In the News: The Telegraph "Infertility...a condition the NHS can ill-afford to treat"

I was alerted to something by a great infertility blog  - although I am in the UK I have never bought or read The Telegraph and was disgusted to read this particular article, arguing that the NHS, with all it's money woes, should not be funding IVF treatment.

Max Pemberton - apparently a "child psychiatrist" (so obviously very well placed to spout about fertility problems) - does not believe infertility is a disease. He is even reluctant to classify it as a medical problem at all. He blathers on that "While childlessness is distressing, it is not associated with long-term disability, morbidity or mortality...Rather, it is about people unable to have something that they want."

Good lord! My sincere apologies, Max. All this time while trying to figure out why my body doesn't work right and coming to terms with the fact that I may never be able to do the most natural thing in the world - have my own child - I thought I was dealing with a medical problem. A condition. An internationally recognised syndrome. After reading your thoughtful article I now see that really I am just a spoilt child in a toy shop, screaming and stamping my feet because my mum won't buy me a Sindy doll. 

I also now see that, far from wanting a child being about my own natural desires, a wish to create something out of the love me and my fiance share, about fulfilling not only a basic, normal human urge but something I want to devote the rest of my life to, actually, I'm just trying to keep up with the Joneses. An "expectation on individuals to reproduce and become parents...childlessness is a status that does not readily fit within society’s cultural norms". I just want a baby because it's what everyone else has got. 

And of course, why am I putting myself through all this when "It’s not as if such people are being denied the chance to be parents at all. Adoption offers them the possibility of parenthood". Why don't I just apply for a child this weekend? Two maybe? I'm sure no time at all I'll forget all my problems!

To cut my sarcasm short, this article is ill-conceived (pardon the pun), badly constructed and downright rude. He is aligning fertility with something like freckles. Some people are born with them, some aren't, and why should the NHS fund giving you an item of such vanity for the sake of fashion? Freckle-less people aren't ill, their lives aren't about to be cut short, and there is no underlying medical problem causing you to be freckle-less. Of course, this is total tosh when applied to infertility. The vast majority of people with fertility issues - even if they are currently under the banner "unexplained" - have an underlying medical reason for that infertility. And - worse than that - increasingly environmental factors are being found to harm the delicate hormonal balances in the human body - toxic chemicals in plastics, certain foods, pestacides.

Let's look at it logically: the human race's ability to reproduce is the reason for our continued existence. If infertility had been rife in our ancestors, we may not have survived as a species. Therefore fertility is the norm; infertility is where there is a problem. Infertility doesn't just "happen" to some people due to "a quirk of fate" as Max so eloquently puts it. It is an abnormality somewhere in our systems. Bodily functions not working as they should. Totally against what our bodies are meant to do. Is this not what constitutes a medical problem?

Max implies that as infertility is not life threatening, it is not as important as "real" medical problems. But what about people with serious burns scars or phobias, or amputees? Reconstructive surgery after a masectomy? People who can't walk or talk because of a stroke? They're definitely not life threatening conditions, so probably shouldn't receive any NHS funding either. In fact, Max, by your own logic, you should be out of a job, because I'm fairly sure child psychiatry isn't one of the leading areas associated with "long-term disability, morbidity or mortality" which apparently is the criteria for determining whether or not you deserve help from the service you pay for.

The fact is, so much of what the NHS funds now could be classified as helping to improve quality of life, instead of extending life. Slot infertility into this category if you will - I see it as something more than that - but even if you accept it as only a "nice to have" rather than "vital" treatment, you align it with a huge proportion of what the NHS offers unchallenged.

Max also seems to imply that those who can't conceive should just accept that it's a natural condition, a quirk of fate. Well, by that logic, people who develop cancer or heart disease should just accept it as a "natural" condition - their body telling them they shouldn't live any longer. Should they be denied treatment too?

Basically, if you rule out treatment for anything that is not life threatening, and anything that just happens to people as a natural "quirk of fate", the NHS would only provide treatment for serious accidents, and a small minority of conditions directly caused by external environmental factors, such as asbestosis or radiation poisoning etc. Everything else would have to be paid for privately. 

Yes, there is only a limited amount of money and resources available, and yes, we have to prioritise. Which is why most NHS Trusts offer a maximum of 1 or 2 IVF cycles per elligible couple. Personally, if funding has to be cut from anywhere, I would much rather see the NHS stop helping people who have actively and directly caused their disease or condition: chronic overeaters, smokers, drug takers, alcoholics etc. - why should my taxes pay for them to receive treatment?

Which brings me to another point. The NHS is funded through my taxes. I therefore have as much right as anyone else to use the NHS to deal with my medical problems. I don't take up resources with my chronic fatigue or IBS, and I've been suffering with anxiety for most of my life without medical intervention. Why should I potentially be denied NHS funding for the one service I would actually pursue and use?

I would love nothing more than for the NHS to put more money into finding a cure for the various ailments that cause infertility, which would save them a hell of a lot of money in the long run. Unfortunately, it is considered to be too expensive, and the money is better spent treating the symptoms of these various ailments - among them infertility - than finding out why it occurs in the first place. If I could do something to naturally correct my PCOS, I would. But I can't, and so I will take all the medical assistance I can get. 

Of course, our friend Max puts a cherry on top by trotting out the old adoption solution, fall back of anyone who is anti-fertility treatment, anti-procreation, anti-life. What these people fail to realise is that wanting to have a child - your own biological child - is an inherent, deep rooted, totally natural urge, not a lifestyle choice, especially for those who can't conceive naturally. Does he think people suffering with infertility would willingly put themselves through intensive treatments, invasive procedures and years of emotional turmoil just so they can be like their friends? NO - this is something that goes through to the very core of what being human is about. Adoption is a fantastic option for some couples, but it isn't the solution for all. And with the ridiculous constraints on adoption, the lengthy and expensive processes and no guarantee of a positive outcome, it is more than many, who have already been through the mill with infertility, have strength for.

Finally I consistently find it baffling that so many consider the prolonging of life more important than creating new life. That intervening to make someone live 1, 5, 10 years more when their bodies have had enough is seen as a societal norm, yet assisting conception - the continuation of the species - is attacked. And then when we get people to live longer they get shoved in a nursing home and treated appallingly. It's a messed up world.

ETA: Ironic that the Telegraph doesn't produce an opinion piece on other, much more ludicrous, means of "wasting" NHS money...see here and here for just two examples that I found in their recent news.

