Let’s have a baby!

It’s Time!

Every couple has a different scenario of events that led them to a fertility clinic, here are ours.

2010

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.

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July 3, 2010

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.

2012

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.[1]  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.

internal-ultrasound

Transvaginal Ultrasound Machine

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

Clock

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.

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Our home on East 24th St.

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.


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