Ahhh… the best part about trying to get pregnant. The two week wait (2ww). The time between when the sperm and egg meet, and you can have enough HCG in your blood stream to detect a viable pregnancy.
You’d think with all of the medical advancements that the artificial reproductive technologies have given us, they could hurry up the waiting a bit. Alas, no. From the date of your IUI, you have to now wait 14 days to get your ‘Beta’ test (aka your blood test). The beautiful thing is that if you drive into the clinic to get the blood work done, they call you around noon with your results.
The fate of your future then relies on one phone call.
I’m getting ahead of myself. After sitting on the couch upside-down for a full day, I began the longest 14 days of my life. It’s practically impossible to pay attention to anything else in the world.
I spent my days trying to immerse myself in work so I could stay occupied on anything but baby making. As soon as I got home from work, I’d hop onto google and search for the most un-scientific things. “Early pregnancy signs”, “What to do during your 2ww”, “How to increase your chances of getting pregnant”, “How early is an at home pregnancy test accurate?”… you get the picture.
It was during this wait that I discovered www.ivf.ca. It’s the most amazing board with thousands of people experiencing infertility in Canada and abroad. Many of us went to the same clinics, had the same questions, and gave each other support in this process that no-one else could really understand. I’d never been one for anything else but my email and facebook on the internet, but this was pure gold.
While I admit, I have the most amazingly supportive family, friends, and husband, it’s impossible to describe what this process does to you to someone who hasn’t been through it. As if the financial, emotional, and physical symptoms/implications aren’t enough, add in massive amounts of hormones into the mix and you get a pure crazy woman.
Even for Dan, who had to continue to put up with me on a daily basis, it was a completely different experience… While being surrounded by supportive people, I felt completely alone. I was dealing with the biggest, hardest, most fundamental question: what makes you a woman? Up until now, being a woman was distinguished from being a man by one thing- the ability to have children. If my body wasn’t cooperating doing the most basic function of being a woman, what did that mean?
While Dan was always careful to refer to anything to do with fertility as ‘us’ or ‘we’, the fact of the matter was that this was MY problem. Everything with Dan was A-ok. It was me that was the stumbling block to us having our dream family.
Did he regret marrying me now? What did this mean to our relationship? How could he not blame me. After all, it is my fault. The only way I could prove my worth as a wife was to get pregnant and show him that I’m not useless- I’m a woman! I can have a baby!
Fast forward about 9 days. I’m feeling great. No period symptoms and every twitch or cramp I felt had to be our baby growing! Dan laughed at me a lot after I continued to tell him about each and every feeling in my belly. “Adele… it’s probably gas pains”. The worst times were when he was right! :S
At night, we’d lay in bed and talk about baby names. I had some ideas, as did he. He mostly threw out 90% of my ideas, but we were narrowing the choices down. I recall one night actually talking to my stomach saying “grow, baby grow!”. While Dan was positive and supportive, he tried to keep me balanced.
The realistic part was that the percentages say that IUI from our clinic is successful about 30% of the time. Not the best odds, but better than an average couple trying (around 25% per month). I was convinced that since I endured pure hell trying to get this darn follicle growing, this was for sure going to work.
I was having early pregnancy symptoms- my boobs hurt and I was feeling a tad nauseous…. However, I was also peeing on a stick every morning and was getting just one line each time. Not pregnant.
I’d call Dan with the news, but then again, it was still a couple days before my period would even come. Probably was still too early to show up. Trust me, I was pregnant.
14 days after the IUI, I rushed to the clinic early to get my blood work done. I had had no signs of bleeding, no signs of cramping etc for my period… I had a smile a mile wide. The staff at the clinic- who knew me well by now after my extremely long cycle- asked me how I was feeling. Pregnant, I told them. They wished me luck.
I had the blood drawn, then went to work. The clinic always called between 11:45 and 12:15. I had specifically booked myself to work in my office until 2pm so I could get the news, then I had a grievance meeting I had to go to.
The clock ticked by even slower than I could have imagined… Noon came. Then 12:30… 12:45… 1:00. What the heck… this was torture. Giving up, I called the clinic and asked if my results were in. They flipped me to the nurses and I left a message.
I left for my meeting and got to the hospital site at 1:45. I still had not received a call. I got my meeting materials ready, met with the member and union rep and was about to start the meeting.
At 1:58 I got the call. A nurse was on the other end and gave me the news that was about to change my life… But then she said it. “I’m sorry Adele, but the results of the test were negative”. I was standing just outside the door where the meeting was about to begin.
“Are you sure?”, I asked. Yes, I had no pregnancy hormone in me she confirmed. I explained my symptoms to her. The nurse went over my blood work with me and explained because my estrogen was so high, I was experiencing pregnancy symptoms, but they had nothing to do with pregnancy- just a result a very high estrogen.
I thanked her and started to cry in the hospital hallway. I was SO sure…
I dialed Dan and he answered after the 2nd ring. He was expecting my call. I gave him the news while drying my tears in a few short sentences. Told him I was about to start a meeting, then hung up.
