The delightful Liz at Womb for Improvement has posted today about her appointment to discuss the possible move to IVF, her IUIs having sadly not been successful.

Her post is here.

When I first read it I shook my head in sympathy, because I’ve totally had that appointment. And then I got really bloody annoyed, because no-one should have that appointment.

I found out early and the hard way that I had lost a tight rein on my fertility treatment. An acute piece of miscommunication between my consultant (an excellent one, despite being a 20-minute egg) and the nursing staff during my first IUI procedure led to him replacing the sperm into the wrong uterus.

I knew I only had an egg on my right side… the nursing staff knew I only ovulated from my right ovary… and I thought I could feel him turning left… but I was too intimidated to speak up mid-procedure and ask him if he was heading through the correct cervix. If he had been about to perform an invasive procedure on any other part of my body… I feel I would probably have spoken out. I’m not altogether certain, but I think it was my own feelings of inadequacy associated with my failure to reproduce unassisted, that ultimately rendered me silent.

Of course, it wasn’t the only reason. I didn’t need to actively draw on sales training to identify that my flat-on-back-and-angled-10-degrees-head-down-with-legs-splayed-and-strapped-in-with-BIG-FUCKING-STRAPS-to-the-stirrups lowly vantage point was not one in which I was likely to gain mental control of the discussion.

There was, in fact, never much discussion. Chatty exchanges to nurses during the scans, yes; I’m always talkative with my knickers off. Lots of wondering why the hell my cleverly different internal arrangements seemed to be responding so contrarily. But during the actual appointments, my function seemed largely to be that of a listener.

And that’s… fine. As far as it goes. I am not a doctor, still less a fertility expert with years of experience. I was there for advice, for treatment, for the love of God, please give me a baby, because we’ve tried and tried and tried and I’m desperate now. Anything. I’ll do anything you say.

In the aftermath of the IUI-error, my consultant telephoned me to apologise for his mistake. (He did, incidentally, immediately accept complete personal responsibility and never even mentioned the fact that his staff had, without a doubt, propelled him into theatre with his didelphic-uteried patient without mentioning that only one uterus was actually good to go.) He asked me why had I not spoken to him of my worries during the procedure, rather than to the nursing staff afterwards? The medical staff, he stated, were a team – and the patient was a key member of the team.

I couldn’t formulate an answer for him at the time, other than to say that I really wasn’t certain which cervix he’d used, and my doubts had grown afterwards – which was true, as far as it went. I left quiet the fact that I found him silent, scientific, unapproachable, intimidatingly senior, cerebral – and that I always entered his presence in an unhelpful mixture of quiet awe, cognitive lock-up and near-total flustered aphasia. The fact that I had either waited long impatient weeks or paid out huge dollops of cash to gain a seat in his presence did nothing to diminish his aura, either. I would no sooner challenge his opinion than I could picture him on the toilet.

My counsellor (for whom I have an adoration little short of outright worship after her years of kind and clever responses to my dribble) challenged me on this theme, I seem to remember. The reproductive-inadequacy that was a constantly recurring topic, but also, for instance, when I was cheerfully submitting to tests, the purpose of which I was foggy about.

Relating all this to you now makes me wonder quite how I got myself painted into such a mental corner, because my polite exterior is underpinned by such an imperious bossy-boots that you really wouldn’t credit me with such passivity; yet when I am faced by someone with a decent degree, a white coat and a confident manner, I surrender my autonomy like a shot. Weird.

Now, not every fertility patient turns into quite such a bunny-in-the-headlights as I did (and after notching up two more IUIs, two IVFs and three miscarriages, I became noticeably better. I even grew to understand and interact with my 20-minute egg rather more effectively. Now, I am probably even operating at everyone else’s level of Normal, with a leaning toward Pushy.) but it’s a common enough phenomenon in the well-documented maelstrom of psychological stresses, traumas and spiky-dildocam-lined emotional bearpits that are so strongly associated with the journey an infertile couple make. 

It’s difficult enough getting to grips with the astonishing degree of bureaucratic incompetence that exists, despite the extra billions, within our health service, without being let down face to face at the actual sharp end. There’s not a doctor that doesn’t pay lip service to the notion of mutually agreeing the road forward with an informed, empowered patient (particularly given the pronounced deep-axe-wounds-to-psyche nature of the treatment) yet all too often the patient encounters a dismissive, supercilious, terse, chivvying, insensitive scientist. I read post after post about them.

Probably not all those traits in the same doctor, mind. That would make them Assisted Reproduction’s very own Basil Fawlty and their IVF stats would have to be awfully appealing to stay in business.