Final edit: And now it all becomes clear. Max is a homosexual male. Max obviously does not see himself having any children naturally, and his article is sour grapes perhaps at the fact that he will have to pay for his children no matter what. Case closed.

Angry Chair

Cycle number: 11

Cycle day: 14

Meds: Met

Outlook: Really f%*!ed off

I am beginning to lose faith in the fertility consultants I see, particularly the one I bemoaned in the last post, even though I am lucky enough to go to a hospital which specialises in fertility.

So after last Wednesday's secretive scan, I toddled back on Friday not knowing what to expect. I was thrilled to discover I had 3 follicles maturing on the right side - one at 14mm, one at 14-15mm and one at 15-16mm - and my lining was looking good. She sent me for another oestradiol test (a horrible man who was clearly new to taking blood (or a sadist) and did the whole thing in painfully slow motion so it hurt as much as possible) and told me to halve my Meno.pur dose over the weekend.

So all weekend I was really excited, even though I was having to waste half a pod of drug each night (so pointless) and, yet again, started to think at last this was the cycle that was going to give us a real chance to get pregnant.

I was told to come back in today and so I went. First off, I had to wait nearly half an hour to be seen in a boiling hot waiting room (so hot a trickle of sweat came down to my elbow from my armpit) and then it was a doctor I've never seen before. He was really thorough at the scan, again saying my lining was excellent and then started measuring the follicles. This is where it started to go wrong. The three she saw on Friday have all grown to a mature size (between 20mm-23mm) but there is a fourth that is catching up (17mm) and a fifth which is smaller. He said I have over stimulated and the cycle would have to be cancelled.

I had to fight back tears on the couch (luckily it was dark so he couldn't see). He then was at pains to explain to me why they would not be giving me the trigger. I asked what would happen if I just ovulated on my own and he said "Well you can't have sex". WHAT?!?! "You could end up with quadruplets and you don't want that! Hahah!" He then spent ages working out the precise dimensions of the offending follicles before saying "Yes this can happen with PCO".........again WHAT?!?!

I then went to sit in the waiting room while he went to get the opinion of a nurse. I went in to see her and she said actually they were going to check the "cycle cancellation" decision with another doctor (Ms Helpful from Wed/Fri) but it looked likely it would be cancelled. She then told me to continue with my half dose of Meno.pur tonight and this time I said it out loud "WHAT?!?" She said she didn't want to be the one to make a decision to stop taking it (i.e. that it should be the doctor telling me) but I was like "Surely if I take more tonight, the biggest ones are just going to get bigger, and the ones that are borderline are going to catch up and there will be even more?" and she said "Ok don't take it tonight" - I was in disbelief. 

She then said I would have to go for yet another blood test (my third in less than a week) and based on my scan and the blood test results she would discuss with Ms Helpful tomorrow and give me a call. I then had to fight back tears all the way up to haematology. And - typical - of all the appointments I've had there, this was the one time Bubble couldn't come with me.

So there are several things that concern/down right annoy me:

• If there were too many follicles growing, why didn't Ms Helpful notice on Wednesday and tell me to halve my dose then?
• If there were definitely too many on Friday, why didn't she get me to stop the Meno.pur over the weekend and reassess on Monday?
• Surely my oestradiol numbers are the most reliable source of info - why after 2 blood tests and all these scans was this not picked up earlier?
• If over-stimulation typically happens with PCOS (and particularly after my over-response to Clo.mid) why wasn't I started on the minimum dose possible? They could then have increased it later on if I wasn't responding well enough
• If I ovulate tonight or tomorrow - as seems likely with follicles that big - telling me not to have sex from now isn't a failsafe way of preventing me getting pregnant since we already did it yesterday! So they have put me at risk of conceiving 4 babies
• If my follicles are already so big that I could ovulate at any given time, why then increase the chance of adding a couple more to that number by telling me to continue with the Menopur tonight?! And why did the nurse try to take the decision herself if she wasn't sure (which she obviously wasn't since my layman response made her change her mind)?
• Are these large follicles actually going to rupture at all, or am I going to be left with a mass of uncomfortable cysts that need another cycle off to get rid of?

Overall I'm gutted. It's now been 7 months since we started treatment. This is only my third medicated cycle and the third that has been a wasted opportunity for a pregnancy. All this just to ovulate, and I'm not even getting that right! Pregnancy seems a very very long way away tonight, and a real, actual baby even further. I can't believe that with all the injections, all the blood tests, all the appointments, somehow this has still gone wrong.

Of course, they can't stop us going ahead and having sex if we want to. And a large part of me is very tempted - why should I waste the only chance I've had so far?! Will wait and see what they say tomorrow, but I'm not holding my breath.

Baby Steps

Cycle number: 11

Cycle day: 1

Meds: Met (and Pro.vera for the last week)

Outlook: Excited

Well, it doesn't look like I did ovulate last cycle, since AF arrived right on cue after stopping the Pro.vera. I'm not surprised. Unfortunately though this AF is giving me a world of pain >_< Not exactly the best way to be around a fertility festival.

I go for a baseline scan on Thursday and have to take along one of my pods of Meno.pur for my first dose. Very excited about this....I never had a very good feeling about Clo.mid, even before I started taking it, since it relies so much on a chain of reactions in your body working in perfect synch (not something my body is very good at unfortunately). The injects work directly into your system and so it seems much more likely that I will get a good response.

As I wrote in a previous post, I've had some problems with my mum not being supportive at all through my ttc trials, and specifically about serious insensitivity related to infertility. So I took a proactive approach recently and sent her a link to an advice sheet for friends and family of those suffering through infertility. It covers a lot of things I think are really important, and she said it was useful. If anyone you know is treating you insensitively, don't be afraid to speak up and offer advice - they may genuinely not understand how much they are affecting you.

She actually told me that she thought we would be stopping treatment now until after our honeymoon....that's December! She didn't know about my treatment in February so essentially she thought we were putting ttc on hold for a year. I told her how funny I found this - I've been waiting four years so far, I certainly don't need to be adding an extra one on for the fun of it - and also how in a serious sense, I'm less than 2 years away from being 30 and certainly don't need to tempt my egg quality to start decreasing on top of all my other issues. I can only conclude that she doesn't understand that longing for a child, and that she must've had me and my sister because it was the next natural step in her life rather than something she desperately wanted. 

