If At First You Don’t Succeed, Try, Try Again (IVF #2, FET#3)

When we last left off in my IVF series, I was blissfully recovering from a blighted ovum in Hawaii. It was my favorite family trip ever, and I was feeling really good about our little family unit.  My daughter and I discussed how it would be ok if we remained “The Three Musketeers.” J said she had her cousins, and we could always get a dog.  A dog! That seemed like the perfect solution.

The following Christmas break, I had two whole weeks off, so we looked into getting a Golden Retriever puppy.  Turns out, Golden Retrievers are a little hard to come by, so we started looking for chocolate, golden or silver labs. We found two litters that would be ready around  Christmas time.  Unfortunately, you have to wait until a puppy is 8 weeks old to bring them home. I guess that’s reasonable seeing as you are basically taking it away from its Mommy. Neither of these litters was available to go home until the end of December.  I started researching crate training and general puppy care. Did you know a puppy may need to pee as often as every 30 minutes? One week off was not enough. DH would need to work from home, or we would have to hire someone to puppy-sit. We could enroll the puppy in doggy daycare but not until the 12 week mark.  The more we researched, the more it became apparent- babies are just much easier!

So we returned to the business of baby making. I started my birth control at the end of Christmas break and began my stimulation cycle in January.  This time, my doctor recommended a Micro Dose Lupron Flare protocol.  I was a bit offended when I read that it was for “poor responders.”  We retrieved 17 eggs during my first IVF, and while only 2 panned out, that seemed to be an egg quality issue more than poor stimulation.  My doctor, who is a pretty smart guy, explained that the goal was not to produce a lot of eggs, but a good number of quality eggs.  I could hardly argue with his expertise, so I endured the five injections per day this protocol required.  You heard that right- FIVE! I injected myself with Lupron and Gonal F both morning and night and Menopur at night only. The Menopur requires a little more work than the other injections (see video here) and burns when it goes in. I had more symptoms during the stimulation cycle (flushing, headaches) than with the Long Lupron protocol, but less symptoms before and after the Ovidrel trigger, as I did not produce as many follicles and was, therefore, not overstimulated.

I was paying full price this time around as there are not too many studies wanting women with four miscarriages under their belt!  Being the thrifty girl I am, I learned a few tricks.  Namely, they had changed the Gonal F pen to where you dial a dose, and the window reads 0 if the entire dose is delivered or tells you the number of units left to complete that dose.  This comes in handy when using the pen’s overfill, which exists to give you the ability to prime the pen before first use and get rid of any significant air bubbles with use.  Each 900 Gonal F pen is supposed to have 126u of overfill and the 300s are supposed to have 115u (in my experience, I found that is not always true but there is always extra in there, and it’s like liquid gold so why let it go to waste). That is why so many people request 300s over 900s as you will use that many more pens and get that much more free Gonal F.  The proper way to utilize the overfill is probably to use 100% of each pen as you go along, which would mean giving yourself an extra injection every couple of days.  I saved all my used pens to the end, which  meant I gave myself 7 injections a day for the last days.  Saved me one whole pen, so worth every stick mark!

At retrieval, 12 eggs were retrieved: 8 fertilized normally, 3 were discarded and 1 was held for observation.  By day 3, 8 embryos remained in culture and 6 of these looked promising.  By day 5, the first day to freeze, none of my embryos had made it to freeze quality (expanded blastocyst), and I began to panic.  If you’ll recall from my first IVF, I had a large number of embryos make it to blastocyst, but only two of these ever made expanded blast, and that happened on day 5.  I began to prepare myself for a cycle that could potentially yield no usable embryos.  <By prepare myself, I mean I shed copious amounts of tears> Finally, on day 6, two embryos of good BB and BC quality were frozen.  The rest were allowed to go to day 7, but no more made it to freeze quality.

