Friday, June 8, 2012

Our Journey to Parenthood

 "When you come to the end of your rope, tie a knot and hang on." -Franklin D. Roosevelt


I had to think long and hard before blogging about our fertility journey.  I think most people would agree that the conception of a child is, well, a rather private event!  But I also talk to so many people that are having a harder time getting pregnant than they had planned, and often times they tell me they feel so alone.  So I decided I could blog about our fertility struggles without getting too personal about it, in hopes that maybe it would encourage some of you going through the same thing.
 
It took us 18 months to get pregnant, from the time we started trying to the time it happened.  These weren’t consecutive months – there were some months in between when we were NOT trying (you’ll understand these more as you read this post).  I know 18 months may not sound like THAT long to some people, but when you a) never had any reason to think you’d have a hard time getting pregnant and b) seem to have a large group of friends that got pregnant without even trying, it SEEMS like an eternity. Not to mention that any length of trying to conceive over 12 months is the medical definition of “infertility.”  So let me tell you a little bit about the journey we went through, and how we got from here to there.
 
We started trying to get pregnant in early July of 2010.  We had been married almost a year, and felt like this was good timing to start a family (especially given the fact that we didn’t get married until I was 28 and David was 27.  There was no time to waste!  I quit taking the birth control pills (Aviane) that I’d been on since we got married.  I made an appointment with my then-OB/GYN to talk about trying to get pregnant.  Everything seemed great from the exam and blood work, so she gave us the go-ahead to start.  I was also told to start taking 800mcg a day of folic acid.  Normally she said a woman of childbearing age would only need 400mcg a day, but because of what happened with my brother I’d need a little more.  My brother Jonathan, born 2 years before me, was born with a rare, severe, and 100% fatal birth defect called anencephaly.  It is a neural tube defect and is, as the books say, “incompatible with life.”  He passed away just 30 minutes after birth.  There is some evidence that neural tube defects can carry a hereditary risk factor, so the extra folic acid would help mitigate this.  So we started trying to conceive right around the same time that I started that daily folic acid dose.
 
As of early October, 2010, we had been trying a few months with no success.  We had been told that up to a year can be normal, and that most couples conceive within 8 months, so at this point we really were not worried.  Just for peace of mind, I bought a First Response Home Fertility Test kit.  It measures a woman’s FSH level, which gives a good idea of her ovarian reserve (the amount of eggs she has left).  Mine came back totally normal, which was a relief.  No issues there, it seemed.  Later that month, we unfortunately found out that David’s job at the time, working with a public health surveillance team under a Homeland Security grant, may become unstable as the grant was to be “restructured.”  This would mean he would be without a job in the following spring.  Given this news and the financial impact it could have on us, we decide we better stop trying temporarily.  Going into parenthood with David unemployed would not be our ideal plan.  Both of us were wary about me starting back on hormonal birth control, since it takes a while to get out of your system afterwards.  So we use alternative methods of birth control for several months.
 
In March of 2011, David got a contract position with Booz Allen Hamilton, handling Environmental Health and Safety for the EPA office in Research Triangle Park.  This meant a 1 hour and 15 minute commute EACH WAY for him each day.  Looking back, this was one of the hardest points in our marriage.  David’s new job was incredibly stressful and demanding, far more than we could have imagined.  And the long commute just added to that.  He was miserable, and I was miserable because he was.  But, since he had relatively secure income again, we went back to trying to get pregnant.  I started charting my basal temperature each day (many of you have heard of this) to try to help us conceive, but for whatever reason I had a hard time determining a time that my temperature specifically “dropped.”  My temps were always very erratic and this made me worry that I wasn’t ovulating properly.  So I started using the ovulation predictor kits that you buy at the store to help us determine the right days each month to try.  At least they did show I was ovulating regularly and help me figure out when that was happening!  But even with our timing being “dead on,” we continue to not get pregnant.  The stress of David’s job, coupled with our inability to conceive, takes a significant toll on us.  I thank God for His help in sustaining us, our faith, and our marriage at that time, because things were very tough in all respects sometimes due to all the stress.  We also had to worry that David’s contract with Booz Allen would not be renewed the following year due to budget cuts.  These were 4 ½ VERY long months for us.
 
In August of 2011, thanks to the Lord’s grace and goodness, David got a PERMANENT, FULL TIME position as the Regional Environmental Health and Safety Manager at LabCorp in Burlington!  Praise the Lord!!!  This is only a 25 mile commute East for him from Greensboro (the same as my commute West each day), which was so much better than what he had been doing.  He starts his job and loves it!  Major stress burden eased!!!  Maybe the lower stress will help us get pregnant!
 
