We Have an Announcement to Make

Finally, in June, 2019,  after eleven unsuccessful months, I took a pregnancy test and it was positive.  We were so excited.  We both called our moms to share the good news. 

As soon as I found out I was pregnant, I called the OB to schedule an appointment. I was told that an appointment would be scheduled for me during the eighth week of the pregnancy.  (Many people don’t know this, but by the time you’ve missed your period you’re already four weeks pregnant.)   A few weeks later I had my appointment. Leading up to my appointment, I started to jot down all of the questions I could think of to ask the doctor.  I had about three pages worth of questions for the doctor.  Less than a week following my appointment,  I started bleeding lightly. I wasn’t sure what was going on. I called the doctor’s office and spoke to a nurse who explained that light bleeding can be normal at the start of pregnancy. She mentioned that I shouldn’t have anything to worry about, and if I wasn’t saturating a sanitary napkin each  hour there was no cause for concern.  The bleeding continued, but it was slightly heavier. However,  I wasn’t saturating  pads, so I didn’t think much of it. The next day I started cramping and bleeding. The cramps intensified as the day went on.  I called the doctor’s office again. They told me I should go to the emergency room, and they scheduled an appointment for the following Monday.  I didn’t know what to expect, but I was still hopeful. When I arrived at the hospital, they took blood and gave me an ultrasound to confirm that I was pregnant. After the doctor reviewed all of the labs she told me that she saw a yolk sac in the ultrasound, but it was low. I didn’t know what that meant, and I wasn’t sure what questions to ask for clarification.  I just knew I was still pregnant and that was all that mattered.  I felt better after leaving the hospital and I wasn’t in any pain, but the doctor told me to take Tylenol in case the pain returned.  The next morning was Sunday, my and Jeremy’s wedding anniversary.  I woke up feeling pretty good. I was hopeful, but by the afternoon the cramps were intense. There was nothing I was able to do to make myself comfortable, I still wasn’t saturating a pad for an hour, so I was still hopeful. Sunday afternoon I had quite a bit of bleeding, and then everything stopped, the bleeding and the cramps.  I felt great. 

The next morning I thought everything was normal.  Jeremy went to work, my mom flew into town, and I thought I was going to have a normal day. 

That afternoon my mom and I drove to the doctor’s appointment, and Jeremy met us there.  I was checked in and escorted to an ultrasound room.   My mom and Jeremy joined me when the ultrasound was completed. 

When the doctor came into the room he explained that the yolk sac that was visible when I was seen in the emergency room the past weekend, was no longer there and that I had experienced a miscarriage over the weekend.  First, before any feelings could sink in I felt blindsided. I just thought to myself, why didn’t the doctor say anything on Friday in the emergency room, I would’ve been prepared for this conversation.  But thinking back, is anyone “prepared” for a conversation like that? Probably not.

The doctor was really nice. He convinced us hope to keep trying. He said since we got pregnant once we could get pregnant again. He mentioned that women are most fertile after pregnancy, but stated that if we didn’t get pregnant within 6 months,  I should see a specialist.  I was quietly trying to hold it together while the doctor talked to us.. All I wanted to do was leave the office.  I just remember the silence in the ride on the elevator down to the 1st floor, and then again once we approached the main level and while walking to my car.  got to the main level walking quickly to my car. 

My mom hugged Jeremy, and he began to tear up, I hugged him and he got in his car and went back to work. My mom hugged me and I started crying and tried to wipe my eyes dry so I could drive home. I’m glad she was there because she offered to drive home.  I was in no condition to drive home.

Jeremy and I were devastated. I remember crying for days. 

Thankfully, Jeremy and I had already scheduled a trip to celebrate our anniversary  a few weeks after our actual anniversary.  I remember being pretty sad on the trip, and all of a sudden snapping out of it, I told Jeremy that I wanted to consider trying to conceive again.  

We started trying to conceive again, and we were back on the journey of expanding our family. This time it was different. I had so many hurt feelings from the miscarriage, and I felt pressure. It was really pressure that I was putting on myself to get pregnant. I desperately tried  to get back to that feeling of excitement and hope that we had before the miscarriage.  Although I felt so much hurt, I still remained hopeful. I kept thinking about what the doctor said, how I would be more fertile since I had just been pregnant. I felt like that was my fuel, like I had this window of time since I would be “fertile”. However, after six months I did not get pregnant. In December, 2019, I made an appointment with a fertility specialist.  

