The Business of Hope: Part 4 of 5

It's hard to believe that our first little one is due this week!  I'm so excited to meet her (and evict her) that I can hardly breathe sometimes! (Of course, that also could be because she has her feet firmly planted in my lungs...) 

Because this week is so different from every other, I've also chosen to write about something very different.  

This week I'm posting a 5 part series about my experiences being diagnosed and treated for infertility.  I can't lie - it's personal and somewhat painful to share. But I also feel it's incredibly important to create an open dialogue about the topic (something that is strangely lacking or taboo) and share the experience in the hopes that those who don't know much about it can become more familiar with the journey and those who are going through it are reminded that they're not alone.  

Friends, as you read this, please do so with an open heart and mind.  Please know that the intentions are not for pity or grandstanding but for a greater understanding of something that is still so isolating for so many.

xo
e.

Click Here to Read Infertility, Part 1
Click Here to Read Infertility, Part 2
Click Here to Read Infertility, Part 3

Infertility, Part 4                                                                              


Explanations

After several months of testing, we finally had a few answers, and frankly, they sucked.  Scott was fine.  I was definitely the problem.  I suppose it shouldn’t have mattered – we were in this together – but it DID matter.  No one wants to feel like it’s their fault.  As though they’re broken.

After weekly bloodwork, tests and meds, it was determined that I was not dealing with any of the usual offenders – blocked tubes, scarring or fibroids.  The problem was a little more unusual.  My AMH count was low – particularly for my age. 

It would take a while to explain (and I’m not a doctor, so if some of this is explained incorrectly, forgive me) but the basic idea is that AMH can be used as an indicator of the number of eggs in reserve in a woman’s body.  Essentially, a woman is born with as many eggs as she’ll ever have.  The eggs in reserve produce this hormone (Anti-Mullerian Hormone) that keeps the egg that’s on-deck healthy.  This means that as we age, and eggs are released, the AMH drops and the remaining eggs receive less of what they need to stay strong. This is why a woman who is in her 40s or 50s is far less likely to get pregnant. She only has a few eggs left and those that are there are most likely not viable. 

The fact that my AMH is low means that, despite being in my early thirties, I may already be approaching menopause. I may already be running low on eggs and therefore producing only unhealthy ones.  Which just sucks. 

It was looking more and more like we were headed toward In Vitro surgery and would just have to cross our fingers that one of the eggs that they harvested would be healthy and viable. 

Before we went that route, however, Dr. Shapiro wanted to exhaust other options.  IVF is invasive, painful, and incredibly expensive and still might garner no results, considering the challenges.  So on to new medications and higher dosages I went. 

The hormones, for me, were something out of a nightmare.  I felt sick All. The. Time.  I was exhausted All. The. Time.  My weight and appetite were all over the map.  My emotions were, of course, affected by the hormones, so to add to the joy, I seemed to be on a constant roller coaster of depression, fear, shame, anger and isolation.  Actually, roller coaster might not be an accurate description.  I think it was more akin to walking through a really freaky fun house filled with frightening clowns and distorted mirrors.  And a slew of screaming 8 year olds that just spilled their cherry drink on my new shoes and ran off.  Jerks.

For the record – if you’re considering going through a fertility clinic I don’t want to scare the begeesus out of you.  This was MY experience with the drugs and how they reacted to my body.  Plus I was on higher dosages than most.  And if it came to it, I would do it again.  I’d just ask to be sedated the whole time.

In addition to the drugs, I had three procedures called Intrauterine Insemination (IUIs) done.  Essentially, a doctor takes sperm from the male and injects it directly into the female past the uterine lining.  This procedure generally only works if the problem has to do with the lining or the sperm itself – neither of which were our issues- but we felt it was worth trying. 

Degradation
“These clumsy feet, still in the mire, go crushing blossoms without end…” – Edward Rowland Sill

Warning: this may be way too much information for some.

Another waiting room in another clinic.  My cycle had, of course, fallen on a weekend so, early on a Saturday morning, Scott and I trudged to the on call facility in a different hospital.  I was supposed to be running a 5K later that day with my dad, but there was nothing to be done about the way my body had timed it out.

