When we started talking about starting a family, I remember the mixed feeling of excitement and fear. It was an exciting step forward in our lives together, but were we really ready or will we ever really be ready? I made an appointment with my OB/GYN and she gave me a prescription for prenatal vitamins and wished me luck. Truth be told, I held on to the prescription for a month before filling it (that was the fear part taking over). In June 2009 I was taking the vitamins and we officially “started trying” and didn’t breathe a word to anyone we were just keeping it between ourselves, we wanted to surprise people. I have so many friends who have babies and most of them it took a while to get pregnant so I wasn’t expecting it to happen right away, but I also knew there was a chance that it could. We were not using any kind of ovulation kits, calendars or tracking system it was just a we’ll see what happens kind of thing. We decided not to think about it too much and if it happened, great! If not, then we would cross that bridge if needed.
A year went by and nothing happened. It was July 2010 and time for my annual exam again, so I made my appointment and explained to my OB/GYN that it had been a year and we were not pregnant. She ordered a Hysterosalpingogram (HSG) or otherwise known as the “Dye Test”, she explained to me that they inject dye into my fallopian tubes and use large X-Ray machines to see if there is any blockage, and she made a referral to a specialist. I walked out of that appointment stunned! First of all I wasn’t too wild about doing the HSG and a specialist…??? We didn’t need a specialist…maybe we just weren’t trying hard enough? When I think of fertility specialist all I knew was that was where people go to do IVF and there is no way we were doing that. So I put off the HSG and the referral and decided I was going to be a little more hands on. I went to the drug store to buy ovulation kits and went home and printed up blank calendars so I could start tracking my cycle. After 4 months and nothing, I was starting to get discouraged again. We talked about it and decided it was time for help, so I called the specialist office to make an appointment to see what our options were (hoping I could avoid the HSG altogether).
It was now November 2010 and our first appointment. We met with our specialist and spent almost 2 hours at her office going over our history, she explained all our options, the tests we would need to do, etc… Basically she explained that we had two options for fertility treatments one is low tech and the other is high tech.
Low tech is Intrauterine Insemination (IUI). An IUI is the least invasive option. The woman takes a drug (in pill form) called Clomid that causes her ovaries to grow multiple eggs, after determining that the eggs are ready (mature) by monitoring via ultrasound, you take a trigger shot that tells your ovaries to release the eggs. 2 days later they use a catheter to inject the man’s sperm into the uterus. Then you lay on the table for 10-15 minutes to rest and you are on your way. Two weeks later you come back for a pregnancy test. Although this is the least invasive there is also a higher chance of multiples since you have no control over how many of the eggs fertilize.
High tech is In Vitro Fertilization (IVF) which is more widely known by the general public. The woman is on an extensive medication protocol to grow many eggs in her ovaries. Again the woman is monitored daily via ultrasound and when the follicles are ready (mature) they’re removed and fertilized with the man’s sperm. The embryos are closely monitored for 5 days and then depending on how many you and your doctor decide to put back in those are transferred back into the woman’s uterus. You are on bed rest for 3 days and come back in 10 days for a pregnancy test. During IVF they have more control over the chances of multiples since you can determine how many embryos to transfer back inside. Although they cannot control if the embryo splits and becomes twins.
We really liked our doctor and it was a positive appointment. I started to get excited that we were on our way starting a family. We left with packets of information and a list of things that needed to be done in a certain timeframe, blood work, semen analysis, pelvic US and the dreaded HSG (which by the way was not as bad as I expected). We got all the tests done in the next two months and went back to the specialist office to review everything. The results…we are two healthy young adults with nothing wrong. Yay!! That is good news right??? So my doctor said that we should have a pretty good chance of getting pregnant via IUI, which was music to my ears because I was not so sure I was willing to or if we were financially able to do IVF, especially since my insurance does not cover a penny of fertility treatments. She told us that she suggests trying IUI 3 times before moving on to IVF. In my head that was not an issue because it was going to work the first time, why not…we were young, healthy and with just a little help we would be set. We did a baseline ultrasound and our doctor said we could start with my next cycle which would be January 2011. She also said that she wanted to do a Sonohysterogram or a “water test” where using a catheter and ultrasound they inject water into the uterus to make sure there were no fibroids or anything else growing in the uterus. That test could be done just before we started the IUI. So we left and spent the next few weeks celebrating Christmas with family and ringing in the New Year with friends. At this point we told our parents everything and of course they supported us 100%. We were excited because I was sure we would be pregnant by February and 2011 was going to be a great year!