During the consultation, the fertility specialist explained the pros and cons of every treatment. We were sent for a ton of testing. All of our tests came back normal, and the doctor diagnosed me with unexplained infertility. At first, I thought,  unexplained infertility, that doesn’t sound so bad… After a while, I thought,  What does that even mean?” How could this issue just be “unexplained”? Why can’t we be told what’s really happening? Is something going on in my body? Is something going on in Jeremy’s body? What’s really preventing me from becoming pregnant? I began to feel frustrated about not knowing. 

Because of the diagnosis, the fertility specialist recommended we start with the least invasive treatment, which was timed intercourse with Clomid. Clomid is a medication used to stimulate an increase in the amount of hormones that support ovulation.  I took Clomid for five days before monitoring began.  Monitoring started a few days after my last Clomid pill was taken, and involved ultrasounds and bloodwork every few days until ovulation.  During the appointments the ultrasound technician measured the growing follicles, and based on the growth of the follicles, the doctor instructed me to administer a trigger shot, and told us the optimal times for conceiving.  We had three unsuccessful rounds.  By the end of the three rounds, it was March 2020, which was when the pandemic started. The doctors said they weren’t helping women get pregnant during that time period since they were unsure of the effects of Covid on pregnant women and fetal development.

We were able to meet with the fertility specialist again in May.  This time we switched gears. We tried Clomid with IUI (intrauterine insemination). 

During that process, Jeremy and I had appointments on the same days. He had an appointment 2 hours before mine, and had to provide a semen sample.  During the 2 hour time period,  they washed the sperm and placed it directly in my uterus around the time my ovary would release an egg.  In a successful case, the sperm would swim up to the fallopian tube and fertilize a waiting egg.  

We tried 3 rounds of IUI, and sadly we were unsuccessful. 

After our third attempt, the doctor told us that each time Jeremy provided a semen sample for IUI, his sperm count wasn’t as high as his sperm count had been prior when we had done our initial testing.  He referred Jeremy to  a urologist.   The urologist diagnosed Jeremy with varicocele which was like varicose veins in the testicles.  The doctor told Jeremy that he could have surgery and it would increase our chances of pregnancy but it was not guaranteed.  We discussed it and opted for the surgery.  Jeremy had the surgery in October, 2020.  The urologist told Jeremy that his sperm count would increase 3 months after the procedure. So we took a break from fertility treatments.  

In the interim,  my mom suggested I make an appointment with the holistic/general practitioner I had in New York.  .  That doctor sent me a prescription for extensive blood work.  Afterwards, we reviewed my labs and  she told me my hormones were all out of whack.  She also suggested I try acupuncture with fertility treatments.

She prescribed some medication and told me which supplements I could take to balance my hormones.  It’s recommended that women who are going to get acupuncture to boost their chances of getting pregnant start 3 months before any fertility treatment.  So, I decided to give acupuncture a try. I followed up with the holistic/general practitioner 3 months later, and my lab data significantly improved. 

In April, 2021, we resumed our fertility treatments.  I felt confident. Jeremy had his procedure and everything went well in that respect. I finally had some answers about what was going on in my body, and I had blood work data that indicated my body was ready because my hormones were back to normal.   I was scheduled appointments for  acupuncture and began treatments. I just knew our good news was coming.  We did a round of IUI in April and we didn’t have any success. The doctor requested I make an appointment to discuss how we should proceed in the event that I don’t get pregnant with my next IUI round which was scheduled for May.  Sadly we had another unsuccessful IUI.  

During my appointment with the doctor, he said we could continue IUI, but he suggested we consider IVF (in vitro fertilization), which was the last thing I wanted to hear. I’d read stories about women who went through the entire round of injections and egg retrieval and just had no luck. I just felt that I didn’t want to go through all of that and have to do the entire process more than once. I was just against it, and I thought it was going to be way too much on my body. I told the doctor that I would think about it. Jeremy and I discussed it, and we said we weren’t going to do it at that point.  

Well, that changed pretty quickly. We thought about it for a few days and decided to go for it.  I began to think about my determination throughout my entire journey and figured why not approach IVF the same way.  I called the doctor’s office and told the nurse we were ready to go forward. Since IVF is such a precise procedure I had to undergo more testing and have more labs done.  

Once I completed all of the testing and labs I was given the go ahead to start the process.  Believe it or not, the first step was starting birth control.  The nurse explained that birth control was a way to keep my follicles, which contained eggs, and uterine lining in a baseline state that is very useful prior to beginning the IVF process.  While I was on birth control the nurse gave me the contact information for the hospital pharmacy,  I called and spoke to one of the pharmacists that specialized in IVF drugs. I made a consultation appointment with her. During the  appointment, she counseled  us about all of the medications that were prescribed and told Jeremy exactly how to administer the injections.  The session was very informative, and she was so supportive. However, It was extremely overwhelming to bring home a big bag of injectable medication.  

