I don't know what physicians expect when a infertile or semi-infertile patient comes in and the physician asks, "so what should we do for you?". Do they expect a girl to say, "oh let's not do anything new because I would like to continue to put myself through the same defeating process month after month without any assistance because this is fun for me!".....I think any girl that has been trying for longer than 4-5 months puts Clomid on a pedestal deeming it, "the magic pill"----and why can't we all just take this magic pill just to speed things along? (In short: it only works if you NEED it, otherwise it has the opposite effect). Asking a semi-infertile girl what she would like to do next is like putting a 5 year old in front of a candy store and a hardware store and asking, "Ok, what should we do next?". This was exactly what my new OB doctor asked me last Friday, "so Kate, what are you looking for us to do for you?". She said so with an inviting smile and a look indicating that I have complete control over how I want to proceed in my 9th cycle of trying....what a dangerous question to ask me. I think the physician should decide what's best for me before I start digging into the candy jar for myself.
Admittedly, 9 months ago when we first started TTC, I consulted Dr. Google with the million dollar question we all ask ourselves when we make an official decision to start trying to have babies--"How long does it take?". The results are infinite yet ironically, I never feel satisfied with the answer. Some stats offer duration of months while others discuss percentages of couples that will be pregnant by XX amount of months. My physician told me it takes an average of 9 months. The internet said that approximately 60% of couples will be pregnant within 6 months and 85% will be pregnant within a year. Any given cycle, a seemingly healthy couple has about a 20-25% chance of getting pregnant if they time baby dancing correctly. This statistic is higher or lower depending on age (I once saw a study that showed girls in their late 20s have about a 40% chance any given cycle......given those stats, I should be 360% pregnant right now). I'm really beginning to understand the meaning of, "everyone is different so there is no way of telling!". I once thought this is what you said to girls so they would not feel defeated if it didn't happen right away. Now I understand, it really does mean, "everyone is different and there is no way of knowing".
This data is further broken down focusing on the remaining 15-20% who are not pregnant within a year. About three quarters of these girls will eventually get pregnant leaving a small tiny percentage of those (I'm guessing about 2-3%) that eventually give up and adopt or just never get pregnant. What was particularly interesting is that the definition of "infertility" is, medically speaking, "trying for one year". Nine months ago, I read all of these statistics and I immediately clumped myself into the "within 6 months" category because I had no reason to think I was going to be one of those that took longer. Some websites evaluated more in depth actual infertility and what impact intervention has on pregnancy rates stating that, "some woman intervene too soon before the one year point so it is difficult to measure how long it would've taken them had they not intervened so soon and instead waited to the one year point". I read this in my head and scoffed thinking, "geesh, why can't these girls just be patient and wait a year before trying to find someone magic fix?"........what would my old self think of me now stuck in this very predicament?
My OB explained to me that insurance typically won't cover tests or x-rays until it has been a year, and since I'm on my 9th cycle, I would be paying for this out of pocket. I explained to her that I have a $2,000 deductible so it doesn't matter whether I start now or wait until the one year because either way, I'll be paying for it out of pocket. However, I somehow feel that I am failing myself the opportunity to get pregnant with minimal intervention by jumping the gun too soon. Contrarily, what does it matter whether I do it now or in a few months when I reach the one year point? I'd always vowed that I wouldn't be one of those impatient girls that demands medicine at the first sign of distress. Finding out I had low progesterone last November was the tipping point. Once this was revealed it precipitously changed the game for me. Over the next month, I slowly began clumping myself into the "infertility" category.....but I'm not infertile yet. Low progesterone alone does not mean I can't get pregnant. The way I understand it, it means that something else is going on and low progesterone is just the by-product of that condition. It takes the average couple 9 months to get pregnant and I'm on the 9th month. So do I wait until the one year point or continue to try knowing that I may just subsequently wind up doing all these tests and procedures in April anyway? In short, should I speed this process up by intervening now? Oh the beauty of Western medicine--it has, "give me the quick fix!" written all over it. I do need to be cautious of how I intervene because trying to augment fertility with medicine may mean I'm passing on the same defective genes to my future offspring thus perpetuating the rising rates of infertility in this country. In my case, it's probably not in my genes or more likely a temporary hormonal imbalance, but I know I must be careful because my body may simply be telling me that it's not ready yet to become pregnant and there could be more serious short or long-term repercussions by intervening too soon.
My OB and I are proceeding onto some more minor next steps which entails taking Clomid for the next 2-3 months which I will start taking with my next cycle in February. As you may recall, I did take Clomid during December which did not augment my ovulation since my progesterone stayed low after ovulation. It may take a few cycles for my body to adjust to the effects of Clomid so this fact alone does mean that I won't respond to Clomid. In addition to Clomid, my OB doctor suggested that next cycle I undergo what is called an HSG test. The way I understand it is they will insert a dye into my fallopian tubes, take an x-ray and determine if there are any blockages. I called my clinic today and learned that this test is $497 so I decided to delay this test until we've reached the one year point in April.
The irony of all of this is not overlooked. I've learned a lot about myself and about TTC in the past 9 months, and I think one of the biggest lessons emerging from this process is that I can never judge someone else until I've walked in their shoes. I've learned about resiliency and the smoke screen we shield ourselves of so not to tip over to the dark side. The point being that once it happens to you, it's never "rare". Clearly, I'm not able to clump myself into the "infertile" and "trying forever" category and I will likely get pregnant within the next few months (do I have to name my kid "Clomid" if I do?), but I feel this whole experience has taught me to never be quick to dismiss what other people are going through (regardless of what it is) because if I ever endure it, I want people to exercise the same level of understanding.
Here's to cycle #9 being where all the magic happens!
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