WHEN NO IS NOT AN OPTION by Glenna Owen - SPRING 2011

WHEN NO IS NOT AN OPTION

by Glenna Owen

Eight years. That’s the time that has passed between then and now. The then being when we began trying to conceive. The now thankfully is a happy ending with two little girls, but let's start at the beginning which, according to my two-inch three-pound fertility file, began in 2002. My then future husband and I met in the summer of 2001 and by end of 2002 we had decided to try starting our family. I was 36 and he was 48. Not too old I thought. The first challenge would be to wean myself off a prescription for methotrexate which I was taking for my rheumatoid arthritis. I was absolutely forbidden to become pregnant while taking this drug. Switching medications would take time (at least six months) and this would serve as my introduction to the waiting game of the infertility world.

We knew we were fertility-challenged as my husband had a varicocele repair surgery, and a sperm analysis revealed several mobility and morphology problems. We tried on our own for six months after I was weaned off the methotrexate, and when nothing happened we were referred to a local fertility clinic. After a couple of months, we finally had our appointment. It was now 2005.

During these two years I became very involved in an on-line discussion group. I don’t know how I would have made it through those long months without my infertile cyber sisters. There seemed to be such a wealth of knowledge out there coming from people in my exact predicament. I had no idea infertility was so huge. It had to be the best kept secret, medical condition in the world! I was continually amazed that it seemed to touch so many, yet the media only seemed to focus on stories about older women who had waited too long because their careers took priority and now wanted “designer babies”: A term which still makes me bristle. These groups had all sorts of women and couples struggling with infertility. Young and older, some with children already, many without. There were couples dealing with male factor and some who had conditions I had never heard of. I ordered books and read on-line medical articles. I read and re-read Taking Charge of Your Fertility and became well acquainted with the monthly changes in my reproductive system. Why didn’t they teach this in high school? I used sticks to complement my temperature taking and cycle charting. Then I upgraded to a fertility monitor and then started buying bulk pee sticks on-line. After all, one has to get savvy and comparison shop while trying to have a baby. These tools of the trade get pretty expensive.

Back to our appointment. I was very excited to go; we were finally going to get some expert help. No more messing around with GP’s and bulk mail orders. The big guns were coming out and I was certain by this time next year we would have a baby. Our appointment went well; I liked my doctor. He immediately noted our severe male factor but wanted another more detailed analysis. He also arranged for me to have a sonohysterogram. In the meantime he suggested we try clomid for three months. It would be both less invasive and less expensive, and at least I felt we would be doing something. My test results were good; there were no abnormalities and an added bonus was that the SGH test cleared my tubes of any surplus mucus, which would be an added benefit while trying to conceive naturally. The odds were improving except that the new sperm analysis came back showing that motility was less that 10% and morphology was 2%. There were also antisperm antibodies on 98% of the sample. Our doctor said it was as though his sperm were trying to swim with boots on. By this time the clomid had definitely not worked and we were referred to the IVF program and slated to begin our first cycle in February of 2006.

Now I'm 39. Wow, what a relief to finally be doing IVF! We would have to have ICSI which added an extra four digits to the cost but, hey, no more timed sex, no more checking cervical mucus, no more temperature taking... no more, no more. It was still late November but no matter, we were going to get married in January and go to Mexico for two weeks so I was going to be busy. I started my birth control pills and was relaxed for the first time in months. All was going to be well. No problems. We had turned our infertility over to science and why wouldn’t it work, right? My winter wedding in the Rocky Mountains was gorgeous and our honeymoon to the Mexican mountains was fun and relaxing. We were spending our last two days in Mexico City when my period started a couple of days too early. I called the clinic from our hotel and I was reassured that it was just a bit of breakthrough bleeding and they would see me in a couple days when I returned.

The day after we returned home I was at the clinic at 8 a.m. for my first blood work and ultrasound. Could things be any better? Wow, this had all just worked out so perfectly. When I called the clinic later that day to get the results from my blood work, the nurse said that my follicle-stimulating hormone (FSH) was very high. Normally they would not continue but, as this was my first cycle it would be up to me. Pardon? FSH? What is that and what is high and why does it matter? She explained that high is over 16 and mine was 23. In July it had only been 8.2 and a high number can indicate pre-mature ovarian failure. WHAT? Could you repeat that? It’s up to me if I want to continue this cycle? My FSH is 23? I must have sounded like a parrot repeating everything she said. I was thrown by this news, as I had never really known much about FSH. Well, um, yes, lets carry on. I’m all set to go, I have my medication and I’m ready to inject myself. After all the nurse had said a high FSH doesn’t always mean a cycle won’t work but that it may be more difficult. Well, OK then. There’s your answer, let's keep going. So off I go, still optimistic.

