I have been waiting to share this story until I had good news to go with it and finally the time has come. After two years, we are thrilled, humbled, and joyful to announce that we are pregnant with baby #2. But it wasn't an easy road...
For 2 years, it seemed that everywhere I looked, people were getting pregnant. Every time I went to the grocery store, I was running into pregnant women, at work, it felt like all of my co-workers were getting pregnant. But worst of all, every time I logged onto Facebook or Instagram, there were pregnancy announcements and birth announcements forced in front of me.
By the time Leon was 3 months old, I started getting the questions, "When are you going to have another baby?" Well that got real old real fast. Once we started trying again, which was when Leon was 6 months, I would answer that question by saying, "hopefully soon, I would be thrilled to be pregnant at any time!" Once Leon was a year my answer started to change. It started to get a little more cynical, a little more doubtful and sounded more like, " I would have liked to have been pregnant months ago but its just not working." And each month after that I just became more and more honest. By the time Leon was a year and half and we had been trying to conceive for a year, I just straight up told people, "we are undergoing fertility treatments but we are not having luck." And as I told people about the procedures we were doing and eventually IVF, I found that each person I told had a friend, a sister, a family member who had been through the same thing, and had a baby last month, last year, 10 years ago. These conversations became easier and easier for me the further along we got in the process because never once did someone tell me, "oh I had a friend who had fertility problems and they never were able to conceive." It was always positive, it was always a success story. For this reason, I decided that if I were to be lucky enough to conceive again, I would make sure to explain how difficult it was and provide hope for those out there going through the same things my husband and I did for so long.
Diagnosis
In order to tell the story, I have to go back a couple years to explain how I got pregnant with Leon. After we were married, I went off birth control right away. After a year with no cycle, I went to my doctor. She kept brushing me off and telling me you are probably fine, its normal since you have been on birth control for 10 years. A few months later, one day before Christmas, I got my period and I was in more pain than I ever had been in my life. I had debilitating cramping and I also experienced other unimaginable symptoms that I will spare the details on. For those inquiring minds, you can email me and I will give the full story blow by blow.
I googled the symptoms I was having and went back to my doctor. I told her I think I have endometriosis. She told me endometriosis can only be diagnosed by surgery so she wanted to eliminate other options. She tested me for polycystic ovarian syndrome (PCOS) and some other things before agreeing that I needed surgery. I ended up switching to a fertility doctor, not because I was trying to get pregnant yet, but because I knew he was a specialist in the area and wanted the best. I had my first appointment with him at the beginning of August and had surgery at the end of the same month. Our doctor told us that I had stage 4 endometriosis, the worst case. He said we would have a 3-4% chance of conceiving naturally.
Two weeks later, I got pregnant. Of course, I didn't know it yet because we were not "trying to conceive". I wasn't tracking ovulation, I didn't even know what signs to look for when I was ovulating, and I had never had a regular cycle in my life so when I was late, it was just like every other month of my life. When I was four and a half weeks pregnant, my boobs were all of a sudden humongous but I just though, oh maybe I am about to start my period. But a week after that I decided to take a pregnancy test and you guessed it, pregnant. We were overjoyed because we always thought that my endometriosis would make it very difficult to conceive even after the surgery. I had an easy pregnancy and was thrilled to welcome our sweet baby Leon 9 months later.
Flash forward to my first postpartum cycle, 6 months after giving birth. Right away we started trying again because I anticipated we would have problems. But this time I started temping immediately. Temping involves taking your temperature every morning and charting it to identify when ovulation occurs in your cycle. This method enables you to learn more about your body and helps you identify ovulation signs and time intercourse to conceive. I used the app Fertility Friend to track my temperatures for 7 months, no pregnancy. I was breastfeeding at the time and had heard that the hormones from breastfeeding can be a natural birth control. So when Leon was one, I stopped even though I wasn't ready. I made an appointment with my fertility doctor again and went back for testing. I thought he would simply say, "ok let's do surgery again!" And that would be that. But boy was I wrong.
