TheBirdsTheBeesAndNeedles

Sitting in the waiting room of the fertility clinic, I notice infertility doesn’t affect one type of person- it affects everyone.  You start to see the different faces of infertility:  the couples, those by their lonesome, the daughter accompanied by her mom, those dressed to the 9’s and those that look they just rolled out of bed and everything in between.

With 70 million people suffering from infertility (10-15% of couples trying), I started to wonder, just how many people in my daily life were silent “carriers” dealing with this issue all on their own. It reminds me of my husband’s last health assessment, when the nurse discovered his high cholesterol and said, “But you look healthy!”  What she meant was, you don’t look sick.

Infertility impacts us all in different ways, but one thing is true- it’s an internal disease with internal symptoms.  Some of us, ok… most of us… didn’t even know that we were infertile until many months of disappointingly negative pregnancy tests or month after month of seeing the “wicked red witch” (as it’s referred to on those many, many, MANY pregnancy forums). Even once we find out it’s not something easily shared.  Why is that? It’s a health issue- something beyond our control, yet it makes us feel as though we did something wrong, or that we are the only ones dealing with this issue.  What if we were more open?  What if we let others dealing with this issue know that they’re not alone? Would it be a different story then?

I can just picture it: Couples and individuals swapping treatment stories, sharing in laugher about their preconceived misconceptions, talking outside of the online forums. Maybe then, and only then would we feel like we’re not the only ones dealing with this and truly understand that the problem isn’t “us.”

It would only be a couple weeks after my HSG that I would get to go in for my saline infused sonohysterogram (SHG).  I felt optimistic with the process moving pretty quickly (seeing as how we’d tried by ourselves with no avail for over a year now, a month or two is fast).  This one was performed by my fertility doctor- the one with the calming smile.  Once I had arrived, checked in, and been placed in my room at the clinic, the nurse gave me a blanket and told me to remove all clothing from my waist down and cover myself with the blanket while I wait for the doctor.  I’m sure she was only 10 minutes or so, but laying there, half naked, made me feel so vulnerable and time passed so slowly.  I laugh at this now, because this would become routine- I just didn’t know it then.

I was all alone this time, and incredibly nervous.  I did not do the same “google research” as I had for the HSG.  The doctor came in and all her instruments were set up on the counter.  She explained the procedure, and then quickly started.  She watched the screen as she pushed saline through my cervix. It was a cold test, but not nearly as painful or irritating as the HSG.  Immediately, she was able to see that there was a polyp in my uterus.  She explained that this little unwelcomed extra tissue could be the thing preventing us from getting pregnant.  I felt immediate relief.  The doctor mentioned the scheduling desk would call to set up an appointment to remove the polyp.  It was the clinic’s policy to remove it before continuing in any further fertility treatment.  After getting dressed, I ran to my car.  I was overjoyed as I called my husband.  The first thing I said to him was, “I knew it- there was something!  They found a polyp.”  The entire time after my miscarriage I kept going to my OB to schedule tests because I felt as if my body still thought I was pregnant, or that something was physically wrong.  After a year of trying to find out what it was, I felt like we finally knew something- there was a polyp.   He and I rejoiced being able to feel like there was something we could do, something we could fixto help us have a baby of our own.

The surgery:

The clinic was able to get me in relatively quickly for the surgery.  This would be the one and only actual “surgery” the clinic would provide for me over the years.  Everything else would be a “procedure.”  I opted to have the polyp removed and a D&C performed- which took off the innermost layer of my uterus and allowed for a fresh, new lining.  The clinic had it’s own operation area right next to their suite.  It was incredibly sleek and impressive.  All of the staff there were incredibly nice (just like the clinic), and all seemed to have their own stories of struggling with infertility.  I don’t remember anything from the surgery, except the stories the staff shared, and that afterwards I was incredibly hungry.  My husband was with me the whole day, and we celebrated as we were excited for the next steps in our journey.

After my initial blood tests (13 tubes!!!) and screening tests to rule out any unknown diseases, it was time for my HSG- Hysterosalpingogram.  Try saying that five times fast.  I really didn’t know what to expect, so I decided to google it.  Boy, was that a mistake!  The first thing I saw was “HSG Pain- What to expect.”  Uhh…  pain?  I read that the test involved shooting dye through my cervix and into my uterus, and ovaries, to see if there were any blockages or issues.  They also mentioned that it would be incredibly painful, like cramps times 10. At least they gave advice- take 2 ibuprofen an hour or two before the test.  Then, I saw the videos… videos of how to read the test and diagnose common fertility issues.  In hindsight, I should not have watched those videos.

