By Chantelle Farrugia

Intimacy and conception: my experience.

My husband is a C5/C6 complete quadriplegic. At the age of 14, he was playing with some friends, and one wrong wrestling move later, he broke his neck and severed his spinal cord. He has no feeling or movement below the nipple line, has no movement in his fingers or thumbs, and has no use of his tricep muscles.

My husband and I met in September of 2009 while we were attending the same college, in the same program. A couple months later, we were an item - inseparable, and completely in love. We thought that we had discussed the major topics of how different this relationship would be than the “normal” relationships out there. One thing we didn’t think too much about was intimacy, and this area has been one of our biggest struggles in the 9 years we have now been together.

Intimacy means so many different things, to many different people. To me, intimacy ranges from hand holding, kissing and hugging, to touching/pleasuring each other in the bedroom. My husband struggles with intimacy. He defines being intimate as cuddling and hand holding. He has never truly had an interest in engaging in much more than that. This has always come as a bit of a shock to me. I am an affectionate person by nature, and if you know anything about “love language”, my love language is touch. This is why we have struggled.

It shouldn’t have come as much of a shock to me though. My husband experienced his accident at the age of 14, never having any sexually intimate experiences before. Now as a quadriplegic, not being able to feel anything below his chest, and not having the same sexual gratifications that most men may experience, he does not long for the same touch that I do. Not only does it not mean the same thing for him as it does for me, but it also brings about stress and anxieties. He knows that he cannot perform the same sexual acts that most men can - as a man in his (now) 30’s, this is huge! It took years for me to finally make him understand that “sex” is not something I absolutely needed in a relationship, but touch was. He has struggled with this and so have I. I always question if he is in fact attracted to me. It doesn’t make sense to me that he says he’s attracted to me but doesn’t want to touch me. I struggle with so many insecurities and body image because of the challenges in our intimate life. 9 years together and it’s still a very real challenge.

Not only has intimacy challenged our relationship over the years, but it made conception and fertility a struggle as well. We both came into this relationship wanting a family together, and it was/is very important to us both. But we never thought it would be as difficult as it was.

We anticipated that we would struggle conceiving, so we started “trying” about 5 years ago. Sex has been mostly off the table as my husband has difficulty maintaining erections, and if he does, it is impossible to maintain long enough to ejaculate - which is a very necessary part of conception. We tried everything from Viagra and Cialis, to vibrators and cock-rings. Viagra made him feel as though he was having a heart attack, Cialis gave him random erections that made him uncomfortable around his PSW’s. Cock-rings gave him autonomic-dysreflexia, and did not provide enough pressure to maintain his erection. I did a lot of research at the time to see if anyone else had a similar issue, and if they had, what was the solution. One forum suggested experimenting with a strong vibrator. The vibrations would ENCOURAGE ejaculation, and subsequently allowed for a longer erection. The vibrator we purchased was the Magic Wand - the idea is to place the vibrator at the base of the penis and hold there on the highest setting. It works very quickly.

With this suggestion, we attempted natural conception - boy was it tough. It was so stressful, and by no means enjoyable. I then thought we could try “turkey basting” at home. I bought syringes and sterile cups online, tracked my cycle, and tracked my temperature. This was also not successful so we then went to a fertility specialist in our area. We did numerous tests, and identified several issues.

My husband had low sperm count, low motility and “sick”sperm. Essentially we were told that his body, since it had not ejaculated much sperm in recent years, had a back up of “dead” sperm, and that we needed to get rid of this before going any further. We were sent home with the instruction to ejaculate every other day for a month and then come back for more tests. This officially took the joy out of any intimacy that was possible in this process.

A month later we were back for more tests. The tests showed some improvement in the quality but not enough in the motility or number. Further testing for me indicated that I had a form of PCOS where I ovulated many eggs at a time, but none were healthy enough for fertilization. We attempted IUI, four rounds of it, with lots of medication, and nothing worked.

