Barren Mare

Dr Endocrine

So, I had my appointment with Dr Endocrine. This involved taking a bus all the way across town with my mother and navigating the maze of the new hospital. But once there, Dr E turned out to be a very pleasant person, very down to earth and clear.

"How are you?" he asked. "Not pregnant yet," I answered.

He then proceeded to talk to me about hypothyroidism, and how there may or may not be a link to infertility. The most exciting part was when he stood behind me, wrapped his hands around my throat and probed my windpipe area for a bit. I can't say I'd ever been throttled by my doctor before, so this was an interesting first.

In the end, he diagnosed me with Hashimoto thyroiditis and prescribed some drugs, specifically thyroxine. Which I will apparently have to take for the rest of my life. The pills may make me feel better, but may or may not help me get pregnant. But I figure anything that will make it easier to get out of bed in the morning is a plus.

We then had a little chat about Scottish politics and the shambolic state of the Scottish Parliament. Which was, I suppose, an interesting little digression from say, my ability to ovulate. He also gave me a nifty, badly illustrated little book on thyroid disorder, which he co-authored.

It was only when I got home and looked at the book and his bio on the back page that I realised Dr Endocrine is, like, a really big deal. I take some perverse comfort in the fact that the man diagnosing my condition is a leading player in all things endocrine. That he must know what he is talking about.

And that this is all paid for by the NHS, rather than me forking out great sums of money for a bit of strangulation followed by ingestion of drugs. I can't wait for my follow up appointment in 3 months time!

Relaxation worked for grandma

I think I probably speak for most infertiles out there who would rank the comment "You just need to relax" on the top 5 of the most hated remarks passed on by random people who have never experienced infertilty and basically have no idea what the hell they are talking about. A good many of us have explained to our closer, and therefore supposedly more sensitve, friends and family the annoyance of the "just relax" mantra.

But the weird thing is how totally impervious people are to being informed that in quite a lot of cases, infertility is more than likely a medical condition, for which all the relaxation in the world will not help. It's like they simply cannot register or believe that infertility cannot be eliminated simply by embarking on a Caribbean cruise or trip to the spa.

I had the "don't tell me to relax" conversation with my mother recently. I told her, quite calmly and gently how frustrating and annoying it is to hear that, and how I was astonished at the level of ignorance displayed by some doctors with regard to the "magic of relaxation". I explained that I know that stress can wreak havoc on hormones and disrupt the balance. I know that being a control freak may hinder matters. But, as I laughed through gritted teeth, I admitted that I have an overwhelmingly urge to rip someone a new one for being so cavalier to suggest that basically, infertility is all in my head and I should just chill.

She nodded knowingly, paused, sipped her tea.

"But you know," she says, "your grandmother had terrible problems getting pregnant. They tried for seven years before they had me. Things weren't so medically advanced back then. They finally gave up. And lo, she conceived. " Further pause. More tea slurping. I know what's coming next.

"So, in actual fact, relaxation is not such a bad idea. Quite useful, actually. To just...relax".

Baby Ambition

Observation: It's hard to sit googling "poor sperm morphology" with your Dad wandering in and out of the room every five minutes.

One thing I realise is that there are plenty of other people who have had a really shockingly crappy time on their "TTC journey"- in some cases, enough to humble me into silence about our possible problems.

But of all the things I have read about couples suffering through infertility, this is possibly the worst. One of the couples duped by Moira Greensalde had been through 13 miscarriages and 8 failed IVF attempts. I can't even imagine the hell that they have already suffered. Another couple, thinking they were finally going to have the baby of their dreams had gone so far as to buy baby clothes and paint the nursery.

It was noted by one columnist that the method of acquiring the baby over the internet was illegal in this country, and with good reason. But everyone acknowledges the desperation some childless couples face in their desire to have a child. In fact, the court in sentencing Ms Greenslade went so far as to describe it as "an ambition."

Is wanting to have a baby an ambition? For some reason that jarred with me. I have lots of ambitions in life- to pass my probationary period at work, to discover how to hook up remote networking on the computer, to learn how to make really good creme brulee ( won't E. be surprised to learn about that one!). But I wouldn't have included having a baby in that list.

