Well I guess that’s it. I’ve taken out the garbage and by doing so I have just defined the rest of my life. My life as a wife, sister and daughter - period. There will be no role as a mother. That trash held my hopes and dreams of being a mother, and of my husband and I being parents. We were going to be the best parents. We were going to be involved in our child’s life. We were going to teach him to read and write, to appreciate music and to sail and play sports. We were going to name him Thomas or Mary if it was a girl. This kid would have been spoiled with attention from their Grandparents. I would have gotten upset with my parents for giving in to the temper tantrums. But none of these things will happen, now that I’ve taken out the garbage.
The garbage full of syringes, alcohol wipes, Leuprolide Acetate, Gonal-F, HCG, Heparin and Prometrium. Additionally there are the temperature charts, basal thermometers and calendars. These are the implements of infertility. They are things that I never thought I would need. I am one of six children, and my mother is one of nine, and so on.
The reality came from the doctor last week. After a second failed attempt at In-Vitro Fertilization (IVF), the doctor indicated I was no longer a good candidate. In fact he said that I had less than a 5% chance of becoming pregnant and carrying to term - because of my age. He said that I could increase that chance to 40-50% if I used donor eggs. That was out of the question for two reasons. First, there is no more money and second, it goes against my sensibilities.
What wasn’t put in the garbage? The hand knit sweater and socks that were made by my mother-in law during my first two pregnancies, just two years ago. Nor are the pregnancy and baby books that my family gave me. Since I haven’t hit menopause yet, my faith tells me that there is still a chance, and I shouldn’t give up hope.
How did we get here? How did we end up in this place? Where do we go from here? These questions rattle through my head all day and all night. When will the crying stop? Do I want it to stop? If I stop, that means that I have accepted it, and I don’t want to. I don’t want to admit that I’ve screwed up the thing that I wanted most in this world, to have a family. Why didn’t someone tell me that there was a “best if used by” date on my eggs?
I’m about to embark on a journey, only I don’t know where it will take me. I haven’t thought about a life like this, a life without children. Everyone tells me these things happen for a reason. I can’t fathom the reason right now. I can’t imagine what greater purpose is being served by our pain and emptiness.
I am grateful. I am grateful for my wonderful husband, my supportive family, my employer and my employees. I am especially grateful to one nurse in particular, that had no reason to care - but did. They have all taken this ride with me on an emotional roller coaster.
Growing up I was what most people would call a good kid. I tried to be good, although I did get into my fair share of trouble. I tried to please my parents and teachers. I had decent grades and seemed to have enough friends to suit my needs. I was normal. I was taught a good work ethic and that if I worked hard enough, I would reach my goals.
I grew up in a large family, one of six children. Yes, I am a middle child but this is not about that. My parents both worked. Along with my siblings, it was always expected that we would go to college and have careers. It was never a question of being a mother or of having a career, I would simply do both. My parents seemed to do it with ease, or so we thought growing up.
The only thing my parents stressed to us along the way was that they did things in the wrong order. They were married and began having children while in college. Since they were in professional careers, they needed to obtain Masters Degrees, which meant endless night classes for the years while we were growing up. It also meant lots of spaghetti and peanut butter and jelly sandwiches! Money was always tight, but they always found a way. They tried to impress upon us children, that perhaps we should get our educations out of the way before starting our families.
I completed my education at age 23 and fully expected to find someone and have a family. It was the finding someone, the right one, that seemed to be the problem. What do you do when the right one doesn’t come along until later, much later? Compound that with Mr. Right not quite being ready when you do find him. I think that if you look up the word ‘procrastinate’ in the dictionary, you will see a picture of my husband. He is thirteen years my senior and since I was so youthful, by comparison, he disregarded my concerns of age. He is a man after all, and doesn’t hear the same biological ticking in his ear.
Eventually, after dating for twelve years, we were married. I was age 39 and he was 52. We were married in October of 2002, and to our delight we were pregnant by January of 2003. I read everything I could get my hands on about pregnancy. We were picking out names and we told the whole world. Occasionally I would catch my husband looking like a deer caught in the headlights… as the reality of what we were doing was sinking in and how our lives were going to change. But all in all, he was super. Although I tried to explain that I didn’t really need to eat for two, he kept a steady supply of ice cream in the freezer. I think it made him feel useful.
