Tuesday, 26 February 2013

Taking Charge of my Infertility

Last post I talked about how the children were growing older and how, for the time being, I was enjoying that.  It's occurred to me that I could say something similar about my own aging.

I turned thirty-five in December, which is something of a milestone birthday for a woman--the biological clock is ticking loudly now, etc, etc.  Yet it didn't bother me, because I had my complete family.  In fact, turning thirty-five just reminded me how lucky I was to have my children, because that's such a hard birthday to deal with if you are still waiting/trying.

Turning Thirty

My thirtieth birthday, for example, was more difficult, even though turning thirty is a fairly low alarm on the biological clock.  The year I turned thirty was the year we had finally accepted we weren't conceiving by ourselves, the year I was diagnosed with polycystic ovarian syndrome.  By the time of my actual birthday, I was on my third round of clomid (a pill commonly used as a first stage of fertility treatment) and aware that if I didn't get pregnant this month, we would start discussing more aggressive treatments.

The pressure was on for that two week wait... I remember I was scheduled to take a pregnancy test on Christmas Day, but I was going to wait until Boxing Day, because I was too afraid of ruining Christmas.  Naturally, I didn't have to bother, because my period was the first surprise I received on Christmas morning.  It's safe to say that Christmas 2007 was the worst one I've ever had.

But even before I knew that that cycle hadn't worked, it was hard for me to turn thirty, which is when the ovarian reserve is supposed to 'diminish'.  I knew it was ridiculous, that my ovaries weren't exactly going to start degenerating on the stroke of midnight, but I was very aware that my odds were getting less (NB Honestly, to be already getting fertility treatment at age 30 was putting me well ahead of the curve, but I wasn't really thinking in those terms at the time).

I would probably have been terrified if I'd known then that we'd sign up for IVF within two months... but I'd have been bloody rapturous to hear that my son would be born before I turned thirty-one.

In the five years since then, I've come a long way.  When I was thirty-three, my daughter was born and the family of four I'd always wanted was complete.  It was a very strange feeling not to have that slight disclaimer in the back of my head: "If we have another baby..."  PCOS went back to being a mostly non-factor in my life--it's still putting me at risk for diabetes and what have you, but it's no longer something we have to combat.

Meanwhile, we made that bizarre transition from trying to have a baby to trying not to get pregnant.  Because PCOS is a hormonal issue and hormones fluctuate in women as we get older and all, we couldn't be confident that I would not conceive naturally in the future.  The odds were slim, too slim for me to bank my hopes on when we were trying to conceive--but not so slim that I could responsibly assume we wouldn't get pregnant by accident.

However, after all the hormone-drugs I'd endured with the fertility treatments, I was not enthused with the idea of taking the pill or any other hormonal contraceptive.  In fact, spending money on probably redundant contraception every time we wanted to have sex was an unattractive proposition.  It just seemed to hammer home how pointless this all was.

Embracing Sterility

So even before my daughter was born, I suggested to my husband that I get my tubes tied--seeing as we'd never used them anyway.  This was where infertility actually worked out for us, because should we change our minds and decide we did want another child, we'd go for IVF again anyway, bypassing the tubes entirely.  It wasn't as big a step for us as it would be for a fertile couple.

There were two methods of doing this.  You can use Essure which puts tiny springs in your fallopian tubes, causing them to scar up, effectively sealing themselves.  The advantage of this is that it's not surgery, it can be done at your ob/gyn's office.   There's also the straightforward tubal ligation, which is keyhole surgery.

I have the distinction of doing both procedures, because the Essure failed.  With the benefit of this experience, my advice to other couples in this situation is: "Get him a vasectomy."  Obviously, in our case, we had a specific reason to sterilise me rather than my husband, but all things being equal, I recommend that the guy takes this one for the team.  The Essure is extremely uncomfortable (unless you're lucky and the spring goes straight in), and keyhole surgery is still surgery and is painful to recover from.

Still, it was one of the best things I ever did.  After years of struggling with my reproductive organs--and putting them through a hell of a lot of abuse during my second pregnancy, childbirth and post-partum complications--I was able to give them an honorary retirement.  I don't think I've ever felt such closure as I did the evening after my ligation.

And so, by the time I turned thirty-five, I'd been sterile for a year.  The biological clock had already stopped ticking, but it was because I'd taken the batteries out.  I'm still older, I've got more grey hairs, my face is lined and god knows my body is not what it once was, but the number was not a big deal.  What was a big deal was that I was where I wanted to be.  I had what my thirty year old self had feared was not possible.  That was cause for celebration.

I'm sure I won't be nearly so sanguine about turning 40, which has more of a mortality feel to it, but right now, I'm in a place where I'm not panicking about the years passing.  I want to enjoy it while it lasts, and I want to make a note of it, to remember this complacency (though perhaps older me won't appreciate the memory... Apologies in advance).


  1. Your article is very helpful. I am facing my 35th birthday in April. I had expected to have my family almost complete by now but, with my son's death last year, I'm trying to prepare myself for another pregnancy in order to give my daughter a sibling. I had to take the decision to go back on the pill because I know I'm strong enough yet to be pregnant again but it's hard to be using contraception when the one thing I yearn for is another baby. (Perhaps I am yearning for the baby I can never get back?) My husband and I have agreed that he will get a vasectomy when we have completed our family but that will be further in the future than we had anticipated.

    1. I hope that the next five years will be as transformative for you as the last five were for me. Here's to your 40th birthday being one to embrace.

  2. Oooo, another great post, Sarah! I am happy you are at peace with your body, it must feel very good after not being able to. And you are very right about turning 40. I am 37, so two years closer. It does sound daunting, especially since I had visions of me in my 30s, but never once one of me after that point. At least I am starting that chapter with a clean slate, eh? :-)

    1. That's an interesting point, about visualising yourself in your 30s but not in your 40s... I think the same applies to me. Time to start envisioning!

  3. I'm sorry you had to go through so much to get your beautiful children, but applaud you for doing it so efficiently! It's a lovely post, and I'm extra fond of the "taking the batteries out" metaphor. We are awfully, awfully fortunate, aren't we?

    1. We're incredibly fortunate! Looking back on it, I can never believe how smooth my infertility journey was. To actually have my family still seems like such an incredible privilege.

  4. So glad you are at peace with this & I love the metaphor as well; best way to get it completely out of the picture. I am still struggling with saying "I'm done". I made the (for me) bold first step of going back on hormonal birth control...just when I thought I was finally ovulating regularly on my own for the first time in many many years. My Gyn strongly suggested an IUD but I...just...can't...do...it. I'm turning 37 this year, so my next biggie is 40. I've found my 30s to be so so much richer than I could imagine. So much depth and breadth to life and relationships (some quite challenging, mind you). I'm almost looking forward to what's ahead, 40s and all!

    1. Yeah... any contraceptive just seemed so unappealing. We used condoms until the ligation, because they felt like the least intrusive measure.

      I like what you say about the depth and breadth to life as you get older. I hadn't thought about it that way, but that seems about right.