On the way to the hospital, I listened to my calming Christian radio station, hoping to calm my nerves.  I went into the radiology testing area and changed into a gown and put on the non-slip socks they gave me (I was incredibly excited about the socks and kept them for home use).  The technician was very nice, and tried to explain the test and process to me, but I was already in my head… and just terrified from everything I had read and watched.  I did take ibuprofen before the test, but it didn’t seem to help.  I remember her telling me “You’re going to feel a pinch, then a burning sensation, and maybe some cramping.”  The second I felt the pinch… I kicked.  I didn’t mean to, but I ended up kicking the technician while she was still administering the dye.  I apologized profusely, and she said, “At least you didn’t punch me. Now, that one hurt!”  I felt a little better and turned to look at the screen.  I could see the dye entering my uterus and flowing through my fallopian tubes.  However, I noticed I didn’t see one of my ovaries.  When the nurse came in to watch the last part of the test, she could see that I was worried about something.  As we made eye contact, I blurted out, “Where’s my left ovary? I only see the other one.”  She came over and assured me it was there, hanging out, waaaaay over and around from where it would be in an anatomy book (or on all those scans I watched on YouTube). She said, “It looks good.”  She started to walk away, then squinted at one of the pictures that had been printed, walked back to me and said, “Wait… I see a shadow here.  It could just be the angle, but I want to make sure.  We will have the doctor do a sonohysterogram in the office.  Once I go over this with the doctor, we’ll call you to schedule one.”

I sighed, and finally relaxed for the first time during that visit after I got the gown off (I managed to keep the socks- I really liked those socks).  I got dressed and the technician came to walk me out. I apologized one more time for kicking her. She looked at me and said, “This was your first one I take it.”  My jaw must have dropped to the floor.  “You mean, people this more than once?”  She chuckled in that “Oh, you poor thing, you don’t know what you signed up for way” and said, “I think it gets repeated every 5 years or so.”  When I was in the car driving home, I couldn’t help but wonder- How long will this process take?  Surely I’d be all done before 5 years, right?

My husband is an amazing man who always seems to know exactly what I need. I didn’t tell him about my morning cry/spiritual awakening, but he knew I needed to enter the clinic that afternoon with him. He arrived at the hospital parking lot before I did (as usual) and waited for me to walk in together. We interlocked our arms and looked at each other with a “Let’s Do This” smile and nod. He actually said, “Let’s do this. Leroy Jenkins!” as he chooses to do adding humor to even the darkest of moments. (If you don’t know that reference, you should definitely google it for a laugh). We found our way down the winding hallway and outside a large wooden door. There was nothing special about the door- it didn’t even have the name of the clinic on it, just the suite number on the side.

The waiting room looked like any other waiting room: chairs, sofas, a TV, and a receptionist behind a glass-sliding window. “Put your name and time on the log, please.” She could probably tell that we were new the way we looked like deer in headlights, observing and taking in the new surroundings. We sat down facing the other wooden door- the one where the nurse comes to take you to your magical destination. I glanced around the room. There were a couple other couples there, and even what appeared to be an older mom and her daughter waiting with us. One lady, sitting by herself, had a binder. I wondered to myself, “Should I have brought a notebook for notes?”

My husband was talking about something… whatever was on the TV or in the magazine he was perusing. I only half listened, as I was too deep inside my head at that moment not knowing what to expect. There weren’t any pictures of babies or families hanging on the walls- like you’d see at most OB offices. A woman in scrubs showed up at the door and called my name. I didn’t hear her, but my husband tapped my lap and looked at the door. As I stood up, he grabbed my hand and gave it a small squeeze to say, “Let’s Do This!”

