At first I was just looking to find success stories from other ladies who had both PCOS and endometriosis. Let me tell you, the results were not very promising. Then one click lead to another (you know how the internet is), and I was reading an article about what three women did when faced with infertility.
The first woman decided treatment wasn't for her, and she made peace with never being a mother. I know that this is something that will never be okay with me.
The second woman decided to say no to invasive treatments due to recurrent miscarriages, and miraculously ended up pregnant on her own. Hurray! Success for someone!
The third woman decided to opt for adoption, and fell pregnant two more times after. This helps reinforce that myth that if you want to be pregnant, just adopt!
These stories got me on to thinking how far down the rabbit hole I want to go with this whole infertility deal. Am I up for being poked and prodded and stuffed full of drugs? And then after all of that, it may not work? I guess for now, my answer is yes - I am willing to try everything: up to and including IVF. Becoming a mom has always been a dream of mine, right up there with finding the love of my life (check), becoming a teacher (check), and traveling the world (check).
And then my mind went on to the "what if...?" How many years am I going to try drugs and treatments and invasive surgeries? How many years should you hold on to hope and keep trying? At what point do you decide, "This isn't going to happen"? After all, our chances get worse every year as egg quality declines - how much torture should we subject ourselves to?
I'm not going to lie, a small part of me is absolutely terrified by the "what ifs". I have to remember that maybe everything will be okay before I have to face most of these options. But then again, maybe it won't be okay. In life, nothing is guaranteed.
Since I want more than anything to be a mom, is adoption ever going to be an answer for me? I know it is a wonderful thing to offer a child a home, but it isn't a cure-all bandaid for infertility. I can't just adopt a child and pretend like I never wanted to grow a baby in my tummy, to create a child that's half me and half my husband. How do people even make this decision, I asked myself. And would my husband ever want to adopt? Adopting a child is a decision two have to make, and it's a pretty big decision that also says, "We gave up."
And then, because I'm clearly trying to make my life as miserable as possible, I started looking up adoption protocol in Scotland. Approval times (long), home visits (many), matching (stressful), it could all take years and still might end in heartbreak. The chances of getting a baby are extremely slim, and at the risk of sounding selfish, I really want a baby. I don't want my first time as a mommy to start with a four-year-old who can already walk and talk. I always kept adoption in the back of my mind as an option, but now - I'm just not so sure.
One of the things that has kept me sane for the last few months was knowing there were more options out there for me. So I'm going to pull back from the adoption option for a while and look at all the wonderful miraculous options that science has to offer those of us who struggle with infertility.
- Surgery - Depending on the need, some women undergo laparscopic surgery to fix known or suspected problems. A woman with PCOS may undergo ovarian drilling - when your cysts are popped and drained. Or if you are suspected to have adhesions, blocked tubes, or endometriosis, the doctors may go in to clear the way and dispose of any problems they find. Some women claim that after laparascopy and an HSG you are "superfertile" because everything is free and clear for the sperm to meet egg. This hasn't been proven in any medical journals of course, but I'll take positive news wherever I can get it.
- Drugs - Usually the first step after tests confirm whatever fertility issue you have, because they are the least invasive. For PCOS, many women are prescribed metformin (Glucophage) which regulates the amount of glucose in your blood and seems to help shorten cycles. Then Clomid (clomiphene) is often prescribed to induce ovulation. Sometimes this requires monitoring through ultrasounds and blood tests to confirm ovulation. It seems the general consensus is to find the lowest dosage that results in ovulation, and only try for 6 cycles. Some women do not ovulate on Clomid, and so Femara (letrozole) can be tried. This seems to be the end of the road for the simple, oral fertility drugs.
- Injections - There are a range of different injectable drugs (Gonal-F, GnRH, HcG, and many more), each stimulating something different. The doctors choose the right cocktail of drugs for your situation, but in general they affect your levels of LH and FSH to induce ovulation. Some doctors avoid injectables because of the higher chance of multiple births and their high cost. It seems success rates are similar to oral drugs, but injectables might be successful where oral medication was not.
- Intrauterine Insemination (IUI) - Commonly used for unexplained fertility or mild known infertility factors, and often in conjunction with either oral medication or injections, an IUI is the placement of washed and concentrated semen directly into the uterus. Timing is important, and the rates of pregnancy aren't spectacular, but it is an affordable option.
- IVF - Often the last stop on the infertility train, IVF ranks quite high in cost, invasiveness, and success. Some clinics boast as high a success rate as 60% live births per cycle! This is a process involving drugs to stimulate egg production, then egg retrieval, then the actual injection of a sperm into an egg (or allowing sperm to penetrate egg in a petri dish), then the placement of the embryo (or embryos) back into the woman. I am lucky in that the NHS covers three rounds of IVF for a woman without any children in cases of infertility.
Even though sometimes I feel like I will never be able to fall pregnant, I am so grateful that there is an entire list of options that I haven't tried yet. I'm just at the beginning of the road, and although some of the options seem big and scary, at least I have options. PCOS and endometriosis can be daunting, but at least I know what I'm dealing with and I can charge straight at it head on. I don't know what the future will bring, but today I'm feeling cautiously optimistic and I'm holding on tightly to that little ball of hope inside.
It's two days until my meeting at the fertility clinic, and armed with my piles of research, only good things can come. It's a long dark road ahead of me, but I think I might just be able to see some light at the end of it.
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