As March rolled around, and my body started changing more noticeably, I was starting to feel like a Mother. I enjoyed the way my husband looked at me. I felt whole. I felt content and as if everything was going to be okay. I was sitting down at night after work and doing cross-stitch samplers for the baby’s room. I was content. My mother in-law knit matching socks for the baby and my husband. My brothers and sisters were offering hand me downs from their children.
And then it happened. That spot. That one damned spot. The one that I told myself, over and over again, not to panic about. The books all say that it is not uncommon to have some breakthrough bleeding. Okay, remain calm. Just call the doctor and everything will be fine. We called the doctor and I was told to take it easy, and not to worry. They told me to call back if the bleeding continued, which it did. It was a long 35 minute drive to the hospital. I told the doctor that we were probably just overreacting and I was hoping we would laugh about this in 6 months. He agreed but he couldn’t hide the concern on his face when he couldn’t get a fetal heart beat. A heart beat that we had never heard, because we were going to get to hear it at our next appointment.
We had to wait over an hour for an ultrasound tech to arrive at the hospital. With the doctor, nurse, the tech and an ER physician present, my husband and I learned that our baby had ceased to exist. It was just a sac. My husband looked dazed. I didn’t understand. At some point over the previous 2 or 3 weeks, it just stopped being. Why didn’t I know this? There was never any pain or any other indication. How could I not know that my baby had died? So they sent us home. No reason. No explanation. They just sent us home. The ride home seemed to take hours. The radio is blathering on about the start of the war in Iraq.
The next day we had to drive back so they could perform a D&C. I’ll never forget sitting in that waiting room and filling out all of that paperwork. Do you know what they call a miscarriage? They call it a spontaneous abortion. I didn’t want to have this done…I wanted to go back to yesterday before I saw the spot. If only I hadn’t seen that spot. Then they finally took me in and got me ready. They put an IV in and said they put something in it to calm me down. Then they had a couple of emergencies come in and my procedure was delayed. I remember laying there and thinking about getting up and leaving. It must have been someone’s birthday or something, I remember operating room (OR) staff laughing and going in and out of a break room. They were eating and being very animated. I remember being angry at them for being happy. Finally, someone asked if I wanted my husband to wait with me and I said yes. I recall telling him that I didn’t want to do this. It wasn’t fair.
They took me into the OR, it was cold. I remember the doctor, someone I’d just met, being very kind. She explained what they were going to do and said she would have me out in no time. I remember her adjusting my legs for the procedure and that was it. I woke up in recovery. I was told that it’s best when this happens, that something must have been wrong in the development of the fetus. But to me it wasn’t a fetus, it was our baby.
We were counseled on subsequent visits that there was no reason to believe we couldn’t have a normal pregnancy. They showed us charts explaining that one of every three pregnancies ends in miscarriage. Correspondingly, many friends and relatives confirmed the same with their own personal stories of loss. Although the next few months were difficult, we did not feel hopeless. We waited the recommended amount of time and began trying to become pregnant once again.
It is very difficult to describe how hard it is to tell people that you have had a miscarriage. You don’t send out “miscarriage announcements“. You pray that someone else has told them and that they have the good sense not to bring it up. We know that people care about us. We know that people share in our loss. But, we are wasting time, the clock is running. We have to try again - NOW. We don’t have time to sit around and wallow in self pity. We have to take action. If I stop and think, I will cry. It hurts too much to address the loss. We have to move forward.
Success! In September of 2003, we were pregnant again. Not bad for a couple of old farts. I am now 40 and my husband is 53. The odds are with us now. We had our miscarriage, this time we’ll have a healthy baby. Everyone sighed a big sigh of relief and we moved forward.
At our first doctor’s appointment, I explain to the doctor that my older sister suffered a miscarriage with her first pregnancy. For her second pregnancy, her physician prescribed progesterone and she delivered a healthy baby girl. I wondered if this might have any merit in my case. My doctor was a resident and needed to confer with the physician in charge. The physician in charge explained that it was not indicated and could in fact be detrimental. We went happily on our way making plans for our family.
