INFERTILITY DUE TO ENDOMETRIOSIS: DIANNE’S STORY
My endometriosis was diagnosed in January 1986 when I was 33 years old. I had sought medical attention when I had been unsuccessful in conceiving after 18 months. Apart from painful periods (always), which were getting heavier and a few odd aches and pains that I’d attributed to heavy lifting at work (nursing), I didn’t have any other problems.
When told I had moderate endometriosis, I was amazed as I didn’t think I had anything wrong.
Over the next two years I had three laparoscopics and two laparotomies as well as courses of Danazol, Duphaston and Provera. The drugs proved ineffective as my endometriosis is apparently very tenacious.
In July 1986, my specialist asked if we had considered going on the IVF programme, as he felt the endometriosis was preventing the eggs transferring from the ovaries into the fallopian tubes.
I said ‘No’, as I thought that was for people who were desperate for a child. It dawned on us that we were desperate! The waiting list was 22 months long, so we put our names down.
I continued treatment and went back to work to save up for IVF. The long wait didn’t necessarily worry me as I believed I would conceive naturally and wouldn’t need IVF, so I figured the longer we waited the better our chances.
When the letter came after 18 months saying that it was our turn, I had to face reality. I was angry and scared, firstly because we couldn’t conceive naturally and secondly because this was our last hope and its low success rate meant we were likely to remain childless.
Before starting the programme, there were a number of requirements. I had to record the first day of my menstrual cycle for the previous six months, check rubella (German measles) immunity and have had a Pap smear within the last two years.
We had to attend a counselling session, be screened for Hepatitis B and the AIDS virus and checked for sperm antibodies. My husband also had to have had two semen analyses done in the previous six months.
Having met these conditions, I phoned in at 9.45am on Day 1 of my period in February 1988. The treatment cycle proceeded approximately as follows:
Day 4: I started taking Clomid tablets twice daily for five days. We attended the clinic for an interview and paid $1000 for non-rebatable fees. We were asked to sign consent forms stating what we wanted done with any extra eggs that may be collected (we were allowed a maximum of four to be put back). The choices were to donate them to someone else or to allow their use for research or to be disposed of. We could also direct them to be fertilised and frozen for our future use, or for any resulting embryos to be donated to someone else or to research or to be disposed of. We hadn’t expected to have to decide all of this on the spot and found it confusing and rather traumatic.
My husband was shown how to take my blood and give me injections. We were given the necessary equipment, etc. (anyone can take blood and give the injections). Day 5: My husband gave me my first morning injection, HMG (human menopausal gonadotropin) which is a follicle stimulating hormone. We both survived! Day 6: Attended the clinic between 7am and 7.30am for blood tests for oestrogen, luteinising hormone and progesterone levels. I saw the doctor on duty and he ordered the appropriate quantity of HMG, and I was given the injection. I found having a well-padded behind an advantage for all the injections.
Day 7: Clinic for blood tests, injection and consultation with doctor. The amount of HMG was calculated from the previous day’s blood tests which were graphed. Each day the doctor showed me my graph and discussed how I was progressing and answered my many questions. Day 8 & 9: Clinic as usual. In the evening my husband gave me another HMG injection.
Day 10: Clinic as usual, and also had an ultrasound scan to determine the number and size of my follicles. In the evening my husband took my blood (a nervous experience for both of us).
Day 11: Clinic as usual, plus took in previous night’s blood sample. In the evening, my brother-in-law (a vet!) took my blood as my husband was at night school. He said I was easier than an animal as I didn’t have to be shaved first! At 12.45am my husband took my blood and gave me an injection of HCG (human chorionic gonadotrophin). The timing of this injection was given to me by the clinic and is important because ovulation follows within the next 36 hours and enabled operating theatre scheduling. Day 12: Took previous evening’s blood samples to clinic. At 5pm admitted to hospital.
Day 13: My husband attended the hospital between 10 am and 11am to provide a semen sample in the privacy of Room 8′. As my tubes were open and normal it had previously been agreed that I have a GIFT (gamete intra fallopian transfer) procedure, which had a slightly higher success rate. I went to theatre at 12.30pm where six eggs were collected during a laparoscopy. These were then washed — as was my husband’s semen — and then the four best-looking eggs and a quantity of the semen were placed in my fallopian tubes. I remained at the hospital until 7pm and I was then allowed to go home.
I then had to wait two weeks before having a pregnancy test and it really dragged. Although there were no restrictions on activity (within reason), I just crept around, almost too scared to cough.
As each day passed without my period (despite checking each time I felt the slightest twinge), I couldn’t help becoming a bit optimistic although I tried hard not to be.
I was glad I hadn’t committed myself to doing anything or being anywhere during and immediately after the treatment cycle as I slept a lot. The travelling and the stress of being on time at the clinic, together with all the hormone injections, really exhausted me.
I went to the clinic in the morning for my pregnancy test (by blood test) and had to ring up at 3.45pm for the results.
I couldn’t believe it when I was told that my test was positive. I repeated my name and asked the sister if she was sure she had the correct results. I waited until my husband came home from work to tell him rather than ringing him as I had waited years to see the look on his face. After this wonderful news, we didn’t mind the numerous extra bills.
I had to have weekly blood tests for hormone levels at the clinic until I was eight weeks pregnant. I then had an ultrasound scan to ensure that everything was normal and to check the number of babies — in our case just one.
After an almost uneventful pregnancy, I gave birth to a normal, healthy boy.
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