I am not the first to be on the Great Fertility Ride, a term I've borrowed from Ovagirl. I am certain I will not be the last. I've found so many fertility sisters on the roller coaster, here on the Internet. Who knew there were these thousands of women riding the same ride? Maybe I didn't see them because I had my eyes closed.
It started 15 years ago when my then husband and I began trying to get pg. Of course, I had my suspicions then that it my be a difficult goal 'cause I hadn't had normal periods in years. I went to doctors and a variety of them. None of them discussed how becoming pg could be made more obtainable. Every one of them wanted to put me on the pill. "But doesn't that inhibit ovulation?" I asked. Yes, they said, it did but I had to normalize my cycle. Well, as all of this made no sense to me and life started happening in a big way, things just went by the by. We figured it would just happen in time. Simple right?
We returned to my parents' neck of the woods after about a year going to university out of province. We came back to help out my mother with the business. My father had died of cancer and now she had shingles + pneumonia. So, we promised to stay for 2 years and help her run the business while we tried to sell the store. 4 years of 17-hour days, no holidays, no time-off, 2 surgeries later, and after finding out my Mum had multiple-myeloma, we finally walked. Of course, I had finished my degree but having no real training, my husband and I were forced to work 2 and 3 part-time jobs (we lived in a smaller city where full-time px's were only obtained through a tight web of nepotism to which we, being "outsiders," did not belong) to sustain ourselves plus balance looking after my Mum while she was poorly.
During all of this, I had no menses, I had heavy menses, I had polyps, cysts. Things never seemed to rectify themselves after surgery or by taking any of the prescriptions (i.e. mainly Provera) that the Doc prescribed. I went to see a specialist in Ottawa who told me, after performing a hysterosalpingogram that I would never be able to get pregnant naturally because my fimbrae didn't work. After much crying and soul-searching I came to terms with that diagnosis. This pretty much meant that I came to terms with never having children because there's no coverage in this province for IVF unless you have a blockage. Well, inactive fimbrae did not equal blockage and bordering on the poverty-line, this was obviously not going to be an option. Sigh.
Well, during this latter time during which we also lost my Mum, I had begun seeing another gynie. After about 2 years of seeing him about my bleeding probs, etc. he asked if why I didn't consider an ablasion if I didn't want to get pg. Didn't want to get pg????!! "No," I said, "you don't understand. I CAN'T get pg. At least, that's what the other specialist said." After another surgery, he stated he couldn't understand why the other specialist had said I couldn't get pg. "Nonsense!" he said. "Take clomiphene. You'll ovulate on day 14, have sex during that period and by day 28, if you don't have a period, you'll be pg!" Hope glimmered and I asked "really?" "Sure," he said. "I don't see anything wrong with your fimbrae. All was flowing freely the last I was in there."
Could it be? Was it possible that I could really get pg? The glimmering grew to a full shine.
I had begun a new career in the interim and had to undergo, in total, 3 years of training, all of it away from home. I had chosen the career because, well, I'd been told I couldn't have children and someone had to earn money to keep the family going. My ex was unemployed at the time, working only part-time jobs. Of course, the training didn't happen all at once but suffice to say, between being away and continued bouts of my body not performing correctly, more surgery, etc. I found myself at the age of 40, separated, but beginning a new relationship with a wonderful guy. I continued to see the specialist who was still insisting that if I took clomiphene, I would "ovulate on day 14.... etc."
After searching the internet, I discovered that the administration of clomiphene is to be accompanied by several other medical procedures i.e. bloodtests to ensure ovulation, transvaginal ultrasounds to monitor ovarian stimulation, and most importantly, referral to a fertility clinic after a specific number of tries on clomiphene. Suffice it to say, I finally bugged my GP enough that I managed to obtain a referral to a fertility specialist. Stress the word "bugged."
So, I've just finished my first cycle on Puregon with a clinic in Kingston, ON. The clinic is renowned. It is renowned even in parts of the U.S. and many American women seek treatment at this clinic. I followed the protocol on Puregon. I made the hour drive there to Kingston and then the hour back at least twice (and sometimes 3 times) a week for ultrasounds and bloodwork over nearly 3 weeks. Saturday last, after another such trips for u/s and bw, I was contacted and told to "trigger," meaning to self-administer a shot of HCG at 10p.m., then return to Kingston Monday a.m. for Intrauterine Insemination. Of course, the morning of IUI, couples are asked to provide a "sample" (read here that your poor husband/boyfriend has to jack-off into a jar. You can help him of course but really, it ends with him jacking-off into a jar.) Well, we showed up bright and early (0730a.m.) and after checking-in with the clinic nurse, adjourned to a bathroom to obtain our "sample." We brought the sample to the clinic. We were told to return at 0900 for insemination. We returned at 0900. That's when night fell on Kingston at 0900a.m. on the 26th of March.
The nurse told me she had some very bad news.
I think it would be fair to say that approximately 1 million thoughts raced through my head.
Was the sperm no good?
Had they discovered something they had missed before in my u/s? My bloodwork?
Had they decided to terminate my treatments because I'm too old?
What in the hell could it possibly be?
They couldn't locate the technician to do the sample preparation (read here sperm wash.)
The doctor hadn't notified her that her services would be necessary on Monday a.m. and now, noone could locate her.
I don't think devastated is an adequate enough term to describe how we felt.