We were seated in a consult room. It was a room just big enough for the round table and 3 chairs, and had a window. The sunlight was refreshing. The insurance guru for the clinic came in with a large binder. “A nurse and doctor will be in to talk about all of the medical stuff. I’m just here to talk about what your insurance covers and the legal forms.” There were A LOT of forms. We had already filled out our medical history and other questions online before the visit, so I didn’t think there’d be this many actual forms to fill out and sign. Turns out, they like to make sure you know 100% that they cannot guarantee you a baby. It doesn’t matter how many treatments you go through. Even if it works, it could take years, and unfortunately for some, it doesn’t seem to work. I could feel a pit in my stomach. After what seemed like an hour of review forms and signing, she left and the nurse came in. We did a basic review of what we’d been through- miscarriage, trying for a year, not being successful, semen analysis, family history- basically a rundown of our combined medical record. She let us know the protocol for all new couples to the clinic and tests that had to be done before choosing a treatment program. There was a gambit of tests to choose from. I HAD to do the genetic testing to rule out being a carrier for certain diseases, as well as a screening test for all of the major diseases (including HIV/AIDS), and then lots of abbreviations that stood for specific tests for my uterus. I don’t think I’d ever really thought of tests for my uterus before, but man, were there a bunch to choose from. We basically agreed to all of the necessary tests, and declined the tests my husband could optionally do. She left after more form signing and told us the doctor would be in shortly.

Now we were about 2 hours into our consult when the doctor arrived. Instantly, after she walked into the room, she greeted us with a smile on her face. Her happiness made me calm. We did a brief review of our situation (again) and she told us all of the treatment options that we would most likely have to choose from. She reiterated what we’d heard from the 2 people before her: we, however, cannot guarantee you a baby. My husband started crying. I have seldom seen him cry. She stopped mid sentence and comforted him asking if he needed a minute. He said, “I keep hearing that we will not have a baby. I’m not seeing any hope.” She looked at him and said, “Listen, you’re both relatively young, and your tests don’t show me any reason why you can’t have a baby.” That was what he and I both needed to hear. I had come in thinking “I can’t have a baby.” Now it changed to, “There is no reason you can’t have a baby.” I don’t know if she knew it, but her words were life changing.   She continued to discuss possible options for treatment, and left after we felt incredibly comfortable with the entire process.

The insurance guru came back in letting us know that she couldn’t get an answer from my insurance company about if they would cover even the basic diagnostic tests. She said my husband’s would, if that was an option to switch at all. However, she worked out the costs for the tests and initial treatments without any coverage. We were still feeling positive- we had learned that there really wasn’t any reason to fear the darkest extreme. We signed more forms, basically saying we would pay for any care received, and she left. We were now 3 hours in.

After a while, the nurse came back in and took me to a separate exam room. While inspecting my uterus with her magical trans-vaginal probe (this will become a common thing to expect at all future visits), she exclaimed, “Oh wow! There’s a lot of eggs getting ready in there.” She made a mention that I had some similarities to PCOS (Polycystic Ovarian Syndrome), without actually having the syndrome. I, for a slight moment, had a sense of relief with thinking that we could have found the reason- and therefore could fix it. Alas, we would learn later that my tests would reveal I didn’t have PCOS, and I became categorized as “infertile- reason unknown.”  I felt like it had taken us a year to get here, and I was looking for immediate answers. Little did I know, our journey was only now beginning- our infertility journey.

After months of waiting, it was finally the morning of our fertility consult. The consult wasn’t until the afternoon, so my husband and I both went to work that day. The days leading up to the consult, I had done some research on adoption/fostering options just in case. I never really processed the idea that we might not be able to have children together and have to adopt until the morning of our consult. Of course it didn’t hit me before my husband excitedly left for work, or even when I was showering as I did every morning. It’s as if the idea was a leaf, gently falling from a tree, and finally landing right as I was putting the final touches on my makeup. I rarely wear makeup, but today was different. I wanted to look my best and needed some faux confidence for the meeting that afternoon. I guess, in hindsight, I knew I was uneasy, but it didn’t hit me until that moment.

The conversation in my head (while staring at the mirror) went something like this:

• I’m so excited to find out what we can do.
• Finally! Someone to help us know why we haven’t been successful.
• I wonder if they can tell me why we couldn’t carry the first time.
• Wait, what if they tell me I can’t get pregnant?
• What if they tell me I can’t carry a baby full term?

Then the thought “What if they say, we can’t have our own kids?” Wow, that escalated quickly. In that single moment, as quickly as the thought came, I had a flood of tears.