The first official day of my IVF treatment was also the first day of my menstrual cycle. On day two of my cycle I had to go to the doctor’s office for baseline bloodwork and an ultrasound.  

Next, ovarian stimulation with fertility drugs began.  I was  prescribed 4 injectable medications, Gonal F, Menopur, Cetrotide and Leuprolide. 

Honestly receiving the shots every day wasn’t terrible. The thought of getting an injection in the belly was way worse than it actually was.  I was glad that I had Jeremy and that he was giving me the injections, I couldn’t imagine injecting myself  a few times a day.  But he was great. Every morning he would prepare the injections that I was supposed to receive, and let me know when he was ready for me.   Lol, He knelt down and gave me the shot in the belly and put a band-aid on the spot if it was bleeding. He was great throughout the entire process. I couldn’t have asked for a better partner while I was going through the process. 

During the ultrasound and bloodwork appointments that  were scheduled while I was receiving the injections, the doctor  monitored estradiol levels, and oocyte growth (oocytes are the eggs in the ovaries). Based on the ultrasound and bloodwork the doctor  adjusted the medication. During my last ultrasound appointment, the doctor measured and counted as many follicles as he could.  I remember him counting about 40 eggs. Mature follicles should be between 16 and 18 mm in size. Imagine 40 plus eggs that are 16 to 18 mm in your ovaries… Sheesh..😬

36 hours before my eggs were scheduled to be retrieved, I was given the

Leuprolide injection. Leuprolide is a trigger shot to mature eggs.  

During the days that I was receiving the injections, I felt extremely bloated. My ovaries were full of follicles. The morning of my egg retrieval I felt so relieved that the eggs were going to be removed.  The morning of my appointment, I was checked in when I arrived  at the hospital. 

I was given a light sedative and taken into a small operating room where the doctor performed the procedure. He used an ultrasound to guide a needle to my ovaries to aspirate the follicle. The oocytes were later transferred to the embryology lab for fertilization. While my eggs were being retrieved, Jeremy was taken to provide a semen sample that would be used to fertilize my eggs.  After he provided his sample, it was put through a special washing process, which separated the sperm from the seminal fluid. The embryologist choose the best-looking sperm to use for fertilization. Because of our history, the embryologist used a process called ICSI or intracytoplasmic sperm injection, which is when the embryologist inseminated the egg with the sperm using a needle. The embryologist watched the eggs for about24 hours to watch for signs of fertilization.

After the retrieval, the doctor came into the room and told me he retrieved over 70 eggs 😬, which definitely explained why I was so bloated before the procedure. I was monitored in the recovery room for a few hours before they discharged me.  

The next morning the embryologist’s office called me and told me of the eggs that were retrieved about 50 of them were fertilized.  

Over the next five to six days the embryologist evaluated the development of the embryos. The embryos divided and multiplied its cells over 5 to 6 days to become a blastocyst. That was the stage most suitable for transfer to the uterus. The embryos that were suitable for transfer were frozen on day six of fertilization to be used for a future embryo transfer. I definitely feel that we were extremely blessed and fortunate to end up with 17 frozen embryos.  

At the beginning of October, which was a month after my egg retrieval I had another bloodwork and ultrasound appointment.  Since my levels were normal I was prescribed an estrogen pill and patch. Estrogen levels need to be just right in order to grow and maintain the uterine lining to sustain a pregnancy.  The estrogen medication supported natural estrogen needs, thickening the uterine lining so that it was prepared for implantation. 

A few weeks later I had another ultrasound to check my lining. Since my lining had grown as expected I was given a date to start progesterone injections. I began to feel excited.  We were getting closer and closer to our transfer date.  The start of the progesterone injections is day 0, and the embryo transfer would be on day 6.  

At the end of October, I started progesterone injections. The progesterone injections were so much worse than the several injections I had to have in order to produce eggs.  The progesterone injection was administered in the hip… ugh… It was so painful, and the nurse told me that if the transfer is successful, I would remain on progesterone throughout the entire first trimester.  

On November 3, I had my Frozen Embryo Transfer.  I was so excited the morning of the transfer.

Although the process was difficult, and I didn’t picture this as my journey to motherhood, I’m grateful for the experience, and thankful for the wonderful outcome.