It’s… not good enough. This isn’t about a GP having an off day and being snippy with the 5th antibiotics-for-a-blatant-virus request he’s had since lunchtime. This is desperate fucking stuff, no pun intended. The course of people’s entire lives gets mapped out in these appointments. Discussing why your body is not doing what is expected of it is acknowledged to be a terribly difficult conversation to have, and yet during it, solutions are still being prescribed, not explored.

All this railroading happens to a person who has already lost all control of something so screamingly fundamental as their own body’s ability to naturally procreate.

Your own fertility treatment is a difficult ship to steer.

It’s 1am. I’m still annoyed.

Harry has woken himself coughing; after half a failed hour of rocking-chair cuddles I have decanted him into the parental bed, looking delighted with himself – John, rather less pleased. He is now attempting to re-bottle him, and there is Screaming. My tonsils are still the size of walnuts, my eardrums are bulging and my neck has grown a fine assortment of swellings and lumps. I have a long day tomorrow.

Rahrahrahrahrahraaaaaaaaah. Bloody, bloody everything.


11 Responses

  1. I think that’s the connundrum – by the time you’re old enough to feel confident in taking charge of your life and medical treatment, you’re probably past your child-bearing years. 🙂

    I imagine it’s a little more difficult there in the UK, because it sounds like you have a little less freedom of choice. I encountered a doctor who was extremely dismissive. I stuck with her for about 10 months before she pushed me over the edge by asking me if an ultrasound appointment at one of the local universities would be OK with me in the most snotty, sneering tone. I was 14 weeks pregnant, and chose a doctor 30 miles away instead of the one 2 miles away. Then I delivered my baby at the hospital 45 minutes away, instead of at the hospital 5 minutes away (or even the one 30 minutes away).

    Hope you’re feeling better soon – Harry too! And I hope John is getting some sleep soon!

  2. * passes HFF a Very Large Whisky which has the advantage of soothing and anaesthetising, but maintaining competence to drive and supervise a toddler*

    *considers passing Toddler the same*

  3. I think this is one of the major differences with the U.S. system. Since we are paying 100% (no insurance coverage for ‘elective procedures’) we are basically offered a list of options and allowed to pick. I’m pretty sure that if I teleported into our clinic today, told them I wanted IVF starting NOW, and a 4-embryo transfer, they would agree. Which is both terrifying and a bit reassuring that all options are open. Of course, I am also still astounded by how little time they spend in appointments when we are trying to decide major life-changing questions, and how much of the medical information is relayed through nurses (who often have no specific training in the field).

    • I will have to pay for all our ongoing fertility treatment, but it essentially makes no difference to the healthcare provided. If a doctor transferred 4 embryos into me he’d likely end up struck off or in clink! That you are empowered to make those sort of decisions is… liberty, I suppose. But possibly not justice.

  4. Flabber very gasted by the Dr Eminence not knowing he had to go right, not left. What? Do they not talk to each other?
    Maybe his glacial demeanour intimidated the nurses too, so they don’t dare point things out.
    In any case, something is very wrong with that scenario.

    • I don’t think their IUI theatre protocols were written with a didelphic patient in mind. There is usually only one cervix!

      But yes, it was an undoubted clusterfuck.

  5. Thanks for this. Luckily my appointment yesterday was simply to set me off on the next trajectory and it is the next appointment with the IVF doc where I will now, following your experience, try and be far more assertive.

    • IIt irks me madly that you have to turn up your Stern & Persistent dials simply in order to have questions about ohhh, this minor thing called MY LIFE-IMPINGING infertility, answered in a intelligent and non-dismissive fashion.

      To be fair, it’s not just repro clinics; Harry’s Paed is just the same. Why should my worries be pissed all over just because I don’t have 20 years of experience? I’ve been right too many times when they’ve been absolutely dead fucking wrong.

  6. If infertility treatment taught me anything, it is how to take control of my treatment, and the absolute imperative to be your own advocate in all medical treatment. You are not the most important patient as far as the doc is concerned, but you are the most important patient as far as you are concerned, so it’s up to you to make sure that test is run properly, to have an extra scan if it helps your mental equilibrium, or to ask the doc if they are going in the right direction. I am going bananas this week as a friend, who is a doc, is being quite passive in her own treatment and I want to run in there and demand the docs are more helpful, but it’s not up to me.

    So I’ll be here supporting you in being more assertive as and when it matters.

    Does it strike you as at all contradictory that you are incredibly assertive and demanding when it comes to Harry’s treatment, but not for your own?

  7. I had one of those 12 min appts too although as it was one that sent us straight to ivf bypassing iui entirely I was quite pleased at the time as I was in “lets get the hell on with this” mode. I do agree that it would help if in general you didn’t actually hear the deep sigh when you drag out your notes or refer to some obscure test.

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