My husband’s mother began knitting again and my family once again began offering all sorts of supplies. I resumed my cross stitch and my husband once again began tuning in to all of my needs. Life is good. At work, we are moving in to a slower time of year and I am pleased that I will be able to take it easy without feeling guilty.
At my second appointment in October, I beg the doctor for a picture of the baby. He is concerned with doing unnecessary ultrasounds and explains that we will get one at 12 weeks. I plead and explain that many of my friends and relatives get them earlier. He does not give in and I go home marking the days until that 12 week appointment. We should have a picture of the baby when we visit my husband’s family for Thanksgiving.
The days go by and the excitement starts to build again. I lay in bed at night with my hands on my abdomen. I don’t want to miss anything. I know it is far too early to feel anything. I just want to hold this child so badly; I want it to know that I am there. Just one more week and we’ll be able to see it.
Just a few days short of that appointment, it happened again. That spot. The oh no, not again. It can’t be happening again. What did I do wrong? I’ve been good. We don’t deserve this. Back in the car for the long drive to the hospital. We arrive in the evening. My doctor, who had worked all day, came in personally. The concern showed on his face as he once again listened for a heartbeat. But there was none.
After waiting hours to confirm what we feared, we were sent home. This time it was recommended that we not have a D&C. It was felt that repeating the D&C could cause excessive scarring and hinder any future pregnancies. We were told the fetus would begin to be reabsorbed into my system and break down. We were told that within the next week or ten days, I would begin bleeding - “about twice as much as a normal cycle with a lot of clots”. Then we were told to wait a specified period of time before trying again.
Through Thanksgiving and the holiday weekend, we did indeed experience what had been described. In fact, by Sunday evening, the bleeding seemed to be subsiding. I decided that I could handle a light day of work on Monday, and my husband could make a short trip to visit his family. We felt it was time to start healing.
While at work on Monday, I was putting up Christmas decorations, and the bleeding started again. It progressively got worse. I went home and decided to take it easy, play a few computer games and watch some television. The bleeding was heavy and nonstop with massive clots passing. I began getting nervous as I used up all of the feminine products in the house. I didn’t call my husband because I didn’t want him to worry and drive home (6 hours) in the middle of the night. Besides, women have been having babies and miscarriages for centuries…
By 7 pm I finally decided to turn in for the night. I was exhausted, my back ached, I had massive cramping and felt if I just went to sleep, I would be okay. As I lay in bed, I could not sleep due to the cramping and the persistent blood clots I was passing. Around 9 pm I noticed that there was a rhythm to the “cramps”…these weren’t cramps - they were contractions! I don’t know how regular they were coming, but around 11 pm, I delivered an intact sac into the toilet. It was about the size of a softball. Oh my God, what do I do? What am I supposed to do? Do you flush it? Do you bury it? Oh my God there is blood everywhere…I’m tired, I’m so very tired.
I crawled into bed. I knew I was still bleeding. I ached, I was crying, I wanted my husband. He would be upset that he wasn’t here. We didn’t expect this. We hadn’t been warned I might actually go into labor. I’m the one that told him to go. I thought it was all over. I needed sleep. I went to sleep and told myself that if I died - then that was the way it was supposed to be. It was no longer in my hands.
In my follow up appointment I informed my doctor that in the future, they should prepare their patients for a broader range of experiences. I explained that having bleeding about twice that of a normal period, was vastly different than my experience. I also explained that since I was a woman that had never been in labor before, it was too late to get to the hospital by the time I realized what was going on. Something could have gone terribly wrong.
We advised him that we were going to seek alternate care for our future pregnancies; and he responded that he felt we should. He explained that he couldn’t face us if we lost another child. I do not blame my doctor. He was an eager resident in a teaching hospital. He displayed caring and concern every step of the way. I do not feel the same about his supervisor…the woman that offered the advice about what we should expect. She is also the one that didn’t feel progesterone was necessary, although she never tested my levels.
