I Did Not See This Coming

We were criminally misled. There was no ‘So! You’ve Finally Discovered Your Bits Are Broken!’ video. My disappointment was acute. All there was, was a dozen couples escorted in a subdued troop to the seminar room upstairs, and shown a 5 minute powerpoint presentation detailing, word for word, the first two pages of the IUI info booklet we’d just been given.  The other couples were so big-eyed and attentive in humbling contrast to my wandering, jaundiced stare. 

After we were herded en masse back down to reception to await our individual nurse information sessions, I surveyed our fellow IUI runners and riders. Their average age – unsurprisingly, as IUI is generally the first port of treatment call – was rather younger than I normally see in this clinic waiting room: early thirties, or a little less. We were the last couple called, so I counted them all out, and I counted them all back in (RIP Brian, btw). I observed their responses to the nurses’ call: flurries of recalcitrant, half-completed paperwork (Reams of it we were given. Reams.) and urgently instructed legs (what IS it about the British Waiting Room that we must virtually run, simply because someone is standing in a doorway with a clipboard, politely calling our name?) on their way to their clinic session; emerging once more, self-consciously clutching, or nonchalantly swinging, their injection and sharps kitbag, moving towards the exit with a noticeably more purposeful look to their stride.

I remember my first departure from that building, with my injection kit tucked satisfactorily under my arm. Early 2005, I suppose it would have been. I can’t swear to the date, even to the nearest season, but the sensation of a bright sun on my face (Metaphorically? Literally? I cannae remember!) is strong: progress, I certainly felt, was finally being made.

Good manners, coupled to a respect for the beginning of their individual journeys, along with a fair dollop of self-ridicule, all rather dictated against permitting my self-constructed image of Jaded Veteran to become fully formed, let alone become flesh: I sternly guarded against Seasoned Sophisticate as my body language of choice, although my inner Patronising Elder Stateswoman was admittedly attempting to smoke a Gitane. Through a holder. 

In this Tatooine Cantina of hope & despair, I felt a world-weary Han Solo to their fresh-faced Luke Skywalker.  I deserved a smart smack of surprise around the chops, I really did. Fortuitous, because I totally copped one.

Our nurse was a delightful lady, who, speaking of deserving, did not deserve me for a patient that morning. Her opening remark was ‘Do you have any questions?’

I suppressed my rejoinder – ‘No, but you will have, shortly!’ – and proceeded to discuss drug regimens, and quite how pointless both their Plan A and Plan B would become in the face of my stubbornly non-conformist gonads. 50mg of Clomid and 75iu of Menopur was, I assured her, although not quite in these words, about as much likely use as pissing in the river. She ferretted through my brick-thick notes industriously, noting my previous glories and (subsequent) failures. Then we got onto the past performance of the Harry Ute of Doom, although I kept it factual and didn’t linger on the topic, and then onto the whole heart palpitations thing – although that was purely because I wandered off IUI topic whilst discussing which drugs suit me (none of them) and which ones make me a sweating, screaming harpy (all of them).

‘I think I’d best go and see Dr. Kind and Beautiful Lady Consultant’ she said, finally.

‘Ok!’ I chirruped, having maintained an attitude of such cheeriness throughout the session that you could be forgiven for thinking I had a hockey stick secreted somewhere jolly about my person. ‘I sent her an email a few days ago about something not directly related to treatment, but I doubt she’s seen it yet.’

She went. She was a while. She came back. She took a deep breath.

Dr. Kind and Beautiful Lady Consultant had recommended, first of all, that I have an AMH blood test. This would be an extra £77 on top of the £650 for IUI, but I have no objection to any test she thinks worthwhile. I was a trifle puzzled why ovarian reserve had suddenly popped out of the woodwork this morning, when I saw her in clinic a bare few weeks ago, but didn’t have the opportunity to analyse the issue, as the nurse was continuing to talk.

‘Dr. Kind and Beautiful Lady Consultant’s just gone into clinic, or she’d have come down to see you for a chat. She says she’s sorry she can’t (reply to?/deal with?) your email, she’s getting hundreds a day at the moment. But she told me that she really thinks you’d be better off doing IVF, so we can replace the embryo in a specific uterus. And although you said that downregulating makes your arrhythmia a lot worse, she said we should use a different protocol using the combined pill and antagonists, so you wouldn’t have to go through a long downregulation at all. And Dr K&BLC recommends you make an appointment with Counsellor X.’

