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Our Fertility Journey Pt. 1

January 22, 2018

Something I’ve talked a lot about a LOT on social media (holla if you watch my Instagram stories) is fertility. I started sharing because it was such a huge part of my life. Like with a lot of important pieces of my life, work, marriage, home life, I share it without it being purposeful, but as a way to clear my thoughts, express myself, and connect with others. I’m writing about our fertility journey to help others who may be dealing with this… it’s NOT easy and no one should feel alone. This is a very personal blog post with intimate details, so read at your own risk.

A LITTLE BACKGROUND

I’ve always wanted to have kids. Even when I was young, I’ve always had that maternal feeling. I’m 36 now, and I always knew I wanted to be somewhere in my 30’s before having kids so that I could enjoy building a career and a home. Roberto and I were married in 2014, and we both looked forward to having kids, but weren’t in a rush. I felt like we had all the time in the world to get on the baby train so to speak. We decided in early/mid 2016 that it was time to start trying for a family, and went ahead just timing things with my P Planner app, having sex on what I thought were my ovulation days, and keeping it light. With after almost a year of having no success, we took a break a few months before our June 2017 Portugal trip, and at that point, I was getting a little antsy, wondering why the natural way wasn’t working. I figured taking a break and resuming while we were on holidays was a healthy approach for my sanity, and hopefully the outcome. Truth be told, I was getting pretty worried about how long this was taking. On vacay, I started charting my temperature on an app (I forget which one because I have since deleted it). Charting your temperature is incredibly tedious and in my opinion, ineffective way to check for ovulation. You do this every morning to see patterns in your temperature – it spikes AFTER ovulation, which works if you have a few months of data and can see your patterns. I personally felt this method was ineffective and not worth the trouble when there are more accurate ways to detect ovulation (more on that later).

Needless to say, we came back from a month in Portugal not pregnant, but relaxed. I went to see my doctor when we got back in July 2017 to talk about our next options. I explained we had been trying for a year, and she gave my a day three cycle test for FSH (follicle stimulating hormone – the higher this number, the more your body is trying hard to push your egg follicles out because you have less in your reserve… the lower the number, the better, because you have plenty of follicles, so your body doesn’t have pump FSH as hard to get them out through ovulation). My FSH was at 5 mIU/mL, which is a very good. 11 – 20 is a reduced and challenged reserve, meaning it’s much harder to see positive outcome with fertility treatment. I was really encouraged with this number. My AMH number was also within range, and my HSG came back normal. My TSH (thyroid) was higher than it should be, more on that later.

WHERE TO START

The following medical tests are an imperative place to start for fertility: FSH, AMH (a higher number may signal PCOS), HSG (this is a dye test for the ovaries and fallopian tubes so they can make sure everything is clear – I’ve heard many stories that after this test, where they literally inject dye up past your cervix, it cleans out the cobwebs and you get preggers. Not the case for me!), TSH (thyroid… mine has been controlled with synthroid for years. Ideal level for getting pregnant is 1 – 2.5)

My doctor gave me a referral to a local fertility clinic, Olive Fertility. I had heard really good things about them, and even though the wait was longer than other clinics, I wanted the best. Little did I know that the wait to even SECURE an appt was a minimum of two weeks. I called the clinic 3-4 times reminding THEM to call me. I wasn’t patient, that’s for sure. This was a really hard part of the process for me, because you feel completely helpless and impatient. I went to see Acubalance for acupuncture to get me through – I had heard acupuncture can be a great place to start in assisting fertility. This was the best thing I have done so far for my journey. Acubalance is a fertility specific acupuncture and naturopath clinic, and they are a huge resource for vitamins, naturopath work, Chinese herbs, and just supporting the process. Dr. Lorne Brown got me on the supplements both my husband and I needed, and I’ve been taking them during the whole process to help support my body so I can not only reduce my stress, but also produce the healthiest eggs and sperm. These include: Omega, Pre-natal, COQ10, Vitamin D.

Eating well, stress reduction, exercise and sleep are all huge parts of being healthy to make a baby. I didn’t get onto a strict acupuncture schedule or anything, but instead choosing when I felt I needed it. For me, that was after IUI cycles to help ‘implantation’ (but more on that later). I get so blissed out during and after a session that they are well worth the cost. I told Dr. Brown that my mom went into menopause at 37, and he was alarmed. Because they work closely with Olive Fertility, he emailed them right away to speed through my intake process, and I had an appointment booked a week later, September 15th, 2017.