Ambition sounds sort of calculating, a bit cold, a bit self-obsessed. But who am I kidding? I am pretty much obsessed. What else would drive me to take my temperature every morning, submit myself to blood tests, spend hours scouring the internet for information on fertility. I know that if I put half as much energy into other aspects of my life, I'd be a Pulitzer prize winner author by now, or a a black belt in karate or an astronaut (ok, maybe not the last one. But it sounds like an impressive goal. Great at dinner parties. "Hi, what do you do?" "Oh, I'm an astronaut. I'm just back from Mars").

I think I might worry more about myself if I started thinking about trying to buy a baby over the internet. But even then, I don't think I would call it an "ambition" as such. Heartfelt longing. Desperate desire. Anguished hope.

Moira Greenslade got two years in jail. The baby has been sent off to social services (it's not clear if the father is, in fact, one of the three men involved). And the three couples get yet another hole in the place where their heart used to be.

Nobody's Perfect

I am stealing 5 minutes personal time from partner and parents to pass along the Great SA saga update.

Well, we got the results..sort of. I should say that we got the results as translated by E. talking to his GP, and frankly, neither of these men are any kind of experts in sperm analysis or fertility. Unlike me, gobbling down the phone....did he tell you? Count? Morph? Motility? Huh? Huh? *Pant pant*.

The good news: the count- good- no, wait- apparently Olympic style excellence- at 245 million per ml.

The bad news- morph at 10%. Not great. But I haven't had time to check out what all this means, what we do next, or where we go from here.

Motility- I don't know- he forgot to ask and the doctor didn't say anything. I am hoping that means he is OK in that department.

So what the first test has established is we seem to have lots and lots and lots of funky shaped sperm. Huh.

We snuck off to the bedroom for a little private conflab after dinner. E. pulled out his Palm pilot and duly relayed what he had written down. And looked worried and a little sad. I can't blame him- he was so sure he was perfect and it was all me. I felt a huge rush of love for him when he said sadly..."but I want to have two children with you. A boy and a girl would be nice."

Now, my time is up, and I have to go sit on the sofa with my family and smile and pretend everything is OK.

What does seem clear is that as I have suspected for some time, this may not be as straightforward as sperm meets egg, voila, pregnancy. But once again I realise there is nobody on earth I'd rather be infertile with than E.

When they say "two days to two weeks", what they really mean is two weeks.

For someone who has routinely, almost compulsively, taken the less easy route to things in life, I am not a patient person. It's an uneasy mix. I deliberately make things difficult for myself in all manner of ways, and then bitch about the fact that it's not happening in the way I want. Which is now, now, now.

*Tap, tap, tapping* of nails on the desk.

While I find it hard to wait on my own body to do its thing i.e. produce cervical goo, ovulate, welcome E's ambitious sperm with eager fertilising joy- I find it harder to wait on the actions of other people. People at whose mercy I find myself. People who I perceive, rightly or wrongly, as somewhat insensitive and possibly even incompetent.

Take E.'s SA.. Aside from the whole fandango of getting the jar of sea monkeys handed in double quick (no place to park at the hospital, no way through the door to the lab, for which you needed a SECURITY pass), the tests results are now taking forever. Now, realistically, they did say it would take two days to two weeks. And to be fair, strictly speaking, the two weeks aren't up until Thursday. So poor E., bless him, doesn't feel as though we should really start nagging until Friday. "We're British, after all, we do that stiff upper lip crap soooo well".

I on the other hand want to reach through the phone and/or the hospital doors and throttle someone. For the LOVE of GOD, we're trying to find out if we are potentially INFERTILE here, for fuck's sake. There is possibly a lot on the line. Our dreams of parenthood, my lovely E's manly ego, the planning of the next line of attack if it does come back OK and the problem lies with me.

Is it really too much to ask that they get on with it? I might be less frustrated if the guy with whom the sample was left had shown the slightest interest or inclination to give some form of response that he might deal with it in a reasonable amount of time. That he might actually process it, instead of leaving it on the tray in the lab to get all...inaccurate. Do they have any idea how nervewracking this is, how sweat inducing, how infuriating it is to know it COULD have taken two days, but they are going to make us wait two whole weeks.