The first week of January I go in for the water test and the results showed a small bump on the wall of my uterus. There was some kind of cyst growing and my doctor said it needed to be removed before they could proceed with the IUI because if the embryo tried to attach itself to the cyst it wouldn’t hold and everything we’ve done would have been done in vain. So, instead of scheduling my IUI we scheduled a surgery. I had the surgery in February 2011 and the results came back that the cyst was benign, no scary cancer to worry about. Recovery was a piece of cake, we actually drove to Temecula to go wine tasting the day after my surgery. Priorities I know…
March 2011 brought the moment we were waiting for, the IUI! To start things off I had a baseline ultrasound, took Clomid for 5 days, went back for another ultrasound and when my eggs looked ready I gave myself a trigger shot which tells my ovaries to release my eggs. Two days later we went back and did the IUI. Then it was the dreaded two week wait… When we got home after the IUI I remember going in the guest bedroom and laying down on the bed. I started daydreaming about that room being a nursery, how I would decorate it, where we would put the crib, etc…I was bursting at the seams with excitement for our future and had no doubts at all that I was indeed pregnant. Two weeks later I went back for a blood draw pregnancy test and waited anxiously for the results. I finally got the call that the results were positive, but she warned me that the numbers were really low and they wanted me to come back two days later for another test. If the numbers increased significantly then everything should be fine, if they didn’t then that means it could be a false positive, or I would lose the baby. I didn’t pay any attention to that, I had a positive pregnancy test! Yay!!! Two days later I went back for a repeat test and they called to tell me sorry, the test was negative, the numbers had dropped significantly. But they were able to confirm that the egg and sperm did meet it just didn’t take. I was crushed…
I immediately made an appointment to do another IUI in April. I wasn’t wasting any time, we did the whole process over again. This time I was a little more guarded with my emotions and didn’t let myself get too excited, but how could I not, we came so close the first time. Unfortunately, April’s IUI was a big fat negative. I was dumbfounded, how could it not be working. We had one more try before we would have to start thinking about the big, scary IVF looming in the (not so far) distance.
We met with my doctor for a consult to review and discuss our options. It was then we started getting really frustrated, we could not understand WHY we were not getting pregnant. What was the reason, what was the problem? We both had a clean bill of health there were no problems to fix. It’s called “unexplained infertility”. Ugh, so frustrating! I started wishing that we did have a problem to explain our infertility because then we could at least take steps to fix it. To do something about it. We decided to take a break for the month of May and relax and we would try again in June. We took a road trip to Arizona to visit a friend and stayed at a beautiful resort for some R&R to take our minds off of things.
In June I went in for an ultrasound to start the third IUI. The ultrasound showed a cyst on my ovary. My doctor explained that it was common in patients who took Clomid, it happens when the extra/leftover follicles fill up with fluid and create a cyst. They typically go away on their own with time. So she said come back next month and we’ll try again. So our one month break turned into a two month break.
In July I went back. The cyst was gone and we did our third IUI, results were negative. Now at this point I was numb, I was still frustrated with the “unexplained infertility” diagnosis and I started to think that we would never have a family. I am not against adoption at all, but at that time I could not think about it because I wanted our own biological child, I wanted to experience pregnancy. I was losing hope in that dream. We met with our doctor again to discuss future options. She said we could continue to try more IUI’s but after 3 negative ones the chances of it working drop to less than 5%, she recommended moving on to IVF. We decided to take a break to talk things over, think about it and save up money if we ended up doing IVF.
I couldn’t believe we were in the middle of this, we were in some kind of denial. The first few months we didn’t talk much about it or really make any solid decisions. I decided to take things back into my hands and started doing online research, reading books and talking to others who have been through this. I bought more ovulation kits and we were back at the old fashioned way of trying to conceive. There was nothing wrong with us so we should be able to get pregnant if we kept trying, right? We had already cut back on the wine, caffeine, we were eating healthier, doing everything by the book.
The warm summer months turned into fall and after celebrating Thanksgiving with family I decided to explore acupuncture. My doctor had recommend it to me a few times and while earning my degree in Google, I kept seeing acupuncture pop up everywhere. By this point we had decided that we were going to do IVF after the first of the year, we were just giving ourselves some extra time to save up money. So I figured if I was going to be giving myself injections several times a day, a few acupuncture needles wouldn’t hurt, it would be good practice!