Again, we found ourselves in the position of having only 2 embryos and the decision whether to implant two to give us a better chance of one making it, or do an elective single embryo transfer.  Last time around, it was an easy choice as my doctor was 100% on board with SET.  This time, however, he mentioned that the protocol for my- ahem- advanced maternal age was to implant two.  We struggled and struggled with this decision, and in, the end, decided to implant just one.  I saw another RE on decision day, and (money aside) he thought we had made the right choice, so I felt pretty good about it.  I was also encouraged by the fact that I had been attending acupuncture throughout my stimulation cycle.

On the day of my frozen embryo transfer, I went to acupuncture both before and after the transfer (and voted in the presidential primary!). I ate  warming foods and brazil nuts and pineapple core to assist implantation for five days because I had nothing to lose at this point.  I also continued with my acupuncture appointments. I was scheduled for a blood test nine days post transfer.  My husband begged me not to pee on any sticks until the blood test, but I don’t like surprises so I was UNABLE to comply. Six days post 5 day embryo transfer (6dp5dt), I had my first positive home pregnancy test. 9dp5dt and the morning of my blood test, I had my second. This embryo became known as “Pinky” in honor of the two pink lines on the pregnancy test, and we decided instead of being cautiously optimistic, we would go “all in.” We recruited an army to pray for Pinky, prayed ourselves and talked to my belly daily, encouraging this little baby to grow, grow, grow.

We entered the infamous beta hell, except it turned out to be not so bad after all. My first beta at 4w0 days came back at a whopping 451, progesterone 10.9 and estradiol 187.  I began to wonder if they messed up and implanted two embryos. The rest of my betas were as follows:

4w2d: HCG 1456, Prog 12, Estradiol 225 (doubling time = 29 hours)

5w2d: HCG 15, 956, Prog 15, Estradiol 347 (doubling time= 48 hours)

6w2d: HCG 55, 319!, Prog 12, Estradiol 357  (I began to get nervous about a molar pregnancy vs. triplets???)

I intentionally scheduled Pinky’s first ultrasound for the end of the sixth week at 6w5d so there would be no ambiguity as to whether we should see a heartbeat.  I spotted the flicker on the screen as soon as the image became visible. Tears stained my eyes.  Dr S. congratulated us, and DH and I  began talking and laughing so much that he had to scold us so he could carefully listen to Pinky’s heartbeat. Pinky was healthy and measuring ahead at 7w1d!

6w5dultrasound.JPG

A little shy of 8 wks, we had our second ultrasound and Pinky’s heart was still beating away. He/she had done quite a big of growing and was measuring a whole 5 days ahead. Dr S. informed me that he would be cutting me loose. Whereas, just two years ago, I was puzzled as to why he was following me at all after achieving pregnancy, now I was hesitant to let go.  I fought the urge to beg him for weekly ultrasounds and accepted my transition paperwork to return to my OB-GYN.

At 10 wks, I saw my OB-GYN. It had been a while since we had connected, and I know she was truly happy to see me viably pregnant.  No one was more surprised than me to see a very ALIVE, dancing baby on ultrasound, measuring in the 88th percentile. My due date was set as November 13, just weeks before J’s birthday. We had opted not to perform pre-implantation genetic testing on our embryos, but we did agree to the Harmony testing.  All the results came back normal.

By 12 wks, I was visibly pregnant . . .

11w5d

And soon after, we announced it to the world.

sidekickannouncement3

We had moved beyond trying to conceive (TTC) to pregnancy after loss (PAL), and THAT was a whole new ballgame!

 

 


 

If you want to learn more about my fertility journey, you can read my fertility series and IVF series here.
Frozen

Frozen

How do you begin to tell a story when you know it doesn’t end well? Well, I guess, having just revealed the ending, there is no better place to start than the beginning…

F.E.T

Prepping for a frozen embryo transfer is a joy compared to what one must endure in a fresh IVF cycle.  There are no needles.  Yes, you heard that right. No needles are involved.  Well, except for a blood draw to check serum progesterone and estrogen levels and another to check for HCG to confirm or deny pregnancy.  It is really quite easy and made me wish all over again for more than two frosties. Dang my aging eggs!

