The day had come. I walked into the hospital alone, irritated that my husband wasn’t going to make it on time for one of the most important meetings of our life. As the elevator dinged and the doors parted, I took a deep breath, squared my shoulders, and stepped off what seemed like a 1000 foot drop with no end in sight. Instead, I found myself standing at the infertility check in window. The desk was situated in a general medical hallway outside of the actual waiting room, which was enclosed by a wall of glass. It felt more like I was standing in line for a movie ticket than for a doctor’s appointment. Actually, it felt more like I was standing in line for an X-rated movie ticket. I felt the eyes of each person that passed. They knew why I was there, why I was in that line. They knew my dirty secret! They didn’t even need a billboard that said, “INFERTILE…STAND HERE!” No, it was written all over my face.
I had hoped to hide in the waiting room, out of sight from the familiar faces of coworkers. But, the location of the check in desk…in the hallway…was far from an ideal hiding spot. I assume that HIPAA requirements were being met, but standing in an open hallway right next to the elevators and the surgery and obstetrics residency work rooms felt like an invasion of my privacy. My shoulders (which I had just squared) were now hunched, and my chin was tucked to my chest. Maybe no one would notice me? I willed myself to disappear, to become invisible for just a few moments. If only I could make it into the waiting room without being seen. There I could at least vanish into the crowd of other women.
As I stepped into the waiting room, I was met by a startling number of pregnant bellies. Was I in the right place? To my dismay I discovered that this waiting room serviced both the prenatal clinic as well as the infertility clinic. So, those of us in the unfortunate infertile group now had the privilege of surrounding ourselves with very pregnant women. Was their fertility supposed to rub off on us somehow? Were we supposed to be encouraged by their success? Or, was this some kind of cruel joke…a rude reminder of our empty bellies?
I scanned the room for an open seat and found one in the corner next to the vending machine. This was the perfect seat! It didn’t completely shield me from the eyes of passersby in the hallway, but it did make it much harder for them to get a good look at my face…especially if I had it buried in a magazine or glued on my I-phone. I reached for a magazine to pass the time, distract myself from the pregnant bellies, and to simply make myself appear occupied. Fit Pregnancy and Parenting were all that littered the tables and chairs. Clearly, the magazines were for the benefit of the pregnant clientele. To an already sensitized women this felt like a slap in the face. I made a mental note to bring my own reading materials in the future.
As I sat in the fish bowl I continued to pray and hope that I wouldn’t been seen by anyone I knew. Although keeping my head down made me feel better, curiosity overcame my shame. I scanned the room trying to decipher who was infertile. Who was like me? Who was jealous of the women with huge bellies and uncomfortable waddles? It was somewhat easy to tell. All of the women struggling with infertility brought something to read or to do. They kept to themselves and in general kept their heads down.
Children played at the little table and chairs situated just for them at the front of the room. Seeing mothers pregnant for the second and third time reinforced my grief and longing. I just wanted one baby. I wanted to be a mother. I wanted to love a being that was made from me.
As I sat alone, with an empty uterus, I felt even more hollow. I had been staring at my i-phone for at least 30 minutes now, pretending to be concentrating on something very interesting. Instead, my mind had been wandering, well not exactly wandering, it had been fixated on my childless state. I was starting to feel slightly angry. Who in their right mind would combine a prenatal and an infertility waiting room? I was primed to give patient feedback on that scenario!
The sound of my name lurched me out of my self-focused thoughts. It was my turn to find out my fate. I looked around hoping that I would see Dave walking through the door, but I was only met by an unfamiliar face asking my date of birth and the confirmation of my last name. We walked a short distance down a sterile hallway into a rather large office. An enormous desk barely filled the massive space. A table with three chairs was situated toward the back of the room. The room was not as sterile as the hallway, but it did lack a sense of comfort and light. The walls were void of windows, making the space feel slightly claustrophobic even though it was so large.
I was greeted by the head of the infertility department. He was nice but very matter of fact. All of this was new to me but very repetitious for him. I was the next patient on his schedule, the next one to get through. I wasn’t very interesting. My story was the same as a zillion other patients. I was just another infertile patient signing up to do whatever it took to make a baby.
Being by myself without my partner wasn’t necessarily uncomfortable; It was just annoying. What was more important right now than our fertility? In my mind, nothing. But, being married to a physician means that their patients come first. Dave was probably stuck in the operating room saving the life of another patient. But, I wasn’t just another patient. I was his wife. I was his life. Medicine needed to back off. I needed him. I needed him to be on time. I simply needed his presence.
As a resident you have no control over your schedule. You are a slave to the system. You are a slave to the attending. You are necessary, yet devalued. I understood all of this. Several months before I had been a resident. I didn’t blame Dave. I blamed medicine. It had already taken so much from me. It had stolen my most fertile years. It had stressed my body with a lack of sleep, nutrition, and balance. It had strained my emotions. It had taken my husband from me on countless nights. I blamed medicine, and I hated medicine; but, in the same moment, I desperately turned to medicine to fix me.
The paper work was spread before me. Spread sheets breaking down the medication regimens, the pricing, the timing, the wavers, and the risks of trying to get pregnant. A knock on the door stopped the buzzing in my ears and forced me to look up from what would soon be my new role- infertility patient. Dave smiled a quick apology my way while exchanging pleasantries with the attending. He sat down, and I quickly tried to catch him up on what we had already discussed.
He was eager. He was a little too enthusiastic and a little too optimistic. My goodness, he was the infertile one, yet I was the one undergoing infertility treatments. This was a little more than unfair in my book. Yes, he had a minor surgery, but that was once and done. Who knew how long this process would take! I could only handle cautious optimism right now.
After discussing the IVF agenda, the attending opened up the conversation for questions. I had a multitude of questions. I had been educating myself on IVF and ICSI (intracytoplasmic sperm insemination). I wanted to know our options, our odds, and our risks. I wanted the minute details. I was encouraged by our odds. I was relatively young. I was healthy. I wasn’t overweight. I wasn’t too skinny. I had normal cycles. Dave’s sperm were beautiful even if few. We could make a baby!
One of the most significant risks with IVF is ovarian hyperstimulation. This is when the medications cause the ovaries to create too many follicles that house the eggs. The ovaries get very large and they spill fluid into the belly. Because the ovaries get so large, they can sometimes twist on themselves cutting off the blood supply and killing the ovaries. This is a rare complication, but ovarian hyperstimulation can land you in the hospital and even in the operating room. I knew the risk was low in general, but I just wanted to make sure that my risk was low. The infertility specialist reassured me that I did not have any of the conditions or features that would predispose me to hyperstimulation. Although there was always a potential for this and many other complications…my risk was low.
We were ready to get started. We signed on the dotted line and handed over every penny we could jiggle out of our bank account. I was determined. I didn’t care how many cycles we had to do, I was going to get pregnant! I was in this for the long haul. I was pretty sure that based on our situation we would get pregnant with the first IVF cycle. Why wouldn’t we? Now all that we had to do was wait for my period to start.
From The Mom in Me, MD