At first, I was a little skeptical, I really didn’t know too much about Chinese Medicine and I kept having visions of an old Chinese guy in his store in a strip mall talking to me in the fast loud way they sometimes talk and I am clueless to what he’s saying. Again, thanks to Google, I found a fabulous acupuncturist who specializes in fertility treatments. She is licensed and has a salon in a medical facility literally 7 minutes away from my house! Score! My first visit was a consultation where we went over my medical history and she explained how acupuncture works, she showed me the needles and answered all my questions. Then we did a short session, her rooms are very much like getting a massage, you lay on a warm comfy bed, the lights are dimmed and there is soothing music playing, you pretty much just lay there and relax and let the needles work their magic, then she gives you a brief massage afterwards. The first few appointments I had a hard time getting truly relaxed because all I could think about was I was laying in a room alone with a bunch of needles stuck in me, what if there was an earthquake (we DO live in Southern CA) or what if I needed to get up for something? She did give me a bell to ring if I needed anything, but how would I know if she could hear it? It was a pretty big office and surely she couldn’t hear the bell if she was in the other side of the office, besides there was music playing in the background in all the rooms, wouldn’t that muffle the sound of the bell? I know, I know, sometimes I have no control over my mind 🙂 After a few weekly sessions I really started to sink into the deep relaxation that is the goal. It is hard to explain, it’s like you are teetering on the verge of a deep sleep, but your mind is partly awake and there is a tingling sensation throughout your body, you can almost feel your blood running through your veins. When I leave her office I am so relaxed and feel like I just had an hour long massage, in fact sometimes I think it is better than a massage because you don’t have someone touching you all the time and you can truly relax. Don’t get me wrong, I still love massages, it’s just a different kind of experience.
Don’t ask me exactly how acupuncture works, it makes sense to me in my head, but I can’t explain it. I read a book called the Infertility Cure and it does a wonderful job of explaining how Chinese Medicine and acupuncture works. Basically it has to do with your Chi (energy) and blood flow. Also Yin and Yang represent different things and you may have a deficiency in one or the other that may affect how your organs function, etc…It looks at improving your body functions as a whole and not just targeting one specific problem area. Which is good because I didn’t have a specific problem. That is just a real basic, basic, minimal explanation. Also, one acupuncture session is not going to do anything, it takes at least 3 months to build a strong foundation. Some people may see changes earlier some may take longer, it depends, everyone is different. One thing that I really find interesting is that the tongue is the only visible muscle in your body, so they often will ask you to stick your tongue out and depending on how it looks they can see how your blood flow is…interesting! Now you will often find me sticking my tongue out at myself in the mirror to see how it looks! Anyway…this began my weekly acupuncture sessions.
In December we went to a local talk that was put on by Resolve which is a National Infertility Association. The speakers were one of the doctors at my specialist office, another doctor from Orange County and my acupuncturist was there as well. The talk was about the new advances in IVF and the room was packed. Looking around I saw couples of all ages and I knew everyone’s story was a little different but we all had a common goal. I started to feel less alone in this world seeing others who were in the same boat. The doctors gave wonderful presentations, answered every one’s questions and there was a raffle for a free IVF cycle at the end, we didn’t win. I wonder if it worked for the couple that did win, I hope so. We left the meeting with more packets of information and questions to ask our doctor and I think we finally were on board, emotionally, to do this. It looked like 2012 was going to be our year!
The first week of February 2012, I went to my doctors office to do another water test and a baseline ultrasound to start the IVF procedure. The water test was normal, whew! The ultrasound however…showed a rather large cyst on my right ovary. After the ultrasound my doctor moved me into one of the consult rooms and explained to me that, again, this needs to be taken care of before we could move forward with IVF. She ordered some blood work and a pelvic ultrasound to get a better look. I did both as soon as I could and the pelvic ultrasound confirmed that the cyst was an endometrioma which is a result of endometriosis. You’ve. Got. To. Be. Kidding. Me!!! Seriously! After everything we’ve been through, we took 6 months off to plan and save and prepare to do IVF and now this…argggh!!! Well at least I have my reason now. Apparently it seems that I probably had endometriosis for a while, but since I was on the pill for so long it was in remission. Even when I went off the pill in 2009 it was still dormant. When we started doing fertility treatments the medications I was taking caused it to flare up. Hence the cyst on my ovary, and it also explains why my periods were suddenly SO painful in the last several months.
