The House of Doolittle

The House of Doolittle

Thursday, 11 August 2011

TTC - The Final Countdown

"Aunt Flo" arrived right on time this month, just as she has every other month for as long as I can remember. Trying to keep one's expectations low means less opportunity for crushing disappointment at this news, but results in more of a constant, low-grade depression.

Last month was not the first time I told myself it would be the last time I would suffer the pain, inconvenience, and indignity of all the requisite fertility procedures. I said I needed a break and I meant it, but when my seemingly inevitable day 1 arrived, I had to make the choice of whether to call it into the clinic or not. Suddenly I began to feel anxiety at the thought of taking a break instead of relief, envisioning one of my poor little eggs making its journey with nothing there to meet it. This is the reality of being in a same-sex relationship: there will be no happy accidents. It would be another lost opportunity; the slimmest of chances that this will be the month. And so I called it into Mt. Sinai, as I have so many times over the last year and a half.

My day 3 ultrasound fell on a Saturday, as so many of my procedures do, and the Mt. Sinai clinic was packed. My appointment was strangely late, at 9:00, and we could barely find seats in the waiting room. We were uncomfortably close to those around us; two couples who had each shown up with needy toddlers. A woman across from us recognized an older gentleman sitting nearby and proceeded to have totally inappropriate, top-volumme conversation with him about what he and his partner were going through. He took pains to be polite, giving ever-shorter answers to her barrage of questions ("So, are you in the middle of IVF?"), but soon appeared to be completely absorbed in his child's video game as a means of avoiding the interrogation. Some people have zero ability to read others, and zero filters.

A very tall, large, and intimidating black woman appeared in the doorway, swinging her long braids and demanding to know who was still waiting for blood work. She then began pointing at people, stabbing the air and grunting, occasionally demanding to know their names. "YOU!" she would yell. "BLOOD?" she demanded, scowling. When she came to me and heard I needed bloodworm, she grunted and pointed at the hallway, which I had to assume meant I should follow her. She didn't smile, and didn't talk other than to point at the computer screen and say, "That you?". Bracing for the test, I was unsurprised when her painful jab missed my vein. While pulling the needle in and out of my arm, changing the angle of entry to spear the uncooperative vein, she finally asked, "Does that hurt?". I was practically in tears, but had to laugh as I responded with What do you think? Once I was done, my wife and I proceeded to watch as she repeated this exchange with other people. How did this woman ever get her job? Surely you still have to interview and be chosen in the medical field, just like with any corporate job? Or as a nurse are you simply given assignments? Does no one care whether you have the shittiest job performance imaginable? There doesn't appear to be any accountability at Mt. Sinai. How could there possibly be so many incompetent people, month after month, doing a bad job with an even worse attitude? It crossed my mind that it was a teaching hospital, but these people were far too old to be students, and there was certainly no instruction going on that I could see.

This ultrasound was our first introduction to Dr. Rebecca Arthur, who we'd been told would be taking over our case during Dr. Liu's mat leave. She seemed nice enough, and spoke with confidence. When I asked about the follicle count, she told me not to worry about it from month to month, as it would probably not vary much given my age and test results (FSH/AMH levels). I think she said there were four this time. I asked about alternative drugs, since I was feeling like the Clomid wasn't having much effect, and she said injectables were an option for about $1,500 - but would likely not have that different a result. What?! I couldn't really process that news. Wasn't that the next step for an actual IVF procedure? Wouldn't those be the "big guns"? She offered to up my Clomid dose to the maximum 150mg to see if that helped, and we agreed to go with that.

This time the side effects included the usual fatigue, increasing mood swings and bloating, but also threw in some new insomnia, daily headaches, and daily nosebleeds. All this, and yet know that it's important to maintain a positive, stress-free environment for yourself to maximize the chances of conception. 

As I go about my daily life, I can't help but wonder whether anyone has used fertility treatments as a reason for actions of temporary insanity in court.

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