So I graduated in December from Nursing school; as previously planned, we started discussing our options and potential courses of action. I had some pretty strong feelings about the kind of doctor I wanted to see. I knew I wanted to pursue infertility and pregnancy with an experienced Reproductive Endocrinologist. For those who do not know, Reproductive Endocrinologists are fertility specialty doctors. Compared to OB/GYNs who will also help with the basics of infertility treatments, such as clomid. My previous doctor was an OB/GYN, and with him not knowing much about my endocrine issues and how they would affect infertility and pregnancy, I decided I needed a Reproductive Endocrinologist on my case.
As I started researching which doctors in my area I would want to go see, I came across an ad for a free informational meeting that was in about 3 weeks. It was for a clinic near my home and work, all reproductive endocrinologists, with great success rates. As I continued to research good doctors in the area, I started feeling a little bogged down with all my options and feeling like I lacked sufficient knowledge to make the right decision. I began to feel like I was not sure where to start so why start anywhere. I know that makes no sense, but for about 2 weeks did not really do anything.
Then one day, I began clearing photos in my phone, and came across the ad that I had found of the clinic near my house. I did not remember that I had taken a picture of it. And to my surprise, the meeting was two days away!
We attended the meeting and were very impressed by the presentation of information. Two of the three doctors that work for this clinic presented the information and afterward stayed to answer personalized questions that each individual/couple might have.
We stayed and ended up talking to one of the doctors for almost an hour about all my endocrine issues, and my concerns with my previous doctor; I expressed my desire to work with a Reproductive Endocrinologist. And as she asked me what medications I was on for my thyroid, adrenal insufficiency and other endocrine imbalances, I was pleasantly surprised to find that she knew and was familiar with all of them. It was a huge relief feeling like I found someone who can truly help me in my particular situation. When I told her of my relief, she further eased my concerns when she told me that she had trained in endocrinology for several years before further specializing in Reproductive Endocrinology. So I became even more excited because it meant that she would know, in detail, about all of my stuff going on, and would truly have the best shot at helping me get pregnant.
After our almost hour long discussion, as my husband and I walked to the car, we expressed how comfortable both of us felt with her and how she was such an awesome doctor. We immediately knew we wanted her to be our doctor to help us try for our babies.
Within a few days, we had our first appointment set. It was all starting to feel so real. I was going to be a mom soon! I could just feel it, or maybe it was just hope. We repeated some of the testing from the previous doctor, mostly the ones that can vary with time. The benefit was my husbands work schedule allowed him to get his semen analysis done much sooner. It took about 6 weeks to get all the testing done.
When we went for our follow-up, once again all signs pointed to the problem being me, because i do not ovulate. She also explained that she thinks I have what is called hypogonadotropic hypogonadism, all it basically means that my brain does not release the proper hormones to get my ovaries to function properly, which explains the lack of ovulation, and could also be related to my other endocrine imbalances, if my brain is lacking in function there as well.
So we talked about our options and discussed a tentative plan of care. But because she thinks the main problem was with my brain no releasing what it is supposed to, she was not sure if many treatments would work as well, since they primarily work on the brain to release more hormones. But together we decided we would go ahead and try clomid, since it is the cheapest option. And if that did not work, then we could try something else.
Although we had decided and agreed on a plan of care, treatment would have to wait. She was concerned that my TSH -hormone relating to thyroid function - came back low. So she decreased my dose, and we would redraw in a month.
A month later, my TSH was drawn again, and it still came back low. So once again my dose of thyroid medication was decreased, and we waited another month. In the meantime, I am starting to see and feel many of my signs of hypothyroidism return and I am starting to get concerned that my dose is too low. But I am willing to do it for my baby. So I waited for this next TSH level, and once again it was low, so she wanted to redraw my level in a month with a lower dose of medication again. However, based on how I had been feeling the past 6 weeks or so with the lower doses I went to talk to my doctor about my concerns and let her know how I was feeling.
When I met with her, I was a little afraid that she would tell me to suck it up and deal with it. But she was so kind and told me we did not want to have me feeling so crappy, and having all these negative side effects of lower doses. She did talk to me about the potential concerns and complications that can happen with a low TSH, but as we talked it through between the two if us, we decided to have me return to my original dose of Thyroid medications.