In January of 2004, we decided to search out a new doctor. We had suggestions thrown at us left and right. We opted for the office that had delivered my nephew and niece. At our first visit, we were advised that because of my age, it was likely that I would need to be on progesterone. (Gee, where had I heard that before?) The office set me up for a series of blood tests that would test my hormone levels throughout my cycle.
The blood tests indicated that I did suffer from low progesterone levels. This is not uncommon in women my age apparently. So I begin a fertility treatment cycle with temperature charts, and we are instructed to have sex every-other-day from day 10 to day 20 of my cycle. We are further instructed to begin taking progesterone tablets 2 days after ovulation and continue taking until I either get my period or achieve pregnancy.
This isn’t hard at all. It is just tiresome. You become very aware of everything you put in your mouth. All of the sudden, you’re afraid to take a painkiller, or a cold tablet for fear that it might impede pregnancy or affect a baby. You have to wake up and take your temperature at the same time every day, week after week, and month after month. You have to count days, pee on sticks and have sex on schedule! We’d joke about it. My husband always said work, work, work, tsk, tsk, tsk…but after a year (eventually) you could hardly say it was spontaneous.
These first three months focused on assisting us to get pregnant (on our own) and maintaining a healthy pregnancy once we became pregnant. Unfortunately, after three months, we had no results. Each month we became hopeful and each month we were disappointed. The “cycling” is cruel. It adds stress.
We reached a point where we had to decide if we should take another step. We were now well into spring and I would be turning 41 during the summer. The nurse that was working with us recommended that we try intra-uterine insemination. This is a process where they fertilize my eggs with my husband’s sperm, in my uterus. It requires a controlled stimulation of the ovaries to produce more than (the usual) 1 egg, for better chances of conceiving. Then with specific timing, the eggs are released and the sperm is introduced. Nature should take its course.
This process required me to inject hormones on a daily basis. It also required intra-vaginal ultra-sounds and blood work every-other-day prior to ovulation. It is difficult to describe the power these hormones have over your personality. I believe I quit my job twice during the treatments. Fortunately, my employer was aware of our attempts to conceive and granted a little leeway. Each treatment cycle brought about a new round of hope, which was followed by an excessive sense of loss. As the months progressed that loss became a silent rage. Why isn’t this working? I’m doing everything they tell me to do.
Then there would be the “off” months. Occasionally, due to the over stimulation of the ovaries, we would have to take a month or two to let the ovaries rest. There would be residual follicles or cysts from producing so many eggs at once. Believe it or not, birth control pills are used to alleviate the problem. How ironic! These months were the worst. My mind would race with the precious time that was being lost. I remember storming my doctor’s office on one occasion, about how no one really cared and if it wasn’t going to work - why not just tell me so. Of course they couldn’t tell me it wouldn’t work, I wouldn’t have believed them.
Eventually it was apparent that these fertility treatments, that were meant to assist us in getting pregnant, were not working. We made the decision, along with our fertility nurse, to seek out In-Vitro Fertilization (IVF) treatment. We were referred to a facility about an hour north of our home. It seemed to take forever to get an introductory appointment. I don’t remember much about my initial visits other than they wanted money – LOTS OF MONEY. We had to pay a certain amount up front, and then provide an account number for monthly payments, sign away our first born, and so on.
Again with the daily temperature taking, shots, pills, internal ultra sounds. The perpetual demands to stay relaxed! Finally the day came to harvest my eggs. I wanted my husband in the room, though it was not on his list of “must sees.” He did it though. I warned him about the needle – that big friggin needle. I won’t go into the semantics of how it is used, because those who are interested can probably google it. But it is large and my husband doesn’t handle large needles very well.
They managed to harvest about a dozen eggs and felt that 8 were of sufficient quality to fertilize. My husband’s sperm had been prepared and were injected into the eggs. Now we had to wait and see how many would grow, and determine how many to implant. We spent the next three days trying to determine how many fertilized eggs to implant! We knew that this procedure might work and that it might not. We couldn’t implant 8 fertilized eggs – perhaps we should freeze four, implant four and hope for one. With our luck we would have quads!
