Monday, February 16, 2009

Infertile Enough?

Because Infertile Myrtles aren't neurotic enough, we like to find ridiculous things to obsess over. In my first go-round with fertility treatment, I often thought about the fact that I really just didn't have it all that hard. I have a relatively simple issue to correct - anovulatory PCOS - which does seem correctable with the right combination of gonadotropins and hCG trigger.

My original (evil) OB/GYN ridiculed me - telling me if I just lost weight and took Clomid, I'd ovulate and get pregnant in a jiffy. I should just exercise more and eat less and I'd be pregnant in no time, she told me. I tried that, and I took her five prescribed cycles of Clomid, unmonitored, I might add, which I now believe to have been a dangerous course of treatment, but no pregnancy. I listened to her lectures. I took her berating stares, believing that this was really all my own fault. I discarded the facts of the case, I ignored the truth, which was that I had gained much of this weight not through my own fault but quite suddenly - sixty pounds in five weeks, due to a metabolic shift in my body that was out of my control, and the rest due to years on migraine-controlling medications such as Depakote (known as Depabloat, for a reason). I took upon my shoulders, instead, the guilt and the shame that she placed there, knowing that my simple problem was my own. If only I hadn't done this to myself, I'd be pregnant.

Eventually, though, I realized that I needed more than stern lectures, and exercise pep talks, and cute little white pills for five days a month, and I self-referred to Ye Olde Fertility Clinic, where I met with a wonderful doctor who told me that this wasn't so much my fault, that I had, at least on the surface, a common issue, that would likely be relatively simple to fix, but that Clomid was not my answer any longer. My OB/GYN at the time was pretty pissed at me for self-referring. She, herself, would have had me take one more round of Clomid before referring me over to YOFC. "But no worry! This is such a straightforward case that just the teeniest little dose of the heavy duty drugs and you're going to be pregnant in no time!"

Nearly a year later, a couple dozen vials of blood, an HSG, many ultrasounds, and four IUIs later, I was, indeed pregnant, and in need of an OB. No way was I returning to that doctor. No. Way. So I got a referral from my RE to an OB who was actually even more convenient to me and (as it turned out) someone who a bunch of my friends see, and I was off. Three months later, I miscarried that baby, and I became thoroughly convinced that I had made the absolute right choice in doctors - he handled the situation with care and empathy and concern for my welfare. And back to YOFC I was, only to find my RE on maternity leave - and when she returned to work, she didn't return to the office convenient to my home and work ... but to an office far out of the way for me. So I switched to SuperDoc.

Even then, a piece of me felt that I just wasn't that interesting or complicated a patient. I have this theoretically simple issue. I don't ovulate. I have PCOS. Give the girl some drugs, give her an hCG trigger, a quick intimate moment in a doctor's office in stirrups with an IUI, and bada bing bada boom - pregnancy (theoretically). Not a complicated case. I knew then, and I know now, that I don't suffer many of the indignities of infertility that a lot of my fellow infertiles suffer. I don't have thrombophilia. Er, not exactly anyway (I am borderline on one test... but not quite enough to make anyone worry). I don't have recurrent miscarriages (yet, and I hope never to be able to say that I do). I don't have natural killer cells. I don't have fibroids or stage IV endometriosis (though it's been suggested that I might have very mild endometriosis which does not in any way interfere with my fertility). I have never had uterine, cervical or ovarian cancer. At the time I had a completely unremarkable HSG with patent fallopian tubes. I do not have premature ovarian failure. I was able to do something that many of my fellow stirrup queens had never been able to accomplish - I had been able to get pregnant. And with only the "low tech" IUI, at that! I knew, really, that I had nothing to complain about.

I've written about it before, but for the sake of completeness of history, I'll tell you the story again... I remember sitting in SuperDoc's office at my second consult with him after another 2 IUIs and saying that I knew that compared to most women with infertility, I have it pretty easy. I have carried his answer with me ever since: He looked at me earnestly, paused, and said, "Let's just say you've handled your burden with extraordinary grace."

I shrugged it off at the time, as I am prone to doing. I wasn't, after all, one of the "real" infertiles. I wasn't hard-core yet. I'd never done IVF. I hadn't suffered multiple losses. I'd only been at this baby-making business for about four years. I'd only had six IUIs at that point, for a total of 11 medicated cycles. After all - there were so many out there who had been through so much more.

Two weeks later I found out I was pregnant. And two weeks after that, I found out I had HOMs a-brewin'. I felt exposed and vulnerable. And once again, like I wasn't a "real infertile." Why, I was so fertile, I'd gotten knocked up with more than I'd bargained for. WAY more than I'd bargained for.