It was around this time that I started searching for another fertility specialist, one that wasn’t wasting time or money - because these treatments are quite costly. We then found Dr. Victory (yes that is his actual name!) and everything changed for the better. He sat us down, after another round of testing, and gave us a straight, no nonsense idea of what needed to happen in order for us to get pregnant. He told us that IVF or donor sperm was the only way this was going to work for us. He leaned more toward donor sperm, because he wasn’t certain that my husbands sperm had what it took. But he sent us home to discuss and make a decision.

To be honest, I was leaning more toward donor sperm as well. I was so tired of trying and being disappointed. I was exhausted being on this emotional roller coaster, and I was devastated by the impact this had all had on our romantic life. My husband, being the forever optimist, was excited by the chance that he could have a biological child, so we agreed to do one round of IVF. If it worked, great. If it didn’t, then we would go the donor route.

The next month we started our IVF journey. Let me tell you, the medications are brutal. The hormones do crazy things to your body, and I was definitely not mentally prepared for all the injections I had to self-administer. The first part of it all is getting my body ready to make as many eggs as possible. The hormones make you prepare multiple eggs for ovulation, and more drugs make it so that you don’t ovulate - instead allowing those eggs to grow as big and mature as possible. Once they are the right size, and look ready (these doctors have a whole list of things they look for) you then have to be put under anesthesia while they remove these eggs from you. They insert a long needle that sucks the mature eggs out and carefully place into a petri dish ready for fertilization. In the meantime, my husband got his sperm ready in another dish ready to be washed and separated - the doctors assess the sample and pick out the “good/healthiest” swimmers to use. The they insert a single good sperm into each mature egg that was removed from me.

This was a very emotional time - keep in mind too that I still had a concoction of hormones coursing through my body. During my retrieval, they took out 11 eggs. Only 9 were mature enough to use. They then insert one sperm into each of the 9 eggs, and we wait.

We waited three agonizing days for a phone call to tell us how many of our 9 eggs survived. When we got the call, they told us that 6 fertilized, but only 3 made it to day 3. We had to see how many would make it to day 5 blastocysts. Whichever eggs made it to this stage, is what we would then use for our IVF round.

2 days later we waited by the phone all day, and did not receive a call. I called multiple times that day to see what was going on, and all that we were told was that someone would call us. My husband and I prepared for the worst, and cried thinking that our chance was over. All our hard work, all our money, gone. We didn’t get the phone call until the next day; day 6.

The embryologist called us and told us that they wanted to wait an extra day to access quality, but he was happy to report that we had 2 strong day 6 blastocysts ready to be frozen and used for our IVF.

We started with 11 eggs, and ended up with 2. It’s a strange thing, but I was sad and happy all at the same time. We had 2 chances at a biological child. My husband was ecstatic, and I was exhausted. Our relationship hadn’t been the same since starting our fertility journey. The stress, the struggle, made a huge impact on our intimacy, and ultimately our yearning to be intimate together.

Two months later, I started another round of injections to prepare my body for one of our embryos to be implanted. On November 10, 2017, at 10:45am, my husband and I watched on the screen as one tiny little speck was inserted into my uterus. It’s a crazy thing, but on that ultrasound machine, when the embryo was let go into my uterus, it looked like a bright light. I wish at the time I had taken a picture, but it wasn’t on my mind. For the next 24 hours, I was instructed to do nothing, other than sit or lay down. I needed to give my body the best chance for this embryo to implant and make itself comfortable. So naturally I didn’t move a muscle for 48 hours. So began our two week wait - the amount of time you need to wait before finding out if it all worked; if I was pregnant.

Waiting two weeks to find out this kind of torture. Pure. Torture. Emotionally it is tough, not just because you’re anxious to find out the news, but because you’re mentally preparing yourself for both the good and the bad. If I ended up pregnant, I couldn’t get too excited because there was still such a long way to go, and I was accustomed to years of bad news. If I wasn’t pregnant, then I would be devastated, heart broken, shattered, and any other word you could come up with to describe ultimate defeat. Not only would I be upset, but my husband will have lost an opportunity to have a biological child. Was it my fault? Did I do something wrong? Could I have eaten healthier? Should I have rested more?