Finally, I found out another friend of mine is pregnant and due in eight weeks! She's sure she told me a while ago but I gently told her I was sure I would remember if she had. I would like now to do a tally of how many people I know who are either pregnant right now or have given birth in the last few months........yep it's 10. There may be one or two I have missed. For some of these it's their second baby since I started ttc. And this list doesn't include people I know solely online on forums and stuff (it would be more like 20 if I included them). I do try very hard to keep focused on my own situation, and let other people's news wash over me, but it is very hard. Especially when you are in the no man's land of never having seen a BFP despite so much trying....it begins to feel like it's all a myth and not something that will ever happen to you.

Bleugh. Despite all this, yes, I am in good spirits - the weather has been glorious, I have been spending a lot of time walking in the woods and doing little indoor gardening projects at home and following the Royal wedding this weekend I just feel so uber excited about my own ^____^

What Not to Say to an Infertile

I have decided to keep a log of every insensitive, mean or downright ridiculous thing anyone says to me about ttc or infertility, and what I wish I had said back to them; hopefully it will be somewhat therapeutic -_-

(After a failed cycle)
Me: I'm so upset the Clo.mid didn't work, I'm going to be the only one left who isn't pregnant :(
My mum: Nevermind, you have a wedding to plan!
Yes I do, and obviously that precludes me from thinking about, wanting, or needing anything else in life! THANKS FOR THE SUPPORT!??>£"$

(During my "off" cycle due to a cyst)
Me: Luckily I've had all the honeymoon arranging to take my mind off of it
MIL-2B: Well sometimes that can work to your advantage
REALLY?! So my body is going to magically start working for the first time just because I've been thinking about something else?! AMAZING! What was I bothering with all those drugs for??

(From my pregnant SIL-2B when she found out I had PCOS)
SIL-2B: Well I was once told I couldn't have kids so I know exactly how she feels
Apart from the bit where you got pregnant without trying you mean?!

(My dad while I was playing with my BFF's baby)
My dad: See, all you need to do is get your ovaries sorted out and then you can have one of those!
Ahhhhhh is that all? Why didn't you say so before! 

(Pregnant friend who would complain incessantly about not being pregnant even though she and her husband only had sex once or twice a month - she finally got preggo after about 8 months of "trying" even though for about half of that they didn't have sex at the right time. Her benchmark for ttc lengths was her sister, who got pregnant first time on both tries)     
Chum: I know it took us a bit longer than most people, but you'll get there
Good grief, how did you honestly cope ttc for 8 months?! You deserve some kind of medal. And of course, you got there - and against all the odds it would seem - so that means I will too, I'm obviously making a big fuss out of nothing!

(Me fussing about on the sofa because of lumpy cushions)
Me: I just can't seem to get comfortable today
Dad: Are you pregnant?
Me: long pause No -_-
Dad: Oh, coz I've been hearing recently that that's a cause of it (He was referring to my nearly-8 month pregnant sister, who I haven't seen or spoken to since the news broke)
That's a cause of it if you have turned into a gargantuan heifer because you've been stuffing your face throughout the pregnancy.   

(During my "off" cycle due to a cyst, and after 2 failed Clo.mid cycles)
Chum: You never know, you might just get lucky and be pregnant in May. I have a friend who also has PCOS and she got pregnant on her first try when she came off the pill - maybe your first try after the treatment will be similar?
Well, I have a friend who has PCOS who hasn't been able to have a child despite years of trying and many different drugs; how do you know I won't be just like her?
 

Balmy

Cycle number: 10

Cycle day: 31

Meds: The usual suspects

Outlook: Relaxed

My my, it is lovely and warm here in London today, and I'm hoping it lasts as I will not be back in work until next Tuesday. Nothing much going on but a couple of little updates:

Tomorrow I go to the fertility clinic for a scan and if all looks well I can start Provera and get cracking on a new cycle. I'm really hoping against hope that the cyst has gone and I can get on with injects at the beginning of May.

I was pleased to see that PETA finally saw sense and removed the reference to NIAW from their vile promotion - reassuring to see that people power does work occasionally!

It was my sister's babyshower on Saturday but I wasn't invited. In fact I wasn't even told about it (I heard it was happening from someone who was invited). As you may have read in my previous post, my family didn't help me deal with news of her pregnancy in the way I would've hoped, and since then we had a falling out (something completely unrelated but also due to her selfishness and belief that the world revolves around her) which means I haven't spoken to her since January. I'm not sure why the whole thing was kept a secret though - I mean even my mum didn't tell me - not that I would've gone or felt sad about not being invited, but to not even mention it seems very strange.

And now there's an issue to do with my sister and our wedding. We cannot have tiny babies there for a variety of genuine, practical reasons (toddlers and above aren't a problem though) and we hoped this wouldn't be too much of an issue. The only people affected are my bridesmaid and my sister. My bridesmaid is fine with it, and her baby will be kept back at the reception venue with her mum for a couple of hours until we all get there. However, my mum recently emailed me to say that my sister and her husband wouldn't be able to come if they couldn't bring the baby. I flippantly said I wasn't expecting them to come anyway given the situation, but I'm going to invite them all the same. I'm sure if they wanted to they could arrange something, but my instincts say they are going to use it as the excuse they've been hoping for which gets them off the hook for not coming.

Finally, I've been coming to terms with the idea that I had a very early loss a couple of years ago. I brushed it aside for a long time, genuinely believing I must've been mad, but now I'm sure there was more to it. It was when I was NTNP with a previous partner, long random cycles and no charting. I didn't even know that I had ovulated. One day I randomly started getting twinges in my uterus, stretchy, pulling feelings that I had never had before. My uterus almost felt hard which was a very strange sensation. I thought nothing of it for a few days, until one evening when eating dinner I suddenly smelled everything very strongly. The next few days I had really bad nausea to the point that I thought I must've had a stomach upset or something. My CM was scarce and thick and white - unlike I'd ever seen before. I became convinced that I was pregnant, even going so far as hauling my sister how ironic down to the shop to get a pregnancy test. I was shocked when it was negative, and thought it was probably just too early to pick up, so I went away to visit a friend for a few days. Towards the end of my trip I noticed I wasn't feeling sick any more and the twinges had tailed off. When I got home I did another pregnancy test - still negative - and my period arrived a few days later. I felt so stupid for even thinking that I could be and put it down to strange hormones, or maybe my first ovulation in however long. But the last few months I've increasingly started to think that maybe it was something that ended before it could become anything proper. All the symptoms at the same time can't just be a coincidence - and the fact that I've never felt anything like that before or since, even when obsessively charting, so I'm sure it wasn't all in my head. Has anyone else experienced anything like this?