It was 7:30 and the clinic was otherwise empty.  Somewhere in the back the first few nurses buzzed around making coffee and trying to catch up on all the work they hadn’t had time for during the week.  Scott held my hand as we waited.  Apparently Dr. Vaughn – the head doctor of the practice in fact – didn’t feel the same about punctuality as Dr. Shapiro did.  I held my breath.  The wait is always the worst, I assured myself.  I looked at the obligatory women’s reproductive system model on the table – this time next to Scott.  I wondered where you got those. 

“Do you think there’s just a warehouse of plastic uteruses somewhere?” 

Scott followed my gaze and smiled.

“I suppose.  Is it uteruses or uteri?”

“To be honest, I haven’t had the opportunity to refer to more than one all that often, but I feel like as a woman I should know.  Either way, I think we should find out who makes them and get a few for our end tables.”

“Or stocking stuffers.  Who DOESN’T want fallopian tubes for Christmas?”

“True story.  I’m pretty sure they were one of the gifts the wise men brought.”

A nurse stuck her head around the corner.

“Ms. Murray? You can come back and change while we’re still waiting for Doctor Vaughn.” 

We moved into the back and I changed into the gown.  The room was the usual 33 degrees.  Scott put his arm around me to keep me warm.  Another 15 minutes went by.  Finally, we heard the doctor speaking to the nurse in the hall. 

The door opened and a tall, good looking doctor stepped in.  He looked briefly at me and then shook Scott’s hand and addressed him without introduction. 

“Your sperm count is excellent.  Congratulations.”  

Scott shrugged awkwardly.  “Ummm, thanks?”

“No, it’s great.  You should be proud of that.”

I looked down at my goosebump covered knees.  So I should feel ashamed that my egg count is low? I shook my head to clear the fog and smallness that I was feeling.

The doctor went to the counter and began preparing the equipment.  With his back turned to me, he instructed me to lie back and put my feet up.  Everybody’s favorite part.  I was starting to think there should be a song for people in my situation with a remix of lyrics that encouraged listeners to “throw your feet in the air, and wave them around like you just don’t care…”

Scott held one hand and put his other hand reassuringly on my shoulder.  After a minute, and without a word, Dr. Vaughn inserted the speculum.  It was cold and fast and it hurt (something that it doesn’t normally do).  I flinched slightly at the pain and the doctor scolded me to lie still.  He grabbed the catheter and pushed it inside. 

“Husband, come here.”

It all happened so fast, and so unexpectedly it caught both of us off guard.  Scott did as he was told and went around the table.   I was now exposed to everyone in the room.  Before I knew what was happening, Dr. Vaughn had put Scott’s hand on the catheter and told him to “push the plunger.”  Again, he addressed only my husband.  Not knowing what else to do, Scott complied.  After this was done, the doctor removed the catheter and turned back to Scott.

“Now you can say that you inseminated your wife.” 

Scott stood there looking shaken.  But it was nothing compared to what I was feeling.

I don’t know if I have ever felt so humiliated in my life.  I love my husband.  I trust him more than anyone on this earth.  But that is NOT a position I ever wanted to be in, in front of him.  I felt like a cow lying there on a table while the men in the room talked about getting me pregnant.  Every little ounce of power, of dignity, of self-dominion was stripped from me in those quick moments.  I laid there in horror and shock and shame – too stunned to know what to say.  

Scott came back around to be beside me, while Dr. Vaughn rambled on that we needed to have sex again later that day to increase our chances as much as possible.  As he talked, I attempted to sit up and pull the sheet back over myself, wanting to reclaim some sort of modesty.  The doctor turned to me, pointed and said “No.  Back down.  For ten minutes at least.” He then continued his conversation with my husband.

Scott helped me cover myself and then asked him if I would be able to run the 5k if I still wanted to.  Dr. Vaughn said, sure, if I was feeling up to it, but again, we needed to have sex later.  At the door, he turned around looked at Scott directly.  "If she gets a good time, you can reward her.”  Wink.  And without another word, he left the room.