How could this have happened? How can a clinic, whose sole purpose is to administer fertility treatments, have access to only one technician? And how could she not be available on a Monday morning during full-swing operation of the clinic? How could the doctor not have phoned her to ascertain her availability for Monday morning? How could the nurse have not known that the technician was not available until AFTER we provided her the "sample"? How could the doctor try and defend herself with statements such as "I've never had to call before" and "in my 10 years at the clinic, this is only the second time this has happened to my knowledge?" How could this have happened?
My boyfriend D simply blasted the doctor on the phone. Through my sobbing in the adjacent office, I heard him say things such as "this is totally unacceptable practice" and "I can barely contain my anger right now." I sobbed some more, begging for strength from an unseen source, and then they hit me with the next suggestion.
They recommended putting the "sample" in and around my cervix. I asked if she was kidding. In my hurt and frustration, I said "we may as well have stayed at home and screwed in the comfort of our own bed." In a fog of total bewilderment and disappointment, I agreed. 20 mins after the nurse "placed" the sample, the technician called. Of course.
The next suggestion was for us to return later in the day and provide another "sample."
What? Another sample less than 8 hours after the earlier one which we waited 3 days to provide? How was this acceptable?
Wanting to prolong the time period as much as possible, we asked the possibility of the clinic remaining open later than its usual 1:30p.m. closing. After waiting for the nurse to confirm this with the doctor, this was agreed and we had to return at 2:45p.m. to provide another "sample" which would be ready for insertion at 4p.m. I asked if we could have preliminary counts to ensure the insertion was worth it. The nurse said of course.
The next few hours were spent at the Mall where we kept our bodies but not our hearts out of the rain. Perhaps we're too intense about this. Perhaps we weren't putting it into perspective. There is afterall a war going on. People are still hungry and homeless. Rape is still a growing crime and children are still targetted for the perverse pleasure of the demented. The world still continues along a downward spiral. But our hearts, our world, our right now, is focussed on having a family of our own. Our hope is a world where D & I can be the parents we've longed to be all of our lives. Our focus to be the best parents we can possibly be to a child that we have born together. Is that really so much to ask of the universe? It seems so.
The "human error" factor has been stressed by both the medical staff and well-meaning family and friends. People, even trained professionals, do make mistakes. Yes they do. As do I. As does D. The thing is, when I make a mistake at my job and it potentially endangers the others with whom I work, I get a dressing down, a reprimand. If it literally causes injury to another, I would find myself before a board and depending the outcome, I would be either punished or dismissed. That's the way my job works.
And because of the seriousness of my job, in which capacity I work as part of a team, we have checklists. We work together to ensure that everyone of us is at the same stage, in the same checklist throughout the execution of our jobs. Apparently there was a checklist for doctors providing Saturday orders but no back-up mechanism i.e. another checklist for the clinician opening Monday a.m. to ensure the doctor did indeed follow that checklist. Hence, the discovery that the technician was nowhere to be found was not made until our sample arrived and the nurse phoned to have it picked-up. Wow.
You would think that running a fertility program that is based on exact dosages and exact times of administration would be a little more concerned about the exactness of the whereabouts of the only technician available to perform a necessary function to the operation of that program. Phew. That was a long sentence but it makes a point. Perhaps my life wasn't physically endangered by the omission but what of my emotional and psychological life? We charge parents and spouses with mental cruelty don't we? Does endangerment only have a physical aspect?
After a nasty food court lunch and much more crying, we returned to the hospital. D checked that the technician was confirmed present before we provided another sample. Jeez. Two times in a hospital bathroom the same day. I guess it would be some guys' fantasy. Again we waited.
This time, the nurse had good news. D's counts were excellent. The procedure went ahead.
Does this diminish the trauma that we both experienced in the a.m.? No. I felt as drained as I did on any day of my life where I had heard devastating news. We were as knackered as if we'd spent the day working in a ditch. Did it all happen for a reason? More than likely. I've found everything in life pretty much happens for a reason. You have to wait a while to gain the perspective though. There's the rub. It could be 10 fucking years before I understand better why this happened.
Now, we wait. All of my heartbreak that day could of course be for naught. The follicle that they saw on the u/s may not have matured and released after the HCG shot. My luck, it didn't. All the washed sperm in world aren't going to help a non-existent egg. Who knows. Whatever the case may be, the universe dealt us another blow yesterday. Again, it could be for a reason. Again, we'll have to wait and see.
I fear I won't be able to get another cycle with the IUI clinic in Kingston before September. They close-up at the end of April and I will have had to begun menstruating before the 7th. I never menstruate on my own. This being the case, they'll have to induce my lining to shed by giving me Provera. This means, I won't have menstruated in time. This means, the next stop is the IVF clinic in Ottawa. That's going to be interesting over the summer, travelling to Ottawa twice a week for u/s & bw, because noone locally will perform these functions. Nice. Sigh.
Well, I will try to focus on the bright side. I will try to remain in the light. I felt myself slipping down the dark hole again yesterday but something has pulled me back-up a bit. Perhaps it's coming-off the hormones. Perhaps I've just simply had a chance to digest it all and begin the task of refocussing. Perhaps I'm just too damned tired to care anymore for now.
But I guess I'm still on the ride. My boss said it best. "If you don't continue, you'll never forgive yourself." This is true. I have to see it to the end. If the worst is waiting at the end, then at least I'll know that I did my best. If the universe says it's not going to happen, I will have to live with that. It'll be painful, but I'd be able to deal with it knowing it was out of our control. I can forgive the universe for not allowing this wonderful experience in my life. The question is, can I forgive the humans if they fuck it up for us?
That was the question that came to mind yesterday for which I still don't have an answer.