I was utterly shocked. I was so sure… how could this happen? More importantly, it was now 2:06pm and my meeting was to begin 6 minutes ago. I had the employer and my membership waiting for my arrival. I wiped my face, swallowed hard, then walked back in the room. I blamed my crimson face on allergies and used a Kleenex to blow my nose. Back to work.
The meeting went fine and I got back into my car about 3:30pm. Before the door was even shut, I was crying so hard there was no way I could drive. I was devastated. I called my Dan and asked him to let my family and Janica know. The thought of talking to anyone that I told that I had to be pregnant was heart breaking. We had put so much into this process… and had nothing but bills to show for it.
Fast forward a couple of days. I had talked myself out of the slump I was in thanks to my amazing husband. We could do this again. Also, although this process was nasty, the docs had learned a lot about what didn’t work for me so the next round was sure to be better. Right?
The only problem was that my period still had not shown. I had called the clinic after about 5 days post beta results, and the nurse had told me to wait. On the first day of my new cycle, I should call the clinic to come in and get a new baseline test done. I continued to wait…
10 days post beta results…. Still nothing.
15 days post beta results… Still nothing.
20 days post beta results… Still nothing. What is wrong with me? I called the clinic and they were also unable to explain what’s going on. They told me that if after 25 days there was still nothing, to come in and chat with our RE.
25 days post beta results I came into the clinic with Dan by my side. The re-did my blood results- perhaps I was pregnant after all? Did I dare get my hopes up? I had another transvaginal ultrasound and was ushered into the clinical room to meet with our doc.
He reviewed the results, my uterine lining was thin again. I was definitely not pregnant. However, the perplexing part was that he wasn’t exactly sure where my uterine lining went to. It was thick… and was now thin. Normally that meant it was shed- aka a period. He questioned me again, was I sure I didn’t have a period? Ok, I appreciate I don’t know a lot about fertility, but I was sure about not having a period.
He wasn’t sure… he hadn’t seen this before. Great- another medical mystery. But the important part was that my lining was thin again. He had a new plan for medication and this time was going to have me switch to a different drug called Menapur. Still an injectible medication, it was a tad different and he was hoping my body would like it a tad better than Puregon. He said we’d have to wait until we got my blood test results just to ensure everything was back to normal, but if it was, I could start the medicine tonight! IUI Round 2, here we go!
April 26th we were to start our second cycle of IUI. The fact that we were now 3+ months from when we began the first cycle didn’t escape me. Most fertility patients had now completed, and gotten the beta results from, THREE different IUI rounds. Breath in, breath out. The end result would be worth it!
The medicated aspect of the cycle refers to medications given to me to essentially help me grow one, but no more than two, really great follicles. These meds are what are referred to as a stimulating medication.
Perhaps the easiest way to explain what I had to do is to first describe a normal cycle for a normal fertile couple. I apologize for taking you back to grade 6 here, however, I have learned more about my reproductive organs on this journey than I ever believed possible. Remember- I chose labour studies (a social science!), not actual science.
So here is goes:
Very basic… NORMAL CYCLE
Day 1 is the 1st day of your period. Your estrogen starts to climb and follicles (inside your uterus carrying eggs) start to increase in size. Eventually, one follicle takes the lead and starts to grow. Inside the follicle, your egg is maturing. Once the follicle is approximately 18-22mm your body gets a shot of Luteinizing Hormone. This causes the follicle bursts and the egg shoots out. This is called ovulation.
During this time, the estrogen that is increasing creates your uterus to make a nice thick lining for a potential baby to stick and grow.
Once the egg is released, it hopefully travels down your fallopian tubes and meets up with some extra strong swimming sperm. The egg and sperm meet, and fertilize, and they continue to grow. Your body is now producing progesterone (another hormone) to support the little embryo (fertilized egg). It travels into the uterine cavity, where hopefully it sticks. Once it sticks, it wiggles its way into the endometrium (uterine wall). This is called implantation. Then, a baby grows!
So for us, the purpose of being on stimulating hormones was to ensure that I grow a good quality follicle and ovulate. Due to my random periods and problematic bleeding, the clinic chose to assume that I was having issues ovulating on my own. Then, once the follicle was grown and ready to ovulate, I would be given another medication to ensure the egg gets expelled from my uterus towards my fallopian tubes. Thirty-six hours after taking that drug, I would be at the clinic receiving Dan’s sperm via a catheter into the top of my uterus. This is where it was to meet my super egg that I grew and ta-da(!!) A baby would grow!
So here we go- the day I had been waiting for was finally here. We went to the clinic in the afternoon and had an ultrasound to get a baseline reading, and then met with our RE. He said everything looked great and he said we could start… today! I’m not entirely sure what I had expected, or when I expected to start, but starting this second was even better than I imagined.
The doc moved on and the nurse came into the room to show me how I would administer the medications. Having my employment information in my file, I believe that the nurses may have believed I was a nurse… not someone who worked for nurses. Anyhow, I got literally a 30 second intro to jabbing myself with a needle.
Step 1: Insert cartridge of medication into needle thingy
Step 2: Clean the top of the needle thingy with an alcohol swab, then place the individually wrapped needle on the top of the contraption. Screw on. Take off needle cap.