My FET cycles went something like this:

  • Baseline ultrasound on cycle day 1, 2 or 3 to ensure there were no cysts that would prevent moving forward with the cycle
  • Start 2 mg oral Estradiol on cycle day three 2x/day
  • Increase estradiol to 3x/day 1 wk later
  • Day 14 lining check to make sure lining is adequate for transfer
  • Progesterone blood draw on day 16 to ensure no spontaneous ovulation. If ok, drop estradiol to 2x/day and start crinone vaginal gel 2x/day
  • Embryo transfer of day 5 blastocyst on day 21
  • Quantitative HCG test 9 days later

Estradiol

To elaborate on the above:  estradiol is a little green pill. It’s the same pill that postmenopausal women use to combat the adverse side effects of menopause. It’s job, in the case of a FET, is to build the uterine lining to entice one of those thawed embryos to implant and grow a baby. It has a few possible side effects:  headache, stomach ache, nausea, vomiting, possible hair loss. I noticed a thinning of my already fine hair. My heart also felt like it was racing immediately after my evening dose. It came with a $0 copay, which in the world of fertility meds is amazing.

crinone

Crinone is progesterone in gel form taken vaginally. It is easy to use, but a little messy. I recommend investing in some panty liners. Also -TMI warning- it is recommended that you manually clear out the extra Crinone every few days while showering. If you do not, it may irritate the cervix and you will end up with discharge that looks like coffee grounds. This is actually old blood mixed with crinone, and will freak the heck out of you while you are in your nine day wait. Just suck it up and clear out the crinone. Crinone has similar side effects to rising progesterone in early pregnancy: headache, fatigue, nausea, bloating and mood changes. Husbands should really not mess with you while on Crinone. Crinone is responsible for supporting the lining along with estradiol. It is critical in supporting the pregnancy if implantation is successful. In a natural cycle, the corpus luteum would produce the progesterone needed to maintain a pregnancy. Since this is a hormonally-induced cycle, there is no corpus luteum and progesterone supplementation will need to continue until the fetus can take over at 10 wks. Crinone may or may not be covered by insurance. In my case, it was, but the copay was high. Luckily, there is usually a manufacturer coupon available, or you can join a savings program like the one featured here. Actavis also has a drug assistance program for several medications including Crinone.

In addition to the above meds, I took my usual supplements including a prenatal vitamin, B-50, CoQ10, fish oil, turmeric and baby aspirin. I also went to acupuncture 1x/wk leading up to the embryo transfer and twice on the day of transfer (immediately before and after transfer).

On the day of transfer, I was prescribed an oral antibiotic to take approximately 1 hr prior to my procedure. When I arrived at the fertility surgery center, I was given a Valium in order to relax my body for the transfer. Then, they start pushing liquids as the procedure works best with a full bladder.  This was probably the worst part for me as my RE is nearly always late! There is no anesthesia. You and your significant other walk to the surgical suite, and you are placed in stirrups (if you have ever given birth, it is exactly the same set-up). The embryo(s) are then loaded into a thin catheter, which is passed through the cervix into the uterus. Ahead of time, you are asked to confirm that the identifying information on the embryo(s) matches yours, which OF COURSE, is a good idea. After a period of brief cramping passes, the RE carefully confirms the placement of the embryo(s) in the optimal position, which is the midpoint of the uterine cavity. The catheter is withdrawn, and the procedure is finished.  Some clinics make you lie on the table for a specific amount of time and then send you home on bed rest. My clinic feels that studies have proven that FET has the highest success rate when women resume their normal activities. I, therefore, walked out of there on my own two feet with only two restrictions: no vigorous physical activity and pelvic rest (code word for no orgasms of any kind).

#1

Our first embryo transfer was such a lovely experience. We were in the middle of a whole house renovation, so I had to trade breakfast in bed and a tranquil bubble bath for a whole lot of hammering, drilling and sheetrock dust. Nonetheless, it was nice to start my day off with acupuncture followed by a rare middle of the week lunch with the hubby. We had chosen to put back only one embryo at a time given my fear of multiples and the fact that we only had two embryos available. Everyone at the fertility center was thrilled with the quality of embryo #1. We were given several pictures, and everyone complimented us on our perfect little embryo. Isn’t he/she beautiful?

