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By:  Patricia Mendell

I never thought that having a baby would be a problem; after all, both my mother and grandmother conceived their last children in their early forties.  Furthermore, I never would have imagined that my infertility and pregnancy losses would become one of the defining moments in my life, shaping, both who I am and what I would do for a living. Now, as a therapist, patient advocate and co-chair of The American Fertility Association (AFA), I am so aware how important it is to have organizations like the AFA that provide the most accurate and up-to-date information for those seeking to have families.

After almost three years of marriage, my husband Richard and I decided it was time to start our family. It became apparent after we had been trying for 10 months that we needed help. We were referred to a general OB/GYN who specialized in “fertility”.  At our first meeting, the doctor suggested some preliminary tests.  We never asked him what tests he was doing and why, because we just assumed he knew more than we did.  One of the first tests he ordered was for Richard to do a semen analysis, bestowing on him the title of ‘Mr. super sperm’.  He suggested that with his sperm counts, all we needed to do was “to have me relax” and we would become pregnant.

In the beginning, I thought that the doctor’s statement was humorous, but over time, I became angered by his paternalistic attitudes.  Finally, when nothing happened after 10 months, he suggested that I undergo a hysterosalpingogram (HSG). I jumped at the chance to get more information.  Luckily, I had decided to have Richard come with me to the test.  No one had warned me that the procedure could be so painful and inaccurate.  All I remember was being embarrassed as I started hysterically screaming and yanking at the radiologist’s tie. It wasn’t until a few weeks later that I stopped waking up with nightmares.  Years later I learned that this test could have been performed with less pain.

Unfortunately, we were told that the results were not good.  The radiologist told us that the good news was that although one of my fallopian tubes was blocked, one was still open.  He suggested that we just go home and keep trying with that one tube. Subsequently, when I tried to speak to my doctor, it was his nurse who returned our call to explain further the results.  She later called back to tell us that there had been a mix-up as to which tube had been blocked and suggested that, because the doctor was ill and out of the office,  we meet with a particular reproductive endocrinologist for a second opinion.  Two weeks later we met with the RE on our lunch hour.  His analysis of the test results was even less positive.  He thought both tubes were riddled with problems and that one of the ovaries looked scarred as well.  He did not feel that trying on our own would be successful.  He suggested that we go back to our doctor to do an exploratory laparoscopy.  At this point, I was beside myself and pushed to have all our records sent to the RE.  As luck would have it, the doctor’s health issues made this transfer possible.

Six weeks later, I underwent the laparoscopy which turned out to be more eventful than I could have ever imagined. After the procedure was completed, I subsequently discovered that the routine anesthesia medications that were administered had resulted in my becoming temporarily paralyzed and unable to breathe without the assistance of a respirator. Trust me; it was one of the most frightening experiences of my life. After seven hours, the medications began to wear off, and I was able to begin moving and breathing on my own.  Who would have known that my parents carried a rare genetic disorder that caused this?  Today, thank God, these medicines are no longer being used.

The second thing I learned from the procedure was that the HSG had caused my uterus and tubes to spasm so badly that, although the results looked like there were significant uterine and tubal problems, there in fact were none, except for two small fimbriae that appeared fused together. This news was the beginning of our wake-up call.  Our lack of knowledge was not only preventing us from getting better care, but it was wasting valuable time.

In our follow-up meeting with the RE, tests revealed that I also had “hostile mucus” that was killing off my husband’s sperm. Again, no one questioned that there could be a problem with my husband. The following month, with the help of baking soda, Clomid and an ovulation predictor kit, I was inseminated.  To our amazement I became pregnant.  I thought we were finally back on track to have our family.  Unfortunately, when I was in my second trimester, I began to experience abdominal discomfort. Although my doctor thought I was overly anxious, he reluctantly agreed to see me, only to discover that the baby had no heartbeat.  Devastated, and unable to understand our options at that moment, we were rushed to a poorly advised OB/GYN who attempted to perform a D/C in his office since the pregnancy looked less far along than it was.  Whatever was given to me to try to lower the discomfort of this procedure did not work.  I know Richard and the whole building must have heard me screaming.  I never thought to ask about testing the fetus.  Nor did anyone tell me the postpartum would go on for months. 

When we finally recovered enough to try again, the issue of my “hostile mucus” became a major problem.  Again, we continued to put our trust in the doctor’s expertise.  Knowing that we needed support I decided to reach out for help from a fertility organization. To my dismay their response was less than welcoming, since my pregnancy clearly indicated that I was not infertile, yet they did refer me to a therapist for individual counseling which did help us through this period. As the months wore on, our hopes dimmed. New problems arose, including a discovery two years into this nightmare that Richard had a significant male factor problem.  To his credit he was furious with this mistake and insisted on having the varicocele surgery as soon as possible.  In our initial meeting with his surgeon, we were told between bites of his bagel that after the surgery we should go on a vacation to Puerto Rico to recover.  I remember we both laughed and told him that the cost of this surgery was our trip to Puerto Rico. 

It was during these new discoveries that I realized the only way we would get better care is if we became educated and asked better questions.  In fact, my motto in my practice is “Your answers are only as good as the questions you ask.” The medical field was quick to make assumptions about my problems; yet, when I started to become educated and ask better questions, other treatment options became available.  After Richard’s surgery we faced more loss, including an ectopic pregnancy, prolactin problems and a need for medications and progesterone.  Finally in 1983, four years after we started, David was born; I was 33 and Richard was 34. 

When we decided two years later to have a second child, I was ready with a list of questions.  Once Michael was born, I decided to specialize as a mental health professional in reproductive medicine. I was determined to help others become better advocates for themselves.  I joined Resolve, AFA and sought training and supervision in this field. I am now a member of the American Society of Reproductive Medicine and their Mental Health Professional Group.  I firmly believe that knowledge is power and patients need to be active consumers in their treatment.  Richard and I received better care once we knew what questions to ask.  Many times we were told we might not be able to conceive, only to discover that the analysis was faulty. What we later realized was that no one had looked at the whole picture; by failing to view us as a “couple”, significant but easy solutions to our care were missed.

When my son David, at the age of 12, asked me whether he and Michael would have been born if I had not lost those two pregnancies, I was taken by surprise. I had never really focused on how much our choices had changed our lives.  As I paused to answer his question, I suddenly understood that these experiences were the reason these two boys were the children that were meant to be in our lives.  Yet, I knew if someone then had told me that something better would come from this pain, I would have never spoken to them again.  The truth is I could not have imagined this when we first began to build our family.  Since their arrivals I realize there has not been a day that I have not been thankful for Richard and my sons. This journey changed everything in our lives.  Now with the announcement of my son David’s engagement to Alexis, I am even more determined that organizations like the AFA continue to exist, helping the next generation in their lives and family building choices.  It was for this reason in honor of David and Alexis that Richard and I have chosen to make a donation to the AFA.