While a shock to think that it could've been something, I'm glad it wasn't because I would probably still be with that ex feeling very unhappy and would never have met Bubble <3

Outted

Cycle number: 10

Cycle day: 25

Meds: Met + supps

Outlook: Lonely

Now, I am not one to post a lot in open forums on the internet - it's part of the reason I have this (anonymous) blog. I lurk on message boards and am a people-watcher on Facebook, rarely posting status updates etc, but due to the PETA campaign besmirching NIAW I felt compelled to say something. So I posted a link to the petition against the PETA campaign which for me felt like quite a bold move, since hardly anyone on there knows that we are ttc, much less about my pcos and treatment etc (not that the post explicitely stated anything about our situation, but I would assume many people made the connection).

It generated rather a lot of comments - 42 to be precise! And I just thought for the benefit of the ttc and/or infertility community I would share some of these gems of "wisdom":

• "Tbh I could get right behind that. The world is overpopulated as it is"
•  "If you're infertile, it's nature telling you you're not meant to breed. Breeding is selfish as it is"
• "The great thing about being human is that we can *choose* not to do things that are detrimental to ourselves and our environment, unfortunately it seems that, due to these detrimental effects not being visible immediately (we are after all used to getting what we want at the touch of a button these days); the fact that they are unlikely to cause the adults that are alive now too much hardship and also the inherent 'drive to reproduce' that is present in all of us; the lack of education about the overpopulation of the planet and the problems that this is causing NOW; the unlikeliness that many people are prepared to make themselves and their entire family 'cease to exist' (not to mention the other factors that come into play regarding murder and suicide), it doesnt seem likely that many people in our western society are prepared to do anything to reduce the harm we are causing our species let alone try to suggest that you don't necesarily *have* to have children."
• "It's more the selfishness side of bringing kids into a world that's in this state that I have a problem with. Personally, if I could have chosen to not be born, and not to live in this world and be contributing towards it's downfall, ...then I would have checked the 'opt out' button. The fact that I also happen to be unable to have kids in my view is a positive. I understand people still feel the need to bring more lives into this world, but what with fuel prices rises, diseases, social collapse, political turmoil, price of living, etc.etc. I don't see why they'd want to inflict such an uncertain future on their offspring. I can choose not to breed, and nature can choose to tell you not to breed, but unfortunately we can't choose to have not been born."
• "Personally, I'd like to see those unable to conceive take nature's sign that they're not meant to, and for adoption of unwanted churned out kids to be made much easier."
• "If it's something easily solved with a quick procedure then fair play, but couples who put themselves through round after round of IVF treatment, endless miscarriages, or surgery on themselves in order to have a baby, sometimes I do just wonder why they don't take nature's hint and maybe accept it's not for them, it's not right" 

You can bet I responded to each and every one. I think it goes to show just how necessary something like NIAW is, because there are so many people out there who just don't understand what infertility is, what it means, how it affects people. The second quote up there, she seems to think that "infertility" is the same as "being infertile". As usual, adoption was rolled out as the solution for every infertile. The majority of the comments droned on about "overpopulation" etc without a thought as to the point of my original post - that those suffering through infertility would be hurt by it.  In one of my replies, I tried to explain that these kind of statements could be really hurtful to someone going through infertility, and that because there is a certain "stigma" attached to it, the hurter might not even know....so basically that it pays to bite your tongue about certain issues unless you know who you are talking to properly.

But by far the worst comment is one I haven't posted above in which the commenter stated that they were "surprised that an intelligent person" like me would hold such opinions. As if I'm somehow ruled only by my base instincts if I am in anyway pro-reproduction. That if I had a brain I would surely see that being staunchly anti-babies, anti-breeding, anti-hope is the only way to go. It was an awakening as to exactly the kind of people I know. Needless to say, they won't be getting a wedding invite...

 

In the News: PETA (Pathetic, Egotistic, Tactless Arseholes?)

Cycle number: 10

Cycle day: 19

Meds: Met + DIM, D3, chromium, B complex, folic acid O_O

Outlook: Grrrrrr

Nothing new to report on the ttc front. Haven't been temping but know I haven't (yet?) ovulated. Luckily I have been very busy the last couple of weeks with wedding planning and honeymoon booking which has been a great distraction as this cycle ticks past.

However, I was alerted to a campaign which instantly invoked rage via a friend's post on Facebook. PETA (USA branch), known for their well-measured, appropriate campaigning - ha - are offering a supporter the chance to "win" a vasectomy if they have also had their cat/dog sterilised. This in itself doesn't bother me - though I do consider it rather bad taste and simply a shock-tactic to gain more notoriety no change there then - but what really does is the fact that they are attempting to tie the promotion in with National Infertility Awareness Week (NIAW). 

I am loathe to get too irate about this because I am sure that's just what PETA want - more publicity - but at best it is inappropriate, offensive and ignorant. Whether they really have misunderstood what NIAW is about is up for debate, but if that's the case then they really need to get some better publicity staff. NIAW is about raising awareness of infertility - with all its many and varied causes - and the very real impact not being able to conceive has on people's lives. Suggesting that removing someone else's ability to reproduce somehow honours this cause is deeply worrying.

They harp on about human life "crowding out animal life on the planet" and how "with a global population of almost 7 billion humans, more of our species could use a (voluntary) snip too". I will reduce my response to bullets otherwise I may be here all day:

• without humans, there would be no dogs or cats or any other pets. They exist because we choose to have them - and in many cases, bred them for this purpose - and in a human-less world, they would almost certainly be extinguished by larger predators. This goes for chickens, sheep, cows etc too. They only exist because we do. And without people, there is no one to look after the animals that PETA seeks to protect
• someone who is willing to volunteer for a vasectomy is likely to be someone who was not intending to reproduce in the future anyway. If PETA is really concerned about over-population of the planet, it would be more appropriate and effective for them to focus their efforts on providing contraception in developing countries, rethinking sex education for young people or seeking to simplify the adoption process.
• people who are infertile, the ones who will get something out of NIAW, are not the ones "overcrowding the planet" - associating a campaign about such an issue with infertility is not only hurtful to those going through it, but also completely pointless. Tie it in with a "stop reproducing" campaign (if you MUST), but leave infertility out of it

As a side note, I have never, and will never understand people who go on about the planet being over-populated, and how humans are a scourge on the earth etc etc ad nauseum - if that's the case then stop moaning and cease to exist right now and take all your loved ones with you! No? I didn't think so. It's hypocritical in the extreme to be complaining about the problem whilst being part of it.


