A few of these chapters brought back memories of my four-year experience with infertility some ten years ago. Keeping my follicular and luteal phase exactly on schedule before each of the seven inseminations, which were followed by four Invitro procedures, created a world-wind of anxiety and hope. With many fertility medications also taken over this timeframe, precautions, side-effects and possible future cancer diagnoses were discussed with my fertility doctor. According to Lehne, (2007), "Regardless of whether estrogens cause breast cancer, there is no question they promote the growth of certain cancers that have estrogen receptors" (Pg. 705). Other side effects that remain vivid in my mind included hot flashes, swollen and sometimes very painful ovaries resulting in ovarian hyperstimulation syndrome, mood swings and weight gain. According to Lehne (2007), "Mild to moderate ovarian enlargement is common, occurring in about 20% of patients. This condition is benign and resolves spontaneously after discontinuing drug use" (Pg. 740). Unfortunately, I was one of those patients experiencing ovarian hyperstimulation syndrome and it did resolve itself once the drugs were eliminated. Frequent sonograms were necessary to monitor my ovarian enlargement and egg stimulation. The drug mostly responsible for this significant discomfort is human chorionic gonadrotropin (hCG). During this drug induced time span, I was diagnosed with painful gallstones resulting in a cholecystectomy at the age of 32. Lehre (2007) noted, "The incidence of cholecystectomy among hormone therapy users was 48% higher than among nonusers" (Pg. 713). After reading this section with regard to hormone therapy for menopausal women, a prospect on which my fertility doctor did not comment, I concluded that the fertility estrogen-based drugs may have indeed contributed to the gallstone diagnosis. Lehne (2007) stated, "Birth control can be accomplished by interfering with the reproductive process at any step from gametogenesis to nidation (implantation of a fertilized ovum)" (Pg. 720). Using the pill for the regulation of my cycle was a mandatory part of the Invitro procedure, as well as drawing daily blood to monitor and evaluate levels to determine when I would be ready for retrieval of my harvested eggs. After finally becoming pregnant after the fourth Invitro, memories of not enduring these fertility drugs was such a relief. Fifteen months later, I became pregnant naturally with my second child without any medical intervention. When looking back on why and how hormone levels are effected, it seems clear that stress and how to manage it, can have a significant impact on our human body. Over a four-year infertility journey that created uncertainty as to exactly why I was not becoming pregnant, stress was mentioned as a possible factor. While a meditation course was also offered to all infertility patients prior to Invitro procedures, questions on marital relationship difficulties were never discussed. Though some patients are in desperate need of fertility drugs to become pregnant, how many of these women are counseled for stress that results from abusive relationships? It is my hope to clinically address the interrelationship between infertility and domestic violence issues, suggesting evaluation of spouse(s) personality type. This approach might help determine the real causes of infertile patients prior to their receiving a prescription for infertility drug treatment. References Lehne, R. A. (2007). Pharmacology for Nursing Care (Sixth Edition). Pgs. 70
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Forensic Nursing Chronicles 