FERTILITY TREATMENTS BEGIN

I had no idea what to expect with a fertility clinic, or what the process entailed. How much would it cost? I had a million questions… as you can imagine, I’m a control freak when it comes to my health. The doctor met me in her office, and went through what my tests said so far (I had normal levels of the ever-important FSH and AMH, which meant I wasn’t going into early menopause like my mom, phew). This meant I had no reason she could see at this point that would make it challenging for a pregnancy to happen… this was both encouraging and scary all at once. She walked me through a potential treatment plan: Clomid (hormone pills that strengthen ovulation to deliver more than one egg), IUI (in-uterine insemination – basically, a tube full of sperm that is injected past the cervix into the uterus to reduce the distance the sperm have to swim) and then moving onto IVF if that wasn’t successful. I was on board and left feeling totally supported and like I was on the road to making our baby. The cool thing about the clinic is that the doctor is always on email for you, and with such a tender topic of treatment, this is so appreciated, and nothing like the regular medical system. Also, anything under the normal course of treatment, like seeing the doctor, the millions of blood tests and ultrasounds, are all covered under medical. What I do have to pay for is any drugs and extra treatments like IUI and/or IVF. IUI is $500/per and IVF can be up to $20K.

The process of tracking your cycle to prepare for IUI is INTENSE. Around day 12 (day 1 is the first day of your period), you head into the clinic most mornings between 7 – 9am where you have a standing order for bloodwork. They test your estrogen, LH (luteinizing hormone – this is what tells you if you’re close to ovulation) and at times your progesterone and thyroid. My thyroid was high at 2.53, and so my thyroid meds were upped. With another tests, my levels are down to .6 which my Dr. says is “perfect”.

The nurses turn the tests around FAST, and call you in the afternoon letting you know if the tests are close enough to ovulation that you need to come in the next day to test again, or if you can skip a day because you’re not close to ovulation just yet. They will also tell you, according to the result, when you should have intercourse. This is part of the crazy thing about the process… you’re into the scientific process of it, and then you have to turn around and make it feel NOT clinical. You’re always bouncing back and forth between the two. Most couples will go into the clinic together, the husband offering support to the wife, but I prefer to go alone and just get in and out. Roberto offers, but I figure it’s unnecessary. You repeat this bloodwork, with an internal ultrasound thrown in with your doctor to check to progression of your follicles – they can see how many are close to maturing. Once they see your LH and estrogen spike, they know you’re ovulating, and book you into your IUI for the next day. Basically, you’re always on eggshells (pardon the pun) unsure of how to plan your life, because ovulation might happen, and you must drop everything for the IUI… not ideal, but whatever it takes! The first month of this wasn’t horrible, because I was full of so much hope for the IUI. The morning of the IUI, your partner goes into the clinic to ‘do his business’ – it involves a small room, a recliner, and a stack of mags. Poor guy! The clinic then prepares the sample, adds vitamins to make them super swimmers, and you both return in the afternoon for the procedure. Our first IUI in October 2017 was so exciting. I remember being in the waiting room and taking a photo of the two of us saying that this could be our last photo just the two of us, because I could walk out of the room ‘pregnant’. The procedure itself feels like a pap, and it’s over in literally 5 minutes.

THE FIRST AND SECOND UNSUCCESSFUL IUI…

And then, you wait. The clinic gives you a blood test requisition to take about 3 weeks after your IUI and all you can think about is if you’re pregnant. Every little flutter that happens, you’re sure it’s the baby you were meant to to have. I was consumed with excitement, and I felt so positive that we had done all the right things to get here. I’ll never forget the blow of getting my period that cycle. It felt like such a huge loss of something we never even had. I called my sister and my best friend and bawled openly on the phone (which by the way, I don’t think I’ve ever done before!). I was just SO disappointed. Why didn’t it work? What was wrong? All the circumstances were ideal… it scared me to think that this was going to be a lot harder than I thought it would be. All I could think was that we were back to square one… day one… and time was slipping away. My doctor assured me that this wasn’t abnormal, there was nothing to worry about, so onward and upward.

