Getting Pregnant

It was a hectic month. After we’d managed blood tests, his and hers ultrasounds, tube checking operations and even a post-coital check-up, we were ready to go back to Dr H and find out the good and bad news.

I was more than a little nervous that day, and spending a good hour or so waiting in the reception area didn’t help. Finally we got in to Dr H’s office and the long process began of him leafing through pages and pages of our tests results and explaining what it all meant for us. In general, we were boringly normal. Dr H told us what levels of hormones or other technical things he had hoped to find, and our results came back pretty much all on target. The interesting part was the Hycosy result which suggested my tubes may have been blocked.

But it wasn’t as simple as blocked tubes that are now clear. Dr H explained that it could have just been a spasm at that moment – or a spasming that often occurs. There was no way to tell if my tubes had always been blocked, were again now or not, and if not, whether they would block again. But, he was hopeful that perhaps a blockage had been cleared, so we were instructed to go away and keep trying with “timed intercourse” for three months. “Timed intercourse” means following the pink lines that appear on an ovulation test kit, and he did reassure me that those we had been buying in the supermarket were perfect for the job. So we went away to keep trying, with a slight bit of optimism.

One of the more embarrassing moments of the fertility testing round – and none of it is particularly free from embarrassment, although you can get remarkably matter-of-fact about it when you have to – was the PCT.

Everybody at the clinic calls it the PCT, never in full, because then it does sound too personal: the post-coital test. At the right moment of the cycle, according to the blood tests and the ultrasound results, a nurse calls you to say “Please do the deed with your partner between 9pm and midnight tonight.”

That’s clinical! And it’s really not very romantic when you’re doing it just because a nurse told you too – especially when you know they’re going to find out the next day whether you actually did it or not!

The next morning, back at the clinic, a nurse took a sample from me in a similar way to a Pap smear. The lab then analysed this sample – the important thing they’re checking for is whether my body is “cooperative” with sperm – because some people have a kind of antibody against them. In fact, everybody does except around the time of ovulation, which is why the timing of the PCT is so important.

I was getting used to the afternoon calls from the nurses by then – after checking results with doctors in a midday meeting, they usually called me between one and three in the afternoon to let me know the results – so I was pleased to get this one to discover our PCT was “normal”. Because that’s not a test I’d particularly like to repeat in a hurry.

As part of the whole fertility tracking month, I had to have a minor procedure done under anesthetic, and I spent several weeks getting utterly nervous about it.

They call it a Hycosy, and the procedure is carried out (in some clinics) under a “twilight” anesthetic – that is to say, you’re asleep and can’t feel anything, but it’s not as deep as a general anesthetic. At other clinics they do this procedure while you’re awake, but the doctor assured me they had better results with the anesthetic. Who was I to argue?

On the morning of the Hycosy my husband took me to the clinic and waited with me until I was called, which unfortunately took about two hours. I was the last operation scheduled for the morning. But after that it all went quickly: into the gown, onto the table, the needle went in, and about half an hour later I woke up.

The Hycosy procedure involved checking my Fallopian tubes by trying to flush them with a liquid; the interesting result of this procedure was that at first, my tubes had been blocked, and then after applying the liquid at a higher pressure, this blockage eventually “burst” and my tubes were clear. The hope was that this blockage had been causing our problems and perhaps now, if all the other tests turned out okay, we might be able to make some progress.

My husband drove me home and I spent the rest of the day in front of the DVD player – yet I slept most of the time. I was a little uncomfortable but mostly just very sleepy. And glad that this dreaded procedure was over.

It’s not just regular blood tests that the fertility clinic wants to torture you with when they’re trying to figure out what’s going wrong with you – there are also ultrasounds.

I was definitely nervous the first time round I trudged across the road to the ultrasound clinic, although I can’t complain about the people there. Both the reception staff and the doctor himself were the friendliest of all people I’ve come across so far in this process, and helped to put me at ease.

And you need to be at ease to let a stranger stick a strange probe up inside to look at your very private parts. It turns out that these internal ultrasounds give them a better picture, plus it’s actually more comfortable in a way as a patient because they’re done with an empty bladder rather than a full one. Every second day for a week or so they check your ovaries and what they’re producing, so they can predict ovulation and see how many eggs you’re growing – important if you end up on the IVF track.

Having to get regular blood tests as part of the testing for our infertility problem was bad enough, but I hadn’t reckoned with the queue at the clinic.

There are lots of reasons why women doing fertility treatment need regular blood tests and ultrasounds – for simple tracking to start off with, or to regulate their cycle using particular drugs, or to monitor them for IVF procedures – and that meant that every morning outside my clinic there was a long line of women waiting to get in. This clinic preferred to do all the tests themselves so the results were immediately available, which made sense, but also made for a queue.

The first time I got there, I arrived just before the opening time of 7.30am but found I was about tenth in line. All of these women (me included) had to get to work after their blood test so I soon learned the trick of arriving much, much earlier. It was a sad state of affairs, really – here was a bunch of women with so much in common – age, gender, medical problems – but nobody really wanted to talk to anybody else. I tried at first, but didn’t find too many people in the mood for a chat, and as I went further through the process I understood why. For example, one morning a woman who’d already been told she was pregnant was in the line in front of me, and while everyone is happy for her, pretty much the last person a bunch of infertile women want to talk to is a pregnant one. I also heard sad stories about multiple unsuccessful attempts at IVF conception and of course, plenty of depressing grumbles about waiting in line. In fact, compared to the queuing experience, the blood tests were easy.