So with that behind us, we were finally ready to start treatment. The plan was to start with Clomid, to see if that would work, even though she had her doubts. But we would start with double the dose of what I took last time. I came in for an ultrasound to make sure everything looked good, and everything did, so I was cleared to start Clomid. A few days after finishing Clomid, I went in for another ultrasound to make sure that my body had responded to it. There was a folicle (mature egg) in each ovary; they were both slightly small, but looked good otherwise. But my ovarian lining looked a little thin, so they sent me home with a medicatoin to help thicken that up and also said that it would probably help the follicles continue to grow to full size.
Three days later I came in again for another ultrasound, and this time, both follicles and uterine lining got the clear to do the final steps to induce ovulation. I was instructed to go home and give myself a shot that would help make sure these eggs dropped and then have timed intercourse to try and increase the chances as much as possible.
Then it was a waiting game. I would return in about 2 weeks to get a blood pregnancy test. Two days before I was scheduled for my blood test, I began bleeding. I was devastated. As prepared as I thought I was for it not to work the first month, I could not help but feel like I had done something wrong, or even worse that there was something wrong with me. Maybe I was never meant to be a mom.
That night at work was the hardest I have ever had, because I just wanted to curl up in a ball and cry my heart out...as it was I did cry my heart out, in a dark corner at work when I had a free moment or two. Other than that I had to put on a bright, cheerful face when my heart was breaking inside.
Due to the heartache I felt, I felt I needed a month break before trying again. I talked with my husband, and he told me that if I felt I needed it, to take it. So I told my doctor I would miss the month of July. But return for treatment in August. When I went in for my initial ultrasound for the month, I was seen by my doctors colleague because my doctor was out on maternity leave. This doctor told me that I had an ovarian cyst on my left ovary. She did not feel comfortable starting me on Clomid while I had a cyst, so we would wait a month.
Two days later, I got this pinpoint pain on my left side, that over the next several hours grew to be extremely sharp pain on my left side. I am pretty sure the ovarian cyst burst, but it burst on a Friday night, or I would have called to see if I could get an ultrasound to verify that is what I felt, but I waited out the weekend on Tylenol and Ibuprofen, and by Monday or Tuesday, the pain was gone. So I never went to the doctor about it.
At this point I am waiting for my next cycle day 1, so I can go in again for my baseline ultrasound to hopefully start another round of Clomid. Who knows, maybe, hopefully, that will the month that we get pregnant.
Wednesday, August 28, 2013
Thursday, August 22, 2013
The beginning of our Infertility Journey
I apologize upfront about these first few posts being long. I have five years to catch up. I will try to get them done in a post or two, depending on my time restraints. Hopefully they will not be too long and boring. Additionally, I am a very religious and spiritual person. I believe that God knows me, loves me, is mindful of my struggles, and talks to my heart from time to time through his Holy Spirit. Just to warn you as I begin this story, because much of the reason I have been able to deal with my struggles of infertility by relying on God's plan for my life and my faith in His love and support of me. And I will mention pertinent spiritual experiences I have had throughout my infertility journey. These experiences are very special to me, and I do not share them lightly, so if you wish to avoid them, please stop reading, and do not demean my faith.
Here it goes...
So I got married, just over five years ago. When we were engaged we decided that we wanted to have kids as soon as we could. We even laughed about how fun it would be to have a honeymoon baby. Needless to say, in our five years of marriage we have never used any form of contraception.
As our first year of marriage came and went, the fact that I was not pregnant yet was extremely difficult for both of us. It was a topic that we did not discuss often together, because it was very emotionally hard, but we also knew that our self and the other were struggling with it internally. We had looked forward to already having our first baby or being pregnant by our one year anniversary. Additionally, us not being pregnant was also made harder by two of my sisters being pregnant over our first anniversary.
By the time our one year anniversary came and went, with still no pregnancy, I knew that it would be a long road for us. I am in the medical field, so without even talking to a doctor, I knew that by one year of unprotected sex and no pregnancy, you were considered clinically infertile. As we talked about how to proceed, we decided that due to many changes in our lives (schooling, moving, starting a new job on the other side of the country) at the time, we would wait a few months to begin fertility treatments.