This hijacking of a supportive campaign is something PETA should feel ashamed of. I have always been pro-animal rights but there is no way I will be supporting anything PETA does from now on. I hope that this merely serves to alienate a huge portion of society rather than generate a lot of media interest as I suspect PETA hopes.


You can show your disgust at the campaign here - please pass it on.

Persistence

Cycle number: 10

Cycle day: 4

Meds: Met

Outlook: =/

So I didn't get pregnant. Not even a hint of a line on the few tests I used over the weekend. AF has been light and mercifully pain-free - presumably another Clo.mid side-effect (or due to the copious amounts of rosehip tea I have been drinking recently). I went for a base-line scan today and most frustratingly the Death Star is still lurking! I learned it was a whopping 6cm x 4.7cm at its largest.....scary big. Today it had shrunk down but at 3.5cm x 2.4cm it's still too large a presence for another medicated cycle just yet.

The Doc (a new one I hadn't seen before) gave me two options - either leave it and hope that it shrinks to nothing over the course of this cycle, or take progesterone to force it to shrink. I opted for the former: I really don't want to be messing with my hormones any more than absolutely necessary and she said that around 90% of cysts disappear after the second period. If it's still there by the end of this cycle I'll do whatever it takes to get rid of it. I may even look into doing a caster oil wrap during this cycle to help it on its way.

And I am relieved that the wait for the next cycle isn't that long. I'm already on CD4 and can go in on CD28 for another scan if I haven't detected ovulation or got my period and they will give me Provera again. A frustrating wait doing nothing but only 3 weeks to go. I still intend to temp and do some ovulation tests (though I have no idea when or even if I will ovulate) so I guess there is still a small chance for this cycle.

I also started taking some additional supplements on CD1 of this cycle: 

- Chromium - I read that a lot of women with PCOS are deficient in this mineral so I am taking 200µg each day

- Vitamin B Complex - PCOSers can be deficient in certain B vitamins and I also read that Metformin depletes one of them (aren't I a font of knowledge....) so I am taking Vitamin B1 20mg, Vitamin B2 20mg, Vitamin B3 30mg, Vitamin B5 10mg, Vitamin B6 20mg and Vitamin B12 50mcg each day

- D-I-M - This is a naturally occurring substance found in veggies like broccoli and cauliflower which helps to metabolize estrogen. Thought it couldn't hurt as PCOS is an estrogen-dominance issue. I am taking 100mg daily.

I also bought fish oil and a calcium/magnesium/vit D/iron tablet but I haven't got into the routine of taking them yet. Additionally yes my poor purse is feeling rather empty right now I got a natural progesterone cream to try if/when I ovulate...I've read that these creams don't really give you enough to make a difference but I'm happy to give it a go, especially when it is lavendar scented! Finally, I bought a pack of red raspberry leaf tablets - originally because I thought I would be carrying on with Clo.mid and read that taking this from CD1>ov can help to thicken the uterine lining (which Clo.mid wreaks havoc on). However, after talking to the Doc today, I learned that I don't have to take Clo.mid again if I don't want to and my next active cycle will probably be using injects. Still, a bit of extra help to achieve a nice thick lining won't hurt.

So back to waiting, again, and hoping that the Death Star has burned out in three weeks time...

Ms. Egg

Cycle number: 9

Cycle day: 16

Meds: Met

Outlook: Shocked!

So there I was, just about getting my head around the fact that I was Clo.mid-resistant and dealing with the prospect of moving on to injectables and I was ready. I went to the hospital this lunch time for a scan to follow up last weeks - and from what the Dr said last week (that there was no response, that it wasn't working, that things weren't going to be as easy (ha!) as we thought) I was expecting no progress, no hope.

Imagine my surprise when this week's Dr said "You have one large follicle on the left"! A late response, but a response all the same. The follicle is currently 15mm so it needs to do a little bit more growing before it will be viable, and my lining is still on the thin side, but I cannot put into words how thrilled I am! 

An actual egg getting ready....it's so exciting. I have to start doing ovulation tests from tomorrow, then I go back for another scan on Friday which will be CD19 to see how it is doing. Of course we have to get busy in the meantime just in case, and I think I'm going to temp for the next few days so that I have another angle to confirm ovulation (assuming it occurs). Usually I don't temp because the anticipation makes me wake up earlier than usual just to do it, thus throwing my temps off and negating the whole process.


And the other good news we got today was that Bubble's repeat semen analysis came back good. His total numbers were at the lower end of the normal range but nothing to worry about, and everything else was excellent. One less thing to worry about.

The Simmering

Cycle number: 9

Cycle day: 11

Meds: Met

Outlook: -_-

So two weekends ago we went to visit Bubble's mum for the day and decided to tell her we are ttc and about my fertility problems. We did this for a few reasons:

• so that if/when I do get pregnant, it is not a total shock
• so that we have additional support through the whole thing (particularly since my mum made it clear we can't get it from her...)
• so that she would feel included from the beginning
• to prevent unsolicited familial comments such as "so when are you two gonna have one then?"

Since my sister got pregnant, I realised one of the things I was most sad about was that I don't get to produce my parents' first grandchild. I had seen it as a rite of passage for them that I was totally excluded from, but being the older child, I felt that it should've been mine to provide. Instead, I thought, we will at least produce Bubble's mum's first grandchild. She was thrilled to bits for us when we told her, and interested and concerned to hear about the fertility issues. We made it clear that it could be several years before we get a baby (if we get one at all). I talked to her about the treatments I'd had and may have in the future, and how Bubble would be going for a second semen analysis to rule out any problems his "end".
Flash forward 5 days, and it didn't help my severe Clo.mid side effects to hear that my soon to be sister-in-law is randomly, unexpectedly pregnant. Big shock, not least because she and Bubble's brother have only just got back together after a six month long split. She's two months gone, and apparently confident that it's his. It was a final straw for me. Officially, everyone I know is pregnant; all friends, all family of reproductive age, co-workers or their spouses. There is now no refuge from pregnancy, anywhere I turn someone with a particular glow is there smiling back at me.

