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The Burning Pain of Infertility

April 1, 2013 | By:

Infertility brings with it many kinds of pain.  The pain of an empty uterus could be used as the catch-all category for the pain we infertile folk feel, but really it can and should be broken down into more palatable and discussable categories. I don’t know about you, but I find that whole empty uterus thing to be a bit patronizing (although true).  So let’s explore the burning pains of infertility, those that are momentary and those that haunt us sometimes years after we ended treatment, those that come and go along with our menstrual cycle, and those that blindside us when we have failed to read The Infertility Survival Handbook and obtain a first hand account of whatever procedure you are undergoing.  I mean let’s face, I have been THERE, and I have done THAT.  All of THAT.  And I get the pain.  Even now.

There is the pain of daily injections (momentary) and from transvaginal ultrasound wands (slightly longer than momentary but nonetheless uncomfortable when one’s ovaries are the size of large oranges and someone is poking at them). There is the unbearable pain of a hysterosalpinogram when you have blocked fallopian tubes (or a sadistic doctor who tries to open your fallopian tubes without advance warning — and for what it’s worth the advance warning just would have made it worse).  And the devastating pain which follows a miscarriage.

There is pain, before, during and after fertility treatment and there is no getting around it.  There is no getting around the pain of a miscarriage, but the lessons we learn from it can make the pain more bearable.  (And for what its worth I think “the lessons we learn from it” also is a bit patronizing.  My apologies but I couldn’t find another way of describing what I want to talk about).

Even in the early days of trying to conceive — the pre-IVF days — there is pain.  The pain in the arse of taking your temperature every dang morning (thankfully the pain isn’t actually in your arse now that they have these wonderful digital thermometers which can help chart your basal body temperature).  And of course there is the pain of toilet paper.

What say you?  The pain of toilet paper?  Indeed my friend.  The pain from toilet paper burn, or TPB for short.  TPB is brought on by the obsessive compulsive mentality that we sometimes wander into when our period is due and we are trying to make a baby.  Any color on that toilet paper might be a telltale sign of our impending motherhood so you don’t want to miss it.  There might even be diagnostic value to the color which would help your doctor determine if there is something going on, or going wrong with your menstrual cycle.  So, for those of us who tend to wander into OCD territory (who me??), TPB can become a real hazard.  And as I recently discovered, it can become a hazard even when you aren’t trying to make a baby.

Now, the average woman going to the bathroom does not wipe obsessively, nor does she pay much attention to the process, technique or results involved in use of TP.  Such is not the case for a woman going through infertility treatment.  There is a significant amount of attention paid to the process, there are several different techniques for wiping (all of which are designed to reassure the crazed woman in the loo that she is not getting her period), and the results are quite obviously, critical.  Many a woman has called a friend or perhaps even a nurse to discuss the details of a particular swipe of TP and the medical analysis or conclusion that should be drawn therefrom.  Stop laughing or rolling your eyes.  This is serious.  When you have lost all control over your reproductive capabilities and you are going through emotionally and physically challenging medical procedures, the littlest sign that something has gone wrong (or perhaps gone right if it’s implantation spotting) has tremendous potential impact on your life.  In the absence of HPT’s, TP becomes a valid and useful substitute for self-monitoring during the post ovulatory or post embryo transfer phase of a cycle.

Why are we discussing TPB as one of the many representations of the pain of infertility? Well recently I had the displeasure of being reminded about it, but not under the circumstances you might think.  Rather, I experienced TPB out of fear that I was going into menopause.  Now let’s be clear.  I am not in menopause, nor am I perimenopausal (well I suppose Dr. C might argue otherwise simply by virtue of my advanced maternal age).  But as the window begins to close on my access to fertility treatments, and as I continue to wrestle with thoughts of going back for one last try, the thought of menopause is, well, frightening.  It’s one thing to have lost the ability to independently reproduce and/or carry to term due to infertility (i.e. without Dr. C).  It’s another thing to have my entire reproductive system close up shop and move to Miami.

Now the rational part of my brain understands that the last several months of my personal life have been subject to profound and extreme stress.  I have always prided myself on the fact that my menstrual cycle is regular to a fault.  The only time I have ever been late, I was pregnant.   But there is always a first time for everything, and so a couple of months ago I missed a month.  Then another month.  I didn’t need to take an HPT because I knew I hadn’t ovulated (let’s just say that after TTC for 7 years some habits die hard, especially if you are a fan of Toni Weschler).  My sane brain was telling me that the reason I hadn’t ovulated was from stress.  My OCD, however, kicked-in into high gear and I was rapidly becoming obsessed by the fear that my days being of “reproductive age” were dwindling. And the longer I went without a visit from Aunt Flow, the more the OCD took over.  How ironic. TPB brought on not by the fear that I wasn’t pregnant (and the hope that I was) but rather that I was in menopause.  Despite repeated attempts at convincing myself I was overreacting, I kept making trips to the loo and quite quickly (haven forgotten good TP technique) I had a significant case of TPB.

I finally decided I needed to decompress and meditate.  So I did. I meditated, I did yoga, I slept, and I paid more attention to eating things other than Snicker’s bars.  And I ovulated.  Or so I thought.  Going by the fertility bible written by Toni Weschler the signs were clear.  But I wasn’t 100% sure.  And so, 11 days after my suspected ovulation I was back rolling through TP, making extra trips to CVS to buy an emergency six pack of TP, and this time relearning my TP technique.  And yet I still felt the burn.  And finally, when I could stand the TPB no more, she arrived.  Precisely 14 days after the day that I thought I had ovulated (and let me extend my never ending thanks to Toni Weschler for teaching me so much about my ovulatory cycle).

I write this neither because this experience with TPB has led me to once again revisit the status of my own family building and a continued longing for another child, nor because I am working through my fears of the inevitability of menopause and that one day my reproductive years will come to a close (although technically the fact that the NOvary has put a “closed-gone fishin’ sign” on the front door does not mean I wouldn’t be able to get pregnant with some medical assistance), but because I was so struck by the way infertility and the quirky little habits and tricks we use to cope with it — TPB — endure.  TPB also is symbolic of the loss of control and fear that we live with when we are infertile.

In the end, I am grateful for that recent opportunity to experience TPB.  It is helping me work through those last remaining “what-if” thoughts which linger after you move on, after you stop treatment without a baby in your belly.  But it also reminded me of how many women are out there running the race to the loo and counting the days until they can take an HPT or get their blood drawn for their beta.  I am glad I had my little TPB encounter because it has once again helped me connect with my clients and understand what they are going through.

For everything unwanted (a negative pregnancy test), there is something wanted (a positive pregnancy test).  For every swipe of TP that remains spotless we need to remember to focus on the spotlessness in front of us and even glory in it, be excited by it, by the expectation of it; and not give in to the fear of the appearance of a spot on another swipe of TP and/or the end of a dream whether for that month or longer.  In the face of a spotted or soaked piece of TP we need to try and remind ourselves to stay focused on the day when we find out we will go months without worrying about TPB or better yet, no longer care.  My somewhat random fear of menopause has served to remind me that all of this, including menopause, is meaningless. Instead of looking at the burning pains of infertility as a negative, at TPB as a negative, I am instead looking for all the positives they reveal.  Without all those trips to the loo, I wouldn’t be here today, with the career I have, the family I have, and without the intense sense of inner peace that my recent bought of TPB has brought to my my life.  Yes the pain of infertility burns.  But through the ashes left behind after the burning subsides, there is birth, or in my case, a rebirth.

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