About six weeks after our first anniversary, one of my sisters had her baby. When she texted to tell me she was in the hospital to deliver, I went to visit her. On my drive home, I began pouring out my heart to God, asking him why I was not pregnant and why did I have to struggle so much for something that comes so easy to others. I even asked why he allows others who do not want a baby to have one, while those who do want a baby can't. I talked with God in my car for about 20 minutes - crying, expressing the inner feelings of my heart, that I had never spoken out loud to any one at this point. Once I was done doing the talking, I decided to spend some time listening for God's response. Almost immediately I was encircled by peace and comfort, a feeling I know can only come from God, especially in the heat of the moment I was in just seconds before. In this moment of peace and comfort, I got this overwhelming feeling that God knew me, He knew my struggles, and He loved me. In that moment, I knew that He only wanted what was best for me and that these struggles were all for my benefit and growth. Just before I arrived home, still in the immense feeling of peace and comfort, I knew that when it was the right timing for us to become parents, God would work whatever miracles were necessary for that to be so. And often I have returned to the feelings of that car ride and try to remember exactly how I felt in that moment, to try and bring that peace and comfort into my daily struggle with not being a mother.
So when our lived settled down a little, and we were all moved it, which was about 6 months, we went to the doctor to start talking about fertility treatments. The doctor said that we had to do all this preliminary diagnostic testing - both me and my husband - before we could make another appointment. Mine was relatively easy to do, because I was not working at the time so my schedule was mostly wide open to get all this done relatively quickly. My husband on the other hand had to do three semen analysis, which even doing one was difficult with his work schedule. He worked from 4:30am until about 7pm. For those who dont know, a semen sample has to be dropped off to the lab within one hour of the sample being collected. With my husbands work schedule, it was nearly impossible to get these samples to the lab within the time frame. No lab is open in the middle of the night for us to drop it off before or after work, and on all the holidays my husband had off work, the labs were all closed for the same holiday. So it took us almost 8 months to get all the samples done so we could get in to see the doctor.
Many of you are probably wondering why not go see another doctor, because this was the only doctor on our insurance plan within a one and a half hour drive from our house. Plus, our insurance, at the time, was one hundred percent coverage, and we were not financially able to pay for anther doctor out of pocket.
Once all the diagnostic testing came back, everything pointed to me being the cause of the infertility. My husbands numbers all looked great - number or sperm, size, motility, etc. Most of my tests came back normal as well, except my estrogen and progesterone (the female sex hormones) levels were low. Which is interesting, because about the same time, I was diagnosted by an endocrinologist with hypothyroidism and adrenal insufficientvy. My endocrinologist has explained that when your thyroid is low, most likely some of your other hormone levels will also be low.
After all my test results, my fertility specialist recommended the typical first-line of fertility medications, which is Clomid. He gave me a 5 pills to take on certain days of my cycle and then instructed me to come in on a certain day for testing after to see if my body responded to the Clomid. Based on the blood work, it appeared that my body did not respond to the Clomid. So we planned to double the dose for the second month. Just before the second month, my husband had a last minute training for his job and was temporarily moved out of state for this training.
I remained at home during that time, and went to see my fertility doctor again. At this visit, I told him of my recent diagnosis by my endocrinologist. His response was, "I am not exactly sure how your hypothyroidism will contribute to infertility but I know they are related, and so I am not really sure how to approach your treatment and medications." So in response to my fertility doctors comment, I emailed my endocrinologist and expressed my concerns of his lack of knowledge on how hypothyroidism and infertility are related and the recommended course of action. My endocrinologist recommended that we don't do fertility treatments, because he believed that with the correct treatment for hypothyroidism, my body would correct itself and I would get pregnant naturally within a year.
Shortly after this discussion with my endocrinologist, my husband found out that he would be getting let go from his job, and we decided to move back to the west coast so I could finish my college degree that I had started prior to our relocation to the east coast for his job. We also decided that since I had just over a year of school left, and per my endocrinologist's recommendation, we decided not to pursue fertility treatments while I finished me college degree and see if I was able to get pregnant naturally.
I graduated from nursing school in December and began working as a nurse in January.
Speaking of work, I will stop here since I need to get ready for work. My next post will catch us up to date on the remainder of my infertility journey.
Here it goes...
So I got married, just over five years ago. When we were engaged we decided that we wanted to have kids as soon as we could. We even laughed about how fun it would be to have a honeymoon baby. Needless to say, in our five years of marriage we have never used any form of contraception.
As our first year of marriage came and went, the fact that I was not pregnant yet was extremely difficult for both of us. It was a topic that we did not discuss often together, because it was very emotionally hard, but we also knew that our self and the other were struggling with it internally. We had looked forward to already having our first baby or being pregnant by our one year anniversary. Additionally, us not being pregnant was also made harder by two of my sisters being pregnant over our first anniversary.