Nearly as soon as the door closed, I began to sob quietly. I crossed my arms over myself.  My body shook with shame.

My husband just stroked my hair and kept whispering “I’m so sorry.”   A visit that should have been something hopeful (albeit, uncomfortable and a little scary), instead left me feeling dirty, humiliated, and powerless. 

Aftermath

I didn’t run the 5k that day and Scott and I didn’t have sex that night.  I couldn’t shake the overwhelming feeling of degradation.

I want to be clear that my feelings have nothing to do with the fact that Dr. Vaughn was a man.  Before moving to Pennsylvania, I had the same male gynecologist for 8 years and never had a problem.  I even joked around with him from time to time.  But he never ever made me feel that way.

Whether or not I wanted Scott to “push the plunger” should have been up to us as a couple, and, ultimately, up to me.  In non-emergency situations it should be MY CALL who gets to see that part of MY BODY.  Furthermore, by not addressing me – by talking only to Scott, I was made to feel like a thing - devoid of emotion, power and control.  And the frat-boy-like comment about “rewarding me (wink)” amplified that feeling ten-fold.  Honestly, I felt violated.

My guess is that Dr. Vaughn’s objective was to make my husband feel more involved in the process.  I can only assume he was attempting to add levity to the situation by some of his comments.  I can’t imagine that someone would go into this field without compassion and, as I said before, I try to believe that most people have good intentions.  But whatever Dr. Vaughn’s intentions were, the result was weeks of feeling humiliated around my husband (who had done nothing wrong and felt terrible about the way it had gone), crying bouts and increased insecurity. 

The thing that it seems that Dr. Vaughn had lost sight of is that people who are coming in to the fertility clinic are at a very sensitive point in their life.  Many are very emotionally raw from months or years of disappointment.  They come in looking for hope. 

They go through weeks and months of testing and procedures - having medical equipment shoved in some very uncomfortable and sensitive places by any number of people; talking about subjects that most hope to keep private; being told when to have sex by relative strangers; discussing what may or may not be wrong with them and what the next option is; going through the roller coaster of emotions that every month brings.  They watch people all around them get pregnant without so much as a breeze of difficulty and they long for what should be so easy.  Whether fair or not, each person carries some variation of these weights with them every time they walk into a clinic. 

To add to the isolation that comes from friends or family who maybe don’t quite grasp (or know about) the situation, it turns out that there is sometimes a desensitization that comes from medical professionals who have worked in the field for long periods of time.  Again, I don’t believe that it was intentional.  I don’t believe that Dr. Vaughn is an inherently bad person.  Maybe he was just tired or having a brainless day.  But those brief moments of thoughtlessness – or recklessness or disregard – had more lasting damage than he will probably ever know. 

. . .

As a brief follow up:

I did talk to my doctor, Dr. Shapiro, about the incident.  She was professional and compassionate and felt terrible that I had been made to feel the way I did.  With regards to the procedure itself, she said that, while it’s not completely uncommon for the husbands to get involved in this way, usually it is something that is discussed beforehand.

I also wrote a letter to the administrative head of the practice.  I wasn’t mean or ugly toward Dr. Vaughn or what had happened – I find that the angriest voice is often the most likely to be tuned out.  But I did go over everything that had happened and my feelings on it.  The administrator called me as soon as she got the letter to run damage control.  She was very kind, but in my view there really wasn’t anything to be done at that point.  She asked if Dr. Vaughn could call me personally to apologize.  I declined.  I didn’t want an apology, and I certainly didn’t want to talk to him.  I just wanted to raise awareness and make sure no one else ever feels the way I did.

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Click HERE to read the final part of the series along with tips on dealing with infertility.

More Reading: 
 Infertility, Part 1 
Infertility, Part 2
Infertility, Part 3

*Names have been changed to protect the privacy of those involved.
**This article is strictly our experience with infertility and not meant to be read as medical advice or fact.