American Medical Association Family Medical Guide - American Medical Association [266]
Our marriage began to suffer, and I didn’t get much support from my family or friends—especially those who were having problems conceiving their first child. They thought I should stop complaining and be thankful for the child I have. They didn’t seem to understand that you can be extremely grateful for a child and still yearn for another. Special occasions that used to be happy now triggered sadness. I declined invitations to friends’ baby showers and stopped going to my sister-in-law’s house because I couldn’t bear to see her children playing together.
Shelby could feel the tension between Ray and me even though we never talked about it in front of her. She became anxious and clingy and didn’t want to be away from us. She seemed to think we were upset with her. I felt guilty about not giving her a sibling.
The doctors eventually discovered a blockage in one of my fallopian tubes that must have been caused by an infection that occurred during my first pregnancy. By then, I was 38 and my biological clock was sounding an alarm. To save our relationship, Ray and I started seeing a marriage counselor and began attending a support group of infertile couples sponsored by a national infertility association. Through these resources, we learned to cope with the fact that the large family we had hoped for might never become a reality. People in the group who had gone through a similar situation helped us mourn our loss and move on, a process that took several months.
Now I’m 41 and Shelby is a happy, healthy 7-year-old. I went back to work when she entered first grade, and I love my job. Ray and I are content with our family and cherish Shelby.
They didn’t seem to understand that you can be extremely grateful for a child and still yearn for another.
The doctor will ask you about your medical history and current health status to determine if any medical problems could be affecting your ability to conceive. He or she will ask about your menstrual history; any past pregnancies, miscarriages, or abortions; any medications you are taking; and the type of birth control you use. Tell the doctor if you have ever had any STDs or abdominal surgery; surgery or pelvic infections from some STDs can scar and block the fallopian tubes, preventing pregnancy.
The doctor will perform a complete physical examination, including checking your thyroid gland for any abnormalities and looking for unusual hair growth on your face and body that could indicate high levels of male hormones. During the breast examination, the doctor may gently squeeze your nipples to see if any liquid comes out, a sign of increased levels of prolactin, a hormone that prevents ovulation. The doctor will then perform a pelvic examination to look for any growths, sores, or signs of infection.
Your second appointment will take place just before you ovulate so the doctor can perform an ultrasound examination to detect any abnormalities of your uterus and ovaries and to monitor the development of the egg-releasing follicle. More hormone tests will be done to screen for abnormal hormone levels.
Depending on the results of these tests, your doctor may also order some of the following tests:
• Hysterosalpingogram A hysterosalpingogram is an X-ray procedure that uses a dye that is injected into the cervix and travels up the uterus and into the fallopian tubes. The dye looks black on the X-ray, allowing the doctor to see any abnormalities in your reproductive organs, such as a fibroid (see page 867) in the uterus or scar tissue blocking the fallopian tubes.
• Hysteroscopy Doctors perform a hysteroscopy (see page 849) using a lighted viewing tube (hysteroscope) inserted into the cervix to see