The funny thing was, I didn’t even know I could feel this way. A few months before meeting my husband, I had decided that I wasn’t going to have kids. I wanted to work with orphans and help them, instead of my own children. In fact, I used to pray as a child that I would not have kids. This was actually a prayer I said… repeatedly… to God. I had literally prayed for infertility for many, many years.

In that moment, I finally realized why I had been researching adoption/fostering. Secretly, I was afraid I couldn’t have kids. That I was broken. Something was wrong with me and there was no way for me to now experience my new heart’s sole desire. What a horrible time to actually come to this realization- I was now running late, and I was doing that ugly cry. I mean, real, soulful, deep crying that I didn’t think would ever end. I suddenly felt alone, vulnerable, and it was too quiet outside of my head. I decided to turn on some music to at least numb my brain from thinking so much. I turned on Pandora and the song “I Need You” came on. I found the words to be expressing exactly what I felt in that moment. Lord, I truly need you. I need your wisdom, your guidance, your grace, your mercy, your love. Something reaffirming that he has me in the palm of his hand. There was a line that stuck out to me “When I cannot stand, I’ll fall on you.” I realized in that moment, I couldn’t stand (I was crouched over holding onto my counter- I told you, it was a deep, ugly cry). I found the song and played it 5 more times. The first time I was crying because I needed God. Around the third time, I realized I needed to trust in God. By the end of the fifth time, I wasn’t crying anymore. I was actually praising God for being everything I need. I decided I would just fall on him, and let him carry me through the day. This became one of the songs that I would use (and even my husband who doesn’t listen to Christian music) to get through my infertility journey. Little did I know that this was the beginning of a strengthening of me, my husband, our relationship, and our faith (individually and together). That deep cry became my beautiful beginning.

I would say that everyone in my family is extremely fertile. My mom is 1 of 9 children, and they all (except for one) have 2-4 children each.  Most of these children (my little sister included) were “surprises” to their parents.  Once I became sexually active, I told myself it would be incredibly important to use contraception seeing as my family is so fertile and I was blessed with what you may call “child bearing hips.”  This was one reason I was so surprised it took my husband and I 6 months of active trying to become pregnant.  I even made him do a semen analysis, which we didn’t get the results to until after we found out we were pregnant for the first time.  However, even 3 months after the miscarriage, I didn’t feel like my body was the same again.  I told myself that my body still thought I was pregnant and that is why I was having such a hard time.  I followed up with my original OB/gynecologist (GYN) and he had me do an US to ensure I didn’t have any extra tissue in my uterus.  To his (and my) surprise, everything was normal.  He said “I bet you’ll get pregnant again here in the next couple of months.”

So we waited…

We were active in our trying, and month after month were disappointed when that angry red monster would show up.  I never wanted to buy pregnancy tests because I felt it might jinx things. My family is incredibly superstitious, so we didn’t even tell people were were trying because it might jinx it. During this time I was following up with my GYN with lab work to make sure there wasn’t something we were missing.  Another 4 months had come and gone with no luck.  We were now 7 months post miscarriage.  My GYN said there were more tests, but recommended going to a fertility specialist because they had additional equipment and procedures they could perform.  This caught me off guard.  ME?  A fertility specialist?  I thought that was for older women, or men with problems, or women with severe issues.  I’ve just been trying to get pregnant for a year without any success.  That can be normal, right?  I’m sure I’m super fertile!  I took the two recommendations for fertility clinics and went home thinking of how I would bring this topic up to my husband.  Remember him?  He’s the guy I forced to get a semen analysis because surely he was the problem.

That evening, I told my husband that the GYN recommended two clinics for diagnostic testing, just to see what was wrong.  He was excited, and I was relieved.  He saw it as a step moving forward; a step to take to be closer to getting pregnant again. Now there was something we could do!  My husband and I (along with being planners) are thorough researchers.  After researching, we discovered one clinic was closer than the other, but all the reviews for the other one seemed better.  We went with the more scientific method- I called both clinics and would see which one would call me back first.  That is how we found our fertility specialist. In hindsight, it’s hilarious, because I take more time in reading yelp reviews for a restaurant than I did “researching” for a fertility clinic.  I guess that’s what makes the journey more fun, though.  Oh and what a journey it will be…