Our Journey with Infertility

Fair warning. If you aren't into TMI or gory details, this post probably isn't for you. 

After our miscarriage in the fall of 2015, we took a little break from trying to get pregnant, and distracted ourselves with the holidays. It was so hard no to think about those milestones though. "We would have been this far along at Christmas." "We would be having a baby in the early spring." I had actually been pregnant along side a few of my friends and a coworker, so watching their bellies grow and seeing them carry to term was bittersweet for me. While all of these feelings of uncertainty were ever so present, we still knew we wanted to start a family. We were ready to try again.

Fast forward to 19 months later and we still weren't pregnant. We tried all the things. Ovulation strips (although I never really got a true reading on any of my tests), ovulation tracking apps, logging my basal temperature, eating right, exercising, not thinking about it, thinking about it, yoga, meditation, you name it we tried it. It just wasn't happening for us. For me the worst part about trying is when you have that late period and you get all excited, and the pregnancy test still comes back negative. Every. Time.

We met with my OB after the one year mark of infertility, and she gave us a referral to the UT Health Fertility Center. Normally people hear the word infertility and they think $$$ (guilty) which is why my doctor recommended we go to a teaching center. What did we have to lose? Young med students get to learn about this tricky path of medicine, while the experienced doctor is right by their side to guide them and step in when needed. We were both open to it, and in the end it saved us a TON of money. 

In the spring of 2017 we had our first fertility appointment. I had lots of blood work done (8 vials woof) and fainted (classic me). Did I mention I'm not great with needles? Derek did the ol' fun time test with some 70s reading material ha. They did an ultrasound just to check out the general health of my reproductive system and to make sure they didn't see any glaring issues. The only thing they could see were some cysts which I already knew about from my previous ultrasounds. However, based on the technology (2D vs 3D) neither of my doctors had any way of knowing if they were blocking anything, causing any harm, if I had always had them, or if they were caused by the pregnancy. She also noticed a small fibroid, and also couldn't tell if it was blocking anything or just hanging out minding it's own business. All of these words freaked me out and I quickly starting thinking that this was all my fault. She assured us that a this things are actually pretty common and usually harmless. I had mentioned that all of my ovulations tests I took came back very faint and inconclusive, so she did a follicle scan to check how many I had and if I was in fact ovulating. I was. 

After testing my blood work, all of my levels came back normal, even my progesterone. The only thing they noticed was that my MMR vaccine had worn off. This is typically a vaccine you get as a child (Measles, Mumps, Rubella) and it normally lasts about 20 years. It has nothing to do with conception, but if you did contract Measles, Mumps, or Rubella while pregnant it could be extremely dangerous for the baby. Derek's guys were tested and the count was fine, the motility was fine, the only issue was the abnormal morphology. She explained that this is usually caused by stress and is completely random depending on the time of day you test, so had he tested an hour later they could have been totally fine. So that was super helpful. Not. Derek was in the middle of taking his Architecture exams for his license, so we just chalked it up to high stress. After hearing all of these medical terms and numbers, the doctor basically explained that we have "Unexplained Infertility", which is not what you really want to hear. "We don't know why you can't get pregnant." So she walked us through all of the options. We had a dollar amount in our head that we didn't want to go over for repeated fertility treatments because let's face it. Neither of us make a ton of money. Plus we were open to adoption. She explained that the order of events would be the following, if we so choose:

HSG Test - This is a radiology procedure where radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix. The uterine cavity fills with dye and if the fallopian tubes are open, dye fills the tubes and spills into the abdominal cavity. This shows whether the fallopian tubes are open or blocked and whether a blockage is at the junction of the tube and uterus (proximal) or at the other end of the tube (distal). 

Clomid - This is an oral medication that can be used to stimulate ovulation. It works by blocking estrogen receptors at the hypothalamus, which is an important "hormonal control center" for the body. When this happens, the hypothalamus is stimulated to release follicle stimulating hormone (FSH), and luteinizing hormone (LH). These are the naturally occurring ovarian stimulants, which prompt ovulation in a normal cycle. 

IUI - This is a treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. It provides the sperm an advantage by giving it a head start, but still requires a sperm to reach and fertilize the egg on its own. It is a less invasive and less expensive option compared to IVF. 