Step 3: Tap vial to ensure air bubbles move to the top, then push one unit of medicine out the top to ensure air bubbles escape.
Step 4: Dial the correct amount of medication. Jab needle into your belly (cue grabbing a good handful of chubbiness), push down the button to push in the meds, wait 10 seconds, extract. Properly dispose of needle stuff.
Okay, I can do this. A needle once a day for approx. 10-12 days, then we’re all set to get pregnant. The clinic went through timing with us. Essentially, after 4 days of medication, I am to come into the clinic every other morning for them to do blood work and a transvaginal ultrasound to monitor the growth of my follicles and track my estrogen levels in my blood. These would be called ‘monitoring’ appointments. All monitoring apts were between 0730 – 0930. Once my estrogen levels are at a high enough level, and the follicle I’m growing is big enough (around 20mm), they would give me another needle to make me ovulate. An average length of time it takes to grow a follicle to its perfect plumpness and size is about 10-12 days.
With this ovulation injection, timing is everything. You are to inject yourself with the medication, then exactly 36 hours later, the clinic would be inserting the catheter filled with Dan’s sperm into my uterus.
The clinic noted a couple of side points that drastically limit your ability to have a life. The first thing is that the medication must be refrigerated. The second is that you need to inject yourself at the same time each evening (within 30 minutes either way of your ‘set’ time).
Cycle Day 1: Our good friends just moved back into Hamilton. Dan and I were invited to go over for dinner and to check out their new place. Little did I know this would be my first day of medication…. Not wanting to cancel, we came up with a plan. I have a little ice pack that I use for injuries that has a tensor wrap in it. We wrapped the medication/needle package in my to go ice pack, and headed to our friend’s house toting the instructions for injection in my purse.
We had decided to share our journey with our close family and friends, so this wasn’t a secret. I tried to concentrate on the conversation during the beginning of the evening, but spent my time either staring at Lacey’s big baby bump, or dreading the needle I’d be jabbing into myself for the 1st time. I was definitely jealous of Lacey at this point… however, perhaps more interested. Because, of course, I’d be pregnant in a few short weeks, so she could coach me along!
7:00pm hit and it was time. Trying my best to act non-chalant, I got the needle out and started the prep work. My heart at this point was pounding… I’m not a nurse, I don’t think I should be jabbing needles into anyone!
The biggest hurdle was that the needle was supposed to be going into my belly… except I have giant boobs, so I can’t exactly see my own belly! So to the mirror I went and counted to 3. 1…2…3… jab. Ok it hurt. A tad. But I think my mind made it worse than anything.
I gave myself my shot, took it out, then let my breath out. I was alive, I felt a tad weird, but probably from being all worked up. Because of my bleeding disorder, the little poke was bleeding, but I just kept pressure on it for a couple minutes so it didn’t soak through my shirt.
I did it. Only 5 more days to go until I head back to the clinic to find out how my follicles are growing!
The next couple days of needles went well. It was becoming easier each time. The clinic warned me about side effects (read: hormonal crazy woman), but thus far I was doing great. Dan, who is terrified of needles, was even stabbing me with a needle every now and then. Every night at 7:00pm, it became like a dance. I had my parts, Dan had his. He would get the needle ready and mark on the chart how much medicine I was giving myself, and how much was left in the cartridge. I jabbed myself, then on we went with our evening.
After 5 days I had my very first monitoring appointment. I walked into the clinic around 8am (so I could make it before work) and was ushered back to the ‘Glass Box’. The glass box was the internal waiting room for the women doing there monitoring. I sat down and waited until the lab tech called me across the hall to get my blood work. Not so bad.
Back into the glass box I went to wait for the next call. This time, another technician took me back into one of the ultrasound rooms. She told me to undress, gave me my sheet, and said she’d be back.
I hopped on the table, figured everything out, and lay there listening to the terrible music playing in the room. The tech entered, did the transvaginal ultrasound and made some polite conversation about the weather. What else are you supposed to talk about? “Hi there, how’s my uterus today?”…
Once she was done, she said nothing about my results, and said to get dressed then pop into one of the clinical rooms. There are 4 rooms, each labeled by a number. This is where they herd us to get our results.
I sat in the room, next to computer and waited for what was to happen next. A nurse came in first and opened up my chart on the computer. I had no idea how to read the chart with various numbers plugged in. She was kind enough to show me what they were looking at for each appointment. Two main things mattered: 1) The size and number of the follicles in my ovaries and 2) my estrogen level in my blood work. The clinic didn’t get my blood results back until around noon each day, so to start, we just looked at my follicles. I had several in and around 10 mm.
I was excited as one was at 11mm. I thought this was great as it proved that this was working, right? The nurse said she’d like to see more growth in 5 days, but went to get the RE. The docs rotate through monitoring appointments and each take a day.
The RE that came in I had not met yet. She wasn’t happy with the level of growth and increased my medication dosage by a couple of units. She felt this would help getting things started.
Off I went with a prescription for more medication. I started on 50 units and was jumping up to 57 units. I was going to be pregnant any day now!
