For the past four years
I have been part of a movement that seeks to de-stigmatise talking
about female sexuality – in particular, our abortion stories. But
abortion stigma is part of a larger attempt to silence women when
they try to talk about their experiences with basically everything to
do with reproduction, whether it's infertility, miscarriage,
menstruation, menopause, pregnancy, childbirth, and post-pregnancy
experiences. There is an unspoken feeling that these things are best
shared very, very privately. And of course, these are private
matters. But the consequence is that often women feel isolated
because they don't feel comfortable breaking the silence.
Over the past four
years, I have also struggled with unexplained infertility. I've had many,
many tests ranging from simple blood tests, to slightly more
invasive, to surgical. I've spent too much time on Google and
fertility messageboards filled with other women desperate to talk
with others who are going through similar issues. I've peed on a lot
of sticks to see if I was ovulating or pregnant. I've spent weeks
taking my temperature every day before getting out of bed. I've
inspected my cervical mucus. I've tracked and charted my menstrual
cycle. I've abstained from alcohol and medication during “the two
week wait.” I've spent hundreds of euro on acupuncture. I've taken
supplements such as vitex and mexican yam. I got vitamin B12 shots. I
cut back on soy intake. I stopped eating gluten. I drank more water.
I took Clomid. And finally, I tried to stop thinking about it
altogether.
You'd be amazed at how
many people seemed to think they were going to cure my infertility by
telling me to “just stop thinking about it!” And yes, everyone
knows someone in their 40s who just suddenly got pregnant. My own
sister is one of those lucky ones. And no, it doesn't mean that my
chances aren't as bad as I think. And yes, I've read that article by
the woman who decides to find out where the dire statistics for
fertility of women after 35 come from and golly gee it turns out the
studies are really old! Yeah, well, all the New York Times articles
in the world aren't going to magically make me pregnant.
One thing I knew I'd
never try is IVF. Well, that's only slightly true. I was told that
with my medical card, the HSE would give me one free round of IVF,
which I thought was fairly generous and incredible. But oops, it
turns out they only give free IVF to women under 40. This would have
been useful information when I was 38 or 39 and going to the
infertility clinic at the Rotunda Hospital. But that's the thing.
Using public healthcare meant that I was only seen twice or three
times a year. I had faith that if I just kept at it, I would conceive
naturally. But when it didn't happen, I had spoken to enough people
who had gone through the pain and expense of unsuccessful IVF that I
knew it wasn't for me (or maybe not unless I won the lotto).
But after a little
research, I thought I might give IUI at go. IUI stands for
Intra-Uterine Insemination and it's often referred to as a “glorified
turkey baster.” But there's more to it than that. First you are
given medication to inject yourself with starting two days after your
period starts. Using ultrasound scans, they track your follicles as
they grown to 18mm or so. Then, ten to twelve days later, they tell
you to take a “trigger shot,” which is a different medication.
Two days after that you go in and they inject treated sperm through a
tube directly into your uterus, bypassing the long journey that the
sperm usually has to take up the vagina and through the cervix.
(That's unfortunately one syllable too long to sing to the tune of
“Over the river and through the woods.”) IVF costs €4,000 to €8,000, while IUI costs €850 (not counting a couple of extra tests that might be needed on the first time out).
Funnily enough, giving myself the injections wasn't nearly as difficult as I expected. It didn't hurt at all – it was more the idea of it and the anticipation that made me anxious. And the second time I did it, it left quite an impressive bruise. But once I got the hang of it, I didn't mind them at all and in fact I felt sort of tough. That is, until I saw the special needle for the trigger shot. But, I managed it, and I have to say that giving myself injections was the least painful, inconvenient part of the process.
Funnily enough, giving myself the injections wasn't nearly as difficult as I expected. It didn't hurt at all – it was more the idea of it and the anticipation that made me anxious. And the second time I did it, it left quite an impressive bruise. But once I got the hang of it, I didn't mind them at all and in fact I felt sort of tough. That is, until I saw the special needle for the trigger shot. But, I managed it, and I have to say that giving myself injections was the least painful, inconvenient part of the process.
In retrospect, we
picked a bad month to try IUI. I started the injections the day
before we moved house. The move took well over a week and cost a heap
of tears. Moving is stressful at the best of times. Under the
influence of fertility hormones? Not recommended. I didn't know
myself. I became a different person. Someone mean. Someone with an
endless supply of rage. Someone I couldn't help becoming. And I
couldn't have a drink to relax, either. In fact, I couldn't even take
my allergy medication, so on top of everything I was a sneezing,
wheezing mess. My poor husband handled me with incredible patience,
though he did admit that in eleven years he'd never known me to be
that way. I was scary.
I was also a bundle of
nerves. For the first time in my life, I spent a sleepless night
suffering from an acute panic attack that manifested itself as
crippling chest pain. And they told me to lay off intense exercise,
so I couldn't go running to let off steam.
I knew that my chances
of success were low. And I knew that they were even lower during a
time of significant stress. And, of course, that stressed me out even
more. And, of course, I'm sure that lowered my chances of success,
and on and on.