IVF - This is a procedure where a they take the eggs from the ovaries using a small needle and fertilizes them with sperm in a specialized lab. After fertilization happens, the eggs develop into embryos. Three to five days later, the specialist re-implants the embryos back into the uterus. 

IVF w/ donor eggs - This is the same process as IVF but with the use of donated eggs rather than your own.

Are you surprised that there are so many options for fertility treatments? We sure were. I feel like so many people (guilty again) hear the words "fertility treatment" and immediately think IVF and "test tube babies". While that is an excellent way to conceive, it is also more of a last resort method once the other methods don't work for you, at least for "unexplained infertility". I was also surprised at how much insurance actually covered. So many times you hear about how it's all 100% out of pocket, which isn't always the case. You also get to sit down with your doctor and ask questions and talk about costs and a plan of action before even getting started. 

I went ahead and got my MMR vaccine, which was difficult to find a pharmacy that carried it, and it's a lot pricer than a flu shot at about $75 after insurance. Our doctor warned us that we would need to wait two months after getting the shot until we could try again due to the risk of getting pregnant while the vaccine is still doing it's thing. So since we had a bit of time we decided to go ahead and schedule an HSG test to rule out tubal factor infertility (TFI).

The test took place at 6am in the Radiology Department. They had me get into a gown, and laid me on what looked like an oversized dental chair with stirrups. They lower an x-ray machine over your abdomen, like right on top of it, so if you're claustrophobic this may be a little intense for you. They do a quick pelvic exam (fun!) and then insert a cannula (catheter) which is what they use to inject the iodine-based dye. I didn't really feel any of this part, but once the dye started to flow I felt intense cramping, to the point where the doctor had to take breaks until the pain subsided. Meanwhile you can watch everything happen on the x-ray screen. It's basically a black and white image of your uterus and fallopian tubes with a dark liquid working its way through everything. This immediately made Derek feel light headed (he hadn't had breakfast yet) so he left the room get some fresh air and water while we finished up the procedure. The doctor confirmed that both of my tubes were blocked with clots, but that the pressure of the dye broke up the clots so that my tubes were completely clear. To me this was extremely painful. Think the very worst day of your period x10. Luckily it was over very quickly and I felt fine the rest of the day. I'll never forget, as I was being walked to the elevator by the nurse she said "you are so lucky that the dye dissolved your clots. That rarely happens!" I asked what would have happened if they didn't, and she said that they would have gone in with a small wire to remove them. What. That just about made me pass out. Another fun fact. They have you wear a giant hospital grade pad afterwards because you will leak iodine the rest of the day. Yay gravity!

Before proceeding with any other fertility treatments we wanted to take a little break and just relax for a bit. We were past the two month mark (May), and didn't want to put any pressure on ourselves. We just lived our lives. We didn't even use any ovulation tests or tracking apps or anything. We traveled a bit, had picnics, and just tried to enjoy this season in our lives before jumping into more invasive procedures. 

Fast forward to Memorial Day weekend and I was 5 days late. This had happened before and I would still get a negative pregnancy test so I didn't think anything of it. My parents were in town visiting and I quietly went and took a pregnancy test just to go ahead and rule that out, so that I could get on with my weekend.

The test was positive.

I snuck into our room where Derek was still sleeping and I whispered "I'm pregnant", to which he flew out of bed and hugged me and we both just kind of stared at each other in awe. I didn't want to tell my parents yet since it was so early and given our history. I wanted to get a blood test first. So that next week I called the Fertility Center and made an appointment to get a blood test and check my progesterone levels. My blood test confirmed that I was in fact pregnant, so they had me come back again the next day to make sure my progesterone had doubled. The first time we got pregnant my progesterone should have been between 11-90 and it was a 3. This time my progesterone was 85, which made me immediately relax and feel extremely hopeful. I went back the next day and it had doubled. They had us make an appointment for the first ulrasound at the 8 week mark (mid June), and for the very first time we saw the little baby bean.

We left her office feeling like we were floating on a cloud. I can still feel the excitement in the room to this day. So many months went by where we longed for a baby we thought we would never have. They told us that the due date would be February 2nd, 2018. 

We were were so excited, but also still very cautious. The numbers were great, there was a baby on the ultrasound. But after losing our first baby there was still a part of us that worried. But also a big part of us that knew this time was different. That everything was going to be okay. We told my parents that night over FaceTime, and then told his parents that weekend when they were in town for Father's Day. We asked our families not to share the news with anyone until after the first trimester when the chances of miscarrying were much lower. 

