Game Plan

This is the story behind our current story. Statistics are involved. And not many adjectives. But it's how we got here, whether we like it or not.

One of the most unexpectedly difficult things about infertility are the anniversaries. These are the days to which you’d already said your goodbyes. Like that last-gasp Halloween party where you dressed up and acted like a kid again, one last time before you had a kid. Only now it’s Halloween again, and this year you don’t feel like dressing up at all. The Thanksgiving where you smiled at the thought of a baby smaller than next year’s turkey. But a year later, there’s just another turkey. That “last Christmas as just the two of you,” which turns into another Christmas with the same number of stockings hung. (Thank goodness your spoiled cats get stockings, too, or the sight of only two would be too sad to bear.) And then there are the weddings. People announce wedding dates far enough in advance that it’s easy to believe you’ll have a belly by the time the big day rolls around. And then one by one, you toast newlyweds with champagne instead. Time marches on.

Enough was enough. A year and a half after first trying to conceive on our own, we became patients at a fertility clinic. Our reproductive endocrinologist ran new fertility screens on us and came to this unhelpful diagnosis: Unexplained Infertility. Further rounds of poking and prodding and running dye through my fallopian tubes yielded nothing more than confirmation: Unexplained Infertility. I had mixed feelings about this diagnosis. On the one hand, my inner overachiever loved hearing that nothing was wrong with us. On the other hand, something obviously was wrong, or we’d be parents by now. Surely there had to be some answer out there, something specific we could try to correct. But no. We were answering every question correctly, yet still failing the exam.

Our doctor suggested we try Intrauterine Insemination (IUI), which facilitates fertilization by placing sperm directly into the uterus. Although we knew my husband’s guys could already swim and my ladies were ready and willing, the doctor believed a medicated IUI would improve our chances without the additional intervention (and cost) of In-Vitro Fertilization (IVF). We’d try IUI for a few rounds, and if that didn’t work, we’d move on to IVF.

According to our doctor, 85% of all couples trying to conceive have about a 20% chance of getting pregnant each month. For a couple like us, diagnosed with Unexplained Infertility, our au naturel chances are only 2-3% each month. Having an IUI without supplemental medications doesn’t meaningfully increase our chances, nor do medications without an IUI. We agreed with our doctor that an IUI plus medications was the best course for us, but this involved choices of its own.

We could take Clomid, an oral medication, and raise our chances from 2-3% to about 4-6%. Or we could choose an injectable medication and raise our chances to about 6-9% per month. There are pros and cons to both, but I disliked what I’d read and heard about Clomid much more than what I’d read and heard about injectables. Besides the obvious discomfort factor of injecting needles into yourself, the injectable route does come with one big risk: a multiple pregnancy. IUI + Clomid has about a 7% chance of having a multiple pregnancy, but IUI + Injectables has about a 30% chance of a multiple pregnancy. (Head spinning from percentage chances already? Here’s another fun one for you: if IUI doesn’t work for us and we move on to IVF, we’ll have about a 40-45% chance of conceiving each month, and only a 25% chance of a multiple pregnancy, but with 0% insurance coverage.)

If you’re now thinking we’re crazy to go through IUI and injectables for an at-best 9% chance of conceiving each month, which comes with needles and a 30% chance of having a zoo of children, you wouldn’t be alone. We thought that, too, when we first started trying. Now, though… it doesn’t sound so crazy at all.

We’re lucky that our insurance pays for a good percentage of an IUI cycle. The thought of IVF terrifies our bank accounts, so it’s prudent to try every other possibility first. Last December, though, as we faced a year of unknowns and all the pressures that come with that, we did something crazy instead of being prudent: we flew to Paris for Christmas to forget our troubles. We had a game plan for 2012, but we had the City of Lights to explore first. And it was worth it.