On top of this we found out that Bubble's mum had been spilling the beans about US ttc. She told Bubble's brother and his pregnant girlfriend not only that we were ttc, but about my problems too. I felt ever so slightly betrayed by this - as we had told her in confidence and I didn't expect within days it would be a general discussion topic.

Bubble's mum had also spilled the beans to her sister and mother (i.e. Bubble's aunt and grandma) that we are ttc (but nothing about my problems). I couldn't work out if this was better or somehow worse - my privacy has been kept, but telling family we are ttc like we have no problems means that in six months if nothing has happened people are going to start asking questions. Or generally think that it's ok to bring up the topic of us trying to reproduce when we are at family gatherings.

This was all too much and I admit I howled for hours. We took it for granted she would keep it quiet given the situation, but I now realise I need to spell it out for people - the more people that know, the greater the pressure of expectation on something that could take years to happen. I know she was just happy and excited for us, and meant us no harm, but it's all come at a bad time. I'm now left kind of wishing that we had just kept it to ourselves.

This weekend I have to meet up with an ex-colleague who is about 4 months pregnant. It's the first time I'll have seen her since it happened. She's been pushing and pushing for us to meet up, even though we weren't particularly good friends (though she did know about us ttc) and now I can't help but think that she just wants to show off her bump and talk non-stop about baby stuff. I'm dreading it.

And then the same night I am going out for a birthday meal with my parents, and Bubble's mum, brother and his pregnant girlfriend. What a happy little party that is going to be.....NOT. I have already told Bubble that if the conversation hovers on pregnancy or babies for longer than a picosecond I am getting up and walking out.

And then Sunday is my 28th birthday. And 4 years since I first started ttc. And 1 year since I started ttc with Bubble.

I hate that I've become such a bitter person when it comes to other people being pregnant and other people involving themselves in my fertility issues, but I don't know how else to be. I can't help it if I get upset about these things, or feel angry, or both. And I try hard not to let people see how I feel because I don't want them to feel hurt or think badly of me. So I have to just let it simmer

One down..

Cycle number: 9

Cycle day: 11

Meds: Met

Outlook: Strangely calm

So I am Clo.mid-resistant. I found out yesterday when I went in for my first monitoring scan. I was upped to 100mg this cycle, CD 3-7, and I felt hopeful that I would have some kind of response, but apparently my follicles just aren't bothered. I was worried this would happen when I didn't ovulate last month, but I had read of people who didn't respond straight away but did later on a higher dose. If it was my choice I would probably try one more cycle with 150mg just to be sure that I just don't need a much higher dose than most people, but I have been told it's the end of the line for me and Clo.mid.

The good news is I will be moving on to Meno.pur, which contains human gonadotrophin extracted from the urine of postmenopausal women. No that wasn't a typing error. It's an injectable made up of follicular stimulating hormone and lutenizing hormone, which hopefully assists the eggs on their route to maturity. I don't know all the details yet but I do know I will be injecting myself in the abdomen with this tasty concoction, a scary thought in itself. I may even be able to start in a couple of weeks if my lining remains thin, rather than have to wait for my period or take Pro.vera again, which is also good news.

But in general it does seem like pretty bad news. I had always heard that Clo.mid was pretty much a wonder drug, people getting pregnant on their first cycle, people taking it for a couple of cycles and then stopping only to get their BFP, and when I was getting ready for my first Clo.mid cycle I really thought "At last I have a shot" - to at least ovulate if not get knocked up. And Clo.mid always seemed like the most obvious answer, like anything else was a last resort and it would be time to panic. I always assumed I would have the full 6 cycles (the maximum allowed) and only then if it still hadn't worked I would move on to something new. 

I'm left with mixed feelings - on the one hand, it would've been frustrating to sit through cycle after unsuccessful cycle with no ovulation and therefore no chance of pregnancy. But on the other I've now ticked off one of the most potent treatments from my list of options, a list that will only get smaller as time goes on.

I've tried to make myself feel better by telling myself it's clearly a sign that my body is too intelligent - Clo.mid works by fooling your brain into thinking that there is no estrogen in your system, so that your brain produces more and this should (in theory) be the kick start the follicles need to get ready for ovulation. But my brain isn't having any of it. I should've known better than to try self deception.

The Meno.pur, however, simply supplements the hormones you already have; it's a much more straight-down-the-line drug, no trickery. And reassuringly my consultant said that just because I haven't responded to Clo.mid, it doesn't mean I am less likely to respond to anything else. I go back for a scan next week but I'm confident there will be no change, and then I will just have to wait about 10 more days before starting the new treatment (they like to leave at least 4 weeks between treatments).

The Clo.mid did wreak havoc with my emotions though. On my second day of it, I was almost in tears for much of the day (stress at work) and then I broke down in the evening (for reasons I will expand on in a separate post). Let's hope the next one's not so bad...

Emotion

Cycle number: 8

Cycle day: 37

Meds: Still the Met

Outlook: Sunny

I forgot to add to my last post something about the emotional impact of trying to conceive for a long time. It's probably better that this gets its own dedicated post anyway. It's not to be underestimated. I've touched on it before but it's worth reiterating, because although no-one* really recognises it, the reality for a lot of women is that it's a pretty traumatic experience, with a negative impact on self esteem, confidence and general happiness.

I'm talking about the feeling that you are a failure as a woman, that your body has let you down. Dealing with other peoples' insensitivity, lack of sympathy and sometimes downright nastiness and rudeness. Having to maintain a calm, collected facade at work when AF arrives for the 500th time (after all, it might mean the end of the world to you, but what is it to anyone else?). Having to maintain a calm, collected, happy facade when everyone around you falls pregnant for the first, second, third time. Fighting off the hormonal surges that tell you to reproduce and make you feel bad for not having achieved it yet, and may never...

And of course there is everyone elses' emotions intertwined with ttc: your parents waiting eagerly to be grandparents, wanting to see your family grow and flourish, unable (or sometimes unwilling) to provide any real comfort to you, their child. The way friends either feel too bad to let you in on their pregnancies or over compensate by treating you like a fragile flower, just in case you weren't already feeling awkward enough. And of course your darling partner, waiting just as you are to become a parent, feeling every hurt and frustration but sometimes unable to express it to anyone but you.

