The beginning of our Infertility Journey - Part 2

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.