On the third day we arrived at the clinic. We were advised that of the eight that were fertilized, five had grown and four were hopeful. They recommended implanting all five in the hope that one or two would take. That is what we did. Our thoughts as we waited were of hoping for success – but not too much success. We had obviously heard of cases with four and five children being born as a result of this procedure. While we wanted children, we did fear having them all at once.
Menstrual cycles get seriously screwed up during these fertility cycles. You can’t trust your own body when you don’t cycle on schedule, and you can’t trust your body when you do cycle on schedule. Every day that passed made us more hopeful. Then the day finally came for the blood test. I wasn’t pregnant. It didn’t take. The conversation with the nurse rolled right over that tidbit into the process for starting a second round of IVF.
The money. We borrowed the next down payment, and added to the amount being sucked out of our checking account each month. We had to wait to start because we had to wait for our pharmacy to get in more of the drugs we needed, and to let my ovaries “relax.” Then we were back on the merry-go-round of drugs and on the roller coaster of emotions.
The next round was as uneventful as the first. It ended almost the same way. The difference was that this time the doctor came in to tell me that it didn’t work. He suggested that perhaps my eggs were just too old. How could my eggs be too old when my husband’s sperm is fine and he is thirteen years older than me???? It’s not FAIR! He’s the one that came of age in the late sixties and early seventies. He’s the one that experimented with every drug a good hippie would! I wouldn’t even take an aspirin if I had a glass of wine!
The doctor went on to explain that I was an excellent candidate to receive a donor egg. I just remember shaking my head no. He continued that I would be able to select the traits of the donor, yet I continued to shake my head no. It wasn’t about my being able to accept another woman’s egg; to me it was an ache that my GOD didn’t want this for me. If not this than WHAT WAS I SUPPOSED TO BE, and WHAT WAS I SUPPOSED TO DO WITH MY LIFE?
As family and friends became aware of our failure, they all offered sympathies. Eventually, my brother’s wife approached me and offered to donate her eggs. I explained that I appreciated (sincerely) her offer, but that I felt it went beyond my sensibilities. In fact, in order to perform this donor egg IVF treatment, we would have to actually pay for 2 IVF treatments; one to harvest my sister in laws eggs and one to have me in sync with her for implementation. We were already in deep debt and not able to make monthly payments. It was financially unfeasible.
I didn’t concede easily. I spent the next couple of years trying to do it the old fashioned way. Laugh if you must. But there was a little bird whispering in my ear about all of the women that got pregnant – once they quit obsessing about it. Once you just relax…blah, blah, blah!
In the months and years since, people have recommended adoption. Do they know how much an adoption costs? Do they have any idea how much the fertility treatments cost us? Do they have any idea how much debt we accumulated? Do they know how mentally and emotionally exhausted we are? Do they know how afraid we are that we would be given a child, only to have the birth mother change her mind? Do they know how hard it is to accept these circumstances, in their totality, only to have it brought up again?
The only suggestion that I have for anyone facing a similar situation is this; I don’t know what you’re feeling – I have no idea. I know what you are doing, and I know it is taking a toll; but I do not know what you are feeling. Only you know your sense of loss. Only you know your sadness. Only you know your pain. It is different for everyone.
For me, the loss cannot be described. There were no funerals. There were no calling hours. There were no children. No certificate of birth or death. No names. No one to hold. No one to say good bye to. Just nothingness.
Five years later…
The only entitlement I take away from these experiences is my right to outrage. Outrage every time I hear of another case of child abuse. Outrage whenever I hear of someone taking advantage of couples trying to adopt a child. Outrage when I hear of children in this country, sitting in orphanages for years because people cannot afford the legal and court fees to adopt – a system that would rather pay to raise children in orphanages than give them to people that would love and nurture them. Outrage at the insurance company that decided, 2 years after my first miscarriage, to reverse payment for my D&C because it wasn’t necessary. Finally, I have outrage at the fertility clinic that had the nerve to send us an invite (4 years after our failed efforts) to a family picnic they were having to celebrate all of their successes – they wanted us to bring the whole family! I restrained myself from sending back a sarcastic rsvp.