Thursday, July 9, 2009

The diagnosis conundrum

As many infertiles can attest, waiting for test results during the "well, let's see what's wrong here" phase of problematic TTC is tense for many reasons. After you've welcomed a team of highly trained, specialized medical professionals to take a stroll around your internal girlie parts -- please pass the hor d'ouevres! -- you anxiously await their word on what they find.

Is it good news, doc?

But it's not as simple as that. Because there are two main outcomes, and neither one really helps you sleep better at night.

The first, which is what DH and I have heard most of the time: "Wow, those are some good looking internal girlie parts." My ovaries have gotten more compliments than all the rest of my parts put together. (And, fortunately, they are all put together. And they will hopefully stay that way for a long, long time.) This would initially seem like the ideal outcome, right? Ones reproductive organs being lavished with such praise as beautiful and gorgeous? Hormone levels being so spot-on that they are textbook? Well, sure... if you don't mind undergoing MORE tests... because sorry ma'am, you are still not pregnant, and we still don't know why not.

In the second scenario, you hear the words you've been dreading: we found a problem. And it's PCOS/endometriosis/high FSH/blood clotting disorder/MFI/*insert fun term here*. Which I don't deny is usually crushing news. But on the (small) positive side, you now know the enemy. You (hopefully) won't waste time on IUIs if both your tubes are blocked. It is easier -- although not on an emotional level -- to plan treatment when you can point to something and say, This is the culprit.

When we were undergoing testing with Dr. Lou (this is the nickname I'm giving our St. Louis doctor -- am I clever or what? Wait, don't answer that), as I said above, he was thrilled with all of our test results. Except the laparoscopy, where my OB/GYN who did the surgery found a small amount of endo. However, both of these doctors agreed completely that due to the location of the endo and its mildness (fortunately neither said this while I was sucking down Motrin on the couch, moaning and clutching my heating pad for dear life, or they both might have been rendered infertile as well), that it was NOT a factor in my infertility.

The best explanation that Dr. Lou could offer me as to why I was not pregnant was: "Nature is inefficient."

Yes, I partially wanted to kick him in the shin for saying that. But truly he is a great doctor and a very nice man, so of course I didn't. That and I have never kicked anyone in the shin in my entire life and can't really imagine myself ever having the nerve. So basically DH and I fell under the category of "unexplained infertility." But I always personally considered us more "suspected female factor." Which is not to be confused with "suspected Fear Factor," which is when you find out that you may have accidentally eaten some pickled bull testicles.

So I hid behind that "Nature is inefficient" explanation for a long time. Even as I did, though, I was obviously conflicted. I would tell people, "I suspect the endo is causing harm." But then, against my usual modus operandi, I didn't do much research on endo or connect with it emotionally as a diagnosis.

When we made the appointment with Dr. Downtown (thanks to Liv for this nickname, I like the suggestion) here in Seattle, I was dying to hear what he would say about the endometriosis.

Or so I thought.

As I mentioned in my post about the consultation, he agreed with what I'd suspected deep down inside -- that it was likely the endo causing my uterus to become a hostile environment for the poor sweet, innocent potential babies.

Which is really too bad, because otherwise my uterus is so loving and compassionate.

I thought this would be a relief. Because seriously, how can the reproductive systems of two healthy individuals be so totally kick-ass yet NOT produce offspring without medical intervention? I finally had affirmation that Something Is Wrong, and This is It.

But you know what? It didn't bring the sense of relief I expected.

I'm angry now.

I'm angry that something inside ME is actively sabotaging my efforts at conception. As I go about my daily activities, washing my hair, getting dressed, eating Frosted Mini Wheats, watching Judge Milian rock The People's Court -- there is this endometriosis inside my OWN BODY that is PLOTTING how to ruin my day/week/year/20s/hopefully not 30s.

I feel betrayed by my body. When before I could simply curse Nature for being a lazy bitch, now I have to point the figure right back at myself. Of course I can intellectually understand that it's out of my control. I can't simply command my endometriosis to Play Nice, Now. I repeat it as a mantra when I start feeling broken: I am NOT defined by my body's ability to get pregnant.

But that's easier to say than to believe.

Do you mind if I crawl back into "Nature is inefficient"?


  1. It is easy to say but hard to live. My uterus has gotten so many compliments as well. Oh it is so perfect. Well if it is why does it spit out dead babies like bad milk? Frustrating!

  2. Ha! I could've written this post myself -- though not with the same level of wit. And if you subscribe to the psychosomatic explanations for reproductive issues, it leaves you feeling really low because then it is your fault! So don't go there. I could tell you some books not to read, but then you might be tempted.

  3. From one endo sufferer to another I hear you loud and clear!

  4. I always thought it was better to know than not know. It makes me feel like I'm following a Plan. (Of course, said Plan has gotten me exactly nowhere.)

    But the feeling of betrayal by your own body sucks.

    By the way, I think "Dr. Downtown" is the best RE nickname I've ever heard. I was laughing my ass off here in my office. (Not that I would blog at work or anything--that would be stealing.)

  5. Wow, I can relate to this even though endo isn't my problem. I had always suspected that PCOS was my problem, and my OB/GYN wouldn't diagnose it. I both wanted the diagnosis so I could have a plan of attach and feared it. And when the RE did give me that diagnosis, all I felt was that same anger at my body for betraying me. I'm not entirely sure how to get past that either - it's not like you can sit down for couple's therapy to work it out.

    I agree with Babychaser that "Dr. Downtown" is pretty darn brilliant!

  6. I'm so sorry to hear this. I wish I had something pithy and witty and hahaha! to say, but I'm just sorry. I've felt betrayed by my body for many things. Drop me an email if you want to talk, please. Anytime. Anywhere.

  7. I'm sorry that you're feeling down on yourself. Maybe it helps to think about how wonderful your body was/is for Bean?

  8. It is so true...both sides of the diagnosis are soul-pinchers!


    I now realize how MANY things can possibly go wrong...and how awesome it is that some people go through the whole journey minus a single hiccup...

    I hope you can find a way through the conundrum...

  9. First off your award post made me cry, thank YOU so much and I don't know what I would have done without you either. Secondly big big big hugs. As much as we crave knowledge it is sometimes SO hard to hear. I have no advice just a listening ear, you know I am ALWAYS here especially during this upcoming cycle!!

  10. "I'm angry that something inside ME is actively sabotaging my efforts at conception." "I feel betrayed by my body."

    These are feelings I am well aquainted with. I have PCOS which means the nearly 10y we tried to get pregnant were wasted because no doctor could give us a diagnosis of anything other than "unexplained infertility". Then, once we found an RE who was able to help us and get me to ovulate, which then led to pregnancy, my body turned around and decided to have an incompetent cervix.

    I understand being angry and hurt. I really wish things were different for all of us...

  11. I am so sorry, Nature is inefficient and not so helpful.

  12. Sorry to hear of your frustrations.

    Any update on this cycle? Surely your 2ww is over by now? Your's does seem longer than mine. :)

  13. Hi, Sunny, You Won the Giveaway! Please email me your address so I can get out this out to you. Thanks so much, also, I need to get in touch w/Michelle at tobaby and beyond, she's a Winner too.

    msakelley at gmail dot com

  14. Sorry that you have got the more definitive, yet totally frustrating news. I don't have endo, so I don't know what that means for your next steps. I hope there are things that Dr. Downtown (good name!) can do to help. I am cheering you on. Also if you want to get together any time for a coffee or gelato, just email me ifoptimist at gmail dot etc. Oh and thanks for the Sisterhood Award! I'm gonna keep it in my pocket for when I need some inspiration for a post.


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