You and your partner decide it’s time: You are ready to start a family. The natural progression of life — piece of cake, and for some it is. What about when it’s not? Why isn’t this happening? What is wrong with me or him? When will it ever happen (or what if it never will)? How do we make this happen? These and many more thoughts run through your mind. How do you proceed and accept that sometimes nature needs help?
After 6 months (over age 35) to a year (under 35) of trying to conceive unsuccessfully, it may be time to start thinking about seeing a reproductive endocrinologist (RE). REs will do a variety of fertility tests to try to determine what might be the cause of your infertility, hopefully resulting in a diagnosis and relevant plan. You would then either decide to jump on the fertility treatment wagon and go for the ride, or to continue to try naturally for some time.
When this happened to us, we really wanted to get pregnant naturally, so this decision didn’t come easily. But, when what you have been doing isn’t working, do you accept help? And what might you expect from that help?
I started with the least invasive and relatively inexpensive treatment option. Generally the first fertility drug that women use, Clomid is easily taken orally and used to induce ovulation. I took Clomid for five days at the beginning of my menstrual cycle and then went in for a blood test and ultrasound a week or so later. I assumed it would work, but after six months and many escalating doses later, my body still wasn’t responding like it should have been. Feeling like these six months were a wash, I wanted to move on to the next treatment option.
The next step up was intrauterine insemination (IUI) with injectable gonadotropins, synthetic hormones that are used to stimulate the ovaries to produce eggs. After going in for a baseline ultrasound and blood test on day three of my cycle, I got the OK to start the medication and continue for five nights, then returned for another blood test and ultrasound. They would adjust the medication as needed and I returned every other day for a blood test and ultrasound.
Around day 15 I was told to “trigger,” which is done using hCG (human chorionic gonadotropin). HCG triggers the final maturation and release of the eggs from the follicles.
Approximately 24-34 hours later, we returned to the office to have the IUI procedure done. Not the way I pictured getting “knocked up,” but it was finally going to happen for us — so I was devastated when it didn’t. We tried again two more times with a “rest month” in between each cycle.
Now well over a year after first seeing the RE, we were still in the same position: childless. It wasn’t working, and I wanted to move on to the next option.
I considered in-vitro fertilization (IVF) the most invasive, unnatural way to get pregnant, all science — but it didn’t and doesn’t matter. IVF is similar to IUI when it comes to medication, but IVF requires higher doses so you produce a larger number of eggs. As with previous cycles, I had to visit the clinic every other day for ultrasounds and blood tests. After you “trigger,” about 34 hours later under twilight sedation (a light general anesthesia) you have an egg retrieval and at the same time your partner gives a semen simple. The embryologist basically tells you what’s next. The waiting is hard, waiting to see how many eggs fertilized, waiting to see how many embryos continued to grow. Will you have a day three transfer or a day five transfer? Will they be good quality?
On day three for me, they transferred two beautiful embryos. Twelve days later, I got my period. I was losing all hope.
The next plan was to raise the medication dose in hopes for more eggs and a day five transfer. We took a “rest month” and tried again. This time they retrieved over 25 eggs; things were looking up. On day five, I went in for the transfer and I was diagnosed with a moderate case of ovarian hyper-stimulation syndrome (OHSS), and my transfer was canceled. Once again, I was devastated. I was told that twelve embryos met the criteria for freezing and that next month we could come back and do a frozen transfer. The next month had to be a “rest month” because I still had not fully recovered from OHSS.
Frozen Embryo Transfer
Frozen embryo transfer protocol includes taking estrogen pills, then progesterone, a relatively easy treatment. We had our first frozen transfer: two beautiful embryos — and it didn’t work. We tried this three more times, and none were successful. The devastation of it all had me beside myself. I just did not know what to do. I had no hope and didn’t want to keep doing what we were doing; it obviously was not working.
We decided to see a new RE. The only thing I have ever been diagnosed with was a uterine fibroid and unexplained infertility. The new RE explained it this way: The uterus is like a nice fluffy pillow and the embryo needs a soft cushy landing to implant. The fibroid is like a big rock in the wall of the uterus. Could you sleep with your head on a rock? His simple explanation made sense. He also explained the size of the uterus compared to the size of the fibroid. The fibroid was 3-4 times the size of the uterus. The other RE had given me this information as well, but she rattled off the size in numbers, along with a general poor explanation of the possible problems it could be causing.
Surgery: This natural girl went from the least invasive to the most invasive option in about three years’ time. On my 28th birthday I had a laparoscopic myomectomy. The fibroid was removed; the recovery was quick. I healed physically, but more so, emotionally.
Over those few months’ wait, I realized that I will be a mom. I didn’t know when, and certainly didn’t know how, but one way or another, it would happen. I would do everything I possibly could. I would have no regrets. I would not look back and say what if. I needed to exhaust all my options. That’s why I let science/medicine take over my body in more ways then I can count.
Today I have a beautiful son, who lights up my life. He was miraculously conceived naturally two months after surgery. I was going in for blood work to start to prepare for my next frozen cycle and found out I was pregnant.
Sometimes it takes science to get you to natural. I don’t know if it was by chance or if the fibroid was the problem from day one. I don’t know if I will have difficulty conceiving a second child. What I do know is, the journey it takes for a child to come into your life doesn’t matter in the end. I would put myself through it all again in a heartbeat.
Lani is mom to a very active boy known as “B” who keeps her on her toes. By trade Lani is a Pediatric Dental Hygienist of more than 10 years, but she is enjoying taking this time off to be with her little man. Lani loves breastfeeding and babywearing. She feels very strongly that women are each other’s greatest support when it comes to successful breastfeeding and parenting. In her spare time she loves photography and up-cycling furniture. You can find Lani at Boobie Time.
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