But it DID start changing my perspective on infertility, quite accidentally. Because being pregnant with HOMs makes you the poster-child for infertility. Suddenly everyone assumes you're an infertile. (Oh I feel so sorry for anyone who is pregnant with spontaneous HOMs - for they must forever be explaining that "No, these were a total surprise!" like it's anyone's business) I began to realize that at any stage of infertility, whether it's someone who's been trying to get pregnant for just one month without success, or someone who has given up trying after months or years of treatment (or anyone in between) - they have a story to tell, and their own burden to bear. People would come to me and say, "I know I haven't been through as much as you, but we've been trying to get pregnant for six months, and..." And I tell these women that they should never believe that they're not "infertile enough" to be legitimate in the infertile world. Each stage of infertility has its own burdens, trials, and tribulations. Each stage has its own challenges. And each set of challenges must be met with its own level of grace and humility. But we have a right to rage against each stage - to express our hurt, our anger, our outrage. We have a right to wonder, "Why me? Why now?"

And now? Now that I've been through IVF and probably failed a cycle, do I feel any more "legitimate" in the world of infertility? No. I still know that I have this pretty simple problem. This problem that should be pretty simple to solve. (Oh, except I do now have that blocked tube on the left side that may be real or may have just been a spasm, so who knows?) I have this problem that should be a simple case of "injections, IUI, bada bing, bada boom, BFP." But nothing is that simple, is it? Most people do IVF because IUI doesn't work for them. I'm doing IVF because IUI worked too well and I can't take that risk again.

I don't regret my infertility as many do. I know there are days that I am on medication when I am not the sweetest, kindest person I could be - and I regret those individual days. But by and large, I have reaped the benefits of infertility far more than I have suffered from it. I have met amazing women, experienced great joy, been introduced to a wealth of knowledge, learned about a plethora of intriguing scientific, ethical and moral issues that many people never even think about. I have become a stronger, healthier and ultimately happier person overall. I have become more sensitive to the needs of others, and recognized that you never know what is going on beneath the surface of another person, and I try to live my life accordingly. I know that the reason I'm going through this again is because I recognize the true gift and blessing of my children - and I know that (for me) I cherish them at least a little bit more for having had the wait (note, I don't mean to imply that fertile myrtles don't cherish their children, I only mean that I, personally, know that I view my children differently because of my experience)

I also know, now, that infertility is never about fault. I know now that infertility is a disease of the reproductive system. And I'll never again let a doctor tell me again that a legitimate disease is my own fault.

9 comments:

Betty Rubble said...

Amen! Your GYN sounds like my PCP--I have type 2 diabetes which as you know is a complication of PCOS, and as a result some extra poundage--even though I explained this to the PCP he said to me "Your problem is your weight, your are just lazy." So once again Amen sister!

battynurse said...

Thanks for sharing this. I remember towards the beginning of this journey feeling this way, like I wasn't infertile enough. I hadn't suffered as much as others had.
As far as the weight, I've never had the RE or OB say I needed to lose weight to get pregnant but I know it couldn't hurt. That said though I'm tired of everyone saying it's simply the weight and making it our fault and something to feel guilty about. Glad you went and found your own answers.

Pam said...

yeah, um, i don't think anyone who got pregnant with HOMs spontaneously needs to be felt sorry for. :P i always got pissed when someone asked if we did fertility treatment, on YOUR (and others dealing with fertility issues) behalf!

Kelly D said...

I love this post. Often times I don't feel like I belong in the infertile category as we dealt with male factor. However, the emotions and struggles in my marriage due to the diagnosis DID make me feel like infertility was/is a part of who I am.

Thanks for posting on my blog. The eSET wasn't popular when my husband and I did our IVF cycle. Knowing what we know now, that would have been our choice too. Hoping it works for you!

decemberbaby said...

Sing it, sister! This is a beautiful post.

And your first OB/GYN sounds like an asshole. Just sayin'.

Beth said...

Outstanding post on infertility. This really is one of the best posts I have read regarding infertility. You may even want to consider publishing it in Resolve or another infertility publication... it was that powerful. Thank you, as always, for sharing your story.

amber said...

beautiful post.

Bea said...

Great post.

I do think trying for one month without success is something else. It's completely normal - it's what the majority of couples who start trying for a baby experience, in fact. It's disappointing - I know - but it's not infertility.

Where's the magic line? That's a harder question. Usually with these things the extremes are easy to identify, but the grey area is large.

Bea

Bea said...

Oh, and what an arse making you feel it was all your fault.

Bea