On second thought, perhaps that's why a security pass is required to get into the lab.

What we do know

Here's what we know so far:

Me- 33 , soon to be 34 years old. No known pregnancies or miscarriages. Cycle length on average 24-28 days. Periods normal, no exceptional pain or discomfort. Occasional pain in midriff around ovulation time, nothing unusual. No known STDs, although I was perhaps not as careful as I could have been in my youth, and who knows.

Ovulation occurs anywhere from Day 9 to Day 15. But it's almost invariably Day 13. I know I am ovulating as a result of 11 months of charting, and also the Day 21 progesterone test confirmed it. Cervical mucus fine- usually at least three days of fertile quality CM, with lots of the eggwhite kind. When I began charting, my luteal phase was on the short side at 9 days, but regular dosages of B6 and progesterone cream have helped increase it to, on average, 12 days.

Other blood tests revealed normal levels of other hormones, including prolactin and FSH. There is however a glitch with my TSH levels, which are high. The first test revealed 9.5, the second test was at 5.4 and the last one at 6.6. Thyroxine levels are OK, so the thyroid is working- it just needs a boot up the arse. Technically I think this is known as sub-clinical hypothyroidism. Thyroid problems run in my family, and my father is on medication. But they don't usually treat sub-clinical hypo. It may or may not be having an effect on my fertility- however, given my ongoing failure to get pregnant, my GP has decided to refer me to an endocrinologist. We're talking NHS here, so it could be months. I have read that my TSH levels should be between 1 and 2 in order to conceive. Of course this gives me something extra to worry about while we wait.

My boyfriend/partner/thingie. He has never, to his knowledge, impregnated anyone. Tends toward high blood pressure but no other known disorders. He did however suffer trauma to the, um, nether regions about 10 years ago. Basically someone kicked him in the nuts, and this messed him up pretty badly at the time. He claims that he was given the all clear back then, but ever since, he has odd pains when we have sex. Luckily this does not deter him from wanting to "do it", at least on occasion.

The home SA test we did was "OK", but I don't trust those crappy kits, so he has just submitted another sample to the lab for a full SA. They said it would take anywhere from two days to two weeks to get the results. But they seem to be taking their sweet old time about it. We have another week before we can call & start pestering them for the results.

Neither of us smoke (tobacco or anything else). We don't drink heavily. We don't engage in the intravenous injection of hard drugs (not that this seems to stop other women around here from getting pregnant). We both have quite stressful jobs, and are born worriers. So no, we can't "just relax".

I know we need a whole lot more information before we can begin to get a clearer picture of why I may not be getting pregnant. But on paper anyway, the only thing seems to be the TSH. So I am impatient to get that regulated- if that doesn't work, well- bring on the big guns, I am ready for all sorts of invasive probing if this means we will get some answers.

Acronymitis

The language of pre-conception and infertlity seems largely comprised of acronyms. I found this extremely offputting when I began my tentative explorations into the online world of "TTC". The first couple message boards I came across were simply baffling.

For the uninitiated, a typical entry on a thread can read something like this:

" Well, it's CD 11, but I know I am about to O, judging by all the EWCM and my CP- that and my BBT. Must be all that EPO I have been taking. Better convince DH that it's time for some BD. I don't know if it's going to work considering my TSH levels are so abnormal and my LP is so short. I'm still hoping that once I POAS, I'll get that BFP. That or AF will show."

After a year of this kind of chat, the eye seems to adjust. You can, with a few brief letters, sum up a entire month of hoping and waiting. You can give your vital stats- how many MCs, how many attempts at IUI or IVF. And for those who are in the infertility club, it's all info you want to know, because it's a quick and easy way to assess someone else's situation. To start that conversation and lend support.

The organisation I work for is also fond of acronyms. At a recent training conference, a large volume was produced- quangos and semi-quangos and offshoots and voluntary groups and interdepartmental divisions, sub-divisions, sub-sub-sub divisions. I spend all day knee deep in acronyms, then come home, hit the boards and spin a few more.