Our fertility doctor transferred our charts and information back to my normal OB saying that her job was done. It was bittersweet to say goodbye someone who was so instrumental in our story, but I guess that's just the nature of her line of work. After meeting with my usual doctor she did an ultrasound and said that the baby would look much different than the last time we saw it. This was the moment when we completely lost our cool and were just puddles of happy tears. Our little bean was now (what resembled) a gummy bear bouncing all over the screen which is why this ultrasound photo is a little blurry. Our hearts just melted. She measured the baby and decided that it's actual due date would be January 30th, 2018. To this day that is still my favorite ultrasound photo. Look at that little belly!

Needless to say this little gummy bear became our sweet Olivia. I'm going to be honest, we were still so nervous before each ultrasound so anxious to hear the heartbeat and to see my OB light up when she saw the screen. Knowing our history and our struggle she was so so encouraging, rooting for us the entire way up until delivery. We actually waited until 15 weeks to announce our pregnancy so that we could hear the heartbeat one more time (just to be safe). Because let me tell you. Having to un-tell people that you are pregnant is just about the hardest and saddest thing we've ever gone through. No one knows how to talk to you, or how to react. So we wanted to see the baby and hear it's heartbeat before announcing our news to the world. Honestly, we probably didn't actually feel at ease with this pregnancy until I could feel the baby moving. Feeling those movements all day everyday helped me know that everything was going to be okay this time around.

I know that this isn't everyone's story, and that so many of you are still waiting for your rainbow baby. And for that I am truly sorry. As it turned out, all around the same time I had five friends who all had miscarriages and have since gotten pregnant, and these are some of my closest friends. Some conceived naturally, some used Clomid, some had several failed IUIs, and some even had failed IVF. So although I lost a few friends along the way, I also gained a really great and encouraging community. We all know what it's like to suffer loss, to be afraid throughout pregnancy that something bad would happen, and to find joy in the lives we all created after such tragedy. 

I want to break the stigma of infertility. It doesn't have to be a million dollars, it doesn't have to be embarrassing, and it doesn't have to be scary. So your baby was essentially created in a controlled environment? Who cares. If thats what it takes for you to get pregnant then so be it. I think it shows courage and strength to go to such lengths just to start a family. If you are still waiting for that positive pregnancy test, I feel for you. I know that longing and I wouldn't wish it upon anyone. I have been in that dark dark place of hopelessness. Had I carried to term with our first baby, I would have been six months pregnant when my dad had his stroke, and I wouldn't have been able to travel to northeast Texas to help my mom take care of him that first year. I can't even imagine that being our story. Everything has it's own timing whether we see it now or not. 

A lot of people (family included) think that we are extremely overbearing and protective parents, especially in her early days of life. But unless you've suffered the loss of a baby, you have no idea how we feel about our daughter. We are so grateful and so thankful for the precious life we were given and the blessing she is in our lives. So if I jump to attention when she starts choking, or I look a little uneasy when someone holds her wrong and doesn't support her head, it's not because I'm a helicopter mom, it's because my heart would literally break if our sweet baby was taken away from us. This is a whole other post I've been wanting to share, about mom-shaming by family members. Woof. 

Navigating a Missed Miscarriage

This is the photo I almost posted to announce our pregnancy last fall, but decided against it because it is so raw and requires some explaining that I wasn't ready to do yet. This was taken back in June after our first prenatal appointment in the parking garage of the doctors office. Obviously we were excited that we were pregnant. But we were also so relieved. After suffering a loss back in 2015 and then not having a positive pregnancy test for over a year after that. This is what pure joy and relief looks like. This is what it looks like when a huge weight of sadness and uncertainty has been lifted off of your shoulders.

With all of the strength I could muster, I hit publish on this instagram post last September. Why was I so nervous to share our story? A story that isn't original. It actually happens to 1 out of 4 women in the United States. A story I am finally ready to share with the world. 

Fair warning. If you aren't into TMI or gory details, this post probably isn't for you. 

Back in the summer of 2015 we had just got back from our trip to Alaska when I had my period. No big deal we weren't trying to get pregnant or anything, but we were also not "not trying". I had taken myself off of birth control that April and knowing it can take a while for that to get out of your system, we weren't really putting a lot of hope into anything yet. A week later I had another period. That's weird. I'm typically a very clockwork kind of person when it comes to my monthly visit. So needless to say I started the deep deep dive into googling. Most of the information I found said that I could be pregnant (!!) and that the second period could actually be implantation bleeding (all words I had never heard before, but now are so so normal to me lol). So I picked up a test on my way home from work and sure enough I was pregnant!

