As we sat anxiously in the waiting room I looked around at the familiar faces. They too, were probably as anxious as we were. But no one asked and no one spoke. It wasn’t the kind of place to fraternize. People largely kept to themselves because everyone’s journey was different. Some were here for the second, third, even fourth time. It was our first. After two long harrowing hours we were called into the senior nurse’s office. I tried to read her face to know what to expect but she had a vacant look. On her desk, was my file with my name legibly written on the cover. She looked from me to my husband and then said, “I am sorry but the process was unsuccessful.” My heart sank.
When I look back at my years as a young adult, I distinctly remember never having a pregnancy scare. While my friends would be counting their beads on their Rosary swearing not to fornicate, because of the fear of falling pregnant, I never had those thoughts. And I wasn’t consistent with protection either. No matter the season or time, my period was always bang on time. And I would have these fleeting thoughts and wonder whether I would be able to have children. But they didn’t linger because marriage and children were not exactly in my ten year plan at that time.
That period of my life was soon forgotten even as I said I do several years later; and we didn’t follow the prescribed order of things. The first few years of the marriage were tumultuous so children were out of the question. We instead preferred to settle our differences before starting a family. When we finally got round to it, we were so inconsistent with our approach and thus were not successful. I took matters into my own hands and started counting days and using ovulation kits. ( Those things are expensive yo). And every month my period came, I would eat sorrow by the spoonful.
It is only after confiding in a friend that she insisted that I should have a medical evaluation. Until then, I believed the reason I couldn’t conceive was because of the on and off turmoil in my marriage. It never occurred to me that there might be something medically wrong. So I sought medical advise after much convincing and was sent for a battery of tests. Life took an abrupt twist when I went for a particular test called a HSG. It’s basically a form of imaging that checks the integrity of the fallopian tubes among other things. I remember feeling anxious about the procedure; having heard horror stories about the pain it caused.
I remember the procedure was on a weekday because I took off from work to have it done. I was ushered into this dark room at an imaging centre and asked to disrobe. I put on the hospital gown and lay on the bed, palms sweating. The doctor explained the steps to me while showing me the various instruments they would use. I was horrified. They seemed so huge and intimidating. As they began, she talked me through it; I guess to keep me calm and very still. When it got to the part where they push the dye through you, I felt a monstruous sense of agony exerted upon my lower abdomen. I gasped. But as quickly as it came, it was gone and shortly after, they were done. I left a while later, report in hand.
While in the car, I casually opened my report expecting nothing. I however didn’t need a medical degree to figure out that whatever it said was not good. To avoid jumping to conclusions, I called a close friend who was also a medic. I read out the report to her and waited.
“Do you want me to give it to you straight?” She asked.
“Yes please.”
“You have bilateral tubal blockage. That means both your fallopian tubes are blocked. There is the option of trying to unblock them surgically but the outcome is usually poor with dismal success rates. Your best bet would be some form of assisted reproduction.”
My tears came in choking heaves as the realisation hit me. All this time I had been trying to conceive and my tubes were blocked. I am not one to wallow in despair so I picked myself up and went to see my gynecologist. He said the same thing as my friend and specifically said I had to go through IVF. In addition, I also had to attend for surgery for the removal of both tubes. One of my tubes had hydrosalpinx ( explanation will follow at the end) and I could not go on with the procedure of IVF with it in place. So we made a decision to have both of them removed. An operation that was to be a day case, ended up being a four hour affair and after I came to, I remember feeling empty. It’s funny how this feeling came at this point and not earlier. With the absence of my tubes came a feeling of inadequacy. That I was not woman enough. That I would never talk about conceiving a baby out of the act of marriage. I had this ideology that if my husband and I could make a baby, it would repair our broken marriage. That dream ended with that operation.
Three months later when I was well healed, we started the process. After shopping around for fertility specialists, we settled on a centre that had all it’s services under one roof. Their sole purpose was all things fertility and I am glad we went with that choice. They were very thorough leaving nothing to chance. During the first visit, we were required to meet with the legal team, a counselor and carry out preliminary blood works. The lawyer took us through a myriad of documents concerning the process. ‘Whether to keep, discard or donate the extra embryos or what to do if one or both of us died?’ It was like writing a will before acquiring the assets. The psychologist was there to mentally prepare us for the journey ahead.
After going through the legalities, counseling and the steps of the entire process, we were set to begin. The system was so intricate. All treatments, scans and procedures were planned to the T. They left no room for mistakes or delays. And rightfully so because it wasn’t cheap. I remember feeling like I was part of a cohort because I would be there almost daily for an injection or a scan and I would meet the same faces. Faces with no voices because no one liked to speak about what brought them there. We would sit silently in solidarity, rooting for each other.
After a series of hormonal injections, and all sorts of do’s and dont’s the time came for egg retrieval and fertilisation. All along I was simply going through the motions. I was good at following instructions and I believed if I did what they said then I had nothing to worry about. So I diligently prescribed to every instruction no matter how small. The procedure was done in an operating theatre where the doctor used a huge syringe to suck out my eggs. It was largely uneventful. They then fertilized them and we were sent on our way.
