Thursday, December 29, 2005


The big infertility story

I’ve been thinking for a while about telling you our infertility and IVF story, and I figure now is as good a time as any. Most of you are busy eating leftover turkey and shopping for deals at the outlet stores, so we’re into light blogging mode.

It’s a long story, so much so that I’ve divided it into two posts, and even then decided to hide most of it beneath the fold. Like any good story, this one begins with heartache, but ends in joy. I mean, you already know how it comes out, and a lot of you know the details already. The trouble is knowing where to begin.

I remember Boxing Day 1998. Beloved and I were on the 401 heading back to Ottawa after spending Christmas in London and Windsor with our respective families. We were talking over some of the early details of our wedding, planned for July of the coming year. I don’t know how we got on to the topic, but I clearly remember talking seriously about when to have kids for the first time. There had never been any doubt about the 'if', but the 'when' had been a big question even though we'd been together for almost four years at the time. In that conversation, we officially decided to start trying for kids on our honeymoon.

I can still remember the feeling of elation, of expectation, of hope. Finally, finally, being a mother was within my grasp.

We almost waited for the honeymoon, but not quite. I remember being in Paris and not drinking much wine, because we had been busy and I was hoping I might be pregnant by a couple of days. When it turned out I wasn’t pregnant that July, I was only disappointed that I had given up a lot of indulgence in the name of a maybe-baby. Little did I know the road ahead.

Toward the fall and winter of that year, I started to buy the occasional pregnancy magazine. Every time I was a day or two late, which seemed to be every cycle that fall, I’d buy a pregnancy test and start imagining how I’d break the news to my family. First it was over Thanksgiving Dinner. Then as a birthday present for Beloved in December, and when not then, as a Christmas gift to my parents. I dreamed up elaborate ways to announce my pregnancy. When I was denied the chance to tell my mother I was pregnant for her birthday in February, I finally made an appointment to talk to my GP about fertility. That month, for the first time in my life, my cycle stretched out to six weeks, and I was crushed when my period finally came.

My GP listened to my story and referred me to the Fertility Centre at the Ottawa hospital. I was a little freaked out by the fact that she didn’t pat me on the head and tell me not to worry, but at the same time confident that whatever was wrong would soon be easily resolved by the ‘experts’.

In hindsight, our referral was processed in an impressively short period of time, but as each month came and went without a pregnancy, it seemed much longer. After a battery of blood tests, a semen analysis (Beloved’s, not mine) and a hysterosalpingogram (an x-ray of my reproductive plumbing), we had a consultation with a reproductive endrocrinologist. She told us that in fact there was nothing wrong with my physiology, but that Beloved’s sperm had such low morphology (poorly formed sperm) that she estimated our chances of conceiving a child naturally at less than three per cent. She said that the sperm were of such low quality and quantity that even lesser treatments like an intrauterine insemination were unlikely to work and that her best recommendation was for us to move directly to in vitro fertilization.

To say we were devastated would be an understatement. That afternoon, I had a prior ‘date’ with a friend planned to play a little catch. I was so blown away by the diagnosis that I couldn’t even tell her, one of my most cherished confidantes, throughout the three hours we were together. It was only when we were sitting in the car and I was about to go home that I finally found the words. And the tears. A river of tears.

I couldn’t cope with the concept of being infertile. Infertility is so much more than a clinical diagnosis. It means giving up on a dream you felt entitled to your whole life. It is standing on a precipice with a yawing future devoid of the children you already felt were a part of you. It is losing what you never had but always expected.

I was tormented by the fact that our infertility was 'male factor'. I wished it were me, simply because didn't want Beloved to be burdened by the guilt of responsibility. As much as the infertility was hurting me, I could only imagine how much worse Beloved must have felt.

In those early days, there were two main obstacles to pursing IVF. The first was money. Beloved had just barely finished his diploma and I was working in a mid-level government job. We were renting a townhouse, living paycheque to paycheque and had no money behind us whatsoever. The drugs would be reimbursed at a rate of 80%, but we’d have to pay the procedure out of pocket at around $7,000. On credit.