It was right before Father's Day so I bought Derek a Fitbit with a card that said something along the lines of "you'll need to count your steps now that you'll be chasing after a little one" or something to that affect. Cute right? We were both SO excited and also SO nervous that we wouldn't be good enough or ready enough for this little baby. 

The next day I called my doctor to setup our first prenatal appointment. And thats when I realized this wasn't a normal pregnancy. "What was the date of your last period?" Well technically it was this date, but then I had another one on this date. "Oh." (after a long pause). That "oh" was not very comforting. So she scheduled it for the earlier date just to go ahead and do an ultrasound and see what's going on. Then we would have a better understanding of the time frame, and how far along this little bean was. 

Waiting for that first appointment was the longest 8 weeks of my life. Everything seemed totally fine though. I was eating all of the right things and not eating the laundry list of things pregnant women can't eat. I was famished all the time, I was super tired, and already feeling bloated. When the day of our appointment finally arrived we were so excited to see our baby on the ultrasound. They said it would probably be too early to hear the heartbeat, but that we would try anyway. So fun fact for those of you who don't know. When you see women get their first ultrasound on TV and they put the cold jelly on their bellies, that's not what happens at all. First of all, you don't get the over the tummy ultrasound until like 20 weeks. Not 8. So they have to do it vaginally, which let me tell you is oh so comfortable. It's kind of like a joystick all up in your business.

My doctor had the screen toward her so that she could look at all of the boring things before showing us the little bean. I could see the look of concern in her eyes. She searched and searched, but she couldn't find the baby. She could see the fetal sack, but there wasn't a fetal pole. It was just empty. She explained that it could just be too early and that we may have been guessing off of the wrong date, and that there would be more to see in a couple of weeks. Either way we were crushed. Derek kept reassuring me that it was going to be okay and it may just be too early, and I agreed. Because I felt very pregnant. At least my short knowledge of what being pregnant felt like. They took some blood to check my progesterone levels, and wanted me to come back the next day to check my levels again to see if they doubled, which would mean that the baby was growing at the rate it should be, and maybe it was just hiding. 

I went back to work at that afternoon, and right before lunch I received a call with my lab results. Normal progesterone levels range from 11-90 during the first trimester and double everyday. The woman on the phone was calling to tell me that I didn't need to come back the next day to be tested because my progesterone levels were only a 3 and that even if they doubled it was still well under the appropriate levels they wanted to see. She explained that I had a Blighted Ovum and that I would soon miscarry. My head was spinning. I remember being in a conference room where I took the call and then immediately had to go into a lunch meeting where I just sat there running a zillion scenarios in my head while trying not to cry. No one around me even knew what was going on. No one even knew I was pregnant. Only Derek and my doctor. 

That night I told Derek and we both just cried. What an odd feeling to know you are going to have a miscarriage, but that it hasn't happened yet and you feel totally fine. Obviously I started googling the odds of a misdiagnosed Blighted Ovum and Blighted Ovums that turned into living breathing babies. There were several cases all over the world, so I clung to that hope like a big dummy. I read horror stories about how doctors told these women that they had an empty fetal sack and encouraged them to get a D&C, and so they found a second opinion and now they have a 3 year old. Things like that. Or even worse, the woman who did get the D&C but is now on the message boards saying how she'll always wonder if her doctor was wrong. Needless to say I got off the internet because it was a slippery slope into false hope. 

Weeks went by and I still hadn't miscarried yet. My doctor had me coming in 1-2 times a week to check my progress and ensure that the sack was still empty. It was. I finally started spotting and bleeding on and off for a couple of days, and my doctor explained that it could take up to a week for my body to evacuate this pregnancy, and that I would know when it happens. A week went by and I was still barely bleeding. She said that if I wanted to push things along that she could give me Misoprostol that would make it happen much faster so that I could get it over with and start to heal emotionally. It was a Friday, and she said that if it didn't finish that night that she would meet me at her office on Saturday and give me the medicine that way I could have the weekend to recover. So I agreed. She explained that it would happen very fast and be very painful, so she also gave me some pain killers. I didn't really know what to expect, since when you see it on TV it's just some blood and that's it. She explained that if I bleed enough to fill a pad in less than an hour to call 911 and go to an ER. I was officially terrified. She said that honestly this way is better if your body isn't doing it on it's own because it could happen while you are at work or in the car, rather than comfortable in your own home.