I called Dan first as soon as I got in the car. I told him the scoop and he was just as happy as I. Next I called my sister Amy. Amy, being Amy, decided she was going to name this little follicle ‘squirt’. He was still small she said, but he was a keeper.
I had to laugh, perhaps this fertility business wasn’t all bad.
Cycle Day 7: My next monitoring appointment was 2 mornings later. I would be monitored every other day until my follicles reached around 18 or so. Then I’d have to monitored more closely. The drive to the clinic was about 40 minutes… Not the most fun thing to do each morning, but I was already on cycle day 7- only about 5 more days to go. Blood work- check. Transvaginal ultrasound- check.
After my tests, another RE came in to give me my results. The 11mm follicle had disappeared, and we had a couple around 10mm still. Not good… nothing was growing. I was worried about the disappearing ‘squirt’, but she explained that that follicle probably was not actually the ‘one’ that would take the lead and start growing, it was probably just a tad bigger than the rest. Feeling a bit more reassured, I asked if she was going to increase my medication again. She said that they always like to keep you on the same dose for 4 days, as sometimes it takes about that amount of time to see results.
The danger of increasing the dosage too quickly was that it could produce multiple follicles. Multiple follicles meant multiple eggs, which in turn, meant multiple children. In Canada, clinics are much more conservative so we don’t end up with any more octo-moms. At my clinic, the most follicles they would allow in one IUI cycle is 2. Any more, and they would cancel the cycle. In fact, they boast a 0% rate of triplets for the past several years.
Feeling frustrated, I called Dan with the news and continued on with my day.
Cycle Day 9: Blood work. Transvaginal ultrasound… Still nothing had happened! The RE said she’d call me when my bloodwork came back to decide how much to increase my medication. At noon, they called and said to increase my medication to 75 units of Puregon.
Cycle Day 11: Blood work. Transvaginal ultrasound. At this point, I’m basically supposed to be ready for a transfer. But I went back to the clinic hopeful that this new dose would mean a nice big follicle. I can never read the tech’s faces when they do the ultrasound… They won’t tell you a thing until you get into one of those clinical rooms. Secretly evil… I get into the room to find out, again, nothing has happened. All my follicles are around 10mm. No growth at all.
As I’m obviously looking quite upset, the RE tries to calm me down and says not to fret, some people just take longer than others. We will get it sorted out!
Cycle Day 13: Blood work. Transvaginal Ultrasound. Still nothing. But no medication increases… stupid 4 day rule!
Cycle Day 15: Blood Work. Transvaginal ultrasound. Still nothing…. Can this really be happening? This was supposed to be easy. PLUS, I’m not here because I have a fertility issue, I’m here because of my bleeding disorder. At least they increase the meds today!
Cycle Day 17: Blood work. Transvaginal ultrasound. Nothing. At all.
By now, my arms look like I’m a serious drug user from all the blood work, and my belly is a patchwork of black and blue bruises. Putting on pants is the most frustrating part of my day because I’m both bloated and the waist kills against my bruised stomach.
My RE is on today and asks the tech to re-do my ultrasound so he can take a look. After seeing my scans, he announces that he believes I have PCOS- Polycystic Ovarian Syndrome. More on this later, but basically, I have lots of follicles, but none will grow. He saw a bit of this in my initial scans, but the new scans together with my follicles that won’t grow meant for sure, PCOS. Again, he increases my meds. I’m now sitting around about 100 units a day. The more medication you take, the more emotional you are. Wonderful… Poor Daniel. In addition, I’m becoming very sensitive to the touch, my abdomen is killing and I’m having massive headaches from the meds. My body feels like I have the flu. Everything is aching.
Daniel, trying to stay positive, starts joking with me by listing all the body parts that don’t hurt. “Does your hair hurt?” “How about your finger nails?” …Yes Dan, I guess it could be worse! 🙂
On we go.
By now, it’s incredible how fertility takes over your life. My days would be something like this:
Wake up extra early, head to the clinic for your blood work and transvaginal ultrasound. Get ultrasound results from clinic then head to work. My results would suck so I’d need to stop crying by the time I’d hit a certain spot on the road so my face wouldn’t be too blotchy when I showed up at work.
Around noon, you would get a call from the nurse at the clinic reporting my blood work. Again, bad news. I’d close my office door, call Dan to report the latest numbers. Crying wasn’t an option in my office so I’d try to keep it together. Then back to work.
I would be so upset from the lack of growth, that I would spend hours sulking around and faking smiley around my colleagues. Faking happy was taking as much energy as jabbing myself with needles each night! After work, I’d get home and watch the clock tick until it hits 7:00pm, then give myself the medicine.
I’d be really down, and by this point, the hormones were kicking my butt. I was so weepy that watching an episode of Grey’s Anatomy would be enough to make me bawl for hours. Dan, being the most amazing guy, wouldn’t bat an eye and console me and continue with his never ending positive words. Some days I just wanted to hit him- how could be always be SO positive!?