In September 2011, we start to get a little nervous that we haven’t gotten pregnant yet.  We are approaching the 12 month mark of trying.  I won’t go into any details in case there are males reading this (ladies, you can email me and ask if you’re really curious), but I’ll just say that my cycles went totally crazy all of the sudden.  I KNEW something wasn’t right, and it had David and I both very concerned, not to mention me feeling VERY bad physically.  I decided to try a new OB/GYN.  I was due for my yearly appointment anyway, and I thought I’d start fresh with a new doctor to figure out what was going on with me and with our fertility.  On the recommendation of several friends, I call Physicians for Women of Greensboro (looking back, one of the BEST decisions I’ve ever made!).  Dr. Neal was the first doctor that could get me in, so I set up an appointment with him.  My appointment is set for October, and that will be the official time mark of the “infertility” definition for us – 12 months with no luck.
 
On October 25th, 2011, I had my first appointment with Dr. Neal.  David goes with me and we both love our new doctor and practice (it is a large practice with several doctors).  Dr. Neal finds nothing unusual on his exam, but wants me to have an ultrasound, which they do there in house, and some blood tests.  The ultrasound revealed an ovarian cyst, which he said was most likely the cause of the cycle issues I was having at the time.  He said he thought it would eventually resolve on its own.  In the meantime, he prescribed me Prometrium, a progesterone, to help get my cycles back on track.  You take it for 12 days and at the end it causes a “Chemical D & C” (ladies, look it up or ask me if you don’t know what that is).  Hopefully, this will be like a “reset button” for my body.  I took 12 days worth of Prometrium from October 30th-Novemeber 10th, 2011.  It makes me terribly mean and moody (poor David!) and also so sleepy that I was in bed shortly after taking the pill each night.  At the end of 12 days, the chemical D & C happened on schedule.  (This did, by the way, fix my crazy cycles – Dr. Neal knew what he was talking about!)
 
On November 16th, 2011, David and I go for my follow up appointment with Dr. Neal (David has been SO good, going with me to ALL appointments through the ovarian cyst, infertility testing, and now pregnancy process!!!  What an awesome husband!!!)  A 2nd ultrasound at this appointment shows that the ovarian cyst has resolved, as Dr. Neal thought it would.  Hooray!  One less thing to worry about.  He refers me to Dr. Mezer, the fertility specialist in their practice.  We are thrilled about that to hopefully get some answers!  Dr. Neal also had the results of my blood work.  They had measured my Prolactin levels (a hormone) and also done a thyroid count.  My Prolactin came back normal, but my thyroid count was a little off.  Dr. Neal recommended I see my family doctor about that (and thyroid problems CAN cause infertility, so I wanted to get that check out – I was hoping that would be our answer!)
 
I got an appointment for the next day, November 17th, with my family doctor about the thyroid.  He did not think the panels were off enough to be significant and ruled out a serious possibility of hypothyroidism.  He ran a second thyroid panel just to be sure, and after looking at it he didn’t think I had cause to be concerned.  So no answers there!
 
On December 6th, 2011, David and I had our first appointment with fertility specialist Dr. Mezer and his fertility PA, Christi.  They do a full consult and order more blood work on me and also a comprehensive semenalysis for David to make sure the problem is not with him.  Dr. Mezer also found out about my brother, Jonathan’s, anencephaly and recommended immediate genetic counseling since we could be at high risk for that.  Really, we left that appointment very down.  We knew we’d just have to wait for more tests to come back, AND we were very nervous about the possibility of our baby having the same issue Jonathan did.  I cried after this appointment!  Not to mention that there is no, no, NO secret of your private life left unturned at fertility appointments.  REALLY, fertility appointments are NOT for people who embarrass easily.  There are certain aspects of marriage you expect to be just between you and your spouse, but suddenly you have these strangers of the medical world asking you every imaginable question.  Dr. Mezer and Christi were great, but the appointment was a bit overwhelming for us for so many reasons.  At this point, I feel like we are at a new low in trying to get pregnant!  And one more thing on the blood work – the fertility testing process requires a LOT of blood work.  A lot.  Honestly, between the blood work during that process and the blood work now that I’m pregnant, I truly feel like a human pin cushion.  Good thing I’m not afraid of needles!
 
On December 13th, 2011, I have a genetic counseling appointment with the Maternal-Fetal Medicine Department of Women’s Hospital in Greensboro.  David doesn’t have to go with me to this, since the genetic issue was on my side, not his.  The genetic counselor is very very nice (and very very expensive, by the way, lol!).  She tells me that, without a higher folic acid dose, our chances of having a baby with anencephaly are a stunning 1 in 50!!!  I am shocked, and a little scared when I heard this (normal is 1 in 600 or so).  But she assured me not to worry, and that I could mitigate this by upping my folic acid dose to 4mg a day.  Now, for those who think that doesn’t sound like a lot – that’s 10 TIMES what a normal, non-pregnant woman needs each day!  This equates to me taking 10 pills each day, which I start doing immediately.  We were not really expecting birth defects be a big concern, but the fertility journey is full of (often unpleasant) surprises!
 