I met her on Saturday morning to get the medication. That afternoon I felt some heavy cramping, but decided not to take the painkillers. I wanted to feel everything. Somehow I thought it would give me a sense of closure. If I was meant to go through this experience, then I wanted to experience it. I was also just curious to see if I could handle the pain. 

So. You don't just lose blood. It's not like a heavy period. Now that I've experienced childbirth, it's basically like the afterbirth you deal with for 4 weeks all piled into one day. It was extremely traumatizing to see and experience. For those of you who haven't experienced afterbith, it's basically like your body is evacuating globs of tissue that look like giant red egg yolks. I basically just stayed in the bathroom until it was over. Crying and having a panic attack.

That next Monday I went back in to see my doctor to do another ultrasound to make sure that the pregnancy was completely evacuated. It wasn't. There was still a ton of tissue everywhere. After what I experienced, how was this possible? My doctor labeled this as a "missed miscarriage" where your body starts to evacuate the pregnancy but something happens and it can't do it on it's own naturally. She said I could wait it out and see if it would happen on its own, but that my experience Saturday could happen while I'm at work in the middle of a meeting, and could happen on several different occasions. And honestly after going through what I had already gone through I couldn't imagine there being more days of that. Or having to go through it in a public bathroom. Ugh. She suggested a D&C (Dilation & Curettage) where I would be put under a local anesthetic, and she would go in and scrape out any remaining tissue and basically hit a reset button on my uterus. Because even if I let my body do it naturally over time, there could still be residual tissue which would keep my body thinking I'm pregnant and would prevent future pregnancies, while also causing long-term side effects to my fertility health. I was terrified of this procedure (thanks internet) and the complications, but she assured me that as long as I don't have more than 5 there really isn't any harm to my chances of conceiving in the future. She explained that it was less than a 30 minute procedure and that I would be out of work for two days to recover. I had been spending the entire month planning a surprise party for Derek's 30th birthday where we were going to announce our pregnancy to our family and friends. Although that wouldn't be happening, I was still using the party as a nice distraction to have something exciting to look forward to in lieu of our current situation. The party was planned to take place that weekend, so my doctor moved her schedule around so that I could have the procedure and be recovered in time for his party. 

The morning of my procedure I was basically in a little triage bay all hooked up to my IV and filling out paperwork. At the top of my forms in big letters it said "Missed Abortion", to which my nurse said "I'm so sorry for your loss". I can still see her face. I immediately started crying. Why was it called that? 

The actual procedure didn't hurt at all, and my doctor confirmed that she was able to remove all of the tissue and that I would be ready to start trying again after a normal cycle, which could take up to three cycles until things were "normal" again. 

It took a while before we started trying again. We were both so scared to go through this experience all over again, and we wanted to be emotionally ready. Little did we know that it would take us 19 months to get pregnant. Our journey through infertility is a whole post which you can read here.

Throughout this process I learned a lot about who my real friends were, and I actually gained some really great friends along the way. Some of my best friends completely shut me out of their lives. I'm not sure if they just didn't know how to talk to me after finding out, but it's like I was invisible. Even our families didn't know what to say. Some would check in every now and then to see how we were doing, while others just pretended like it never happened and would openly say things like "I don't get why people have such a hard time getting pregnant, we got pregnant right away. A+B=C" And other insensitive things. 

On the flip side, after finding out that I was out from work for two days for a medical procedure, one of my coworkers asked me how I was doing and alluded to the fact that she knew what was going on. It turned out she had gone through a very similar situation and so we bonded over that. We now both have healthy happy babies and have come out on the other side of this all. 

If you have suffered a miscarriage and are feeling alone or less than, please know that you are not alone. If nothing else, I am here to listen. It's okay to be upset, to be pissed, to feel sorry for yourself, to feel inadequate, to feel hopeless. But know that you are none of these things. These are just emotions that will make you stronger in the end. It will make you appreciate your children whether biological or adopted or fur-children. It will make you love with a vengeance. You survived this and you are powerful. Welcome to this very special club that no one wants to be in.