18 December 2020, by Marian Nathan
I had done everything I was supposed to do.
I ate right, didn’t engage in strenuous activities, took my vitamins, you name it. But, it did not stop me from losing three pregnancies back to back.
After my third loss, I started experiencing physiological changes, I was much more fatigued, and oddly enough, my neck started swelling ever so slowly. I decided to see a doctor after getting numerous comments about my neck being much larger. Many referrals and tests later, I was diagnosed with hypothyroidism, meaning that I now have an underactive thyroid (a hormone-producing gland in the neck) and would need to take medication for life.
The condition affected my fertility. While I got pregnant fairly quickly the previous three times, this time… nothing happened. No matter how much we tried, I kept getting my period. So now it seemed that not only would I have trouble keeping a pregnancy, I would have trouble even getting pregnant. I had my fair share of self-pity but I managed to pull myself out of it and decided to take matters into my own hands. We were going to try IVF (In-Vitro Fertilisation).
Like many couples, we were unaware of the success rates of IVF, or any kind of ART (artificial reproductive technology). We also thought it was a quick and straightforward process. We decided to take the subsidised route so we got a referral to KKH from a polyclinic.
The process was to wait for the hospital to book your first referral appointment, go for a mandatory health check and wait for the results, go for mandatory counselling sessions and see the doctor for the first approval to go ahead and begin the ART process. We made the decision to try IUI (intrauterine insemination) first as it was significantly cheaper, even though it has a lower success rate than IVF for us.
The mandatory counselling sessions included financial counselling, which made us aware of all the subsidies, co-fundings (up to 75% for a couple who are both Singapore citizens) and the MediSave claimables, which really did help lighten the financial load. We were also counselled on the low success rate of all ARTs, and for us to manage our expectations.
Going through IUI – I had to self-administer injections into my lower abdomen daily for almost 2 weeks, with the last dose the day before I was scheduled to ovulate. The purpose of doing this is to get more than just one egg to “ripen”. Even though the injections were relatively painless, it’s actually a lot harder to inject yourself as we all have a natural inclination to not willingly poke sharp objects into ourselves. I had to overcome my fear of needles and remind myself why I was doing it.
We had to make a few trips to KKH to do an ultrasound scan to determine when is the right time to get inseminated with my husband’s sperm which were pruned with only the best swimmers to encourage successful fertilisation and implantation.
After insemination, we began the 2 weeks wait before going back for a pregnancy test. But, about 2 days before my appointment, I started my menses. I was filled with so much dread. It was really hard to keep hopeful. I called KKH and was told that it is possible to be pregnant and bleed, I should come back on my appointment date and they would perform a blood pregnancy test, which is the most accurate way to test for pregnancy even in its very early stages.
As the day wore on, I didn’t need to know the result, because I already knew. I was at full-blown period by then, and having been pregnant three times before, I knew I was not this time. I spent the day crying. The blood test 2 days later just confirmed what I already knew, I did not conceive in the IUI cycle.
I got myself together, ready to try IUI again. The process would involve waiting to get another appointment to restart the cycle and then waiting for the beginning of my next menstrual cycle. And then the painful wait… The days were filled with alternating feelings of building up hope and pushing down fears. A day before my appointment, I started cramping and feeling damp. I didn’t want to use the bathroom, for a fear of what I would see, but eventually, I just had to. I had started my period again…