I have a cunning plan...

This morning I had never heard of Dr R - tonight she may be my favourite person in the world! Well, in the top ten at least.

Thank you so much to the people who have followed me over the last few weeks when my incessant blogging has been such a great way to try and diffuse my nervousness about our fertility consultation today (well yesterday now, it’s got quite late!). For those who are keen to hear all the details, these will be included below. But for people who would rather just have the summary, it went something like this:

Appointment was 45 minutes with the lovely Dr R, who took all our details in a sensitive and reassuring way, explained everything, answered our questions and decided that my history merits further investigation and treatment. I need to schedule an HSG in my next cycle (to check for blockages) and if all goes well, take medication to boost ovulation in the cycle after that. We have clomid in the house! With any luck I’ll be taking it by the end of the summer, and by Christmas, who knows... we might just be on the way to babyland.

And England won their World Cup match!

Great day.

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I thought hard about whether blog readers would be interested in a long post about exactly what happened today. I decided to give a detailed account for two reasons. Firstly, I personally love it when someone tells their whole story (but maybe I’m just nosey!). Secondly, this blog is an important way for me to record and reflect on my own journey and I’m finding it tremendously helpful.

The summary above is your opportunity to find out the highlights and skip the rest. So anyone reading further into what I expect will be a very long post, you have been warned!

I decided I would take the whole day off work, even though our appointment wasn’t until 3pm. I was in such a flutter, and I was supposed to be chairing a meeting at 1pm which would not have been a good idea given how worried I would be. So I asked a colleague to cover my meeting, and told my boss I wouldn’t be coming in after all.

It was a good move, and meant I felt much more relaxed as we set off. By ‘more relaxed’, I mean only feeling sick, scared and like I was about to sit a very important exam without having studied or revised at all!

M was far more chilled about the whole thing, even though it meant he would miss a vital World Cup football match. That’s love for you! He was so calm in fact that he announced he intended to treat himself to a burger on the way in. I was so tense I couldn’t even manage a single chip.

We wound our way through the labyrinth which is any major hospital, and presented ourselves at reception. The waiting room was almost full, mostly couples, and the England match was on in the corner. The male members of the party seemed greatly relieved by this. How inconsiderate of us womenfolk not to have realised two months ago when we made the appointment what a blunder it was to have picked this particular afternoon ; )

A nurse called me in alone and took my blood pressure, height and weight. “How are you feeling, today?” she chirped merrily. “Quite nervous,” I replied, looking pointedly at the blood pressure cuff.

“First consultation is it? Well, I’ll know what to think if the reading is high... goodness look at that, 154/85. That is quite high. Never mind, we know why, don’t we?”

My weak smile concealed my real thoughts... if you know that this is a stressful situation, why take my blood pressure??

Back to the waiting room (still 0-0 in South Africa), and other couples were called. Each of the consultants came out personally and calmly walked their charges away. Every one seemed relatively young and very kind, my two favourite qualities – or prejudices depending on how you look at it!

At 3.15 it was our turn. Dr R appeared; a friendly and cheerful woman who instantly inspired confidence and started to make me feel this might not be so bad. She whisked us off to a consulting room and started off with a few easy ice-breakers – names, address, dates of birth; things we could warm up with before getting down to the more serious questions.

Well, in the end it was completely painless. We breezed through contact details, medical histories, and our story of how we ended up in this room. With amazing tact and aplomb, Dr R broached even the most potentially difficult subjects. Topics such as “Have you made any other ladies pregnant before?” and “Any previous history of sexual infections?” were skilfully blended with the more mundane queries about rubella immunity and abdominal surgery.

As a reward for being brilliant (in so many ways), M did get the “Mr. Super-sperm” award after all. Apparently it’s rare to have such a high count. Although he hid it extremely well, I think he felt quite proud!

Dr R gently talked me through the circumstances of my miscarriage, with just the right combination of apology, sympathy and professional detachment. It made the whole thing feel distant but not irrelevant; regrettable but not overwhelming.

Then, before I really had time to grasp how much ground we had covered, she reached the end of her questions. I had been so hung up on whether or not I would “qualify” for a diagnosis of polycystic ovary syndrome, I couldn’t believe it when she just matter of factly said my cycle pattern and other indicators meant I was probably ovulating but not all the time.

She recommended ovulation induction with medicine which would increase our chances of pregnancy, and just to be on the safe side I should have a hysterosalpingogram (HSG). This would involve injecting special dye into my uterus and seeing on a real time X-ray how much “spilled out” into my abdomen, showing whether there were any problems with the fallopian tubes. Never thought I’d be pleased to hear such a drastic recommendation!

We asked all our questions and then were ready to go. I was armed with the phone number to call to make the HSG appointment on day one of my next cycle, another number to call to set up the clomid monitoring for the cycle after that, and a set of hospital only prescriptions.

We are now well equipped to battle the infertility monster with the heavy guns.

My arsenal included five prescriptions, and some quite complicated instructions:

1. An antibiotic to take the night before the HSG. And by ‘take’, I do not mean swallow.

2. A painkiller to ‘take’ one hour before the procedure.

Not too thrilled by this. But on the other hand, my only other experience of this kind of medication was immediately after my daughter was born, when it was the only way to take the edge off pain that wasn’t touched by two local anaesthetic injections and puffing on gas and air for all I was worth. Must be good stuff!

3. A course of antibiotics for the week after the HSG, to minimise the small risk of infection.

4. A course of medicine to shock my body into a period, so I can get a move on with all this and not wait for my next cycle to begin naturally.

Bit controversial this, and it’s only an option. I was in two minds about it and Dr R went straight to the rescue. “You don’t have to decide now, I’ll write the prescription and you can choose whether or not to fill it.” Actually, even though I did get the tablets in the end, I think we’ll give it one more go 'naturally' this month and then move on to the HSG without trying to speed things up. It’s only a few more weeks, and because I had the choice I think I can be patient. Only ground rule is of course to be ABSOLUTELY CERTAIN that I’m not pregnant when they fill me up with chemicals – hence having to wait until beginning of next cycle.

5. ((Drum roll please...)) 30 tablets of clomiphene citrate, aka clomid, 50mg.

So about 40 minutes later we were on our way. In the end, we waited longer in the hospital pharmacy for the drugs than we did for the whole consultation. As an added bonus, two of the scripts were free (the painkillers, don’t know why but I’m not complaining!) so I only paid three charges... a grand total of £21.60. Thank you, Lord, for the National Health Service.

All being well, I will be able to make an appointment for the HSG in 3-4 weeks, and be on a monitored clomid cycle 5-6 weeks after that. I will be monitored with ultrasound (to make sure I don’t end up with octuplets) and blood tests (to guarantee that the lazy ovaries are doing their job properly) for one or two cycles. Then, when they are happy I’m on the right dose, I can keep going for a while and see what happens.

I came home with everything I had wanted – answers, reassurance, a plan and some real tools to make it happen. I am not so naive as to ignore the risks; side effects, bad reactions to tests, emotional rollercoaster and potential disappointment and heartbreak once again. But I have walked this path on such bad days that I am definitely going to appreciate the things that go well.

The weather was so beautiful today and our bedroom was full of the scent of honeysuckle when we got home. Our babysitter had bought us some wonderful chocolates. And England beat Slovenia 1-0.

Surely the omens can’t get much better than that!