I remember the seminal conversation with my wise mother. She asked me, ‘What else are you going to spend your money on?’ And she was right. If anything was ‘worth it’, this was worth it.

Except, the other obstacle we were facing was the fact that even if we could scratch up the $7,000, there was only about a one in three chance it would succeed.

One in three.

All that money, all those needles (oh, how I feared the needles), all those hormones and all that disruption to our lives, and no guarantee of success.

And once again, we decided that if anything was worth it, this was worth it. We made an appointment to tell the clinic we wanted to go ahead in the early summer of 2000.

And then, on our first wedding anniversary, July 3, I peed on a stick because I was four days late and I never learn.

And I was pregnant.

For the summer of 2000, I felt like I was living in a dream. I felt tired but wonderful. My feet never really touched the ground. My due date was in March of 2001, and I found out one of my very best friends was due the very same month. It was fate.

Except fate is a cruel mistress. One afternoon in late August, three days before my first OB appointment, I went to the washroom and there was blood. Not a lot, but enough. I was scared. I managed to get an appointment at the after-hours clinic, and while I was in the waiting room, the cramping started. They tried to find the baby’s heartbeat, and when they couldn’t they told me it was probably too early. Lots of people had spotting. And, the nurse said with sympathy, even if it is the worst, there’s nothing we can do for you.

I cried all night long. I was still crying the next day when I asked Beloved to take me to the emergency clinic because I was in so much pain. Nobody told me that a miscarriage at 13 weeks would involve contractions, and I was terrified on top of being in pain and heartbroken. The emergency room staff were clinical and unmoved by my near-hysteria. They said the earliest ultrasound they could schedule was in five hours, and told me to go home and take some Tylenol and wait.

I passed the remains of the baby into my underwear, in my bathroom at home, alone. Trying hard not to look too closely at the lost little soul no bigger than half my fist, I scooped up what I could into a plastic container, because I had the idea that if I brought the fetus back to the doctors, they could tell me what happened. The only thing that kept me from a complete breakdown was the idea of protecting Beloved from my hysteria. I had to be strong for him.

Of course, the doctors had no answers for me. They said the baby was small for 13 weeks, so had either died some weeks before or had been falling behind in its growth. No matter, really. It was over.

We went back to the fertility clinic, and our reproductive endocrinologist opined that maybe we should try intrauterine insemination (IUI) after all, if I had managed to get pregnant given Beloved’s sperm counts. I imagined my ova like some giant Death Star in my fallopian tubes, gathering up wayward sperm.

By this point, getting pregnant was my all-consuming obsession. It was all I thought about. Each day, I would open my eyes and wonder how long until we could be parents. I would roll out of bed and dutifully chart my temperature, watching for that tell-tale dip in body temperature that indicated the beginning of monthly fertility. After sex (every two days, just like the books recommended) I would rest with my legs up the wall, a pillow under my hips, trying to coax lost sperm in the right direction. For two weeks I wouldn't drink alcohol, ingest aspartame or deli meat or soft cheese, hoping that this was the month the miracle came back. And each month I would obsess over the toilet paper, watching for that first tell-tale smear of muddy blood, the dream dead for another two weeks.

I tried not to be bitter about other people's pregnancies. I've never been the sort of person who begrudges someone else their rightful joy, but even seeing mothers out playing with their children was like rubbing salt into an open wound. The year in between our infertility diagnosis and the start of our IVF cycle was one of my darkest. The loss was hard to cope with, but the hope nearly killed me.

We opted for IUI with superovulation, meaning I would inject myself with follicle stimulating hormones to produce more than one egg, thus improving our chances for conception. Our first IUI ran through December of 2000. My period came, indicating the failure of the cycle, on Boxing Day at my sister-in-law’s house – two years to the day after our decision to have kids as soon as possible.

We tried another superovulated IUI in February of 2001. My anxiety was ratcheted even higher for that cycle, because I was desperate to be pregnant before facing the due date of the baby we lost to miscarriage. But, it didn’t work out that way. After that second IUI failed, we decided to stop piddling around with intermediary procedures and go big or go home.

We decided to spin the big wheel and try IVF in the spring of 2001. And I’ll tell you about it tomorrow.

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