So it has come to this.
Last Wednesday hubby and I attended our first IVF consultation, thus formally acknowledging on our medical history that infertility has beaten us and we have reached this juncture.
We met a lady who I hope will be our doctor from now on, though you can never tell who you're going to get at the clinic (in which respect it's a little like Forrest Gump's chocolates). I'd not met her before but I liked her manner instantly and by the end of the appointment she'd stared into my innermost recess with interest so I felt we'd bonded.
The session took way over an hour in total and, as is typical of visits to the clinic, wasn't what I'd expected. We first reviewed our progress, or lack thereof, to date and then discussed the fact that despite my cycles having righted themselves post-clomid, we're still not pregnant. I've tested for ovulation these past three months using home predictor kits and have had a positive each time. We've had sex bang - if you'll pardon the pun - on the right days. And yet we're still not pregnant.
Our doctor said that in an average month, consisting of average sex (is there any other kind? I nearly quipped but thought better of it) between an average couple with nothing much wrong with their average bodies, there is a 20-30% chance of a pregnancy. However, once said couple have been trying for more than three years, as we have, this probability drops to just 3% due to the likelihood of there being an as yet undetermined problem. Happy thought, isn't it?
Anyway we agreed that while we could wait interminably for a couple more years, this is not an option for us emotionally and that we need to move on. That leaves us with the option of IVF.
I knew all this from the previous discussion with the clinic's professor, of course, but the purpose of this meeting was to go through it all in glorious technicolour. And inevitably to stare up my bits once more. It'd be rude not to.
Yes, I had another scan with my old buddy the Renault Espace. This was because it has been nearly two years - which is appalling, in a passage-of-time sense - since our first consultation and my first triple-S session of Swabs, Smear and Scan. Quadruple-S if you then add in Sore. Or Shitty. Or...I'll stop now.
I forced hubby to come in with me as I think it's about time he started confronting some of the realities of this process rather than sitting in blissful ignorance thinking that the most traumatic thing any infertile person ever has to do is wank in a cup on demand. He wasn't happy but he acceded to my request and hovered uncomfortably at the edge of the room looking dubious while the doctor rummaged around looking for my ovaries.
I had a moment of vindication - all summer hubby has doubted my claims to be ovulating independently - when she identified a recently burst follicle out of which an egg would have popped about six days previously - on the day I thought I'd ovulated, and on my right ovary where I'd felt the telltale jabbing pain.
I very nearly shouted "Hah!" in hubby's face but revised my decision at the last second in case it cast aspersions on the robustness of our relationship. I had to content myself with looking smugly triumphant - or at least, as triumphant as it's possible to look with a remote-control-sized doppler hanging out of your undercarriage.
The scan checked out - both ovaries looked good, I'd clearly recently ovulated and was starting to form small follicles for next month, and neither looked polycystic, firmly placing the opinion of the very first doctor I saw at that clinic in the category of utter bollocks. My womb looked fine also, and was half-filled with normal-looking endometrium consistent with that stage in my cycle.
BUT WHERE IS THE FUCKING BABY, I hear you cry. Or at least I hear myself cry, on a daily basis. I have no idea what is preventing us from conceiving, and not knowing is frustrating beyond words.
I got dressed and we returned to the consulting room where the doctor took us through the seven weeks of the IVF process in elaborate, terrifying detail.
Three weeks of nasal spray to "control" - for which, read "shut down" - my natural system.
Two weeks of daily injections, self-administered in thigh or tummy, to pump me full of eggs.
Scans to look at said eggs. Lots of scans. (The local authority where I live is building a new road tunnel beneath the river to ease traffic congestion. Said tunnel will be able to be closely modelled on my vagina by the end of this process.)
The dreaded egg collection, or "harvesting". (And on that, why so many fertility terms are quasi-religious is beyond me. This word always puts me in mind of a choir of small children singing "We plough the fields and scatter the good seed on the land".)
This involves being sedated, strapped up and plumbed with the Espace, which this time will be accompanied on its journey by a needle which will pierce - and there's a word you don't want associated with your bits, unless you're a body art fan - my vaginal wall and pop into my ovary to extract the baker's dozen eggs I will be filled with.
At this point in proceedings, hubby has to have his wank. In, like, the CLINIC. In some shitty private room with no, like, windows or anything. Into a POT. I mean, the trauma of it.