Day After Clinic Day:
Ok time to make myself get out of this slump. They increased my medication, so this is going to work now. So what it’s taking longer than they thought… good things come to those who wait, right? I’d spend most of the day talking myself into good and positive thoughts. This was going to work! Think big picture- the end result would be more than worth this!
Clinic Day again…:
Blood work. Transvaginal ultrasound. Head back to the clinic for more bad news. The roller coaster of emotion was to start again.
Cycle Days 19-29: Blood work. Transvaginal ultrasound. Nothing changes. No growth. Now the RE’s are concerned. I’m on high dosages of medication (similar to those who are double my age) and it still isn’t working.
The RE’s at the clinic actually have a meeting about me to try and figure out ideas- they just don’t know how to explain what is going on. They come up with another idea, they are going to add in a second medication to try and get things going. It’s now mid-March, and I’m a emotional nightmare. Another needle, sure I can do that. More hormones, wonderful.
Now on about 150 units of Puregon and a microdose of HcG. Two needles a night now at 7pm and heading into the clinic every other day is certainly taking it’s toll!
Cycle Days 31-37: I still have not one follicle over 11mm. Really? What is wrong with me? Even the docs don’t know how to explain this! If I make it to cycle day number 39, then it’s officially a new record for the clinic- longest cycle ever. Wonderful… I’m breaking records for having useless ovaries.
Dan came into the last appointment with me so we could discuss options with the RE. The RE is now suggesting that we just cancel this cycle and try again after I take a break. Most people don’t make it to Cycle Day 20 because of the time, money, and hormones. Did I need a break? Hell yes, but wasn’t cancelling the cycle giving up? We decided we’d give it 2 more days, then, if there was nothing still, we’d call it quits.
Cycle Day 39: Blood work. Transvaginal ultrasound. It’s like us threatening to give up gave my ovaries a kick in the pants. We finally had growth!!!!! I have one follicle at 16mm- it was growing and my blood work was rising as it should be. I’m beyond ecstatic. I call Dan, my parents, my sister, my sister-in-law, and Janica- my best friend. I’m practically crying (happy tears this time!) just trying to share the news- we have a good and growing follicle! Amy is sure that this is ‘Squirt’ rejoining the game so it looks like this follie has a name!
As the cycle days continue, I’m going into the clinic each day now for monitoring appointments. By Cycle Day 45 we are ready to go! We actually have one follicle at 19mm, and another following behind at 16mm. The clinic is nervous if we wait much longer, I may grow more and we may need to cancel the cycle due to too many follicles. It’s time- I get instructions on how to give myself the needle to make me ovulate. April 4th is going to be our IUI!!!!!
April 4th: Here we go- it’s a gorgeous day out and I’m joking with Dan that today seems to be a great day to get pregnant. Lord knows I’ve now been through hell for a month and a half straight (and Dan has put up with me for that many).
The first step is for Dan to produce a sperm sample in the morning, and make our quick drive to the clinic to make it within the 30 minute window. Dan had to explain to his work what was going on so he could get the day off with little notice. Off we drove, again, with our sperm sample under my armpit for warmth.
We dropped it off at the clinic as they needed to do a ‘sperm wash’. Insert joke here… trust me, I think we’ve thought of them all! No, he doesn’t have dirty sperm (well at least so the docs say!). Basically, they separate the seminal fluids from the sperm. We just want the swimmers.
Dan and I head out for breakfast while the lab does their thing. We found a great breakfast place and enjoyed a relaxing morning together. Target had just opened in Canada so we decided to take a peak. We walked by the baby aisles and I was secretly dreaming about the boy or girl that was about to be. I actually stopped at the newborn clothes… Dan grabbed my arm and said perhaps we should wait on that type of shopping. :S
11am- We went back to the clinic and waited to be called. We were placed in a clinical room and I got undressed from the waist down and on the table. The RE entered and gave us the results of the sperm sample. The numbers were fantastic as was the quality. Dan and I actually gave each other high fives- awesome sperm! We had to sign off on the paper work that the sample was ours, and then sign off consent for the procedure.
The RE put a catheter up into my uterus- not so bad, just a bit of a pinch. Then, the doc pushed the vial of sperm through the catheter into the top of my uterus. I even made an IUI playlist on Dan’s iPhone so the swimmers had good beats to swim to (Dallas Green, Taylor Swift, and Carly Rae Jepson!). It was over in less than 5 minutes. She told me to relax for a couple minutes, then head home and spend the day there resting.
Five minutes later, I was off into the car. I laid in the back seat of the car with my knees up hoping that gravity wouldn’t work against us. This day took me 45 days to get to- not 11 to 13 like they estimated- and damn it, it was going to work. I spent the rest of the day at home on the couch with my feet straight in the air. I was actually nervous to pee… illogical I realize, but what if we lost them all!
Now the next big dilemma- when could I consider myself pregnant? The egg had to have met the sperm by now. Look out, I was almost ready to park in the expectant mother’s parking spot!
Every couple has a different scenario of events that led them to a fertility clinic, here are ours.