The thing about
fertility is that there is some information that is set in stone, but
even more that seems...questionable or conflicting. I had been told
by doctors that the time from ovulation to menstruation is always 14
days. On day ten of my cycle during the IUI process, I thought I
might have ovulated. But when I went for the scan, the technician
said that everything looked great, the follicles were still growing,
and we were still all systems go. Two days later, they told me to
take the trigger shot, and when I went in for the IUI, I still hadn't
ovulated. So you can imagine my surprise when I got my period on day
24 of my cycle.
Wait – this wasn't
how it was supposed to be! I was supposed to get my period on day 28
or 29 – sure, I'd know that the IUI failed, but that at least
things were working as they were supposed to. Based on what I'd been
told, if I got my period on day 14, I had to have ovulated on day 10,
which means the ship had sailed way before the IUI. I rang the clinic
for an explanation.
A very tense and
defensive doctor just kept repeating, “We did everything right. We
did everything right.” Frustrated, I tried to explain that I wasn't
ringing to see did they do everything right – I wanted to learn why
this happened to me. I wanted to learn. I also wanted to know whether
I'd just wasted over a thousand euro, and whether I should even
bother trying it again. After that conversation, I did some googling,
of course. I learned about a condition called Luteinized Unruptured
Follicle Syndrome (LUFS), also known as trapped egg syndrome. It's
when your body shows all the signs of ovulation – well, all but one
– but you're not actually ovulating. The only way to actually know
that you've ovulated is through ultrasound scan to see that it has
actually ruptured. I convinced myself that this could hold the key to
my unexplained infertility.
My husband and I went
into the clinic a couple of days later for a review session with a
different doctor. “Before we begin, what did you think your chances
of success were for the IUI?” the doctor asked me. I grimaced. I
knew they weren't great. “About...ten percent,” I answered,
tentatively. He told me that I was way off. But, actually, not as far
off as most people. “You'd be surprised how often people like you
come in here and tell me they think their chances are fifty percent,”
he said.
It turns out, my
“fecundity,” as he kept repeating, before the IUI, was only 2%.
It kind of bears repeating: 2%. Two. Percent. And I am a healthy 42
year old woman with no known illness. That two percent is not based
on some kind of defect with either me or my husband. That's just
based on age and the number of months in a year. With IUI, I doubled
my chances. Doubled, in most circumstances, sounds promising. But in
this case, me doubling my odds is 4%. Suddenly, trying to find out
whether I might have LUFS seemed basically pointless. Besides,
there's no known cure.
He worked out some
math, and in order to get pregnant with IUI, according to the odds, I
would have to spend about €25,000. He compared that to IVF, which,
it should be noted, only ups my odds to about 10 percent. But since
IVF costs so much more than IUI, I'd have to spend €40,000 to get
pregnant that way. Now, of course, we could be one of those lucky on
the first try types. But those aren't the odds. That's not realistic.
And to be honest, all I want right now is to be realistic because
this is my fucking life here.
The long and the short
of it, he said, was that to be honest we could probably double our
chances without IUI by me not thinking about it anymore. Yes, there
it was: the old “Just don't think about it” advice. Except, what
the doctor was saying is, this isn't going to happen for you. If you
accept that, you will have a much happier life, a much happier
marriage, and hey, you never know. Except you kind of do. Sorry.
So that was it. I heard
the things I already knew, yet hearing them in this context felt like
the nail on a coffin. Like so many hundreds of times before, I had to
dry my eyes, buck up, and go on with my day. I went to work. I took
deep breaths. I tried not to think about what it all meant.
But here's what it
means. It means I have to learn how to stop questioning whether bad
decisions I made in my life have led to my not being able to have
children. I have to stop feeling that I have failed myself. I have to
stop feeling that my husband failed me. I have to stop closing my
eyes and picturing what it would feel like to hold a child that is
mine. I have to stop questioning every life decision I've ever made,
thinking about my career choices, my relationship choices, my
financial choices. I have to remind myself that I actually love my
life and part of why I love it so much is the freedom that not having
kids affords me. I can stop worrying that I'll have a child that has
a disability. I can stop worrying that I'll have a child who is
obnoxious. I can stop worrying that I won't be able to afford a
child. I can stop worrying that I am adding to overpopulation. I need
to think of all the wonderful, smart, and thoughtful life decisions I
have made in my 42 years. I need to celebrate all the interesting and
world-changing projects I will now have time for. I need to stop
wondering what people will think. I need to stop thinking about
people from my past knowing I couldn't have kids and saying I deserve
it. I need to stop thinking about other people's pity. I need to stop
thinking about anyone else at all.
I know so few people
going through this. And I'm going to be honest: I feel embarrassed
and ashamed that I couldn't have kids for the simple reason that I
wanted them. I wanted something and I failed at getting it. I keep
telling myself hey, there are lots of things in life you wanted and
you didn't get. But truth be told, I haven't failed at too many
things that I thought were realistic and attainable that I actually
tried for. This feeling is fairly superlative. As a little girl, I
played with dolls. In fact, I played with them until my teens. I
dreamed of being pregnant. I dreamed of being a mother. And the only
time I questioned those dreams were when I had partners who didn't
want kids. But in my mind, I felt like eh, it's always an option,
somehow, if I decide I want to. And I did decide. Wholeheartedly. And
now, well, now is now.