Post-transfer relaxing consisted of acupuncture followed by going to the rock yard to pick out granite for our kitchen. The nine day wait flew by. I was given strict instructions by the staff not to pee on any sticks (POAS). DH also pleaded with me to resist the urge. Alas, he was out of town in the few days leading up to the blood test, and I just could not wait any longer. After doing a lot of online research, I picked up a box of First Response Pregnancy tests. On day #8, I POAS, looked hard and long at it, squinted and saw a faint second line. Interesting. It was so faint that it was difficult to tell if it was a positive or an evaporation line, so I just stuck it back in the box. The next morning, I took another and got a similar result. I was pretty sure by now that I HAD to be pregnant, but I was going in for my labs that morning so would have my confirmation soon enough.

At the end of the work day, my IVF nurse called to let me know that I was indeed pregnant. That was the good news. The bad news was that my HCG level was only 21. They like it to be at least 50, and upon further reading [obsessing], it would ideally be >100 to be a good indicator of a viable pregnancy. It was possible that my embryo was a late implanter or that this would turn out to be a chemical pregnancy.

I did not take this news well. In fact, in confronting DH with it, I completely fell apart. It was an ugly sight, complete with lip quiver, a fair amount of hysterics and lots of feeling sorry for myself. It was a rough two days until I retested and HCG fell to 10. Chemical pregnancy was confirmed- an early miscarriage in which the embryo implants and stops growing shortly thereafter, presumably due to  chromosomal abnormality. There was nothing to do but pick up the pieces and carry on.

#2

FET#2 was a different story. DH and I tried to recreate our romantic lunch-time experience, but were running short on time and settled on take-out.  I did not carefully read the label on my antibiotic and accidentally consumed it with dairy, which made me feel like I would hurl in the moments prior to my procedure. No one complimented us on our beautiful embryo. In fact, the embryologist told us not to worry about the apparent debris around it. What! Do you mean our embryo is ugly? It was such a striking difference that we mentioned it to the team in the surgical suite. They laughed and laughed saying many an ugly embryo made a perfectly healthy and attractive baby.

The nine days ticked by, and it was once more time for my blood test. This time when the IVF nurse called me, she had better news. Not only did I have a BFP but HCG was 178. A strong positive.  I was thrilled! My estradiol was a little low at 189, so they increased my estradiol to 3x/day. I then began the torture known as beta hell. This meant at regular intervals, I went to the lab to draw levels for HCG, Progesterone and Estradiol. During the first four weeks of pregnancy, HCG should double every 48-72 hrs. By 6-7 wks, it takes an average of 84 hrs (3.5 days) for HCG to double. HCG levels reach a peak around 8-10 wks of pregnancy and then decline and level off for the rest of pregnancy. My levels were as follows (I obsessively used betabase to interpret the finding):

  • 5/23: 4 wks: HCG 179, Progesterone 11.3, Estradiol 189
  • 5/26: HCG 387, Progesterone 15.5, Estradiol 244 (doubling= 64 hrs)
  • 6/2:  5w3: HCG 3154, Progesterone 13, Estradiol 212 (doubling= 56 hrs)
  • 6/9:  6w3 : HCG 13,172, Progesterone 17, Estradiol 224 (doubling= 81 hrs)
  • 6/16: 7w3: HCG >39,000

A gestational sac can be visualized on ultrasound once HCG > 1200. I had my first ultrasound at 6w3. At this time, a gestational sac and fetal pole should be visualized. Most of the time, a tiny flickering heartbeat can also be seen.  At my ultrasound, we saw an appropriately sized gestational sac and what we think was a fetal pole. No heartbeat was seen. DH and I were very disappointed as we had been down the road of blighted ovum before. Our RE told us that blighted ovum was a possibility, but that it was too early to make presumptions. I was scheduled for another ultrasound 1 wk later at 7w4.

