire
process, and they are as knowledgeable, kind and patient a bunch as I
have ever met. In our experience, our doctor made the initial decision
for treatment, but the nurses did the actual labor, and their
sensitivity helped us tremendously during this time.
Eventually we were ready for egg retrieval, which is a hospital visit.
By now my ovaries were lumpy with 10 to 20 follicles, and hopefully
each contained a ripe egg. The doctor put me under a much gentler
anesthesia than I had previously experienced, inserted a needle into my
uterus and extracted the fluid inside each follicle. They managed to
take out 13 eggs.
Once they have the eggs, they first try to simply lay the sperm on top
and wait for fertilization, but apparently the lab technicians noticed
nothing happening, and actually selected healthy looking sperm and
injected each one into a different egg, forcing fertilization.
Eleven of the eggs became embryos. For three days those eggs sat in the
hospital and divided, and we sat at home and worried. On the third day
we went in for transfer: the three embryos that survived were placed,
via catheter, into my uterus. And then we went home. They told us to
come back in 11 days for a pregnancy test, and those were absolutely
the longest days of my life. In IVF, you can get used to the injections
and the constant blood tests, but waiting was the worst. Our
distraction and apprehension made it difficult to do our jobs, to
sleep, and to relate to our friends and family. Thankfully, we managed
not to take out our stress on each other, and I can only imagine how
some couple’s relationships must suffer in this process.
Our story of anxiety and struggle has a happy ending, and I am grateful
every day that I spend with my now almost three-year old boy. We were
incredibly lucky on so many levels: we only suffered through a single
IVF cycle and I know of couples trying four, five, six times to get
pregnant. I am also lucky that we have a state that forces coverage
from insurance companies, and my insurance was really quite good, in
comparison to most. Finally, I am lucky that it worked at all, because
we have tried for a year to get pregnant a second time, without
success. It is hard not to be angry about that. My body has already
successfully become pregnant, and successfully carried and delivered a
baby, and so I know that it can, and yet it won’t. And again, no one
can tell me why.
There is no treatment for infertility when the doctor cannot find
anything wrong with you. In our experience, all Western doctors know
how to do is unite egg and sperm through whatever method, place embryos
into the uterus, and hope something happens. Western medicine is very
good at mechanical, invasive procedures and although that approach is
inherently limited, we did benefit from it. If we had had the option,
we certainly would have tried Chinese medicine once the Western doctors
couldn’t “fix” us. Chinese medicine takes all a woman’s emotional and
bodily functions into account before beginning treatment, not just
uterus and ovaries. It is certainly a gentler, more holistic approach.
When we approached the doctors to help us with our infertility, we felt
attacked on all fronts. We were buffeted by our feelings of failure,
anger, and frustration, and we were dealing with a complex branch of
medicine the Western doctors do not fully understand. The situation
demands that you ask questions constantly of everyone involved, which
is not always easy with the hierarchical and authoritarian attitude of
many doctors. You should read all you can, and seek support from your
loved ones. This advice sounds foolishly simple, but it is often
difficult to follow when you are swamped by the emotional chaos of
infertility.