We had an initial consult with our doctor and he explained that doing the surgery again is not recommended. It can create more problems and even make it impossible to ever get pregnant again. So we had to go back to the drawing board. When you go to a fertility doctor, it takes a very long time to actually start a fertility program because they want to eliminate all potential other problems. So I did ultrasounds to check my egg quality and count. I did more ultrasounds to make sure there was nothing in my uterus that would inhibit pregnancy. I had yellow dye injected into my fallopian tubes to make sure they were clear. And last but not least, Townsend got the glorious task of having his sperm checked. My testing was not so fun or rewarding, but Townsend was forever pleased to know that with just a small amount of effort, he was able to produce 192 million perfect, fast swimming sperm. I cant tell you how many times over the next few weeks I heard that fact. Oddly, no one was ever as interested when I told them my fallopian tubes were indeed clear.
Each of these tests has to be done at a very particular time of the month. So I would get one test and then wait another cycle for the next one. This is an infuriating process when you have an irregular cycle that most of the time is 35-45 days long. You are just waiting and waiting and waiting but all you can think about is getting pregnant. 5 months later, we finally sat down with the doctor to discuss our options. We had a 1-2% of conceiving naturally due to the regrowth of my endometriosis compared to the normal percentage of 20% per month. He gave us 3 options:
- Take an ovulation drug such as clomid or letrozole and have timed intercourse which increased our chances of getting pregnant to 5-6% per month
- Interuterin insemination (IUI) which involved taking the ovulation drug and then having the doctor inject Townsends sperm into my uterus. This increased our changes to 10-12% per month.
- Invitro Fertilization (IVF) which involved extracting my eggs and fertilizing them with Townsends sperm outside of my body and then putting the embryo back in. This increased our chances to 55-80% depending on the IVF path we took (which is basically code for, depending on how much money and time you want to spend).
My doctor advised us to go with the second option, he didn't think we would have trouble getting pregnant with a little extra help. I had several friends who got pregnant through IUI so I was excited to get started. We did our first cycle which involved ovulation drugs and one shot, which I was SO terrified of (little did I know what was coming next). The procedure was easy and I was so excited to wait two weeks and see two lines on my pregnancy test after almost a year of negative tests. But alas, less than two weeks later I woke up to debilitating cramps and knew, it didn't work.
It was also around this time that I decided to stop eating gluten, dairy, and soy. I read online that you can cure endometriosis by changing your diet (a word of caution: if you are trying to conceive, STAY OFF THE INTERNET). Gluten, dairy, and soy all cause inflammation and basically create an environment for the endometriosis to grow. We tried IUI again the next month, but same thing, not pregnant. At this point I was doing a lot of research on the internet (which again, I strongly advise against) but I found that IUI is much less successful for patients with endometriosis. Unanimously, all of the research sites said that IVF is really the only chance for conceiving with endometriosis.
I went back to my doctor and said that I wanted to start IVF. He agreed we should go for it and our journey began.
This was equally as infuriating as the initial testing we did because the process takes SO long. Just to get on the calendar to do IVF, you have to make sure all your testing is up to date. Since, I started testing in July, it had already been 7 months so I needed to get updated testing. More ultrasounds. We had to attend a required informational class on the IVF process, and we had to go in and sign consents with the doctor. A month later, after harassing all the nurses to quickly get me scheduled for all of my testing updates and appointments with the doctor, we were ready to start.
We elected to go for the longest, most expensive IVF option because we wanted to know that if it didn't work, we had done everything in our power to get pregnant. We had the option to do either a fresh or frozen transfer. A fresh cycle is when you do the egg retrieval, the doctors fertilize your egg with your husbands sperm and 5 days later they implant into your uterus. A frozen cycle involves, doing the egg retrieval, the doctors fertilizing your egg with your husbands sperm, and watching the embryo grow for 5 days. Once the fertilized egg has grown for 5 days, it is called a blastocyst. An embryologist will then rank your embroys and for the ones that meet the criteria to be frozen, they will do a biopsy and do genetic testing on the embryo. It takes two weeks to get the genetic testing results back so they freeze the embroys while you wait for the results. Then, you wait a month and they start you on a new round of hormones to create the perfect environment for a baby. The frozen transfer takes at least two months longer than a fresh transfer but the likelihood that you will be pregnant increases from 55% to 80% which is significant.