Dan and I have always known we wanted a family. I remember going in to see the Minister prior to being married and him asking us our thoughts on raising a family. We both smiled and talked about our dreams of having a nice house with some land, and of course, a couple of kids running around. However, we also weren’t naive. We knew because of various chronic medical issues that I have, it may not be as easy for us as some. We told the Minister that we knew it may be a tumultuous go- but it was worth it for us. We had even talked about back up plans. I will never forget the Reverend’s face when we told him if we can’t conceive then we are both open to adoption. Not that adoption was odd, but he was so happy to hear that we had already thought about the future and that it may not always go as planned. Perhaps we were odd, telling him about our hopes and dreams… and then explaining our plan B. But that’s us.
For those that know me, this will not come as a shock. I’m a type ‘a’ personality who feels most accomplished when the To Do list I created gets one more item crossed off the list. I just can’t help it! My mantra- Hope for the best, plan for the worst.
Dan and I married fairly young- Dan 26 and myself 23. We had time on our side and were not in a huge rush to have a baby. We, of course, had a list to accomplish before we hit that next stage- a home, stable jobs (with benefits!), and a comfortable financial situation.
In early 2012 I was awarded my dream job. It helped us meet all of the above criteria so we started planning. Unlike most couples, we had a couple of hurdles to jump through first. Each of these appointments had the potential to change everything. My fear was that one of my medical conditions would prevent us from even trying to get pregnant. This was the hurdle we expected. Little did we know these would be the least of our problems.
Stop 1: Anti-depressants?
I was diagnosed with chronic depression shortly after my 19th birthday. The long and the short of it is after trialing many medications with various specialists, I found a medication that works for me- on it I feel great and, quite frankly, most people have no idea as I no longer have any symptoms. The more complicated part, however, is that continuing on these medications during pregnancy came with it’s own risks.
As such, I was referred to a clinic that specialized in women’s issues. After careful review of my history and medications, the clinic gave me the medical answer we were waiting for. The best case scenario would be that I could lower, or even go off, these meds during the pregnancy. However, due to the high dose that I require and the personal risks to my health if I was to follow the above treatment, it was not recommended. Essentially, the clinic gave me the best and worst case scenarios of health risks to me, and to our baby. The percentage increase for potential birth issues/defects if I continued the medication was very small. The other good news story is that the medication that I’m on is the one that they suggest if you intend to keep taking it through pregnancy. After careful consideration and understanding the specific risks, Dan and I decided that we felt comfortable going ahead and trying to conceive.
Stop 2: Excessive Bleeding?
The next stop on the doctor’s office tour was to my Hematologist. I have a bleeding disorder that makes simple things a tad more complicated sometimes. Pregnancy would need to be a planned event and that included a detailed birth plan from the hematology team. After lots of blood work and a couple appointments we got good news. My specialist explained that the majority of people with bleeding disorders do not have a higher risk of miscarriage. However, there are risks of bleeding during conception (during the implantation stage), if the pregnancy were to be spontaneously aborted (miscarriage), and of course, during birth. The good news is that women with bleeding disorders give birth all the time, and just need extra care and attention. The drug that reacts well with my platelets can be given to me as I go into labour, and while it does cross the placenta, there have been no long term effects noted to the baby. There is a decent chance that the baby would have the same disorder as me, however, a pediatrician would follow the infant until it’s status was determined.
The first part I was ok with- I understood the risks and had a great team of specialists behind me. However, the chance of passing along this same disorder to my children required more thought. Ultimately, we looked at how minimally this disorder impacts my life on a day-to-day basis. Additionally, the fact that the baby would be assessed right after birth and followed meant that we would know the diagnosis and could manage it if needed. After all, I’m pretty much a pro at this now.
Again, after absorbing the above information and plenty of discussion, Dan and I decided that we were ok continuing with the risks presented to us. At this point, I started to get excited. Up until now, I was cautiously optimistic. After the good news we got- times two- things were coming together. We can do this!
Stop 3: Where do we start?
Next stop, my ob-gyn. Because of my bleeding disorder, I have had a very hard time stopping my periods. In fact, after our wedding, I menstruated for over a year straight. Yes, a year. After various attempts, coordination with my hemo team, and a whole mis-mash of medicine, my ob-gyn was able to get everything under control. The scary part was that if we were going to try to conceive, that would mean I’d have to come off all of the mix of birth control that had been controlling my bleeding.
After the consult, she suggested that we be referred to a fertility clinic in the area so that we could coordinate the coming off the medication with (hopefully!) a successful pregnancy… and ta-da, no bleeding in between. She set up the referral and we waited for the appointment.
It took 6 months of poking and prodding and lots of doctors’ appointments, but we made it… we jumped through every medical hoop given to us, and it was really happening! Let’s make a baby!
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All Cleared- Let’s have a baby!
Well, not quite. Not yet anyway.
We were referred to the fertility clinic in area and secured an appointment within a couple of months. Our first appointment we met with our Reproductive Endocrinologist (RE) which is a fancy name for our fertility doctor. He is a well-known doctor in the area of fertility and is involved in many provincial, national, and international committees/studies.
We arrived at the clinic and were sitting in a nice waiting room with coffee and a daytime television shows played in the background. It was amazing for me to sit in a room filled with people, and every single one of them seemed to be absolutely intrigued by their shoes. No one looked up. No one smiled. This was a serious place.
