- Fertility & Reproductive Systems
Infertility: The White Elephant in the Room
The White Elephant
One in eight couples struggle with infertility, yet I am willing to bet that unless you've had to struggle with it yourself, that you're hard pressed to name someone you know that has dealt with it. Why do we treat infertility like such a dirty little secret; the little white elephant in the room?
My first thought is that it's due to how little knowledge there is about infertility. The resources are available to those who are curious but much like any other medical condition, people don't bother looking into it unless it's something affecting them. The lack of knowledge leads to preconceived notions; with infertility these often include age, weight, overall health, and sexual history.
This leads me to my second point; judgement. In this day and age, infertility and reproductive assistance gets a bad name thanks in part to the "Jon and Kate's" or the "Nadya Suleman's" of the world. It's human nature to judge people based on the things you associate with them, and infertility is no different. The last thing anyone going through infertility wants to hear is criticism.
Lastly, privacy plays a part on multiple levels. Infertility is very emotionally overwhelming; to share one's experience is to put an open wound out for display and hope no one rubs it raw. Think about it. The more people who know that a couple is struggling with infertility, the more questions can be asked. The more people who know about a reproductive assistance cycle, such as in-vitro (IVF), the more people with which you will have to share possible heart-breaking failures. Aside from that, talking about infertility in any detail is like discussing what goes on in your bedroom; for many people it's just too embarassing.
Oddly enough, if you are one of the couples who has to go through infertility, you will find that by letting the White Elephant out of the cage just a bit, that you can easily find others that are in your situation whether it be family, friends, or coworkers. You might just be surprised to find out just how many people you know that are also struggling, or how many people are willing to educate themselves so that the conversation doesn't have to be awkward.
I was 19 when I met my husband, R, 26, online. It was a much safer time even those 11 years ago when I drove two hours from college to meet him in person. I wound up dropping out of college and moving in with him. Three years later we got married and two years after that bought our first house.
I was 23 when the "baby fever" hit me. My sister-in-law was pregnant with their first child and we were holding her baby shower. Another friend had shown up with her newborn and I spent the entire time holding him and rocking him...and it just hit me. Right then and there, that second, I decided I wanted a baby. In a single moment of time this thought wrapped itself around me, coursed through my veins, and I was determined. Unfortunately, R was not. Upon having the baby discussion, he agreed to try after three years so that he could get things in order better financially. That was a LONG three years. Sister-in-law had her baby and gave us a great nephew, who I played with every chance I got. Needless to say, having a baby was still very much on my mind. Two and half years later, while out celebrating my 25th birthday, I got drunk and sappy and asked R, for surely the umpteenth time, if we could start trying for a baby. He said yes! Oddly enough, once it was on my shoulders, I waited an additional two months to stop my birth control.
We started trying for a baby in January of 2007. One year passed by and nada. I made an appointment with my OB/GYN to figure out what was going on. They explained they could do some basic tests and depending on the result, I'd have to see an infertility specialist. So, I went for blood work and R went for a sperm count. Both came out just fine. Next step was for me to have an hysterosalpingogram (HSG) to take an x-ray of my uterus. Well, I waited and waited but month after month my OB/GYN was unable to fit me in for this test.
By August of 2008, finally fed up with my doctors office, I scheduled a consult with a Reproductive Endocrinologist (RE) in my area. In the first visit with my RE, they performed a transvaginal ultrasound and saw cysts on my ovaries. At the second visit, they did a sonohysterogram (SHG), which is a saline ultrasound, of my uterus and determined that I had a polyp. A few appointments later nothing had changed so I was scheduled for surgery in October; a hysteroscopy/laparoscopy/D&C. They removed the polyp, confirmed that I had PCOS (polycystic ovary syndrome) and confirmed endometriosis on top of it. (Endometriosis is the development of uterine-lining tissue outside the uterine wall.) At that point, they put me on some meds to control the cysts and keep the endometriosis they removed from growing back.
We followed with three IUI's in January, February, and March of 2009. IUI's are fairly straightforward - I took medication (Clomid) to help produce more mature eggs, the doctors kept an eye on things via transvaginal ultrasounds once or twice a week, then they told me when to give myself a "trigger" shot which would make me ovulate. R would provide them his sperm sample which they would "wash" and then transfer into me (yes, more or less the "Turkey Baster" method). While the IUI's weren't as intensive as other reproductive assistance cycles, they were emotionally draining. Every month I'd get my hopes up only to be let down. I cursed god, I hated myself, and I was in a constant state of depression. The IUI's obviously weren't our answer.
We moved on to an In-vitro (IVF) cycle. We were lucky enough to have insurance that covered it, as most don't. Still, I wound up paying in the range of $5,000 out of pocket as between the three IUIs and the IVF, we'd maxed out the $15K lifetime maximum our insurance offered. Knowing we had one and only one chance before we were done was difficult to deal with an only added to the stress. If it didn't work, our only choice was looking to adoption which has it's own fair share of hardships. I had to go back on all my meds for a couple months and then finally, at the end of May 2009, started the actual IVF process. I had to give myself shots every day and go twice a week to get monitored. I think it was somewhere in the range of 50-60 shots in two weeks that I wound up giving myself. Once we did the trigger shot we went for egg removal where they put me under anesthesia and used a needle of some sort through my girl parts to retrieve the 17 eggs I'd produced. They manually injected R's sperm into half of them (a process called ICSI) and those were the only ones that fertilized. We wound up with 7 embryo's, 2 of which I decided to have placed in my uterus in hopes that one would implant. Yes, it was a risk putting two back in, but put yourself in the situation. We had exhausted our options, nothing else had worked, so really why should we believe this would be any different? But...it was.
In March of 2010, after an uneventful pregnancy, I was induced at 38 weeks and gave birth (vaginally I might add) to beautiful twin girls. It's hard sometimes, but I don't regret a thing. Had we only had one child, we would have no doubt wanted to provide a sibling one day and then would have to repeat the whole process. Now our family is complete.
There is one odd afterthought to all of this. What about the remaining 5 embryo's that were produced from our cycle? They were frozen, as is customary, until I could make a decision. I could have had them stored for our own future use but chose against it. It would have required paying exorbitant storage fees every year (money we didn't have after the whole process) and hit hinged on wanting future children). The other two options were to destroy them, or donate them. The doctors office sent me slips for both options, and R signed off on both. The decision was mine. I decided to donate them, not because of any religious views or reasons, but because I envisioned another couple who might not have any other option and I wanted to have a chance because of me. It's all anonymous and I will never ever know what turned up of our embryo's; I will say it's odd to think that technically I could have other biological children out there.