On December 17th, 2011, David has a complete semenalysis done at his own workplace – LabCorp!  We were told they were the best around for this type of testing.  A few days later all of his test came back 100% normal and great.  So we can rule out anything on David’s end as being an issue in our fertility struggle!  Around the same time, I get the results from my latest round of blood work done by Dr. Mezer.  Anti-thyroid antibodies are normal.  3rd thyroid panel is normal.  Cystic fibrosis carrier screen is negative (meaning normal).  Progesterone levels are normal and in fact shows that I am ovulating “perfectly.”  Blood pregnancy test is negative (of course).  By all indications from these tests, we should be the MOST fertile couple in history!  But still, no baby.  VERY frustrating!  Dr. Mezer recommends that the next step be an HSG for me, to see if my fallopian tubes happen to be blocked, which could cause infertility.  I am not going to go into too much detail on the HSG, but feel free to look it up.  I was totally willing to do it, but also very nervous because I had read TERRIBLE stories!  It’s done without anesthesia of any sort, and it can be extremely painful (mainly by causing extreme cramping).  I had read stories of women with children that had it done and said it was WORSE than labor.  But, what has to be done has to be done, so I scheduled the procedure.  The one advantage of an HSG is that it tends to “flush” your tubes out, so you have a higher chance of conceiving in the three months after it’s done.
 
On January 9th, 2012, I go for a mandatory pre-HSG blood pregnancy test at my doctor’s office.  The HSG is dangerous and unnecessary if you happen to be pregnant.  I knew I wasn’t, but I had to go for the test anyway.  Surprise surprise, a big fat negative pregnancy test.  On to the HSG!
 
During this whole time, my grandfather (age 90) has been diagnosed with a very rapid form of cancer and was given just weeks to live.  He ends up at Wesley Long Hospital in Greensboro, and then at the hospice facility.  Needless to say, this is yet another difficult thing to content with during an already stressful time.  I start taking one of several doses of antibiotic prescribed to me to ensure that the upcoming HSG will not cause an infection.
 
January 12th, 2012, was HSG day!  David and I arrived at Women’s Hospital (where it is done) at 7:30am.  I know this is going to be an unpleasant procedure, and it’s made worse by the fact that, due to it being done under x-ray radiation, David cannot be in the room with me.  I don’t like to have ANYTHING scary done without David with me, so it was hard for me to have to leave him in the waiting room.  The procedure is uncomfortable at best, but really not quite as awful as the things I’d read.  Dr. Mezer does a great job.  There is one small complication in the beginning (not Dr. Mezer’s fault, just happened) and he tells me it is going to make it a little more painful than it would normally be.  I do cry a little during the quick procedure (only takes about 15 minutes), but I survive!  David has to help me to the car because I am very woozy and lightheaded (they had warned me I may feel this way).  He stays with me at home a while to make sure I’m okay.  After lunch, I go back to work, where I continue to feel yucky the rest of the day.  Luckily, the next day I feel better!
 
On January 17th, David and I went for our follow up appointment with Dr. Mezer.  The HSG revealed that my uterus and right tube look great!  My left tube, however, looked like it may have a slight blockage.  I had long suspected that I had a degree of endometriosis, due to some symptoms I have had for years and the fact that my mother had it.  Dr. Mezer thinks it’s probably endometriosis blocking the tube.  This would lower our fertility for sure.  He recommends that I set up laparoscopic surgery (which Dr. Neal, my original doctor there, would do) to see what’s going on and clear any blockages.  Dr. Mezer told me we can keep trying for the month of January, but he puts me on “ectopic precautions.”  Because of the tube blockages, I am at a higher risk of ectopic pregnancy.  These precautions mean that, if I have ANY symptoms of an ectopic pregnancy, the ER will see me immediately as that is a medical emergency.
 
On January 18th, 2012, David and I started attending an Infertility Support Group at Women’s Hospital.  There are 4 other couples and we get to know their stories.  It is nice to have other people to talk to about this stuff!!!  They understand!!!  We will meet with them several times over the upcoming weeks.  Two days later, my grandfather passes away.  It’s a sad time for the whole family.  It’s odd to be so sad about that and also to have to think about all these tests and procedures we are having done!
 