One of the least comfortable things for me about all of the fertility tests is the number of blood tests they need to do. Not because I’m scared or even particularly squeamish about blood tests – although I admit I usually do look away – but because my veins are tiny, slippery, sneaky things that resist all attempts to get a needle into them.

The first blood test was the biggest – a huge number of tests would be done, so they needed to collect something like eight vials of my blood. The same went for my husband. But fortunately the phlebotomist on duty that day was a real pro, and the instant she saw my veins she threw a heat pack in the microwave, then in my arm and by the time she had the needle poised there was actually a sign of a vein there, and she got the required blood okay.

Over the next month, I had six or seven blood tests, some bad and some good. There were so many nurses at the clinic that it was rarely the same one who took my blood, so I got used to going through the whole routine with them and in the end was able to instruct them immediately to use the “baby needle” – literally, a needle so small they usually use it to take blood samples from newborns – and to direct them to the arm most likely to give good blood that day. Luckily it was winter, so my bruised and scarred inner elbows were covered by long sleeves and nobody else could see what must have looked like a junkie’s attempts at getting a hit. But every time I reminded myself that these blood tests were all being taken for a very good reason.

It seemed to take forever, but the day of our first appointment at the fertility clinic finally came around. I was incredibly nervous; I’m not a big fan of going to see doctors at the best of times, and this one was a really big unknown.

We had to wait about half an hour after our appointment time to see Dr H, but we soon found out that his lengthy chats made all of his appointments run late. I’d rather that than a doctor who rushes you in and out without any small talk, though.

He took a detailed medical history of both of us, covering a fairly full picture of our health, and he mentioned – and it turned out to be true – that having checks for fertility problems are a great way of having an overall health check. In separate rooms, we both had to strip down and he examined all our important bits and made notes; so far, nothing bad.

The next step, he explained, would involved a series of blood tests and ultrasounds to track my hormones and other important bits during a menstrual cycle, and we would also both need to have a thorough ultrasound to check out our vital bits from the inside.

So it was a bit like the first round at the GP – please go away, do all these tests, and then come back and see me and we’ll talk about the results. Unfortunately, I had a trip to Melbourne planned for a couple of weeks into my next menstrual cycle, so we had to delay all of the tests for a month – in a way, I was grateful because with my period due the next day, launching straight into the barrage of tests might have all been a bit much for me. A month to get used to it felt much better.

The first round of tests were over. Time to head back to the GP to find out what was going on with us.

The answer? Nothing. That is to say, all of our test results came back perfectly normal. A good sperm count for him, a good hormone level for me, and yes, confirmation that I did indeed ovulate. The ultrasound turned up nothing unusual apart from the fact that I have a retroverted uterus (it kind of faces backwards) – but that’s quite normal and doesn’t have any impact on fertility.

Time for Dr K to write us a referral to a fertility clinic. There are a few major ones here in our city, but we had already decided our preference, since a friend of my husband’s works as an embryologist at one of them. We figured that having someone “on the inside” couldn’t hurt, especially as otherwise the clinics were all fairly similar. Dr K agreed and wrote us a referral letter explaining the history she’d taken and the results of our tests so far. Basically, here are this lovely young couple who can’t have a baby and we don’t know why.

One thing I hadn’t expected was that getting an appointment at the fertility clinic would take so long. I rang up the following day – nervously – and the first available appointment they had was about three months later. My husband saw this optimistically and said we had three more months to have a good try and he had a good feeling that we’d be cancelling this appointment. Unfortunately, this was the first of his many good feelings that were not quite right.

After our first visit to the doctor, a month went by which involved a couple of blood tests for me, and a semen test for my husband – we had to “deliver” it to a pathology clinic within half an hour of it being produced, and bringing it into a waiting room was certainly a little embarrassing.

I also needed an ultrasound which I could book at a centre just down the road from my house, and I managed to book it in the middle of the day when I was working from home; that meant (with my husband taking the car to work) I had a twenty-minute walk to the centre with the instructed full bladder and more than a little nervousness.

Of course, there were all kinds of people at the centre: broken arms and legs for x-rays, all sorts of people needing blood tests, and so on. I had to wait at least half an hour after my appointed time and holding on to the full bladder was rather uncomfortable, as you can probably imagine.

Lying on the table for an ultrasound made me a little sad. Looking up at the monitor, the grey and black blobs looked similar enough to the ultrasounds you usually see of pregnant women, checking that the babies are okay, so I couldn’t help but feel a bit of a failure. I left the appointment feeling a bit teary, especially as I was alone, I guess. But I just kept reminding myself that this round of tests was the next big step in us finding out if there were any problems preventing us from conceiving a child.

It was a relief to be able to tell a doctor that we had been trying to get pregnant for a year, without success, and could she please help us - and to have the doctor immediately say of course, and take our relevant histories and send us for tests.

Dr K said that she would do basic initial tests and then depending on the results, might refer us to a fertility clinic. That sounded fine to us. She explained that there were so many possible reasons why people had trouble conceiving but that her initial tests could rule out a few of the basic ones to start with, so she sent me off for blood tests, and another one on Day 21 of my cycle to check that I ovulated; my husband had to give his first “sample” for a semen analysis. While I think it’s fair to say that women have a lot more hard work to do in the instance of being pregnant and giving birth, I have a lot of sympathy for men who have to give semen samples.

It was a relief to be having some kind of “action” taking place. I knew all the stats - something like 80% of couples conceive naturally within the first 6 months, 90% within 12 months, 95% within two years. It seemed like we were at least in the unlucky 10% who need more than a year, and might have some complications that were, well, inhibiting our progress. It ws great to know that we would soon have more information.