Haisla's Adventures in Endoland

..that is the question.


Now, I like sex.

I'm sure I've said it here before.

But for quite a while during our infertility journey things were not this way. This was especially before I got my endo diagnosis, when I often found sex (and intercourse in particular) to be painful and not in the kinky, turn-on kind of way. I find now that I know what is wrong with me, I can better manage the condition, and believe it or not, somehow the pain also feels more bearable, when I know I'm not doing permanent damage to my innards, but that there's just something in there that oughtn't be there, that is always going to emit a level of pain.

As is the case with most IF journeys, there obviously also came the time when sex became strongly associated with rigid timetables, high expectations (talk about performance anxiety) and perpetually dashed hopes. Add to that heady mix a level of depression and despondency and you have a potent marital bedroom buster in your hands.

So we've worked really hard to reclaim our sex-life back from the claws of infertility and it's really only been this year that I've finally got my mojo back.

I have to say that ART has played a huge part in this. Knowing that we don't have to try so hard every month has lessened the sense of panic and pressure and we've actually had time to recover our sexual appetites again.

From reading other blogs, I'm aware that a lot of ladies give up sex during their IVF cycles, often at their doctor's orders and I, too, have contemplated this myself. However, the thought of giving up this (fairly) newly rediscovered source of joy, (now that we are finally embarking on our first IVF cycle) is a little disconcerting.

So, I've been doing a bit of research.

It turns out that there are quite a few studies conducted to decipher whether it's safe to engage in bedroom sports during IVF. I know that different clinics have different policies. Our clinic has been fairly laissez fair; I think we were told that we can have sex up until a few days before the retrieval (in fact, more sex = improved sperm quality) and haven't been given any guidance on what to do or not to do after.

This study from the Oxford Journal (2000), appears to suggest that the male partner's sperm introduced into the uterus during an IVF cycle may have a positive impact on implantation rates. If I've understood the study correctly they reckon that the male partner's sperm may 'familiarise' the mother's body to the 'paternal bits' (yep, that's the technical term I have decided to use) of the embryo so it is better able to accept the embryo and not reject it as an invading, foreign object. The effects appeared to be more pronounced for some reason in the fresh IVF cycles than the frozen ones.

The only risk that I could see them identifying were uterine contractions that may result from intercourse as these may have the unintended and unfortunate consequence of disrupting embryo implantation.

I still think, that in the light of this study (even if it is a little old now), it may be advisable if not advantageous to engage in a bit of rough and tumble at least before the transfer (providing one is not completely incapacitated following the retrieval). There seems to be no harm in having some of M's 'material' inside of me, welcoming the embryo(s) in, especially since some theories purport that endometriosis may do funky things to one's  immune response and set it on a bit of an overdrive.

However, since I have history of having occasional bad period-style cramping post-orgasm (especially in the post-ovulatory phase for some reason), I think I'll definitely try to abstain after transfer (plus who would want to mess around when using those messy pessaries anyway.. they act as a bit of a mood-killer from what I can recall).

At least these were my thoughts on the matter, before I stumbled upon this case study. According to it, a woman undergoing IVF treatment ended up with a quadruplet pregnancy (after a transfer of two embryos) as a result of having sex during her IVF cycle.

To cut the long story short, there was a happy ending in that she had the babies at 34 weeks and they all survived and lived on in health and happiness (apart from having more siblings than was intended). However, there were some questions asked about how she could have ended up with quadruplets from having had only two embryos transferred. Apparently this is a highly unlikely scenario. When they looked into the case more closely and studied the babies genetically, they found that the four babies could not have originated from the two embryos transferred. It transpired that the couple had had sex both before the HcG injection and before retrieval and that at least two of the babies were the result of natural conception that concurred with the embryo transfer and implantation. Crazy stuff, eh!!?? The writers of this case study suspect that more of the twin  and triplet pregnancies that occur in relation to IVF treatment may actually be as a result of unprotected intercourse that takes place at the time of the treatment. As this issue hasn't really been studied to try to establish whether the babies all originate from the transferred embryos, the assumption has always been that for some unknown reason IVF results in greater number of twin and triplet pregnancies than natural cycles. It's interesting stuff, and perhaps more studies should be (or may have been since this is quite an old case study?) conducted.

This study did give me pause for thought. I certainly don't want to end up with triplets let alone quadruplets. Could my 'throwing caution to the wind' attitude heighten our risk of having multiples!?

With further thought, the lady in this case study was suffering from secondary infertility and had been able to conceive naturally and without any problems six years previous, which may place her in a completely different category from me. At least she had proof that her body was able to produce a natural pregnancy.  Considering that we have now been trying  for 3.5 years with absolutely zero results (not even the chemical kind), the fear of a natural pregnancy occurring simultaneously with our IVF cycle sounds a bit fantastical. I think at this stage in the game I should really be more concerned about whether we'll be able to get pregnant at all..

So, I think "to have sex" it will be for us, but in a well-considered, moderate and scientifically approved manner, in order to maximise our chances of a successful pregnancy..

However, first we kind of have to get to the transfer stage, I suppose.

I shall write a bit more on that later.