This time, it was clear. There was only a large gestational sac. No fetal pole was seen and no heartbeat. Our baby dreams had been dashed again. This time there were a few tears and a brief nap before picking  J up at school. We had told the RE that we would take no further action at this time. I would go home and wait out miscarriage. For two weeks, I walked around wearing the most super-sized maxi pad I could find and black spandex shorts under my clothes in case, god-forbid, my miscarriage started while I was out and about. I work in a swimming pool for 1/2 of my working hours as a Physical Therapist, so I had to pull myself out of the pool for obvious reasons. I really, really wanted this miscarriage to be over quickly. But my body seems to be oblivious to lack of development of a fetus. Initially, I think my HCG was continuing to rise. I say this because at 8 wks, I started to experience morning sickness. The smell of bacon cooking would send me scurrying off to my patio, gagging all the way.

It was also around this time, that DH decided we needed to go on vacation. Either that, or I needed to see a shrink. I chose vacation (duh), and we started to plan a last minute trip to Hawaii. My BIL lives in Kauai, and DH has a client in Honolulu that had been asking him to come onsite for a while. Of course, this messed with my timeline for a natural miscarriage because if I eventually required a D&C, I needed a two week buffer between my surgery and flight to ensure there were no post-op complications.  In the end, we decided it would be best to schedule me for a D&C at the two week cut-off and hope I wouldn’t need it. Except I did. Guess my body is as reluctant to become un-pregnant as it is to be pregnant. The good thing that arose out of having a D&C is that the genetic testing could be done on the fetal tissue.

The test results came in about a week later. I had miscarried a chromosomally normal boy. The significance of that is this. If the test results come back “normal female,” the lab automatically assumes they accidentally tested your own tissue. After all, the majority of miscarriages are attributed to chromosomal abnormalities of the fetus. My result, however, could not be a mistake, and it was heartbreaking. Difficulty getting pregnant. Repeated pregnancy loss. And now miscarriage of a presumably normal embryo. This was clearly not good for my prognosis. My RE recommended I consult with a repeated pregnancy loss specialist in Tennessee to get to the bottom of this. But I could not worry about that now. I was going on my dream vacation with my family, and I was determined to have a good time.  And guess what? We did.  The time of our lives.

 

 

 

 

Blighted

(`blit-ed): used as an adjective to describe something that has a condition that makes it weak or unable to grow

There is an old saying, “New house, new baby.” A coworker reminded me of this when we moved into This Old House at the end of May 2012. At the time, I thought perhaps she was crazy or, at the very least, oblivious to the absolute chaos surrounding our move. For a reminder, click here, but I will quickly summarize. In 4-6 weeks time:

  • My parents came to visit, which prompted a lot of home projects as a precursor to their arrival.
  • During their visit, nanny had to be terminated after she confessed to repeatedly stealing- get ready for it- vodka from our bar in order to self medicate. She claims she did this after hours, but this is clearly every parent’s worst nightmare.
  • Impulsively purchased a new house and began the whirlwind of home inspections, appraisals and mortgage paperwork that followed during the ten day options period.
  • Frantically prepared our beloved home to put on the market. Sold in less than 2 weeks time.
  • Also frantically searched for a new nanny, a process which took over a month.
  • Packed up entire house, mainly during nap time and the wee hours of the night and, often times, by myself as hubby was out of town on business three times during the month of our move.
  • Moved into new house and promptly began pool/patio renovations. Oh, and it seemed like everything else started to unexpectedly fall apart!

At the end of all this, I collapsed into a heap and DH and I were lucky to still be on speaking terms. It was a VERY stressful time, and procreation was the furthest thing from my mind. That is until, at the end of July 2012, I began to wonder if I might actually be pregnant. I was spotting at the time and had been for several days before my expected period. This was not unusual for me. I have seen multiple doctors through the years for breakthrough bleeding. This spotting went on for five days without turning into a full-blown period and was accompanied by breast tenderness, extreme fatigue and a strange cramping in my uterus. In short, I felt exactly as I had when I was pregnant with J. I hunted through my medicine cabinets for a home pregnancy test, held my breath and peed on the stick. I was struck by the ridiculousness of it all and was about to shove it back in its wrapper when I noticed two pink lines indicating a BFP. At this point, I nearly fell off the toilet. I felt such a rush of emotions.