She stopped for a bit here, probably because she noticed she was confronting a pair of saggy-open jaws. I stuttered for a bit, looked at John, stuttered some more, and eventually found first verbal gear long enough to express that this WAS the counselled Me, and they should have seen the emails I was writing before therapy. And that we were going to have to go away (Again. God Al-fucking-mighty.) and chew on the whole IVF thing. And… was this advice being given to us simply on the basis of my distrust of my right uterus? Nod.

We looked at each other and I pulled my favourite ‘Well, Bugger Me Sideways!’ face. I know John doesn’t fancy IVF; Christ, he wasn’t even fancying IUI much. I asked for the needles kit anyway, on the basis that whatever we do from here on out, we’d require it, and I have an amended IUI prescription sheet with more elephantine quantities of everything on it.  We are to ring when we have decided what treat treatment we want to select off their menu.

I’m being offered a chance of using my ‘Good’ uterus – just at the point where I’d come to terms with using the ‘Bad’ one. I’m being offered a protocol I didn’t know about, aimed at low responders, and, co-incidentally, also at those whose cardiac knickers get in a twist about prolonged pituitary suppression; that’d be… me, then, really. It seems a damn good offer – providing you overlook the slight matter of the gaping wound it would deal to the Hairy exchequer, the fact that I said I’d never do IVF again, the fact that it’s a far more invasive intervention than either of us envisaged (or require?), and the fact that I could be spending thousands of (possibly gratuitous) pounds, simply because of a gut fear; a feeling that might be completely and utterly wrong. 

I shall need to do more than eschew all hokey religions and ancient weapons in favour of a good blaster at my side to work this one out.

And I wish the bloody goal posts’d stop moving.

25 Responses

  1. uh, wait, what?

    That’s all I have.

  2. Oh my. Oh me oh my.

    Choice. Sometimes it’s a bugger, no?

    Sending calm, decision-making vibes. And hugs.

  3. with respect, John’s role in IVF is not really different than an IUI, so not sure what his different feeling is? I am very negative about IUI, I think in almost every situation it is an utter waste of time, and particularly given your uterine challenges, I would say Dr KABLC is completely correct and I even like her protocol, although not sure what the combined pill is doing in there.

    So. there. I have an opinion. HOw are you feeling?

    • Calmer, thank you! It’s absence of choice that triggers my anxiety!

      I know you’re not a supporter of IUI, and I don’t like the quoted stats much myself. In my particular case, though, there has never (that we know of) been an occasion where J’s sperm & my egg have not successfully partied on, albeit for a short space of time. I am due for a statistical bucket of cold water, I’m sure, but I do seem to become pregnant easily given all the right ingredients, hence we were fairly sure IUI would result in a pregnancy for us, however fleeting. I am liking her protocol really rather much, although I’ve only had time to glance at the sheet. Will mug it up over weekend!

  4. Wow. You must have made quite an impression! So, do you suppose the thought of trying the other side and it’s unexplored territory will bring John around? Best of luck in your decision making process.

    • I think I have, to a greater or lesser degree, succeeded in infecting him with my fears, although he has a distressing tendency to listen to what my Drs *actually* say, rather than what I would like them to recommend. Hence his hesitations regarding assisted conception: Dr K&BLC was initially (and still is) quite happy for us to go away and try for a pregnancy at home, given my previous home-grown conception rate.

  5. Blimey – food for thought indeed! Best chew it over slowly and thoroughly. At least the treatment plan seems to take into account all of your bodily foibles. Good luck with whatever course of action you decide on.

  6. I’m with thalia. You know your body. If you think the other uterus is the one, then I think you’re probably right.

  7. I’m with Thalia on the waste of time of IUI in most circs. That said it’s a bugger that the cons couldn’t have dreamed up this new idea in your physical presence at your last bloody appt for f’s sake. Choices are difficult things.