The process of IVF is like attending a job interview. You start out with many participants that keep being weeded out as you proceed to the next stages. I started with 12 eggs and they fell off the wagon until I ended up with 4 embryos. Did I mention they are graded based on their quality? Like exam results. Grade A and B and so on and so forth. Sigh. I remember after I was implanted, I was scared to even get up from the clinic bed and walk. I thought the embryos would fall out. I almost wanted my husband to holst me over his shoulder and carry me upside down. The nurses laughed.
It was after that long process that we found ourselves in the waiting room 12 days later waiting for the results of our pregnancy test. It is that dreadful day that the head nurse said it wasn’t successful. I remember being told about the odds of success vis a vis the odds of failure but who pays attention to percentages? After she delivered the news she proceeded to counsel us for a full 20 minutes. Words and more words that felt thin and empty. I saw her mouth move but couldn’t connect the words. I heard things like hope, try again, not the end, have faith but all I wanted was to leave.
After going through the motions of loss, in the stillness of night thoughts tumbled in my mind making and breaking alliances. I started to recall her words; which started to come together and make sense. As I sat feeling low I replayed them. That even perfectly healthy couples trying to conceive don’t get pregnant the first time. ‘Never confuse a single defeat with a final defeat,’ she said. It is this; only this that had us going back to try again. And so, three months later we were back to start round two. With a different cohort this time. Because of the first failure, I was more anxious. More guarded. More aware. More afraid.
We started the process from scratch. The daily injections, the scans, the reviews; name it. I recall after implantation while waiting for the 12 days to end, I woke up one day and found that I was bleeding. I knew I was losing the pregnancy before I had it. And I broke down. My husband rushed me to the centre where they administered some injections and said we should still wait for the prescribed period to be over. When we finally went in for the pregnancy test, I was emotionally exhausted. I was sure it had not been successful and I had started asking myself whether I was willing to go for a third cycle. This time we were called in by the clinic psychologist. I saw him and was convinced they had called him to deliver the bad news and then deal with the repercussions. Again, my file was on the desk. He looked at us and said, “Congratulations! It was a success.”
We were ecstatic. Beyond ourselves with joy. A few weeks later, we had a scan and not only was I pregnant, I was expecting twins. I was uncontainable. I continued my follow up at the centre until the third month of pregnancy — as was their policy. All was going well as I started to plan for my double blessing. Everything on my google search engine and pinterest wall was saturated with all things twins. I yearned for the day I would hold my babies in my hands. Because the pregnancy was considered high risk I was still on hormonal treatment and alternate week scans. I didn’t mind, as this was still inclusive in the initial cost and who wouldn’t want to see the miracle of life grow within them. So life dealt a blow to me when at the 12th week scan the radiologist told me he couldn’t hear the heartbeat of one of the twins. And just like that, I lost one baby. I mourned him or her. I would never know the gender. I was just getting started and then this. I couldn’t begin to describe the loss of a tiny hand that I had never held.
I took the scan to the doctor for clarification and he encouraged me. To hold on. To have faith and refuse to become paralysed by what had happened. That it was difficult to know what could have happened. And despite the pain, I still had one baby left. And so I held on despite my fear and by the grace of God, I carried him to term. Yes it was a boy. The most wonderful miracle of life.
When I look back, I can’t equate the experience of the IVF to the wonderful outcome of this little boy. I am thankful for the advancement of science that I wasn’t written off as barren simply because my tubes were non functional. I now know that you may have to fight a battle more than once to win it. He turns one this week.
IN VITRO FERTILIZATION (IVF) — Is a treatment for infertility in which a woman’s eggs (oocytes) are fertilized by sperm outside the human body. One or more of the fertilized eggs (embryos) are then transferred into the woman’s uterus, where it is hoped they will implant and produce a pregnancy. WHO SHOULD CONSIDER IN VITRO FERTILIZATION? — IVF is usually considered by couples who have: ●Absent or blocked fallopian tubes. ●Severe male factor infertility (sperm counts or sperm motility is low) ●Advanced reproductive age, ●All other causes of infertility (eg, endometriosis, ovulation disorders, unexplained infertility), if treatment with other therapies is not effective. ●An inherited genetic disease that they wish to avoid passing on to their child ●Ovarian failure, although donor eggs would be required in this case. Although IVF has a high rate of success in helping couples to become pregnant, it has some disadvantages as well, including: high costs, potential risks from fertility medications and invasive procedures used, as well as an increased rate of multiple gestation (ie, twins or triplets). Women who are considering IVF should discuss the risks, benefits, and alternatives with their healthcare provider and partner before treatment begins. In most cases, several cycles of a less expensive and less invasive infertility treatment are recommended before considering IVF. *Hydrosalpinx — blockage of a fallopian tube with fluid. Can be caused by a previous pelvic or sexually transmitted infection or previous surgery.