Oh yes, a baby!

Oh no, what terrible timing!

Oh no, I’m bleeding! I must be having an early miscarriage.

I picked up the phone, dialed the OB-GYN’s office, described my situation and they wanted to see me right away to draw blood for a quantitative HCG blood test. Meanwhile, I scrambled to draw a picture announcement for J to give to DH and cried as I delivered the good/terrifying news.

DearDaddy

My blood work came back positive and my HCG doubled as expected in the first four weeks of pregnancy. However, my progesterone levels were lower than expected, and I was started on progesterone suppositories and scheduled for an ultrasound at week 8. In my case, the suppositories were inserted once daily at night. They were a bit messy and intensified pregnancy symptoms such as breast tenderness, nausea, bloating and night sweats. They did, however, stop the bleeding, and I began to feel more relaxed about this pregnancy. During this- the longest three weeks of my life- the pool/patio renovation continued, and I also flew to New England for my nephew’s first birthday party. I told very few people about my pregnancy due to the bleeding but broke the news to my sister ahead of time in case I needed to seek medical care while home. Unfortunately, the bleeding recurred during the plane ride over, and I spent several days on bed rest hoping for the best. My ultrasound was scheduled within a few days of arriving home, and I was realistic but hopeful.

I had a transvaginal ultrasound, and as soon as the results became visible on the screen, I knew the news was not good. My uterus looked like a big black abyss. There was no comforting heartbeat to be heard. My OB-Gyn politely searched my uterus while questioning me to see if I might be off on my dates. She knew I was not. There was a big black circle indicating a gestational sac, but no squirming bean inside. “I’m sorry,” she said, ” I don’t think it is going to work out this time. Looks like a blighted ovum.” She offered to recheck in a week and go over our other options once we had time to digest the news. I waited for her to leave the room and began to cry. Even though I knew this was wrong from the start, I could not stop the tears from falling.  I sat in the back seat of the car with J while DH called person after person telling them our sad news. I may have managed to croak out a few sentences to my Mom, but didn’t feel like speaking to anyone else.

blightedovum

A blighted ovum, or anembryonic pregnancy, is when a fertilized egg attaches to the uterine wall but the embryo fails to develop. It’s kind of like a house with an open door and all the lights on. You keep ringing the doorbell, but no one is home.  I went off my progesterone supplements and immediately started bleeding. I wish I could say I waited out miscarriage. I usually prefer to do things the natural way. But somehow, waiting felt morbid and disruptive. I had a D&C one week later.  It was a relatively quick procedure. I had some minor pain for a few days, bloating that made me look at least 5 months pregnant and night sweats that forced me to sleep on a towel until my body rid itself of all the pregnancy hormones.  Life went on. I continued to go to work.  I chased after an active toddler.  The only real change I had to make was that I could not go in a swimming pool.  This may not seem very devastating except I spend 50% of my working hours as an aquatic therapist, was accompanying my daughter to water babies swim class 1x/wk, and we had just completed an 8 week pool-patio renovation.  Bah humbug! The day after my D&C, we had friends over  to swim (clearly DH’s idea), and I dipped my toes in the water while covering up my bloated belly the best I could.

I had two very sad days surrounding my miscarriage- the day of my ultrasound and the day of my surgery. I spent most of those two days sleeping. And then, to my surprise, time carried on. It did not have the decency to stand still for me and my tragedy. I was as busy as I ever was. And I coped a little too well.  I did not give myself a whole lot of time to mourn, reflect or relax.  I talked about it, of course, with a few trusted friends and family members, but the rest of the world was unaware of my pregnancy, and now did not seem the time to tell them about it and its demise. I discovered that the subject is awkward and people- including myself- are not sure how to react. There are those who know but choose not to say anything lest it upset you. There are others who check in too often – “How are you feeling?” “Do you need to talk?”- to the point that you want to remind them that you still have a life to live if only they would stop bothering you. Except you don’t because they are just showing concern the only way they know how.  And then there are those who have been through it before.  Those are the best kind of people. They need say no more than, “I know,” and give you a reassuring hug or glance. And you know that they do know and that is the most consoling of all.