We got out initial questionnaire that we had to fill out. It started pretty solid with our basic info and some medical background. As the questionnaire continued the more invasive the questions got: How long have you been trying to conceive? How many times do you have intercourse a week? Do you use any lubricants? Reason for using lubricants? What type of lubricants do you use? When was your last menstrual cycle? How long was it? How would you rate your bleeding? … And the questions continued for multiple pages.
I guess going to a fertility clinic involves sex. I get that… just thought they might ease you into it. I tried to mask my shock/embarrassment while sitting in a relatively full waiting room and continued to fill out the questionnaire.
A nurse called us into a room and we went over our answers. We were not a typical couple coming to a fertility clinic. In fact, Dan and I had never actually tried to get pregnant! So this review of our answers was quite brief. Though we did learn some random facts: the only lubricants to use while trying to conceive are some name brand that’s made special so it doesn’t act as a spermicide and canola oil. Yes, I’m serious, canola oil. Though I don’t remember everything from that appointment as we were on information overload, I do remember that tidbit. We laughed so hard on our way home imagining have a large kitchen bottle of canola oil in the bedroom. We even debated making this a staple in our gift repertoire to couples who told us they’re were trying to conceive… Perhaps the biggest mystery to me is who the heck thinks this stuff up to test if it works? Ha
The nurse left us and we then had our first visit with our RE. We immediately quite liked him, plus his British accent was entertaining to listen to. He went over our history and felt we were in the right place. He was very optimistic and felt with minimal intervention we would have great chances of getting pregnant. He explained the process moving forward and we were sent on our way with a list of follow-up tests to book to ensure everything was A-ok.
We both went to the blood lab and had practically everything you had ever heard of tested: Blood types, vitamins, STDs, HIV, Cystic Fibrosis, Hep A/B/C, hemoglobin, German measles, iron, even blood disorders like sickle cell etc. I went in feeling pretty darn confident, however, weirdly enough, when I saw the list that they were testing for I got nervous. What if I had one of these disorders? What would that mean for us trying to conceive? I already have enough risks, can I just pass one of these tests with a solid A+?
We had an appointment booked for about 1.5 months after our initial assessment. This was to our ‘results’ appointment. This was going to be our big day of info. We thought, and the RE thought, we should be pretty standard with the minor complication of a bleeding disorder. These tests would (hopefully!) confirm that.
The next test for me was called a sonohysterogram. Sonohysterography is a technique in which fluid is injected through the cervix into the uterus, and ultrasound is used to make images of the uterine cavity. The fluid shows more detail of the uterus then when ultrasound is used alone. This procedure can find the underlying causes of many disorders such as abnormal uterine bleeding, infertility, and repeated miscarriages. There’s the fancy explanation.
Basically, they shove a catheter into your uterus and squirt saline into your fallopian tubes- it hurts. Not terribly, but not enough to make you squirm and cramp up for the rest of the day. The theory is that this is a way to ensure that both tubes are open. The RE actually comes in and performs this one. The nice part about this test was that as the saline pushed through my tubes, he declared they were both open and clear. Instant results- my type of test.
After the sonohysterogram, they did some baseline ultrasounds. This was my introduction to a transvaginal ultrasound (sometimes called an internal ultrasound). For those of you who have had the pleasure of one of these, you know exactly what I’m talking about. For those who haven’t, let me explain… This test is used for multiple reasons throughout your cycle, but mostly for measuring your endometrium (uterine lining) and looking closely at your ovaries (and the good stuff inside them- follicles!). Basically you sit on the table naked from the waist down with your feet in the stirrups (think pap smear) with a sheet draped over your legs. Next the ultrasound tech gets the ultrasound device ready. The actual machine is a cylinder probe with a round head on the top- basically a thin white dildo with a ball on the top. They prep the top with lube then put a disposable glove over the top. Honestly, actually a glove- they put the probe in one of the fingers of it! Then they lube up the outside of it. Cue the standard phrase “ok, you’re going to feel something cold” and in it goes. The tech then manipulates the screen and starts taking the pics needed. They ask you to push down on your belly here and there to get better views and they push and tilt the probe inside of you. You’d swear that some techs take out their day’s frustrations jabbing inside of you while you lie there helpless, others aren’t too bad and actually start up a conversation about the weather or something to get you through it. The whole thing takes anywhere from about 1-5 minutes total. Nonetheless, a very long 1-5 minutes with a random person’s hand under the sheet somewhere controlling that thing.
The next test was a sperm analysis. They hand you the paper bag with the specimen cup in it and have the option of using one of their ‘specimen rooms’ or heading home then coming back. To date, I’m still curious to see the inside of one of these rooms- maybe I’m weird, but come on, who doesn’t want to see what ‘assistance’ a fertility clinic provides! Needless to say, Dan chose the go home option.