This is because the hormones you take for the egg retrieval do not create an ideal environment for a baby. It results in a uterine lining that is sometimes too thick and thus, makes it harder for the embryo to attach. It also creates a potential for you to have an embryo implanted that is genetically abnormal which increases the likelihood of miscarriage. After hearing all these facts, it was pretty easy for us to decide that we wanted to do a frozen transfer.
Egg Retrieval
The egg retrieval begins with 2 weeks of birth control. They have you take birth control so that it will shut down your bodies natural hormone production so that they can alter it to grow more follicles. After that, you start the follicle stimulation drugs "stims" that cause your body to grow many dominant folliciles instead of the typical one or two that become dominant in a normal cycle. I had 15 follicles that month so we were hoping for the stims to develop all 15 of them in order to get the most embryos possible. My doctor told us that typically 75% of follicles will produce viable eggs. Some follicles are empty of the egg is not good quality. Of the eggs that they retrieve, about 60% will fertilize and of the fertilized eggs, approximiately 60% will grow to become blastocysts and of the blastocysts, approximately 75% will be genetically normal based on my age. So it was important to me to get as many eggs as possible since the numbers just drop and drop and drop after that. He told me that based on my egg count, 4-5 embryos was his expectation.
So we did 10 days of stims which started with 2 shots per day in the stomach, then added a third. The stims went by quickly, the shots didnt hurt, and I didnt have any emotional side effects. My body responded to the stim drugs perfectly and we went in for the egg retrieval hopeful for 13 or more eggs from the 15 total that I had. When I came out of surgery, the doctor informed my husband that she had retrieved 6 eggs. SIX!!!! Out of 15!!!! She said the rest of the eggs were covered in brown endometrial tissue and were not viable. Townsend told me the news when I woke and I was devastated. I never expected this. This made our chances of having more than one embryo, or any at all very low. This was the first hard day followed by 5 more.
Each day I would wait for updates. They called me the day after the retrieval and informed me that 4 had fertilized. What happened with the other two I wondered? They actually hand pick the best sperm (out of the 192 million which seems impossible) and place them into the egg. So it seems rather unlikely that they wouldnt fertilize. But alas, we were down to 4. Several days later they called to inform me that of the 4 that fertilized, 2 had grown into blastocysts. The other two, didnt make it. I was devastated yet again. once the eggs had fertilized, I felt like those were my babies. I had 4 babies that my doctors were monitoring very closely but two of them didnt make it. Why? I had to leave work that day because I was so upset about the two babies we lost. At this point I had never had a miscarriage but it felt like I had just had two. Our other two fully grown blastocysts were biopsied at this point and then frozen.
Two weeks later, the genetic testing results came back and both were 100% normal. We were so thankful. My dream of four children turned into three and I was ok with the fact that these two babies would be ours and this was our plan from the universe.
Frozen Embryo Transfer
After a month off, we started drugs for the frozen embryo transfer (FET). Again you start with birth control to shut down your bodies natural hormone production. Then I started stomach shots for 3 weeks. midway through the stomach shots, I started estrogen injections. These suck. They are intramuscular shots so you have to do them in your butt. They are long and they hurt. Once I finished the stomach shots, I started progesterone in oil shots (PIO). These SUCK! The only thing thats worse than one shot in your butt every night is two! Because you are injecting oil into your muscle, you start to develop big hard lumps of oil. They hurt so bad. Nothing good I can say about them. Once my body was perfectly prepped for the implant, we went in and were reunited with our baby! We waited a very long 9 days and then went in for blood work to see if I was pregnant. And I was! Best day ever! All of our hard work paid off! I continued to be monitored via blood work and ultrasounds until I was 8 weeks at which point I was released to my regular doctor.