Of course, I would be remiss if I forgot to mention the large category of people who say, “Well, at least you know you can get pregnant.” This includes just about everyone. And while extremely annoying and not the least bit comforting, it is the truth. I could get pregnant, and I began to want to try again…

Determined

I must admit, the decision to set forth and procreate made me a little uneasy. What if I wasn’t ready to be a Mom? What if I was no good at it? I’m a planner by nature and wanted all the details to be perfect. I needed a little push, and it went something like this:

DH (a little over a year into our marriage): Hey, when are we going to have kids?

Me: I don’t know. Do you think we are ready yet?

DH: I don’t think we’ll ever be ready. Might as well bite the bullet.

And so, in January of 2009 we began trying to conceive- abbreviated TTC from here on out. Also, in case you were wondering, DH refers to “Dear Husband.” I’ve discovered that one must quickly learn a new code language when TTC.  Not sure if its tantamount to being in a special club or if all the extra friendlies leave little time for anything else, including full pronunciation of vocabulary. Anyways, I promise to keep you up to speed.

DH and I went on a ski trip to France in February of 2009 and had romantic notions of conceiving while on vacation. After all, vacation extra friendlies are quite extraordinary, don’t you think? Sadly, when we returned to the States,  I joined the Bump and discovered this thing called an ovulation calculator. The calculator tends to assume that all women have set cycle lengths with ovulation occurring smack dab in the middle. This is not exactly true, but still a good tool  for beginners or those who don’t have too much trouble TTC. The ovulation calculator told me that my fertile window actually took place when we arrived back in the US and DH had the flu. It was only our first month of trying, but already,  I felt the pang of missed opportunity.

By the second and third month, I had the ovulation calculator down pat, and had somewhat customized it to my own cycle. I was able to feel ovulation pain, called mittelschmerz, so felt like my body was on the right track. My period, referred to in the TTC world as AF (Aunt Flo), came every 28 days like clockwork. I had read that it is best to have extra friendlies, a.k.a. BD (the Big Deed), every other day during your fertile days. Naturally, this was exactly what we did. In retrospect, I approached it like an important job- which it definitely was- while sacrificing the usual romance. This determination is not unique to me. I had other friends who were TTC, and we were all completely baffled as to why our respective DHs were not always on board with this schedule. Is this not every man’s dream? Or is it really the chase?

By the forth month, at DH’s suggestion, I resorted to peeing on ovulation detection tests. These track your LH surge. Luteinizing Hormone, or LH, is what triggers the ripening egg to mature and break through the follicle leading to ovulation. This surge is detected 24-36 hours prior to ovulation and helps pinpoint the two most important days on which to BD. We were sure this was going to work!

By month 5, I consulted with a coworker, who I knew had also been struggling to conceive, and she helped me to begin charting. I purchased a basal thermometer, which you stick in your mouth at the very moment of waking, all the while trying not to make too much movement so as to accurately capture your lowest daily body temperature (BBT). It is the most accurate way to detect ovulation, as the BBT will rise on the day following ovulation and then drop off when AF arrives. I charted for a total of 6 months. I will hold off on going into the craziness that this caused me. It is a topic for a whole other blog post. Given how type A I am, I can guarantee that my charts were perfect and full of encouraging pregnancy signs until my period inevitably arrived 28 days later.

Attachment-1

By month 8, I visited my OB-GYN, who assured me that I would get pregnant, and it was too early to panic. I was feeling really discouraged at this point, and didn’t really have anyone to talk to about it. It is one of those things people don’t tend to discuss. Just the fact that you are TTC is TMI. DH was encouraging, but did not share my worry, and I was starting to feel very lonely in all this. By months 10-12, I slowly started to open up about it  and discovered a whole secret club of gals struggling to conceive. They did not simply tell me to relax and let it happen. They acknowledged my fears, shared with me their insight, and I was eternally grateful for the company. While, on the inside, I wept as friend after friend got pregnant with no problem, I really rallied for the girls in my club and rejoiced at their successes. It gave me hope.

