Infertility

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• Trying to Conceive - Expecting to Expect

By Sara Dimerman

It used to be that if a couple hadn't conceived a child within their first year of marriage, family and friends would begin to ask questions and make comments. Now, most know better. Being childless is not necessarily their choice, but often the result of an unexplained infertility, low sperm count, blocked fallopian tube, hormonal imbalance and other complications.

When Leigh and Arnold, a Markham couple, felt they were ready to have a child they were in their fourth year of marriage. Leigh had just turned 29, and Arnold 32. It was just then that Leigh started, for the first time in her life, to experience erratic cycles. She was no longer able to calculate when she was ovulating since she was so irregular. Convinced that she had induced this physical state, Leigh consulted with her family doctor and was diagnosed as having dysfunctional uterine bleeding, which she says, "said nothing of cause, nor prognosis." Reluctantly, she placed herself in the care of a gynaecologist. "No-one," she says, "has been able to give me any answer as to why this happened after 17 years of regularity. All they've done to control the problem is put me on the birth control pill, which does wonders for becoming pregnant," she says sarcastically. "That was a year ago. When I decide that I want to try to have a baby, I have been told that I will have to go directly onto a fertility pill called Clomid."

"Besides the frightening aspect of what this bleeding is doing to me physically," she says, "I feel emotionally drained. No-one, not even a doctor, can understand what I am going through, unless they've been through it themselves."

Frustration and anger are strong emotions felt by all women and men who are dealing with infertility. Michele, 27, lives with her husband in Aurora, Ontario, are settled in challenging careers and mostly content with life. The only thing marring their happiness is that Michele cannot conceive. Three years into her marriage, four years ago, Michele and Dave felt financially and emotionally secure and decided to have a child. As with Leigh and Arnold, it was not as easy as they had anticipated. Six months into basal thermometers and counting down days to ovulation, Michele consulted with her physician and finally with a specialist. One painful test of many meant dye being injected into her fallopian tubes. The dye found difficulty in seeping through her one tube; unable to pass through her other at all. This meant major surgery and a three to four week stay in the hospital. The tubes were "folded back like sleeves," she says "to try to open them up further." Within 24 hours the closed tube had collapsed completely. The other tube showed minimal improvement. Still, her doctor advised her that it had been a success and that she should be pregnant within three months. Nothing happened. "I decided to lay off for a while," Michele sighed, "I thought that if I didn't concentrate so hard on making it happen, maybe it would, but that didn't work either." So, she started a course of Clomid - five pills at a cost of $32.00 per month. Six months ago, one and a half years into this course of treatment, Michele became pregnant. Exhilirated by this seeming miracle, she celebrated with her friends. Three weeks later, she cried after losing the baby. Her only hope, she says, is through an IVF (in-vitro fertilization) program. However, hospital waiting lists are long and private clinics expensive. "Besides," she says, "since there's a three year waiting list at Toronto General, and I'm only 27, I seem to be getting kicked back further and further." Older women are seen first.

"My emotions are up and down all the time," she says, "when I get my period, I get very, very angry and then I calm down when I realize that it's there and there's nothing I can do. Also, I get angry at my husband. There's so much stress to perform on command that it takes the joy out of lovemaking. So, I try different tricks - sometimes I seduce him, sometimes I don't tell what time of the month it is. But I'm always aware of working towards something."

"I want my own child," Michele says. "That's why I won't think of any other options until I'm at least 40."

Over the years, the number of couples who have sought out help for infertility has increased. Technological advancements have opened up doors to many possibilities hardly thought of years ago. Newspapers have cited case studies of legal suits arising from such alternatives as surrogacy and frozen sperm. Religious groups have denounced the use of many technological alternatives, saying that they go against God's will and that the children born out of test tubes are sinners.

Five years after trying to conceive, Chris and her husband, Ian were diagnosed with unexplainable infertility and began their journey to parenthood at Toronto East General. She too had been prescribed a course of Clomid, but declined that route after hearing of adverse long term side effects. "You only have to look at a CPS manual to realize what high doses over a long period of time can do to you," she says.

Following a laparoscopy, a procedure in which a tube is inserted into an incision below one's belly button, at the end of which a little "hook" retrieves the eggs, Chris was admitted to hospital.

Ian's sperm were washed so that only the strongest ones remained, and were placed, together with Chris's eggs, in a petri dish. "Here," she says, "they go to bed in the dark, no less, while I lay in the hospital bed, still in pain."

After 48 hours the fertilized eggs are removed. Three of Chris's remained. Optimum, she says, for implantation is three to four. Some lucky couples have many more and can now freeze them for use at a later date, if need be.

The fertilized eggs are implanted through the vagina, through a glass catheter. "It's unbelievable," says Chris, "that I saw my eggs before they implanted them. They look like little, dark dots, and around them is a halo of light. I sometimes look at Tristan now and think, is it really possible. It just boggles my mind."

Within weeks, two of Chris's three eggs had naturally dissolved back into her body. No evidence of a miscarriage, just a natural phenomenon.

Tristan will be four years old on his next birthday. Contrary to what some may think, he looks no different to any other child. Chris has been through the program three times since. Twice at the hospital and once privately. At this time she wonders if she can do it again. "Im not sure that I'm up to it anymore," she says. "It used to be an obsession but I have to know when enough is enough. I look at Tristan and I couldn't ask for more. He's healthy and happy and I think that maybe I should quit while I'm ahead."

Chris is open in sharing what she has experienced. She's kept a scrap book with ultrasound pictures and a diary, and will one day share it with Tristan.

© Sara Dimerman B.A.A., Dip.C.S., all rights reserved