I couldn’t wait the two weeks. On Saturday, November 18, at 7:26 in the morning, I tested. I peed in a cup, and used that test strip. I put it on my bathroom counter and I waited. With my husband unaware of the test and in the bedroom asleep, I cried. I cried because I was overwhelmed, and scared, and excited, all at the same time. Then I slowly watched that second line appear. It was light, but it was there. I was pregnant. I was finally pregnant. 5 years later, I was pregnant. My first ever positive test. I cried even harder, and then I began to laugh. I snapped a quick picture and skipped (yes I skipped) into the bedroom. I turned on my husbands bedside lamp and shoved the test in his face, tears streaming down my face - the moment I had always dreamt of, finally telling my husband we were pregnant.

He looked at the test and said “What does that mean?”

Are kidding me? After all this time, and everything we’ve been through; that’s your response?!

I said “It means I’m pregnant!”

“Are you sure?” he replied.

“Yes! I’m sure!”

I couldn’t believe that was all he said. He didn’t cry, he didn’t even smile. I was so dissapointed. He said he wanted to wait until the blood test next week to confirm I was pregnant. I was mad at him at the time for how he responded to this unbelievably exciting news, but now I know this was his way of guarding himself, and me, for a possible disappointment.

A week later we got the phone call from the blood lab that confirmed it. I was pregnant. My husband cried, and kissed me, and squealed with delight. While I had already be reeling in this excitement for a week, he was finally able to relax and enjoy.

An ultrasound on December 2nd (a day after my husbands birthday) at 8:09 AM confirmed there was a heartbeat. I have never cried so hard in my life. It was relief, just spilling out of me. Hearing that heartbeat was the most beautiful sound I have ever heard. Thumping away. Just like it was supposed to. Our pregnancy journey had begun.

Now our lives really changed. Before being pregnant, I was my husband's sole caregiver. I did all of his personal care, all of his bathroom routines, got him dressed and undressed. I did it all. It was part of our intimate time I guess. It was an important part of our relationship. It meant that we always had to be close, that we could never go to bed without speaking to each other. But now that I was pregnant, we decided it was best to hire help to do these things for him. We didn’t want to risk losing this baby.

Since having a PSW in our house, our intimacy had changed drastically. We fight more often, we go to bed angry more often. I hate that another women gets to see my husband in such an personal way. I hate that she touches him more often than I do. It bothers me more I guess because my husband and I have always struggled with intimacy. But this is how it is now.

I had a great pregnancy, very comfortable and easy; I was very lucky. We enjoyed every moment, all the ultrasounds, the showers, decorating the nursery, and picking names. It was everything I had dreamt of. The 9 months flew by so quickly, too quickly almost. And before we knew it, I was in labour.

We had planned a home delivery with a midwife - I hate hospitals and needles. I just wanted to be relaxed, quiet and comfortable at home. My labour at home was beautiful. I loved every minute of it. Each contraction was painful, but so peaceful. I breathed with every wave of it, and I knew that each one was bringing my baby closer to me. I laboured at home for 29 hours. I got to 8 cm dilated, but my baby wasn’t coming down. My midwife was concerned, and suggested we go to the hospital.

When I got to the hospital I was 9 cm, and there was still no difference with my baby's position. The doctor broke my water and let me wait. Still no change. He then put me on pitocin, and suggested we wait for a couple hours to see what would happen. 6 hours later, my baby still had not moved down. By this point I was fully dilated and ready, but my baby wasn’t. So I was scheduled for an emergency c-section. 20 minutes later, at 5:06PM, my baby boy was born. Beautiful, 8lbs and 4oz, healthy and screaming. He was here.

We finally had our family. All of the pain and struggle of the past 5 years, it all became insignificant. He was perfect. I loved him so much, right from that moment. I loved him the minute I knew he existed, but the love I felt after seeing him for the first time, holding him in my arms, it’s indescribable.

We struggled for years, but it was all worth it. Has our relationship changed? Yes, absolutely. But I truly believe we will be okay. Intimacy is always work for us, but I hope will get there eventually.

My husband asks me when we want to try our last embryo ….. I’m not even close to ready to entertain that discussion yet. For now, I’m relishing in every moment, and loving every bit of this little, perfect man we created