It's funny though how unaffected women seem by all this one they finally achieve their pregnancy. I guess the tremendous warmth you get from knowing there is a life growing inside you makes everything you have been through seem worth it a thousand times over. I wonder how many of these women even remember how tiring the whole thing was once they have their little one to dote on? Or do they just take it all in their stride? I wonder, then, what happens to the (relatively) small proportion of women who never achieve pregnancy or acquire a child in another way? Are there significant lasting effects to what they have experienced? What do they do to move forward without that hurt inside them? I would be interested to find out. I do hope I never get to that point.

The Waiting Game

Cycle number: 8

Cycle day: 34

Meds: still the Met

Outlook: serene

Today I booked an appointment at the fertility clinic. I will go there next Friday for a scan to check my lining. If all is well, I will take Pro.vera to induce a bleed, and will then start on my second round of Clo.mid. I'm excited to be moving forward again. I tried Clo.mid for the first time in October, but didn't ovulate. Bubble and I have since been on a ttc break as our wedding is in September and we didn't want to risk a baby due around that time. It's been a strange time...no active thinking about baby-making but no prevention either apparently I have my own in-built contraceptive... It's just been a time of waiting and waiting.

So I am uber excited to be doing something about it again. My dose will be upped to 100mg and hopefully I will ovulate this time. Just to ovulate would be a massive achievement, to know that it is possible. People who "just" get pregnant simply don't know how lucky they are not to have to think about this kind of stuff. As I have written about before, my sister is currently pregnant. She wasn't actively trying and it was her first month off birth control. She didn't even realise she was pregnant until she was nearly 10 weeks gone. She's never read anything about trying to conceive, or pregnancy, never made any changes to her lifestyle to improve her chances, never even talked about having children to my knowledge. And yet here she is, over halfway towards having her own child.

It is tiring having to actively try. Even if you don't go completely overboard and become quite obsessed - which understandably happens to a lot of women trying for a child - there is so much involved in the whole process for those to whom it doesn't just happen after the initial "honeymoon" couple of months when you are blissfully unaware:

• The Science - how the hell does this conception thing work anyway? Bizarrely, one of the most natural and personal endeavours in the world is still a mystery since they forgot to include it in any school curriculum. Terminology, maths, biology, charting (I'll come back to that), you pretty much become a certified fertility nurse after the first six months
• The Reading - anything, everything, online, in books, in magazines. Definitely online. Stories of conception and birth and what worked and what didn't, sifting through medical journals and horror stories and old wives tales, self diagnosis, message boards, forums, blogs.....especially blogs ;) Trying to absorb and make sense of this large quantity of text can be extremely challenging
• The Self Obsessing - Symptom checking, fretting over this pain and that... is something wrong with me? If so, what is it? If I felt a twinge on CD7 does this mean that I have PCOS? Am I pregnant? If I felt sick at this point last cycle and I don't now, does that mean something? O_O The constant self analysis can be incredibly draining and psychosomia-inducing
• The Charting - a fresh hell for anyone who is already starting to panic about ttc. Temperatures, taken to the very same minute each morning otherwise they could be misleading, but is the thermometer accurate? Are my multivitamins interferring? Did that curry last night cause it to be higher than usual? For me, the anticipation of my morning temperature-taking would always cause me to wake before I should, which then made my temps inaccurate, and the whole thing just made me tired before I could even start the day
• The Deed - what was once an expression of love between you and your partner suddently becomes a regimen even the army would be proud of. To do it every night or every other night? Or the SMEP system? Or twice a day if we can manage it? And should it be in this position or that, using Pre-seed or egg whites or some kind of headstand at the end? This is even more frustrating if you don't ovulate at the same time each month (or hardly ever at all) and you just have to keep going for weeks or months with no end in sight just in case you miss that egg.....!!
• The Waiting - waiting to ovulate, waiting the Two Week Wait, waiting through symptoms and negative HPTs, waiting to start fertility treatment, waiting for appointments, scans, procedures.....and ultimately waiting for that little magic to spark inside and create a life

I almost can't imagine conception from the perspective of a fertile, just being able to decide one day "I think I want a baby" and within a few months knowing it is there; finding out you are already several weeks pregnant without even knowing; getting excited at the prospect of getting pregnant and then having all your dreams fulfilled instantly. The rest of us work so hard to get and stay pregnant, and when it finally does happen, it must be the greatest achievement of our lives.


Don't get me wrong, I'm sure fertiles love getting and being and staying pregnant, and love their babies and the whole shebang. But the test you turn up for on the day without revising never means as much to you as the one you spent months studying for; instant gratification is never as satisfying as something you have worked hard for and has consumed your life; and in the same way I feel almost lucky to be in my position. When I do eventually have a baby, it truly will be a miracle for us; I will never take a single day of its life for granted or all the moments leading to it. I will have worked really hard for it and I will spend each day being thankful for my reward.


I just have to wait a little bit longer......

Facebrag

Cycle number: 8

Cycle day: 31

Meds: 1000mg Met.formin

Outlook: grrrrr

"I have carried a human life inside my body I have comforted a baby on my chest I have been puked, peed & pooped on ive woken up to a hungry baby & stayed up all night with a sick baby but I wouldn't have it any other way my body isn't magazine perfect but when I look in the mirror I see.........a mummy and there is no greater honor or blessing!!! make this your status if you are a proud mummy cuz i am!!!"

"Does she work.... Yes she does!!!... 24 hours a day. why? Coz shes a MUM... a cook, a cleaner, a parent, a teacher, a referee, a nanny, a nurse, a handyman, a maid, a photographer, a councilor, a chauffer and a comforter... she don't get holidays, sick pay or any days off.. she works through the DAY and NIGHT.... litrally on call 24 hours!!!"

Just a couple of the delightful chain-status updates I have seen on Facebook in recent months. I can't help but wonder what is the point of them other than to brag about the fact you've had children? It's as if the assumption is that motherhood is looked down upon, that mothers are being vilified in some way in society, and by putting this as your status you are somehow defying that and standing up for yourself and mothers in general. 

 Except I really don't think that's the case. Of course you get the odd newspaper article about working mothers vs stay-at-home mothers and that kind of thing, but I really don't feel at all that there is any stigma attached to being a mother. Feigning defensiveness just seems like a good excuse to paste your smugness across the interwebs.