They look at the outcome of said wank and if the sperm are decent sorts, mix them with my eggs and put what you have to imagine is the resulting gelatinous mess in an incubator overnight, the idea being that by morning several sprightly embryos will be jostling the sides of the petri dish in their eagerness to become kids.
But here's the rub: you might have fuck all embryos. You might - and by you, of course, I mean ME, the poor, beleaguered woman - go through all of that only to discover that for some unknown reason, your eggs and hubby's sperm just don't like each other (much like you and hubby on bleaker days). You might also have crappy embryos which would never, could never become successful pregnancies and just have to be binned.
If all goes well and you have at least one good-quality embryo, you go in the day after to have it transferred back into your womb via my old chum the balloon-toting catheter. I already have all the literature from the clinic about these procedures and weirdly on the day of the embryo transfer you're not allowed to wear perfume, body lotion or strong deodorant as "strong smells can be detrimental to your embryos". Who knew that?
You then basically cross your fingers, toes and legs and wait for a fortnight to see if the embryo(s) implant. If you haven't bled by the two-week mark, you go for a pregnancy test, and if it's positive, you presumably bellow with joy all the way home and then return in three further weeks for a scan. If all's well with THAT, you're turned over to the care of your local GP who will arrange a midwife for you. I cannot imagine the word "midwife" ever applying to me at this point.
If things fail at any of the stages mentioned above, you presumably cry until your lungs fall out your nose and then the clinic give you six weeks or so to "heal" physically and emotionally before you have a review consultation to discuss where it all went wrong, and next steps if any are available to you.
It's huge, scary as shit, deeply traumatic and life-changing. Where I am right now is terror - not of the process itself; I think I can handle that after everything I've been through already - but of it not working. I know I can drag my body through all the physical trauma and survive, but I can only do that because of the shred of hope that it will work and that this is just what I personally have to go through in order to become a mother. What I can't countenance is putting myself through all of that and failing.
The clinic want more early-cycle bloodwork from me - fuck knows why, they've taken blood at least 1,100 times; I swear to you, they're vampires - and more sperm from hubby, which as you might imagine he is overjoyed about. He goes on Thursday, actually - he's going to have a dry run, as it were, of doing his sample in the clinic to prepare him for what he genuinely referred to as "the trauma of the day". I told him I'd share his pain and that he could share mine by allowing me to inflate a cocktail umbrella inside his shaft when we arrived home.
Once the results of this final batch of tests are in, we can start. Nasal spray is likely to be November - I have no confirmed dates yet, which makes me feel a bit like I'm in limbo - so the egg collection/embryo transfer process is likely to be just before Christmas. This is bittersweet - I hate Christmas anyway so the prospect of spending it with sore bits doesn't really bother me - but equally it's an emotive time of year and I'm likely to be in pieces. On the other hand it will coincide with holiday from work so I'll have plenty of time to rest up and recover from the op - which, by all accounts, only takes a few days.
It's so weird. I suppose a tiny part of me - a part that's nowhere near my vagina, I can tell you - is excited because this might actually be it, after all this time. But a much bigger part is want-my-mum petrified.
All I know is that it's autumn now. Cold, crisp weather descended the minute the calendar flipped last week. This has been the most difficult year of my life.
There are days when I'm not doing so good, and days when I cope OK. The balance would be very much in favour of the former were it not for certain key things and people - encouragement from those who comment on my blog; the candid and frank relationship I have with my wonderfully supportive mother; an interesting and challenging job; a cosy home and a husband who knows how to do comfort food; my darling cat, who is on his very last legs but keeps plodding on for my sake; and most of all, the distraction, silly times, late nights, shoulder-cries and belly laughs provided by my dear best friend, who knows who she is and to whom I am eternally grateful for helping me pick my way through this mess.
And amid all the terror, this glimmer: I may end this year with a tiny embryo in my womb. That's a pretty amazing thought, and getting there justifies all kinds of nightmares en route.
It seems extremely lofty and pompous to use a quote from Paradise Lost to describe my ordeal, but fuck it, I watched Seven the other night and it's in my head, and I don't imagine I'm the first person to feel this line has a resonance with the battle of infertility:
"Long is the way, and hard, that out of Hell leads up to light."
Monday, 5 October 2009
So it has come to this.