I am relieved that there seem to be no acronyms (or at least none that I have come across so far) for the things that need proper words- like, I am so sorry about your miscarriage. Or, I am so terrified I might never be a mother. But sometimes I find myself resorting to that shorthand of acronyms, cause it's easier to hide behind a bunch of letters than express how I really feel about what is going on. That to say AF has arrived is simpler than trying to convey the gutwrenching disappointment, sitting in the bathroom cubical at work with a wad of toilet paper in my hand watching the hope and anticipation of the last month crumble into nothingness. Knowing I have to go back out there and pretend it's OK. That it's part of a cycle and I'll have another chance in a couple weeks. And knowing that many women out there reading those two letters will know, all too well, exactly what I mean.

Hurry Up and Jab Me

I had a rubella shot today- or, correction, my MMR jab, because they don't do the single vaccine doses in this country anymore.

I am not fond of needles. I wouldn't go so far as to say I am "phobic" but it did prey on my mind all day that I was going to have to go have this done later, and wishing I could get it over with. I had a really bad experience in college giving blood, and since then the sight of anyone coming at me with a needle unnerves me somewhat.

There have been more needles in the last three months than I have encountered in the past 10 years- so far I have had blood drawn for 3 three separate thyroid tests with some extra blood extracted for progesterone and the rubella antibodies check. And now the shot. It's sort of all right if I don't look, but only if I don't see the needle.

The nurse, who was nice but a wee bit ditzy, ran around for ten minutes looking for the purple form. "You haven't filled out the purple form!" I didn't recall this elusive purple form being mentioned earlier- so I'm thinking, do I have to sign a disclaimer saying I won't have unprotected sex for the next month once I have the shot in case I get pregnant? Can they make you sign something like that? Is that legal? And what would happen if you did become pregnant, and the baby got somehow infected by the rubella shot? Could they sue you for damaging your unborn child? Or arrest you? Even though in this country unborn children have no rights until they are born? Except for the peculiar legal anomaly that is the "Nasciturus Fiction" (subject of a whole other blog) and that wouldn't apply in this case.

This is how my mind works. I need to get out more.

Turns out all she was looking for was the form you fill out when you are getting vaccines before you travel. I explained that I am not, as far as I know, going anywhere. At which point she calmed down and pulled out the needles. Then there was this big to-do of all the little separate vials and bottles. I am becoming increasingly agitated at this point. FOR THE LOVE OF GOD, GET ON WITH IT, AND GIVE ME THE SHOT. No, she loses one of the little bottles, and gropes around the desk for it until I point out she has already attached to the needle, the NEEDLE- and I really begin to feel myself starting to have shallow, panicked breathing.

Finally she does it. And it was fine- it always is. Let's put it this way, the paper cut I got this morning felt worse and bled more.

So we are now now officially on a month off from TTC. I am telling myself this is good- I can sort out my blog, drink some wine, recharge the old batteries in the bedroom as it were. And brace myself for more needles.

You have to start somewhere

It was really only a matter of time until I created my own blog. I've long been a lurker elsewhere, living vicariously through others as I fumbled through my life story up til now. Moved to a different county. Married. Divorced. Putting self through university (again) while scraping by on the crumbs of wages from a part-time job. Falling in love with someone unsuitable, falling out of love, falling in love with the right person this time.

And then wanting to have a baby....this is where I begin to feel like I finally need to take myself out of myself, and tell some of what is happening to me. It's not all that I do, but it's a lot of what I think about at the moment. There are a lot of us out there, watching, waiting, wanting, as I have discovered- and it can be lonely.

The title of this blog "Barren Mare" was the result of one of those mindless roving websearches for information on fertility. It's actually on a website to do with breeding horses. I was about to move on when a quote caught my eye.

"Unfortunately Mother Nature sometimes has other ideas. One of the most persistant and frustrating situations a breeder can face is a mare which, mysteriously, refuses to "catch". A season or more of this labels her a barren mare. Getting to the root of the fertility problem can feel like blundering around in a cave ( Ed's note: How Freudian!) without a flashlight."

It's been 11 months. I have refused to "catch". Label me....a barren mare?