 Luckily neither of these were posted by my actual FB "friends", otherwise I would've had to make some kind of comment (and possibly a deletion!). Of course there is no harm in being a "proud mummy" - and I'm sure I will be filled with pride if I ever get to be one - but this kind of bragging is also pretty hurtful to people who may be dealing with infertility, miscarriage or any other problem conceiving (and some of this posters friends are).

 It's true, there is "no greater honour or blessing" than being able to bring a life into the world, no one would deny that. And being that it is such a great, personal, deeply poignant moment in life, why would anyone choose to celebrate that by reposting a generic, badly thought out, poorly written blurb?

 I'm not saying everyone should tread on eggshells 24/7 in case an infertile is lurking somewhere, listening in and taking offense.  Of course not. I would feel as bad about that as I do about these statuses. I just think that expressing your joy in your family and children can be done in other, much more genuine ways than this which won't come across as rubbing other peoples' noses in the fact. Ways that come from the heart rather than from the keyboard of someone somewhere reveling in smug superiority.

 

Getting It

Cycle number: 8

Cycle day: 26

Meds: Met.formin 1000mg

Outlook: Hmmmm

Most people feel that their mother is the one person they can totally rely on in life (despite their nagging*). I also presumed that she would be the one person who could fully support me on my journey to becoming a mother myself, but a recent incident proved me wrong:

She had known we were trying to conceive, and knew that I had just completed a round of Clo.mid which didn't work. Yet she didn't intervene or advise or prepare for the fact that my sister was about to announce her own pregnancy. It was upsetting, after entering my fourth year of infertility, to receive a text from my sister saying "Hello Gim" (her demeaning nickname for me which I hate), "I have some exciting/scary news! You're going to be an Auntie!" My mother of course had known about it for some time (6 weeks at the time of the text). I didn't even know they were trying. Why, I wondered, didn't she think to prepare me in some way? Why didn't she think to advise my sister to be slightly more tactful or sensitive about the way she told me? Her response? "It didn't even occur to me".

Worrying. Even more worrying was when she said that, being someone who had never had any problems with fertility, it wasn't something she could identify with. Isn't that a symptom of autism? This got me to thinking, why is it that so many people are blind to infertility?

My best friend had to have two babies terminated in recent years due to a genetic disorder. My mother was perfectly able to sympathise with this, and recently expressed her joy at the fact that my friend is now pregnant with a healthy baby. When my sister had a minor scare just before Christmas, my mother was first on the scene to support in case of a miscarriage - something she has never gone through herself but was able to identify with. Even my dad texted me on that day (and he never, ever texts me) to let me know, saying how it was going to be a "grim Christmas" if the worst happened. So even my DAD was able to sympathise with the situation.

Why then is infertility not on people's radar? Why does my four year struggle and not even a single pregnancy not get the same support? I understand that it can be more difficult to identify with if you haven't been through it yourself, but is there really an excuse for total ignorance? 

There is no "big event" with infertility like there is for a miscarriage or a termination - no focal point for all the sadness and dread. The pain and fear is instead a daily grind, mixed in with a bit of hope and anticipation for good measure. Of course I would never wish to go through a miscarriage or a necessary termination - and I feel tremendous sympathy for those who have - but in some ways I do envy that focal point. A day when everyone would just be nice, where there were no comments like "Aren't you getting broody yet?" or "Are you not really interested in having children yet then?" or "You just need to get your ovaries sorted out then you can have one of these!"**. A day when I would be allowed to cry and people would offer comfort and support, reassuring stories, hopeful mantras and a kind smile. And after that day was over, I could begin moving forward with my strength buffered by their compassion, people would get on with their lives but a little bit of them would remember that day and there would be no more hurtful comments. 

I can only conclude that the people who are unsympathetic or unaware - and there are lots of people who aren't - see that the infertiles didn't have anything to begin with, so haven't lost anything. That until we get to the day that we stop trying to conceive, there is every possibility that we will. That until it never happens there is the chance that it might. There is something frighteningly naive about that view, but also kind of pure and hopeful: it can, may, might, should, will hopefully happen for us. Let's not forget that.

*I know I'll be there myself someday....

** GENUINE comments said to me, I'm afraid to say

The Very Beginning

Ahhh my very own blog. A fairly scary prospect, putting my thoughts, fears, hopes and dreams out into the midst of the interweb for any old person to read. But also very exciting, controlling my own space, getting some of the things that burn a hole in my brain out, and by putting them into words, hopefully understanding myself and others more. 


But make no mistake, this isn't some random, thoughts-plucked-out-of-the-air, "what has annoyed me today?" type blog. My poor other half has to cope with all of that. No - this is very specific, on a topic I can't discuss with many people:

Infertility.


Not the sort (touch wood) where I have been told I can never have children. That would be a very different blog. I am not at that point. There is hope for me but fertility is not one of my strong points. 


When I first got my period at age 11, it was the worst moment of my life. I suddenly felt very alone, not knowing anyone else in my peer group who had, and felt marginally disgusted by my body doing this vile thing. This disgust and horror continued for a few years, not helped by very heavy periods, horrendous cramps and feeling I had lost control of myself.

It wasn't until I was 15 that I began to suspect something was wrong. Where other friends were by now used to their monthly visitor, I was still wary, and I realised it was because it wasn't happening monthly. Two might happen consecutively then nothing for three months, nothing for six months. My GP batted away my concerns like a predictable bowl - it was nothing worth worrying about until I was ready to conceive and would likely be resolved by going on the pill.


Mostly I was relieved that it was nothing "serious" but underneath a tiny pair of teeth started to gently bite something is wrong, a gnawing that would grow over the years.


Simultaneously I started to dream about the future, as teenagers are occasionally known to do, and in my blissful ignorance I would tell anyone who cared to listen how I hoped to have 8 children, a nice big family where something was always going on. Having come from a small and somewhat cold family myself this seemed the perfect aspiration. And of course you are flippant at that age. Children were something for the future, sure, but what really mattered was education and a good job and prospects. Children were the easy option for those who failed, a natural, biological process as old as time (and a little bit older). How little I knew.


And so we spring forward to now. I am approaching 28 and have never been pregnant. I have been trying to achieve this magical, elusive state since March 2009 with my lovely Bubble (since February 2007 with a previous partner). I have poly-cystic ovary syndrome. I am about to start fertility treatment.


The end of the post, but this is only the beginning...