I did some research to see how endometriosis affects fertility. They really don’t know much about what causes it, they only know what it is. Basically endometriosis is a result of retrograde menstruation, instead of menstruating the normal way, the cells from the lining of the uterus go backwards back out through the fallopian tubes and creates cysts on the outside of your ovaries, uterus, pretty much anywhere in the area. These cysts can cause scarring and blockage which causes infertility. Since my HSG showed that there was no blockage in my fallopian tubes, and everything else looked normal I am still not entirely sure how it was preventing us from getting pregnant. But my doctor did remind me that they still do not know everything about endometriosis but they know it does affect fertility in general.
My specialist does not treat endometriosis so she sent me back to my OB. My OB scheduled the surgery right away. It was done laproscopically in March and there was a 2 week recovery. I ended up having a small internal infection which I was on antibiotics for due to the camera and other instruments they used during the surgery, and one of my four incisions took almost 2 months to heal. At this point I was getting very comfortable with the Women’s Hospital and the nurses even commented that I seemed so calm and my heart rate and blood pressure was normal. I just smiled and said this is not my first rodeo, I’ve been here a few times. How can you not like reclining in a recliner wearing a robe complete with a hole to attach a warm heating hose to, along with the purple socks with no slip grips on the bottom while everyone is waiting on you hand and foot, it is pretty cozy!
The pathology report came back benign again, and it reconfirmed the endometriosis. They took lots of pictures during the surgery (don’t worry I won’t post them here) but it was pretty interesting to see it all. Both my doctors were very impressed with the size and the general condition of things, I kept feeling like I was going to end up as a case study in one of the medical journals, how cool would that be! I had my 2 week post op visit with my OB and she declared me healed and the next day I was back at my specialist office. Lets try this again…
My specialist immediately put me on an Estrogen pill and gave me a medication protocol to follow. We took a “class” with my IVF nurse, who I soon came to love! There we learned how to mix the medications and give myself the injections. Yes, you are responsible for it all… I was kind of surprised at how much responsibility as far as mixing the drugs and making sure you have the correct dosage as well as injecting it in the correct place at the right time, etc… I am a pretty organized person and I created a spreadsheet and checklists to help me remember all this as well as setting several alarms on my cell phone, but it still a bit nerve wracking since mistakes could still easily be made with an amateur and I couldn’t imagine someone who does not have an organizational bone in their body trying to do this. They ordered my first batch of medications for me and a rather large box showed up a few days later. I spent the evening checking the shipment with the protocol I was given to make sure it was all there & decided to take a few pictures of the “Frisco Pharmacy”.
I started with 3 injections a day while going into my doctors office every day for blood work and/or ultrasounds to monitor my estrogen levels and to see how my ovaries were responding. When my blood work results came in they would call me everyday and tell me how much to increase (or decrease on one occasion) my dosages. After a while I added another injection into the mix to prevent me from ovulating so my eggs could continue to grow and mature, I continued to go to my doctors office every day. After 6 more days of that my eggs were finally ready! Then came the dreaded Lupron shot…This tells the ovaries to release the eggs. It is an intramuscular injection and came with a nice long needle and had to be injected in the butt. In an area that is just right so it does not hit your sciatic nerve or bone, and it needs to get deep enough into the muscle tissue. So they sent me home with a nice diagram picture of where to inject the needle. Before I left the parking lot I immediately called my husband and told him he had a job to do that night. You see… He had plans to go to the Padre baseball game with some executives who were in town from his company’s headquarters. Usually when these guys get together they have lots of fun and there is no expense spared when it comes to food and beer. So I begged/pleaded with him (or maybe it was more like threatening him) that he would only have 1 beer, I wanted him completely SOBER and home at a certain time to give me my shot. It actually was a pretty funny phone conversation, one I never thought I would have with my husband.