Our second cycle went along the same lines, but she upped my does of Clomid to 150mg. I’ve heard horror stories about how this can make you feel, but my symptoms were actually ok, thank goodness. Maybe the odd hot flash, but otherwise, nothing too much. The second cycle was a little different, because instead of going in for daily bloodwork starting around day 12, I also cross tested with my LH urine strips so I wouldn’t have to go in everyday (I HIGHLY recommend getting these if you’re starting to track your cycle – the drugstore ones are way too expensive, so get these ones online or at Acubalance). Honestly, my second IUI was such a blur, I hardly remember it. I think I was trying to remove myself from the emotion of it, and so I blocked some of it out maybe. We went to Whistler right after for a getaway so I could relax, and I liked doing that since it got my mind off the procedure a bit, and helped work on my stress. Stress for me has been something I’ve worked on reducing by doing less and having downtime. Needless to say, my second IUI was not successful. By this point, I was feeling pretty defeated, and I cried a lot. I can’t explain how hopeless unsuccessful fertility procedures feel. You think it will never be you. You wonder why your body can’t do what it was basically made to do. You wonder why it’s so easy for “everyone else”. You get envious of others who get pregnant – strangers, friends, the lady walking down the street. All you see are people getting pregnant. While my husband is incredibly loving, he doesn’t always understand how this all feels for a woman. You wish, and hope, and dream and envision what a baby you and your husband create will look like, what the nursery will look like. You go through so many what ifs, you become obsessed. For me, this meant taking a month off. It was the holiday season, I wanted to really enjoy, relax, and reset. Plus, I’d heard that this can help your body do what it needs to MAKE A BABY.

… AND SO WE MOVE FORWARD

Cycle three started right after the holidays, and I started 150mg Clomid again (day 3 until day 7). I had some business travel coming up in January, but luckily it was supposed to work with my cycle, meaning that I would be in town when ovulation was due. Well, your body don’t play like that, and it’s apparently on its own schedule. My ovulation was extremely delayed (day 21?!) so after going into Olive to get my ultrasounds and bloodwork, I ended up being in San Francisco during. We DID however try naturally twice over a three day span (“honey, I have to be at the airport at 10am, it’s 8am so do your thing” – super romantic). This was all very disappointing and frustrating since I took the Clomid this cycle, and didn’t feel like I was making the most of it without an IUI.

At this point, it’s mid-January 2018. My period is due, and nothing came. 2 days later, and still nothing… there was hope. I was elated. I was never late, always early or on time. Could this be the one? I can’t tell you how excited on the inside I was. I went to buy a pregnancy test, and when it came back negative, I was discouraged, but thought it may be early. I felt like there was a little glimmer of hope, and perhaps now that my thyroid was within perfect range, I was finally pregnant, and started planning for the future… I couldn’t help myself. After two years, I thought it was our time, and any shred of possibility was enough for me. On day 4 of my late period, I emailed my doctor, and she told me to test – I tested and negative again. She assured me this meant I was not pregnant, and told me I would have to take Provera to start my period. Even writing this, I’m emotional. I’d never NOT gotten my period; what was happening to my body? This scared me A LOT. Taking pills to ovulate, pills to get my period… all this even though I have no medical issues to cause “infertility”. I was feeling really down and blue, and had a full work day on Sunday for an event. I’m the type of person who puts my clients first, and work helps me get my mind off things, therefore, I was happy to be working. During the event, I got my period and I spent a few minutes just crying in the bathroom. I was just so disappointed. I came home and just lost it, crying on my husband’s shoulder. I just wanted to crawl into a dark hole. I felt incredibly lonely, yet I wasn’t alone at all. By far, this cycle was the most challenging of the whole journey. BUT, there is nothing to do but move forward. We will be doing another IUI this cycle, and then will reassess with the doctor about what further testing I should maybe have, and what IVF would look like for us. I’ve dreaded even thinking about IVF, it terrifies me.

Thank you to all of you who reach out to send encouragement. It’s something not a lot of people can understand, but some of you who are going through a similar journey have made me feel not so alone with your kind words. I hope this helps anyone who is struggling with fertility, and I plan to continue to document this process here. XO

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