Turning you off your cereal

I'm impotent. Or maybe omnipotent. Or omnipresent perhaps, I forget.

Some one of those anyway, but basically I'm in many places today. Here, and somewhere deep in the bowels of today's Irish Times health section.

Early last year they featured an article about our attempts to conceive, and today they ran a short catch-up piece for the sane people with jobs who don’t read here every day.

Complete with picture that makes me look like an anaemic wino with a glandular problem, and a title that will nauseate many, today's article can be found here.

For the lazy among us, the original feature was run last March and a follow up based on the reaction it generated ran a few days later.

As you were.

Far more entertaining are the guesses being placed here. Go on, give it a shot.

If at first you don't conceive...

My wife and I have a story. It’s a common one unfortunately, infertility.

Normally it falls upon the fairer sex to discuss it, but I have a big mouth, and I don’t really need to be asked twice.

It’s two years since my wife and I decided to start a family. Where the decision came from I have no idea, but once we both said it aloud there was absolutely no doubt that this was right. In fact, we wondered why we hadn’t thought of it before.

We dove straight in, eager and naïve. Thanks to the combined educations furnished by the Sisters of Mercy and the Christian Brothers, we had no idea just how naïve we really were. Once we’d established that we couldn’t actually get pregnant by watching English television channels or by holding hands outside the newsagents, we soon worked out what would work and what wouldn’t.

The early months were great fun; the honeymoon period of trying to conceive is every man’s dream. Dragged by the belt buckle into the bedroom at every opportunity and pounced upon by a fine specimen of womanhood. The disappointments each time we failed were sharp, but the desire and the excitement carried us forward easily into each following month.

Two months became six, which became nine, which became twelve. Something wasn’t quite right. We started absorbing more information from books and websites, using ovulation prediction kits, and charting body temperature. We applied potential solutions to unknown problems. We called in the big guns and headed for our GP.

The first steps were to be the least invasive ones, which meant I was in the spotlight.

Bear in mind that a man’s role in trying to conceive is basic at best. It includes nothing more than fundamental caveman activity. Climb on board, grunt a little, send her into rapturous ecstasy, deposit man milk, and roll over snoring. Actually, the snoring is optional and the rapturous ecstasy is, well, a long shot.

A man’s role in trying to conceive in combination with fertility testing and examination is a whole other beast. A bizarre, often comical, and anxiety-fuelled beast over which you have absolutely no control. You do stupid things, say stupid things, and without beating around the bush, you have to, in fact, beat around the bush. Right into a little pot.

I became so flustered on the morning I had to first speak to the doctor about providing a sample for a semen analysis I forgot how to dress myself. I sat in front of him with one black and one brown shoe on, he certainly wasn’t holding out much hope in my ability to procreate if I was struggling with coordinating footwear. We both coughed every time we used words like ‘semen’, ‘sperm’, or ‘sample’, but I managed to get the general idea, and left.

What was to follow was just ridiculous. Thankfully in matching shoes this time, but red as a beetroot and sinking fast into humiliation, I stood outside the locked office door with my own semen in my pocket.

After what seemed to be no less than six weeks waiting for it to open, it eventually did and I was beckoned inside. I handed the nurse the fruit of my loins in a plastic pot and answered her list of questions in the calmest post-self-pleasuring voice I could manage.

We waited two weeks for the results of the tests, I took them home and hit the internet for an interpretation. My motility score was dreadful. Not just poor or having some room for improvement, but more like a pair of Nokias had been super glued to my testicles. They were that zapped.

I pushed back my keyboard, put my elbows on the desk, and for the first time in years, I cried.

My wife could have finished me off that night, with the wrong word or look, or with any hint of blame in her voice, but there was none. She squeezed my hand tightly, reassured me, and we arranged a second test.

I repeated my duty, brave soul that I am. I was still mortified when I delivered the product of yet another solo sex act into the hands of a stranger, but any shame was instantly forgotten when two weeks later the results were back showing a huge improvement. The first test had been an off day, my swimmers were back. The focus turned to my wife.

We waited months for a specialist appointment, who told us to just go home and keep trying. So we did, every way possible. Each month we tried something different, sex daily, sex every second day, or saved up sex. Sex while suffering with a cold or flu is romantic kryptonite. More months passed and with life now on pause, we went back to the specialist on our knees.

They offered to monitor her menstrual cycle, where we learned that she’s an egg producing superstar, firing out big juicy follicles as regular as clockwork.

Importantly, I learned where you should not sit, and definitely not look, when your wife is in stirrups and a doctor is inserting camera equipment that would be the envy of RTE, inside her.

Indeed, I learned many things I never imagined I could.

I know my vitamins and supplements, I can tell what will have your sperm pulling handbrake turns. I know when a cervix is in the mood to slip into something a little more comfortable, or has a headache. I recognise enough about the ideal consistency of cervical fluid to never want to break an egg again, and with an ultrasound, I can identify a ripe follicle faster than I could a tomato in Tesco.