The nurse had suggested that I ice the area for a few minutes before and then walk around afterwards. So when the time came I had been icing my butt for 15 minutes it was completely numb! We went over the instructions several times and with my eyes closed and a death grip on the bathroom door jam Justin gave me my injection and I hardly felt a thing! Which was great! We took the dog for a walk and then I started panicking that we didn’t do it right since I didn’t feel a thing, it was supposed to hurt, right! After our walk we even looked up videos on you tube on how to give the shot to reassure ourselves that we did everything right. But my mind was racing and I had a hard time sleeping that night since all I could think about was we came this far, this can’t be the one thing that messes it all up! The next morning at my doctors office I told the nurses the story and they laughed with me and reassured me that they blood work would confirm that we did everything right and if we didn’t, then we could do it again the next day. Whew! These fertility drugs really do make you crazy! After the Lupron shot I had 24 hours of pure injection free bliss!!! No more shots! I can’t tell you how wonderful that feeling is!! The whole process was not fun, but it is amazing what you can do when you put your mind to something, I never thought I wanted something bad enough that I was willing to give myself injections everyday to get it. Now that part was over…I was scheduled for my egg retrieval on April 27th and I was ready to get them out of me. My ovaries were full! I wouldn’t say it was really painful, but pretty uncomfortable. I could actually feel my ovaries, they felt heavy and I noticed it the most when walking the dog, going up and down the stairs, sitting a certain way or doing any kind of physical activity. I once heard someone describe it feeling like heavy rocks, and that is a pretty accurate description.
On the retrieval day we got up early and headed to my doctors office. In the OR they have a window that passes through to the lab and the embryologist is on the other side of the window with her microscope and petri dishes ready to receive the eggs. The anesthesiologist put me out and the doctor got started. They got 15 follicles (eggs). I was sent home to rest and stated a new medication regimen in pill form, suppositories and hormone patches.
The next morning the embryologist called to give us an update. Of the 15, 8 were viable and 7 of the 8 were fertilized. The embryologist said she would call in 2 days and give us another update. Her next phone call she said we still had 7 and they looked great, but warned us that all 7 may not make it to day 5 (transfer day). Two days later was May 2nd, our transfer day (and my grandma’s birthday). We went to my doctors office, they gave me Valium to help me relax, and we were chatting with the nurses waiting for the doctor to come in. The embryologist talked with us for a while and explained that 5 embryos have reached the stage to be transferred, she was giving the other 2 another day to see if they catch up. She was very happy with our embryos and we had decided beforehand that we only wanted one transferred. The embryo she selected for transfer was a beautiful, Grade A classification. She said this is what we see in the textbooks as a sample of a good quality embryo!The doctor came in and we all exchanged hugs and high fives, and got down to business. It was so cool that we were able to watch everything that was going on via microscope images up on the TV screen and ultrasound (must be why they call it high tech), we even got a chance to say HI to our little embryo once it was safely transferred and snuggling in my uterus. We went home and I was on bed rest for 3 days. I was under instructions not to watch any sad or scary movies, I was to keep my spirits up and think happy thoughts. The embryologist called the next day and said the other 2 embryos did not catch up so we have 4 in the freezer, our future snow babies! After my 3 days of rest was up, then came the dreaded wait for the pregnancy test…I was familiar with this time frame by now and tried not to think too much about it. My mom came into town a few days before and we went shopping, drove to see my grandparents, had lunch, watched movies, got pedicures and did all kinds of things. Then the morning of my test we went to my doctors office for blood work and they said they would call with the results. That day was so hard waiting, we kept our selves busy and finally got the call that it was positive, a strong positive! We were pregnant!!! I went in two days later for a repeat test to make sure my numbers were increasing and sure enough they were! We really are pregnant!
Looking back on this and rewriting our story for the last 3 years is really kind of crazy. I remember doing all these things, feeling the emotions, sorting through all the information, wondering if we were ever going to have children and in the end it was all worth it. I hope that our story provides some kind of hope or comfort to others who may be struggling through this. I am not looking for any kind of sympathy or a pat on the back from anyone. I found comfort in other people’s blogs and stories and I hope to return the favor. We don’t get to choose our path in life, but we can choose how we walk the path. I never thought we would be on this path to start a family, but by leaning on God we held hands and walked the walk. It makes our baby that much more special to us.
A woman I talked to who also went through her own fertility struggles once told me, don’t worry about the traditional way of doing things, sometimes you have to step outside the box to get the family you dreamed of. She said this to me 2 weeks before I was starting my IVF medications, and it stuck with me. A big part of this struggle was coming to terms with the fact that we could not conceive our baby the “traditional way”. Medicine has come a long way and it is amazing what fertility specialists can do now. I would not change a thing. Yeah, it would’ve been nice to not have to deal with all this, but this whole process taught us a lot, and we learned so much about each other that we may never have learned. It brought us closer than I thought was even possible and I am so thankful for that.
“For I know the plans I have for you”, declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future” ~ Jeremiah 29