Miscarriage
And then, after 10 weeks of joy over our pregnancy, we learned that we lost our baby. There was no heartbeat anymore. Our genetically normal, perfect baby that we had been preparing for over the past year and half was no more. This was followed by the saddest days of my life. We had told Leon about the baby so he continued to ask where the baby was. I told him we lost the baby, and then he would see an ultrasound picture on my phone and say, "look mamma! I found our baby!" I had several friends tell me they were pregnant a week after my miscarriage. I'm still not sure why people think its a good time to tell someone their happy news because I am sure I didn't give them the response they were looking for. I felt like they had stolen my joy. I was supposed to be joyful and excited and passing all these pregnancy milestones, but instead I was living a nightmare watching everyone else experience my happiness. I realize these are irrational thoughts, but I had them.
I also had friends tell me that maybe this was a sign from God, that I shouldn't have any more babies. Maybe I should be happy with just one and that wanting more was selfish. If I thought that seeing pregnancy announcements on social media was hard while going through IVF, it was nothing compared to seeing them after a miscarriage. Especially for February babies. Every time one of my friends told me they found out the gender, or they felt the baby kick, I just thought about how I would never feel my baby kick or find out the gender. And Leon would see my pregnant friends and say "mamma, do they have a baby in their belly? Where is our baby?" After telling him so many times, he started answering that question himself. He would tell the person, "mamma doesn't have a baby in her belly anymore, our baby is gone." For months I would be ok one second, and then a mess of tears the next. Anything would trigger it. I had to leave work several days because I couldn't hold it together. And Leon became so used to seeing me cry that he would say. "its ok mamma, be calm." I started to feel embarrassed that I really could not get over this. I knew people who had experienced miscarriage before and they had gotten over it rather quickly. And anyone who didn't I would think, come on, this is normal, it happens so often, cant you get over it already?
It started to get better as I kept myself busy with travel and weekend plans, but as our second transfer came closer, I went downhill again. I was so emotional for the weeks leading up to the implant and it was something I couldn't really even explain. I was thinking about the baby we lost, the new baby we would hopefully get to meet. The day before our implant, a friend of mine sent me a text that I will remember forever. She had never been pregnant before, had never tried to conceive or battled infertility so this was all very unknown to her. But she somehow captured everything I was feeling. She said, "I cant imagine what you are felling right now, but I want you to know that I wont only be praying for you and your new baby tomorrow, but I'll also be praying for peace over the baby you lost." I felt like the whole time leading up to the second implant everyone was focused on the next baby, and I was still thinking about the one we lost which no one seemed to understand. I felt guilty for being excited for our next baby, as if when I was pregnant again, I would forget about the baby we lost.
In November we went through FET #2. This time we did things a little differently. I took birth control for 3 months between my miscarriage and the next FET. My doctor thought this would suppress the endometriosis and make a better uterine quality for the baby to grow in. I also did acupuncture for a month leading up to the implant and up until I was 12 weeks pregnant. Acupuncture is known to increase blood flow to the uterus which also improves the quality of the lining. This time it worked. I was pregnant again and a total lunatic worrying about whether I would loose another baby. I had tons of blood work to check and check and check that I was pregnant and weekly ultrasounds up until 12 weeks. I'm 18 weeks now and still a lunatic. I don't think I'll believe that everything is ok with this baby until I am holding it in my arms.
I am trying to look at the positives of this process taking so long. Originally I wanted children so close in age, but since Leon is older, I am really enjoying seeing this pregnancy through his eyes and hearing the questions he has about our new baby. "Mamma! Why is your belly so big?" or "Where's the baby? Is she in there? Is she cozy? When can I see her? Can she come over to my house tonight?" I also continuously remind myself how lucky we are. As a result of sharing our miscarriage experience and being open about this process, I hear stories about births and pregnancies that are so devastating and so unimaginable, it makes me again feel foolish for being so sad and emotional about our miscarriage. 2016 was a very difficult, emotional year. But now here we are in February 2017, the same month we were supposed to meet the baby we lost, and as we continue to mourn that life, we are overjoyed about the life that's growing inside me. I know that when we welcome this baby in July 2017, we will remember the sadness we felt when we lost our baby exactly one year before.