On January 23rd, I have a consult with Dr. Neal regarding my surgery.  We schedule the surgery for February 7th at 7:30am at The Surgical Center of Greensboro.  It is outpatient, but will be done under general anesthesia.  I will be out of work 2-3 days afterward.  I am excited and not a bit nervous – I’ve always been pretty brave about surgery, and to me this is a huge step in the right direction!  David is very nervous, on the other hand, because he worries about me a lot.  I’m just ready to get it done!  I ask Dr. Neal if we can still try in the month of February, a week or so after my surgery.  He chuckles and says, “If you feel like up for it, go ahead!”  hehe.
 
On January 26th we decide to take an Early Pregnant Test to see if the HSG happened to fix the problem.  We get TWO false positives from the brand we were using!  Very faint lines, and when I took more tests later that night there was nothing there.  Reading online later, I find that this brand is notorious for false positives.  It feels like the most absolutely cruel joke EVER had been played on us.  To be so excited for a few hours, only to find out it isn’t true.  I’m as not-pregnant as ever. 
 
On January 30th, 2012, I get a call from an employee at the Surgical Center of Greensboro to give me pre-op instructions.  Of course, she tells me that I’ll have to take off all jewelry for the surgery.  I explain to her that I’ve never had my wedding band off, never intend to take it off, and that I am sure they can just simply tape over it for the surgery (as they have done for other people I know).  She tells me very firmly that it’s up to the doctor and nurses, but I may HAVE to remove my wedding band.  With the stress of missing my grandfather and our fertility issues, this almost pushes me over the edge.  I understand it’s for my own safely, but if David can’t be in the OR with me (which obviously he can’t) then I AT LEAST want to be able to wear my wedding band in there!  I am so upset and resolve to myself that, on the day of the surgery, I will just simply refuse to remove it.  Also, around this same time, I go to Babies R Us to get a shower gift for a friend.  The cashier asks if I have a Babies R Us Rewards card.  I tell her no, and she says “Oh, I guess you don’t buy baby stuff often, huh?”  I go to the car and cry.  She had no way of knowing, but still.  Things that would never bother me are bothering me at this point!
 
On February 3rd, I take ANOTHER home fertility test kit.  FSH is still coming back good.  February 7th is surgery day!  Dr. Neal did not find endometriosis in my fallopian tubes, but he DID find it all over both ovaries.  In fact, he found a rather large “endometrioma cyst” on my left ovary, which we think may have been pressing down on that left tube and blocking it somewhat.  Maybe that will be our answer!  He removes all the endometriosis he can find, but warns us that it WILL regrow at some point, if we don’t’ get pregnant or go on birth control (these two things keep it at bay).  Frustrating for me because we can’t seem to get pregnant, and we aren’t going to go on birth control and just defeat the whole idea of trying to conceive!  In any event, I’m only in surgery about 45 minutes and in recovery an hour and a half.  I wake up in some abdominal pain (I would say a 7 on a scale of 10), but the nurse gives me extra IV drugs to knock that out.  Dr. Neal had told David all about what he found while I was in recovery, so on our way home David explains to a very sleepy me how the surgery went.  I lay on the couch for 2 days and David takes wonderful care of me.  We watch lots of movies. J  VERY easy recover, I have to say.  And guess what, I did NOT have to take off my wedding band for the surgery!  Now we will just wait and see if this surgery was the answer!
 
On Valentine’s Day, February 14th, 2012, I joke with David that maybe we will have a Valentine’s Day baby (I’d been taking ovulation predictor kits, so I knew that was a possibility).  Little did I know how right I’d be!
 
On February 22nd, we have a long talk and decide to really change our perspective.  God has given us so many gifts, and there is no reason to let our fertility struggles bog us down so much, especially when we always have the option of other treatments or adoption.  We resolve to be more positive and focus more on our marriage and our relationship with God.
 
On February 27th, 2012 – We get a POSITIVE (not false positive, REAL positive) pregnancy test!  Numerous ones, to be exact!  Looks like my endometriosis was the issue the whole time!!!  WOW WOW WOW!!!  You can read more about this experience in my previous “We’re Pregnant” post!!!! 
 
So there it is in a (rather long) nut shell!!!  I have to say, our fertility journey was one of the hardest journey’s we’ve been through as a married couple.  But the end results is already just so so worth the struggle!!!  We ARE hoping my endometriosis will stay away and that getting pregnant in the future will be easier for us!  I encourage ANY of you struggling with fertility issues – find me or another friend who has been there to talk to about it.  I know how hard it can be, and I would love to lend a listening ear.  Above it all, remember that God’s timing is PERFECT!  Looking back, David and I wouldn’t trade the “extra” time to just be married for anything in the world!!!

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