  8. Huh.
    Well that’s a shocker.
    Um… I don’t really know what to say, except that guts are usually right, and you’re obviously a sensible and well-informed woman, so I would trust yours.
    An interesting option. Sleep on it, lots, then do what your gut tells you.
    Sorry I haven’t been any more help.

  9. Well, crikey nora. The power of the printed word and all that. Good you have options, but don’t envy you the renewed need to make a decision bit.

    Still, if she is offering you the option, surely she sees your concerns as valid?

  10. Janey, when they DO listen, it’s almost as disconcerting as when they don’t. Still, a very interesting offer.. but urg.. financial considerations. Of all the considerations, I like them the least.

    You’ll know what to do. My faith is unwavering.

  11. Wait now WHAT now?

    *Rushes off to write very very very long letter to own medicos. And then delete all the swear-words and all the synonyms for ‘incompetent’*

    Chasing galloping goal-posts is bloody infuriating at the best of times, when said goal-posts are about something minor and pointless. This? THIS? I, oh, gah, I don’t know. Hurray, they listened. Can’t they listen at the time you first mention it rather than dropping it on you Deus Ex Machina style once you’re braced for Something Other? Or does this violate some basic tenet of doctoring they’re all sworn to secrecy about?

    The Powerpoint of the leaflet you were actually holding is a New Low. Seriously, do they think most infertility patients are stupid? Can’t read? Have amnesia? Because whenever I get that sort of meeting/presentation at work, I usually feel very bored and VERY OFFENDED.

  12. heavens to betsy. i am at a loss. except i’m stuck on the IUI costing so much — that’s worse than american prices, i think.

    • Unsure what US charges these days. Our clinic’s charges are really quite low, compared to London, but there’s still not much change from £3,000 for a fresh IVF cycle. Frozen is £750. A SCAN is £120, if not part of a cycle.

      • the IVF and FET prices are low to me. the scan is about the same. i think the IUI seems high, but my insurance actually paid for mine (less the spunk, which costs a great deal more to buy from a bank than its street value would suggest), so i could be wrong.

  13. This is good. This shows you’ve been listened to, and taken seriously. I like it. Even though it is a curve ball that Beckham would be proud of I reckon it is a positive step. (And I like more people here am so over IUI’s!).

    BTW – the reason we leap up like a coked-up jack-in-a-box when our name is called is because we have usually been waiting weeks and weeks if not months for this appointment and it has been so impressed upon us that if we are late or a no show our appointment will be canceled forthwith, we don’t want to risk the nurse assuming we aren’t there if we don’t run to their heels like an obedient spaniel the moment we are called. (Although I know from past experiences obedient Spaniels are a myth – but I digress).

  14. My Spaniel was last obedient in 2006.

  15. I have been so absent from blog land for so long, and it is a relief to find that some things never change: Thalia is as wise as ever.

    I almost never ovulated, but the few times I did, I nearly always got pregnant (and miscarried early-ish). When we did IVF and saw the state of our embryos, it made me appreciate the facility of IVF for selecting the best ones, which is as strong an endorsement for it as anything else, I feel. I’m pretty sure I could have gotten pregnant with IUI (if I hadn’t overstimulated on even letrozole), but I am far less certain said pregnancy would have been viable. Something to ponder, anyway.

    I had hoped to get to London this month (and surprise you with a meet-up), but my plans were foiled. I will be in Europe in April/May, but only on the continent. Maybe you could swim across the channel?

  16. Don’t know how to sympathise in meaningful way, but want to…

    Kudos on getting ‘hockey’ and ‘hokey’ into the same post. Was it a bet?

  17. I know this might be a misinterpretation colored through the lens of insomnia and terrible-threes screaming (my kid’s almost the same age as Harry), but it sounds like you’ve been taken seriously and are being treated as such. It’s not the course you expected, but isn’t that about par for your reproductive course? So I say, hurrah! And good luck indeed.

  18. […] quite excited at the whole prospect of this cycle, when I’m not being overly-cognitive or Han Solo about it. I am peeved that there isn’t a prospect of – or at least, a great deal of […]

  19. […] Harry’s IUGR, I moaned loudly about my perceived poor vascularity of the right uterus, especially after finding that my […]

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