Wednesday, April 10, 2013

Unexplained Infertility, Part of the Reason I Am an Older Mom.

If someone has children the same age as mine, I assume they are younger than me. Especially here in Sudbury. I know reports say women are having children later in life, but I am an older parent in Sudbury. I did not meet my husband until I was 27. A lot of women at my playgroups started having kids younger than that. I was not ready to have children in my 20s, but I was also single most of my 20s. I am usually six to ten years older than the other parents.

My husband is three years younger than me. I was ready to have children before he was. I finally convinced him to start trying when I turned 31. We got pregnant after a few months of actively trying. I was using the temperature method to pinpoint my ovulation. I would track my cycles online. A few of my friends were also trying and getting pregnant around the same time. Unfortunately, I had an early miscarriage, and then my body stopped working the way it should.

There are no fertility clinics north of Barrie, in Ontario. I think Sudbury could support a clinic, and provide services for women in the North, especially those who have to travel to southern Ontario or the States for treatment. Maybe someone as already deemed it not cost effective. Whatever the case, having fertility issues in northern or rural Canada is difficult. My problems started when we were living in Chapleau, and I was referred to a doctor in Timmins who told me I had no ovarian pathology. I just had not had a period for four months, so, normal, right? Since I was moving back to Sudbury, I managed to get referred to a local gynecologist.

In Sudbury, the new doctor gave me a prescription for Clomid, and made me take a larger dose to jump start my cycle again. I used to have very painful periods, but after a four month hiatus, this was one of the worst. Clomid did not work for me. In fact, it made my cycles longer, and unpredictable. Later, he prescribed Metformin, but without officially diagnosing me with Poly Cystic Ovarian Syndrome. I eventually stopped taking the Metformin as it had no impact on our ability to conceive. The doctor decided to perform a hystro-salpingogram to determine whether or not I had blocked tubes. He said my left tube was blocked, although, during the procedure he said it was the right. The next step was to find a clinic down south, and also have a laparoscopy to actually see what was up with my tubes and uterus.

At the time, I was still seeing my family doctor in Oakville, and she got me a referral to a clinic in Mississauga called the Isis Regional Fertility Centre. She seemed to think it would be months before they would be able to see me, but we had an appointment within the month. I saw Dr. Henry Cheng who explained various procedures. All of them required me to be nearby, which was not too much of an issue since my parents live in Oakville. The procedures were also dependent on my cycle, which was an issue because, at the time, my cycle coincided with a trip to Grenada and our wedding during the summer months.

My laparoscopy, performed in Barrie, showed no tubal blockage, and my ovaries looked fine (no PCOS). They did notice some evidence of endometriosis, and cauterized some tissue, but otherwise, there was nothing to explain why I was not getting pregnant. I was diagnosed with unexplained infertility. The doctors had no idea why I could not conceive, and I should just persevere. Just relax, it will happen. The words we all hate to hear when we are unsuccessful at starting a family.

I became more and more neurotic as the fall progressed. Every month I would be let down yet again. My husband was having trouble dealing with my moods, and suggested I should go see a counsellor. I decided we needed to go back to the Isis clinic. Letting things happen on their own was not working. We needed to be proactive. My husband took a day off work, and we drove to my parents for a "long" weekend.

We decided to go with injectable FSH, to stimulate egg production. Then, we would try IUI (intrauterine insemination). If that had not worked, we would have explored other options. We drove back to Sudbury on the Sunday, and my period started that very day. I took the bus back to my parents on Monday, and started my week of ultrasounds, blood tests, and subcutaneous FSH injections. These needles were easy to inject into my thigh. I could barely feel them. The ultrasounds were to see how the eggs were developing.

At the end of two weeks, my husband needed to drive down so we could meet together with the doctors and discuss the possibility of multiples. I remember him saying on the phone he was fine with twins. I had a few more than two eggs ready to go. We were informed there were 18 ovules mature enough to be released. The doctor said there was a possibility of conceiving multiples, but there was also the chance only one fertilized egg would implant. We had to decide whether or not to proceed or scrap the month and start over with a lower dose of FSH.

We went ahead. I was required to inject myself with hCG to cause ovulation. This needle was a much larger gauge, and I had to inject it in my stomach. It took a few false starts, but I was able to do it on my own. Because I released so many eggs at once, there was so much fluid interference, and they were unable to confirm ovulation with the ultrasound. We assumed it worked, and almost two years after my miscarriage, and two weeks before my 34th birthday, we conceived my daughter, and only my daughter. No wife and hubby plus 18!

The release of so many ovules by hCG caused a minor complication. I experienced Ovarian Hyperstimulation Syndrome. By the time I was ready to take my pregnancy test two weeks later, my belly was bloated, and my mom told me I looked five months pregnant. The only pants I could wear were yoga pants. After a quick visit to the fertility clinic I was told to drink a litre of Gatorade each day, and monitor my urine output. I was back to normal within the week.

I had some spotting around six weeks, and was worried because this was the time period I had the last miscarriage. We spent an evening in emergency, but the ultrasound revealed a tiny fetus with a beating heart. Only one. I often wonder if the spotting was due to other failed attachments, but we will never know. Otherwise, my pregnacy was uncomplicated, and my daughter was born at the end of August, one week early.

Fortunately for us, we did not need help to conceive our son, and he was born nine days short of two years after my daughter. We were lucky to have had it so easy, and relatively inexpensive. Many of my friends had several IVF treatments, costing thousands of dollars. We only had to pay for sperm washing (to get the fastest swimmers). Everything else was covered, even the drugs because we only needed one month's worth.

Next time you see a couple without children, it could be very likely they are trying everything possible to conceive, but there is something wrong. Sometimes the issue happens after there is already one child. Try to be sensitive when asking peiple about their family sizes or choices to start a family. And above all, do not tell them to relax and let nature take its course. Let them be the ones to approach the topic first. I have no problem talking about or troubles now, but I was a basketcase when all I wanted was to be a mom.

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