On day three of my protocol I go in for my ultrasound and there, on the screen, is nothing. Well, not exactly nothing but pretty close to nothing. Two small follicles on one side and three small ones on the other. Not looking good but we’ll do one more day and see how they look. Well, the next day comes and there is no change. They suggest changing to an IUI and basically trying to salvage at least something of the cycle given that I’ve spent the money on the drugs. I go home so disappointed. I had been sucker-punched by infertility. I was completely unprepared for IVF not to work. While I knew people didn’t get pregnant every cycle, I didn’t know that some did not even get to egg retrieval. This was so harsh. I had an IUI the next morning. I was still somewhat hopeful but 14 days later the blood work showed that I was not expecting.

This was repeated five more times over the next year and a half. Four IVF starts resulting in one more IUI and three cancellations. The medication was increased over the course of the cycles but my ovaries were still only producing one or two follicles. When I went in for my post cycle post-mortem my doctor advised that it was most likely my age. It was a cruel blow as I wasn’t old, or thought I wasn’t, when I started, but this whole process takes so long that now I was, at least in their eyes.

I marched on and began turning to alternative medicine in the form of acupuncture and Traditional Chinese Medicine (TCM). My cycles had always been on the short side, 26 days, even 21 days. I tended to ovulate early, like on day 9 or 10 so it seemed like my short follicular phase wouldn’t have produced a mature follicle anyway. That summer I decided to fly down to Austin for a Randine Lewis Fertile Soul retreat. As I had become more and more of a failure at IVF, I thought maybe I should try a different strategy. I just couldn’t accept that I couldn’t have a family. Nope, it just wasn’t possible. With all this technology and science and alternative therapies, couldn’t they get just about anyone pregnant?

The retreat turned out to be one of the best things I have ever done for myself. I knew I was stressed out from all of the cycling and failures but I didn’t realize to what extent. Looking back I don’t know how I held it together. Honestly, had I been allowed, I would have cycled back to back until it worked. If I had all the money in the world I would have flown to clinics all over the world until it worked. I had no will to stop. I had to keep trying. I was able to acknowledge that I was incredibly burnt out, and the course helped me to mellow and gain some perspective. When I returned I took a small break from treatment and repaired my body using the dirt tea of TCM and acupuncture. My cycles began to lengthen and I started to ovulate later too. I also began meditating and trying to calm my active mind down. I joined Weight Watchers and lost 23 pounds and started a running class. I don’t know if all this helped bring about my successful cycle in the summer of 2007, but it certainly helped my stress level.

Five years after we embarked on this journey I had my first ever Big Fat Positive (BFP) result. As always, I had ordered bulk home pregnancy tests on-line. I began testing day 9 after my egg transfer. Nothing. Day 10, Negative. Day 11, Negative…. wait. Wait. Could it be a very, very, very faint second line? Yes. No, wait. Hard to tell. I think I’m just seeing things. Go downstairs, get a coffee. Come back and yes, I think I do see something. OK, I have 12 home pregnancy tests (HPT) left. Let's have another cup of coffee and test again. Sure enough a second but very, very faint line shows up again. I raced down to the computer and went to one of my favorite websites. If one is pregnant the line will get darker as time passes soooooo I wait until the evening. I know it’s not the first morning urine but it’s now 12 hours later so if I am pregnant it should be darker or at least the same. Yes, it’s the same. I can hardly wait until the next morning to test again, and again and again. Every time it was the same but darker.

Oh goodness, what a feeling. So happy, so relieved, so scared out of my mind! Of course, after trying for so long, a regular pregnancy is denied. Now, I was thinking about losing it. Will I miscarry? The thing about struggling with infertility for a long time is that it can rob you of your ability to have a “normal” pregnancy experience. The beta test confirmed I was indeed pregnant. The six-week ultrasound also confirmed it and showed that there was only one fetus. It was OK. I always thought one at a time was better for me anyway. We only told five people until everything was re-confirmed at my 19^th week ultrasound. I wasn’t due until mid-March but there was still no way I was going to buy any baby stuff until at least after the new year. Nope, I Will Not Jinx This By Buying Baby Things. Crazy? Yes. Understandable? Certainly.

On March 5, 2008, at the age of 41, I gave birth to our daughter Elizabeth by cesarean section. Two years later, on April 11, 2010, when I was 44, we welcomed a second daughter, Claire, from a single frozen embryo transfer. This time I was better prepared and had a beautiful vaginal birth after caesarian section (VBAC) at home with two midwives, doctor-free and drug-free.

I’m now done with that part of my fertility journey. While I wouldn’t say I’m scarred, it has certainly left its mark. I’m thousands of dollars lighter but it’s been worth every penny. Would I change anything? Well sure, I think I would have preferred having children at 35 but this is the hand I’ve been dealt so I try to live and be happy.

Even though I am now busy with a baby and a toddler I spend two evenings a month co-hosting a couple of infertility support groups in my area - one being an IAAC support which I helped start two years ago. The groups have helped me let go of some of the residual emotions from my years of struggle, and even though infertility can be such a painful and isolating condition, I hope the people in my group find it hopeful to have a story like mine to hear.