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Lately

Things have been looking up in some ways for this little family. Even though we’re still struggling, I think we’ve had more happy moments in the last couple weeks than we’d been having previously.

As far as infertility goes, we’re just moving forward one step at a time. The second HSG was much better than the first. I was nervous but took a relaxant beforehand to make sure I didn’t spasm, and I’m grateful for that. It was much less painful, and the dye flowed through my tubes before I even knew what was happening. They were completely open and clear. I almost couldn’t believe it was true, but I was so relieved.

This means that I either spasmed last time, or that the first HSG loosened things up so that everything was able to get cleared out this time. I had a lot of unusual cramping and ovarian pains throughout my cycle this past month, so that’s definitely a possibility. Either way, this was amazing news that lifted a huge weight for us. I am so grateful that we were able to get this test performed as soon as possible instead of having to wait a few months to get an appointment with the fertility clinic, as we had initially believed would be the case. It is such a blessing that we didn’t have to continue until December believing that my tubes might be completely blocked, as this was such a difficult thing for us to deal with.

Even though the results were great, the rest of the appointment was a disappointment. I’d had my misgivings about this particular fertility clinic ever since we first started looking into it, which is part of the reason it took me so long to set up an initial consult. There’s only one fertility specialist in our entire city, so we didn’t have much of a choice about which doctor to see. The doctor is board certified and is perfectly qualified, but for some reason his style just rubs me the wrong way. From the very beginning, it just seemed like everything on the clinic’s website was almost too good to be true, and was a bit more flashy than I would like. I was hoping that my feelings would change once I actually met the doctor… but that didn’t happen.

Instead, I was pretty upset with the way the doctor talked to me. I wanted him to explain my options and give me the information I needed to be able to make an educated decision, but I felt like he was a bit demanding, telling me bluntly what he thought we should do next without offering any explanation of his reasoning. I was in such a fragile emotional state and wasn’t feeling up to making a decision to go forward with an aggressive treatment plan right away, so I asked him if it would be possible to start slowly with a medicated cycle. His response was to assert that combining medications (letrozole) with an IUI would be the best option.

Now that I’ve had some time to do research on my own, I think that this is what we will likely end up doing. At the time, however, this was all very overwhelming for me. Infertility treatments, such as IUIs, carry intimidating emotional, physical, and financial costs, and deciding to start the first treatment cycle seems like a huge step. It’s been so hard to come to terms with the fact that I will most likely need help to get pregnant, especially when my doctors haven’t been able to point to anything that is actually wrong with me. We know that I ovulate, that my tubes are clear, and that there are no male-factor issues. If nothing actually is wrong, it might just be taking more time for us, and we might have a chance of getting pregnant naturally; if this is the case, it seems pointless to put ourselves through all the stress of an IUI. On the other hand, if something is wrong on such a deep level that my doctors haven’t found it yet, an IUI might be completely ineffective and a waste of money.

Anyway, when I hesitated, explaining that I didn’t feel ready for an IUI and that I was worried about spending too much money without being sure it would be necessary or beneficial, he quickly responded that if I wasn’t ready for an IUI, I wasn’t ready to have a baby. He continued to say that babies are expensive, so I might as well get used to paying an extra $500 a month; if I wasn’t ready for that, then why was I trying to have a baby?

I was absolutely shocked that he would say something like this to me, and I couldn’t really hold it together after that. These are the sort of comments that I might expect to hear from a random acquaintance who knows nothing about infertility, but never from a doctor who spends every day working with infertile couples. Of course I understand that babies cost money (and we do have the means to care for one) but that doesn’t mean that I want to spend thousands of extra dollars trying to get pregnant, something that most couples are able to do for free. It doesn’t mean that I am ready to commit to an invasive and expensive treatment plan that would only give me (at best) a 20% chance of success. Being ready to have a baby is a very different thing from being financially, emotionally, or otherwise ready to begin fertility treatments. We have been at this long enough now that we know we are ready for a baby, and our commitment to making whatever sacrifices are necessary has been tested over and over again throughout the past two years.

This is especially difficult for us right now because of the fact that we are unexplained. If we knew that there was a serious problem and that we couldn’t get pregnant without help, our choices would be clear. However, there is always that hope in the back of my mind that it could still happen without treatments, although it is unlikely at this point. We also don’t have insurance coverage for infertility, which further complicates things. Infertility treatments are very expensive, and it is difficult to be at a point where we are trying to decide whether or not to drain our savings account in order to take a gamble on a treatment plan. Having children is our top priority in our lives, so we will ultimately do what is necessary, but we also want to be sure that we are going about this in the right way. We want to be careful in our decisions to make sure that we will come out of this ok, emotionally as well as financially. As it is, it may just take us some time to come to terms with the options before us.

I was upset enough that I actually stood up to the doctor, something that is a bit out of character for me, and he ended up backtracking a bit. He apologized, saying that he misspoke, but then reiterated that I should schedule an IUI, without giving any further elaboration. I was in tears at that point (I’ve been such a basketcase lately), so I simply asked him to stop pressuring me because I just wasn’t ready to make this decision yet. At that point, he finally realized he needed to back off. He gave me a few minutes to change and pull myself together, then we met him back in his office, where he said that they would put in an order for medications for us and that we could call them when we were ready to start a cycle – either just with meds, or with an IUI as well.

I was too upset at that point to really want to consider it or to ask questions, and he didn’t offer any other information about our options. I now wish that I had had the strength to ask him for more information, but I just wasn’t able to at that time. It would have been nice if they had scheduled a follow-up consultation so we could come back after having some time to think through the possibilities. As it was, we didn’t stay long, leaving after telling the nurse we would probably wait a month before calling to start a treatment cycle.

For the time being, our plan is to take a break from doctors for a cycle or two. Having had an HSG, our fertility should be boosted for a few months, and we’re hoping to take advantage of that. If we have no success by December, we’ll call the clinic and decide where to go from there. Depending on what we can get insurance to cover, we might go ahead with meds and an IUI right away, because that does have a higher chance of success than doing either one on its own. It can pay to be more aggressive with treatments, because the cost of having to do several cycles of less-effective treatments can add up over time and surpass the cost of doing a single more intense treatment. However, there is a reason that doctors don’t start every patient with IVF, despite its higher success rates. There is something to be said about starting small in order to minimize the emotional and physical costs, if not the financial. Because we’re young and have time, and because the stress has been so difficult recently, we might start out more slowly despite the fact that it might take longer or cost more in the long run. We’re just going to take it one step at a time and see what we feel ready for.

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