The post-mortem

You’re wondering what happened at the specialist …?

Nothing.

Seriously.

Apparently …it’ll happen when it happens.

Ha! Hahahahaha!!

Actually, I’m not kidding.

Al and I have been assigned to the 'big black hole' category of unexplained infertility.
There is nothing wrong with either of us that should inhibit pregnancy, and yet we’re not pregnant after 22 cycles. We’re abnormal, but there is no reason for it. Our chances of becoming pregnant naturally are good, but reduced because we’re not pregnant after 22 cycles. You with me?

A normal, healthy, fertile couple is generally accepted to have a 20% chance of becoming pregnant each cycle. Because of our history, our chances are more like 15%.

I had endometriosis, but that has been successfully removed, and I have fully recovered. The specialist said it would be easy for him to blame our infertility on the endometriosis, but he doesn’t believe that’s the case. He does not feel we are infertile because of endometriosis. In fact, even with endo, he believes my chances of becoming pregnant were good …possibly not even reduced. Endometriosis is graded from 1 (being mild) to 4 (being severe), and it is graded on the endo itself, not the symptoms it presents. I had severe symptoms, but only Grade 1 endo. I will have to verify this statistic, but I think endometriosis actually only negatively effects fertility in 40-60% of women. 'Only'. Ha. You know what I mean though.

Kudos to me - he did say I came to see him at the perfect time in my cycle. He did an internal ultrasound, and showed us my ovaries, and particularly the beautiful, healthy, follicle which was very close to releasing an egg (and winked at Al when he said that I’d be ovulating in the next couple of days). The lining of my uterus also looks perfect pre ovulation, and ideal for implantation. (It was a little weird having your husband standing there while another man wiggles an almighty great probe around in your yoo hoo ...but that's a post for another day)

I do not have PCOS. We turned that one on its head with the internal scan, and has been clarified once and for all. It explains why I don’t have any major symptoms of PCOS. My ovaries may look polycystic, even to a seasoned surgeon, but they’re not. I’m fine.

He asked me how I am emotionally, because that has a bearing. I said I’m fine. I’m OK. Or, at least, I feel fine and OK. I think that right at this moment, I am forcing some pretty strong feelings down …I have barely eaten since the appointment, and I barely slept last night and they’re my two tells. But, I need a couple of days. Once I’ve had that, I will have my feet back underneath me again.

Our only option for fertility treatment is IVF. It is the only option which will increase our chances of becoming pregnant. He was quite blunt about that. IVF will give us a 50%-60% chance per cycle. He said Clomophine will do nothing for me because there is nothing wrong with me. Clomophine has a purpose, and for me, it can’t do anything that my body isn’t already doing itself. I am disgustingly healthy, and I ovulate every single month. IUI (artificial insemination ala turkey baster) will raise our chances from about 15% per month to about 18% per month. 3%. Sweet FA. So, we could realistically spend thousands of dollars on artifical insemination and drugs when having good old fashioned sex for free will give us pretty much the same odds of a pregnancy.

In relation to the IVF, he said please don’t rush it …Enjoy your life, enjoy each other. We’re not harming our chances of starting a family by waiting 2 years. I’m only 28 now, so 2 years will only make me 30 (I think …I’ve only got 20 fingers and toes, and I can’t find my calculator). Being 30 won’t reduce my chances any for becoming pregnant. I’m not 35, or 40, or in an age danger-zone. It's only what I can or can't cope with emotionally.

So, it becomes about statistics and odds from here on in.

He explained it in gambling terms …

We have a slightly less than a 1 in 5 chance every month of becoming pregnant every cycle. Obviously, if we don’t succeed, it stays a 1 in 5 chance, it doesn’t become a 2 in 5 chance then a 3 in 5 as the cycles go by. We knew that. He believes that based on statistics and a long career, that our chances are about 15% and that we can become pregnant on our own in 2 to 3 years and recommends waiting. The operative word of course is ‘can’. He didn't say 'will'.

But, he also acknowledges that based on the same statistics and our history, that we could conceivably (no pun intended) get to that 2 or 3 year mark and still not be pregnant. This is where we must roll the dice.

I told the specialist when I left that I hope I never see him again. He said he hopes so too.

Statistics and odds.

The generally accepted fertility facts for a normal, healty couple having sex regularly are:

25% will be pregnant within one month
60% will be pregnant within six months
75% will be pregnant within nine months
80% will be pregnant within one year
90% will be pregnant within eighteen months*

We're rolling the dice based on that.


After the appointment, Al and I went for a coffee to discuss our plan.

The conversation went like this …

Him "So what is the plan?"

Me (shrugging, defeated) "We wait"

Him "How long do we wait?"

Me "2 years"

Him "No. Twelve months"

Him again "Can we have ten grand in twelve months?"

Me "Easy"

Him "Then we do that. We start saving now."

Me "I’ll start saving when I’ve done my other things. I’m not living my life for this any longer."

Him (chokes on his coffee and starts laughing)

Me (immensely surprised that he finds this funny) "What? Why are you laughing? How is that funny? We are getting our bathroom done, we are getting our new dining suite, and we’re getting our coffee machine. We talked about those things, we're planning them. I’m doing those things first. I’ll save for IVF after."

Him "Oh"

Me "What do you mean, 'Oh'? Why are you laughing?"

Him "I thought you had a secret shopping list or something …you know …a pair of Prada boots…?"

Honestly! I don’t know where that idea came from …I don’t even like Prada.

Anyway!


So, we’re waiting. 12 months. When we get to 12 months, we will hand over our credit card, and start private IVF. That’s the plan.

And just one little thing ...no matter how tempting it is to make me feel better by offering me platitudes, or telling me to relax …don’t do it, because I am balancing on a knife edge. I will mash my relaxed fist into your nose. Just so you know. Fair warning and all that.

Now ev'ry gambler knows
the secret to survivin',

is knowin' what to throw away,
knowin' what to keep.

'Cos ev'ry hand's a winner,

and ev'ry hand's a loser …

You have to know when to hold ‘em,
Know when to fold ‘em,
Know when to walk away,
Know when to run.
You never count your money,
When you’re Sittin’ at the table,
There’ll time enough for countin’,
When the dealin’s done.**

* Dr Miriam Stoppard, "Conception, Pregnancy & Birth" (p. 29)

** ‘The Gambler – Kenny Rogers