You have to book a specific time that you hand it over to the lab. We were lucky as it turned out as we live just within the ‘do it at home’ boundaries. You have to be able to get the specimen to the lab in 30 minutes. So myself, enjoying that Dan is having to get tested for something, marked a big star on the calendar and shared the special day with our friends. Dan’s good friend even put it in his iPhone calendar to ensure to text him some encouragement that day.
D-day arrived and Dan hands me the brown paper bag as I would be the official courier. We were told to label it before bringing it in. Dan writes his name in big black marker on the paper bag. Laughing, I suggested that they probably meant the specimen jar. We couldn’t find another paper bag, and with the clock ticking the 30 minutes down, we gave up and I rushed to the car to transport our double-labeled precious cargo.
Another important tidbit- you have to keep the sperm at body temperature until it arrives at the lab. So here I am driving through Hamilton traffic to the clinic with a bottle of sperm in my arm pit. I’m on the clock as it ticks my 30 minutes down, I can’t speed for fear of having to explain my specimen container in my armpit to an officer and thus missing my time window and having to book again. I was actually playing out the conversation in my head of what I would say to the cop if he pulled me over… Although I was apparently well prepared for the chat, I didn’t need it as I made it just in time and passed along my specimen to the lab. It turned out to be fairly uneventful. Seeing as they apparently do this 100 times a day and the lab tech didn’t seem to notice my best efforts to hide my blushing cheeks and act entirely non-chalant about this whole matter.
The next step was to wait. This theme of ‘hurry up and wait’ was just beginning… and pretty much sums up the rest of 2012-2013. Four weeks later, and another star marked our calendar, we headed back to the clinic with knots in our stomachs to find out how the Doc felt we should proceed. By this time, we’re almost at nine months since we began this journey… The irony of the timing did not escape me.
After our RE reviewed all of our test results he indicated that everything came back good. He went over my blood tests, sonohysterogram, and ultrasounds one by one. My blood work was great- minus my bleeding disorder however this was hardly news. My fallopian tubes were open and clear. My uterus was slightly tilted but it good shape with no signs of fibroids or other issues. The only slight finding what that my ovaries appeared to be slightly poly cystic- meaning a lot of small follicles. However, he did not appear to be troubled by this finding, so I guess we weren’t either. Next up was the sperm analysis results- the last piece to the puzzle. I can’t recall the specific data however basically everything was amazing quality and very high numbers- Dan sat up very straight slightly puffing his chest out for this test result. Yes Daniel, you are truly a man. *Cue rolling my eyes here.
All in all, great news! Our RE had come up with a plan of action for us. We would be trying something called ‘Inter-uterine Insemination’ (IUI). On the scale of low tech to high tech of fertility treatments, we were being placed somewhere right in the middle. We decided not to try non-medicated options or timed intercourse as we drastically improved our chances of conceive by going ahead this way.
A normal couple would then wait for your next cycle to start- the day you get your period being day 1- however, due to the massive amounts of birth control medications being given to me to stop me from bleeding, we just started a random day.
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Timing is everything
I remember deciding when to start this cycle was a big decision. Dan, also known as Mr. Patient, was worried about the timing. The big news in our lives at this point in time was that we were well on our way to opening our own franchise of Pita Pit. We were negotiating the final aspects of the lease and were working through our franchise agreement. We were doing this on our own so the nerves and stresses of opening our first business, paying for it, and ensuring we were making the right decisions were taking their toll.
Additionally, we were living in a small 1.5 storey, 900 sq ft home on Hamilton mountain that Dan had completely renovated the year we got married. It was really cute and had an amazingly big backyard for our dogs, however, it seriously lacked in space. While it had 2 bedrooms, we didn’t have a garage and the basement was only ¾ height and used solely for storage. Somehow the two of us had accumulated so much stuff that we were essentially out of room. The thought of adding baby gear to our home was overwhelming at best, so I started my mission to talk Dan into moving somewhere a tad bigger.
Oh, also, we owned two other duplexes that each had two sets of tenants. On the busyness scale, we were ranking pretty high and needed to figure out our priorities. Four separate sets of tenants and three homes to maintain were keeping us busy- forget about our full time jobs and Pita Pit happening in the background. We had to make a decision, and the rentals were it. Our real estate agent was happy to hear our decision, and within weeks, we had both rentals up for sale.
(Both houses sold quickly. We had a couple minor hiccups with home inspection bs, tenants claiming that the other agents were stealing his jewelry (…enter the police), and such, but both houses were gone and we had a whole lot less to worry about by May 2013.)
Anyways… yes, back to the point, timing was important. There was, of course, the most important timing: when would be the due date? In retrospect, this is actually humorous that this is what we were planning our lives around, but who wants a birthday at Christmas? No one! Did we really want to start in February with the potential to have a child at the end of November into December? After much discussion, and my lack of patience, we decided to go ahead! This was it, no more waiting, we were getting pregnant! In the middle of February 2013 we started our medicated IUI cycle.
Until I actually get this up to today’s current date, I’ll be posting in ‘Our Story’.
I have quite a bit of writing to go until I get caught up… including us doing a round of Inter-uterine Insemination, Invitro Fertilization, and 2 rounds of Frozen Embryo Tranfers.
Then I’ll start writing here. Thanks for your patience!