On month 12, I revisited the OB-GYN who was no longer lighthearted about my lack of success. She ordered a hystersalpingogram (HSG),which is an X-ray in which they insert a catheter into your uterus and inject saline with dye in order to visualize your fallopian tubes. The radiology tech thought my uterus was locked down tighter than Fort Knox. After much trying and a lot of pain on my end, she was successful in inserting the catheter.   My fallopian tubes looked flawless.  With a negative HSG, I was started on a first round of Clomid on cycles day 5-9 and referred out to a reproductive endocrinologist (RE).  Clomid is a fertility drug which stimulates the ovaries in order to induce ovulation in those who don’t ovulate naturally or to enhance maturation of the follicles in those that do. There is a small chance of multiples, as it may encourage more than one egg to be released during a cycle. The Clomid gave me hot flashes and made me want to rip DH’s head off. I did not like it one bit, and it did not result in success, so I was a little bitter about the whole experience.

By month 14, I made it in to see the reproductive endocrinologist. He was charming and cocky and made fast friends with my DH. They talked baseball and business until I tapped my fingers on the desk and reminded them that the fate of my fertility lie in their hands. DH was sent for a semen analysis, and we both were put on an antibiotic Z-pack just in case.  As we were at least $1000 out of pocket at this point with no clear diagnosis, we held off on scheduling my follow-up with the RE until after my next AF.

Except, it never arrived! At month 15, I actually waited a whole five days until after it was due to discover that glorious + sign known as the BFP or Big Fat Positive.  My hands were trembling while I presented DH with a card and envelope containing the test. Except, I made the mistake of presenting it to him while he was working from home and had to wait an agonizing ten minutes before he opened it.

We held our breaths for nine weeks, suffered through two incidences of bleeding, and then finally saw our beautiful bean, beating heartbeat and all. At 37 wks, our perfect angel arrived, and all was forgotten. My unexplained infertility seemed a minute detail on the road to parenthood. Stress? First baby jitters? Who cares. I was a Mom and never happier.

 

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Changed

Recent events in my life have led me to this decision to blog about a personal matter.  You might say, why Nicole, you blog about personal matters all the time. You blog about your home, your daughter’s birthday-for goodness sake, you blogged about your septic. Who does that?

While discussing your bathroom habits (and publicizing it to all your Facebook friends) does demonstrate a certain lack of modesty, what I want to talk about is more heartfelt. I’d like to share my experience with infertility.  Before I begin, I feel like I have to issue a disclaimer. I feel that, because I do have a beautiful, amazing daughter, I have to tell you that my case is really not all that bad or uncommon. I have known women who have tried for 10+ years before having a baby.  Some, after much grief, give up this dream and never have a  child to call their own. I have known several women who have lost their babies late in their pregnancies, one who opted to carry hers to nearly full-term. Others are afflicted by heartbreaking repeat miscarriages never to discover why they could conceive but not carry.

I feel like I have to tell you how blessed I am, and that I have no right to complain. Yet, what I really want to say to you- those who are going through it like me- is that you have all the right in the world to feel however you want to feel. If you want to wallow in a box of Kleenex – Gray’s Anatomy style- please do so. If you want to kick and scream and loudly announce your anger at the injustice, be my guest. If you want to lie in bed forever, I wouldn’t blame you. Each person’s experience is their own.  Who am I to judge? Just know I’m rooting for you to get back up because YOU want to.

I know my experience has changed me. I can’t say with certainty for the better or the worse. I do know that part is entirely within my control. So I am taking a first step towards making it something positive by announcing my intention to share what I have learned.  I am somewhat of an expert on the crazy and not so crazy things you can do to boost your pregnancy chances. That is useful to any couple with baby fever. And for those of you who are trying and getting frustrated or dealing with a pregnancy loss, sometimes it is just nice to know there’s someone else in the same boat.

I hope you will bear with me on this journey, however long it takes.

Thanks,

Nicole

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Nicole Austin, TX