It’s possible I may already be a qualified gynecologist in fourteen Eastern European countries.

With us both having the all clear, and more months passing us by, the only option left was for my wife to have a laparoscopy. She would go under general anesthetic and through small incisions they would check her ovaries and uterus, and making sure her fallopian tubes had no blockages. We wanted it over and done with, wanted answers, but my wife was terrified.

I can honestly say watching her being taken into surgery in tears was the lowest moment of these two years. We had started out normal, light hearted and giddy with excitement. We only wanted normal things, happy things, and here we were a million miles away from anything resembling normal or happy. My wife was putting herself though hell for that normal.

I was helpless, or more accurately, useless.

The dust settled, and after all the embarrassment, the intrusion on our personal lives, and all the physical discomforts, we had a diagnosis.

We have “unexplained sub-fertility”, a diagnosis, but not an answer. The advice, go home and keep trying. The next step is hopefully a shot at intrauterine insemination before the summer. Meaning more stirrups, more cameras, and more orgasms in a pot.

I’d love being a dad, I think I could be a good one. I love to laugh, I’m employable, and reasonably intelligent most of the time. The kid would have to learn how to arrange their own footwear mind you, but overall I wouldn’t be bad.

Some days I hate having to watch other fathers with their children, purely through jealousy. There are days I feel humiliated and useless when I see boys half my age managing to do what I can’t. I wonder what do they have in them that I don’t? It’s illogical, silly and unbecoming, but two years of failure will give you those days.

So here we are, two years on from a naïve evening on the couch where we came to the biggest decision we’ve ever made. We are nowhere closer to the ‘normal’ we laughed about in bed; statistically we are further away than ever. We don’t discuss names, childcare options, or how many children we should have, now we just hope we get one chance.

A chance to see a positive test, to hear the delightful sound of my wife vomiting her guts up daily, to feel the excitement of a pregnancy, to not have an empty house. A chance to be normal.

All of it is uncertain now, except for one thing. If we don’t get the chance, I know my wife will still be squeezing my hand.

I’ll be squeezing right back.

'If at first you don't conceive...' was originally published by the Irish Times on 11th March, 2009. Subscription required for articles more than 1 year old.

The great conception question

It’s been just over a week since I wrote about our attempts, and failures to conceive.

The original decision to do so was not an easy one.

I was anxious about telling people about the embarrassing moments, and ashamed to have to admit to the sadness, failures, and jealousy. I feared that there would be no response, and I would regret having ever opened my mouth, leaving us to carry on alone, but exposed.

The responses were overwhelming. People with no personal knowledge of infertility sent their best wishes, and people with experience of it shared their very intimate stories.

My wife and I spent the evening reading the messages, and each one we went through justified our decision.

We felt validated, and reassured. We felt unburdened, and supported.

The boost they gave us brought it home how much we really did need that support, and just how isolated we had started to feel. The tangible relief in the words of some of the messages illustrated just how much everyone in this situation needs some help, and how much they long for someone to tell them they have that backing.

Men identified with the absurdity and the paternal desire, women were grateful for a peek into their partner’s frame of mind, and everyone recognised the need to be more open, frank, and honest.

They show us that infertility doesn’t discriminate. Your nearest infertile is most probably not some demented woman, trawling the maternity ward looking for a newborn to put in her handbag, it’s your neighbour, your work colleague, or your friend.

The messages we received reconfirmed to us just how common this is. It’s easy to use a statistic like ‘one in six couples need help conceiving’, but only when you see a list of messages from people with real names, and real stories of failures and successes can you get a feel for how widespread these problems are.

The number of those affected, and the amount of open discussion are extraordinarily out of proportion.

The responses made me see how much people on the periphery of the problem want to help. Often family and friends get privately berated for not saying the right thing, not saying enough, or saying too much. In reality, they won’t have any answers, they just want to show that they are behind you, and are there if you need them.

How can we expect them to have the perfect sound bite reaction to something we keep so close to our chests?

For those who are part of this hushed infertile underworld, a silent community, the reward for speaking out could be so much more tangible than just emotional support. If more people felt comfortable enough to be able to take their whispered discussions away from their kitchen tables and into the public domain, people in positions of influence would eventually have to listen.

One in six couples equates to a lot of people, or more importantly a lot of health insurance customers. Irish couples certainly deserve at least the option to be covered for the full range of fertility treatments if they are willing to pay the premiums.

Of course, there is always the dream that such treatment be made available through the public health service. The idea that there are couples, who are so committed to raising a family that they would put themselves through these procedures, and yet are being completely denied because they don’t have the finances, is a very sad one.

The tax relief for these expenses has already been cut. If we don’t make ourselves known, we will never be served.

I’m glad that what I said last week gave a handful of people the feeling that they don’t need to be isolated, and are supported enough to add their stories here. I hope that in turn, each one of those will help another handful of people to do the same.

I know just how vulnerable you feel at the very moment you begin to tell someone your story. The feelings of anxiety, fear of exposure, and even shame have stopped me on many an occasion, but the positive reaction in the last week has made all that disappear.