By the time our one year anniversary came and went, with still no pregnancy, I knew that it would be a long road for us. I am in the medical field, so without even talking to a doctor, I knew that by one year of unprotected sex and no pregnancy, you were considered clinically infertile. As we talked about how to proceed, we decided that due to many changes in our lives (schooling, moving, starting a new job on the other side of the country) at the time, we would wait a few months to begin fertility treatments.
About six weeks after our first anniversary, one of my sisters had her baby. When she texted to tell me she was in the hospital to deliver, I went to visit her. On my drive home, I began pouring out my heart to God, asking him why I was not pregnant and why did I have to struggle so much for something that comes so easy to others. I even asked why he allows others who do not want a baby to have one, while those who do want a baby can't. I talked with God in my car for about 20 minutes - crying, expressing the inner feelings of my heart, that I had never spoken out loud to any one at this point. Once I was done doing the talking, I decided to spend some time listening for God's response. Almost immediately I was encircled by peace and comfort, a feeling I know can only come from God, especially in the heat of the moment I was in just seconds before. In this moment of peace and comfort, I got this overwhelming feeling that God knew me, He knew my struggles, and He loved me. In that moment, I knew that He only wanted what was best for me and that these struggles were all for my benefit and growth. Just before I arrived home, still in the immense feeling of peace and comfort, I knew that when it was the right timing for us to become parents, God would work whatever miracles were necessary for that to be so. And often I have returned to the feelings of that car ride and try to remember exactly how I felt in that moment, to try and bring that peace and comfort into my daily struggle with not being a mother.
So when our lived settled down a little, and we were all moved it, which was about 6 months, we went to the doctor to start talking about fertility treatments. The doctor said that we had to do all this preliminary diagnostic testing - both me and my husband - before we could make another appointment. Mine was relatively easy to do, because I was not working at the time so my schedule was mostly wide open to get all this done relatively quickly. My husband on the other hand had to do three semen analysis, which even doing one was difficult with his work schedule. He worked from 4:30am until about 7pm. For those who dont know, a semen sample has to be dropped off to the lab within one hour of the sample being collected. With my husbands work schedule, it was nearly impossible to get these samples to the lab within the time frame. No lab is open in the middle of the night for us to drop it off before or after work, and on all the holidays my husband had off work, the labs were all closed for the same holiday. So it took us almost 8 months to get all the samples done so we could get in to see the doctor.
Many of you are probably wondering why not go see another doctor, because this was the only doctor on our insurance plan within a one and a half hour drive from our house. Plus, our insurance, at the time, was one hundred percent coverage, and we were not financially able to pay for anther doctor out of pocket.
Once all the diagnostic testing came back, everything pointed to me being the cause of the infertility. My husbands numbers all looked great - number or sperm, size, motility, etc. Most of my tests came back normal as well, except my estrogen and progesterone (the female sex hormones) levels were low. Which is interesting, because about the same time, I was diagnosted by an endocrinologist with hypothyroidism and adrenal insufficientvy. My endocrinologist has explained that when your thyroid is low, most likely some of your other hormone levels will also be low.
After all my test results, my fertility specialist recommended the typical first-line of fertility medications, which is Clomid. He gave me a 5 pills to take on certain days of my cycle and then instructed me to come in on a certain day for testing after to see if my body responded to the Clomid. Based on the blood work, it appeared that my body did not respond to the Clomid. So we planned to double the dose for the second month. Just before the second month, my husband had a last minute training for his job and was temporarily moved out of state for this training.
I remained at home during that time, and went to see my fertility doctor again. At this visit, I told him of my recent diagnosis by my endocrinologist. His response was, "I am not exactly sure how your hypothyroidism will contribute to infertility but I know they are related, and so I am not really sure how to approach your treatment and medications." So in response to my fertility doctors comment, I emailed my endocrinologist and expressed my concerns of his lack of knowledge on how hypothyroidism and infertility are related and the recommended course of action. My endocrinologist recommended that we don't do fertility treatments, because he believed that with the correct treatment for hypothyroidism, my body would correct itself and I would get pregnant naturally within a year.
Shortly after this discussion with my endocrinologist, my husband found out that he would be getting let go from his job, and we decided to move back to the west coast so I could finish my college degree that I had started prior to our relocation to the east coast for his job. We also decided that since I had just over a year of school left, and per my endocrinologist's recommendation, we decided not to pursue fertility treatments while I finished me college degree and see if I was able to get pregnant naturally.
I graduated from nursing school in December and began working as a nurse in January.
Speaking of work, I will stop here since I need to get ready for work. My next post will catch us up to date on the remainder of my infertility journey.
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