Infertility is one of the last taboo subjects of Irish society. I want these responses to be a small part of something bigger that helps to change that.

I want them to hold value for others like they have for my wife and me.

I believe they will.

'The great conception question' was originally published by the Irish Times on 20th March, 2009. Subscription required for articles more than 1 year old.

After years of trying

It’s supposed to be simple, starting a family. For 25 months we did our utmost to conceive. Over and over hoping for the best, which never materialised.

Lifestyle adjustments, supplements, research, matching his n’her embarrassing tests, daily monitoring, surgery, and not to mention no small amount of sex, had all come to nothing.

Trying to conceive was influencing every decision we made on a daily basis. We were feeling the effects of cyclical failures, with no explanation, and we were tired.

Finally, last March, following two years of invasive tests and procedures, trying and failing, we received the go-ahead for intrauterine insemination (IUI). It’s a huge weight off your shoulders when a doctor tells you they will step in and actively try to help.

My wife was to start medication to stimulate follicle development, and should we both survive the battering her hormones would go through as a result, she would be inseminated with a batch of my own finest contribution.

On returning to the hospital to monitor progress we discovered that the medication had worked brilliantly. Too brilliantly. Instead of the 2 or 3 viable follicles we had hoped for, there were more than half a dozen.

Partly due to the fact that neither of us are reality television material, but mostly due the hospital’s refusal to continue with the procedure, the cycle was wisely cancelled. We left the hospital that day being advised to use contraception.

That cycle resulted in failure, as did the following one. In May we returned for another attempt at the IUI, with an aggressive reduction in dosage and a cautious increase in worry.

After a week of monitoring, watching numerous follicles appear and disappear from view like lucky numbers in a lottery drum, we finally had the right number for an insemination.

That was the signal for us both to do what we do best. Me, abuse myself in the name of procreation before parading through a public building with my own seed in my pocket, and my wife, prepare to lie there wondering is it in yet.

Watching an overly chatty stranger set my bar-coded semen loose amongst her genetically modified eggs could only be described as surreal. Unless you consider ‘was it good for you’ jokes as being of some value, I may as well have stayed at home for all the use I was.

The procedure passed as uneventfully as any attempt to create a new human can, and we settled into the most drawn out two weeks of our lives. Our minds raced and skin crawled for days before she finally got to take the test.

It’s remarkable how long you can continue to hold something covered in urine when it represents good news. Perhaps it was a symbolic start to a future handling someone else’s bodily waste products, because against the odds, the IUI had worked first time. The pregnancy test was positive.

The weeks that followed are a blur. There were many checks on the progress of the pregnancy coupled with a lot of breath-holding. Eventually, we were freed from the care of the fertility department and let loose into the wild as a set of normal expectant parents.

It’s hard to shake off the negativity that takes over you when you’ve spent so long trying and failing to conceive, success in itself isn’t enough to immediately reverse the damage. Our first afternoon in a bookshop picking out pregnancy books can only be described as sheepish; embarrassingly glancing at books like a 14 year old would at the top shelf of a newsagent. Even later, trips into baby stores felt like spying missions behind enemy lines. Get in and out as fast as possible before someone realises you don’t really belong.

One oddity about long term trying to conceive was that while we put so much energy into attempting to become pregnant, we had failed to spend any time in preparing for life after getting pregnant. We had spent two years trying to achieve one thing, and now that was done we were utterly clueless.

More truthfully, it was just too hard to put already scarce energy into something that always fell just beyond our reach.

Hearing our child’s heartbeat, powerful and strong, was a huge moment. Ultrasounds and videos, kicks and movements, all one by one added layers of reality to something very hard to believe. Previous cautiousness started to give way to excited plans for what lay ahead.

Some might feel disappointed that they have to take this route to start a family, but not me. I’m hugely proud of what we have done with the help of some very skilled people. A lot of hard work and difficult times have been endured to bring about this baby. We are responsible for getting this far, we did the pushing; we kept each other motivated when repeated disappointments made giving up an attractive option. If ever there was a reason for people to keep trying, this is it.

As if to remind me that I have absolutely no control over how this will progress, my previous plea to be able to hear the joyful sound of my wife vomiting her guts up has fallen on deaf ears, she hasn’t been ill once, it’s been the perfect pregnancy.

This hasn’t been a journey of 9 months; but one of almost three years, one where we’ve slowly come around to the idea that we can be normal again. It’s just that sometimes being normal means working your way through 27 failures, 34 eggs, a pint glass full of erratic swimmers, surgery, and having a dozen or so strangers poking around your wife’s ironically dubbed ‘private parts’.

With just 3 weeks to go, while she struggles to get out of a chair, I can hardly sit still. These days are the most exciting, positivity filled, and happiest we’ve known.

The best bit of course, is that this is only the beginning.

'After years of trying.' was originally published by the Irish Times on 2nd February, 2010. Subscription required for articles more than 1 year old.