An Update

Being that it is Pregnancy and Infant Loss Remembrance Day, and it’s been almost a year since I last posted, I thought I’d give an update on our infertility journey. Spoiler alert: I’m not pregnant. But I have been pregnant since my last post.

The last update I made was last November, before our second IUI with trigger. The IUI did not result in pregnancy. But as a quick side note: HCG triggers are painless.

After our second IUI did not work, my husband and I decided it was time for a break. A break from the emotional toll of wanting a child with every fiber of our beings and seeing those negative tests month after month. We’d invested a lot of time and money into our rainbow baby and our efforts were in vain.

So we stopped the fertility meds. I stopped temping and testing and worrying and it took some time to heal, but life was honestly and genuinely good for the first time in a long time.

I took a step back and realized that I had married the man of my dreams. This re-realization made me breathless and I enjoyed months of feeling dizzily in love with him and with life.

Then one day in late February, I stopped and realized that I felt pregnant. I was dizzy and nauseous and bloated. So I took a test. Negative. Then, some corner of my brain screamed at me to take an ovulation test and I listened.

Positive.

Without meds, I had ovulated on my own. I was happy, and my husband and I did make sure to cover our bases, but I honestly didn’t think it would result in anything.

At this point, I suspected a progesterone deficiency even though we’d already tested for this and “eliminated” it as a possibility. I briefly considered refilling my prescription of progesterone suppositories for the TWW (I had used these after my last IUI), but I didn’t. I didn’t because I was on a break from it all. And I didn’t want to stress myself out over nothing.

Two weeks later and, miracle of miracles, I’m pregnant.

My first beta at 12dpo showed a blood HCG of 2, my second at 14dpo jumped up to 6 (at which point my doctor refused to believe I was pregnant), then it shot up into the hundreds almost overnight. I watched my digital tests go from “Pregnant 1-2” to “Pregnant 2-3” and I thought, “Maybe this is it. Isn’t this what they said would happen? As soon as I stop trying… that’s when I’ll get my miracle.”

Except that I was bleeding. Heavily. Throughout the entire first week and into the second, when my levels fell to 54 and then to 13 and I said goodbye to my third angel baby.

My husband was on a choir trip the entire week that I miscarried and I am not exaggerating when I say it was the hardest week of my life. I was on Spring Break and therefore not working, so I sat home in physical, emotional, and spiritual pain for 7 days and wept bitterly over my empty womb and my broken heart. I cursed God, I didn’t eat, I wanted to die. Later, I was diagnosed with post-partum depression and prescribed antidepressants. At the time, I didn’t realize how far gone I was, wrapped in the grief of another loss and blaming myself for not getting progesterone when it had first crossed my mind, because surely if I had gotten the prescription filled, I would still be pregnant.

I reached my lowest of lows and realized then that I was done.

Being “done” lasted 5 months–5 hard months of soul-searching and brokenness and, somewhere in the middle of it all, healing. It wasn’t until August that I walked back into my RE’s office and sat down with him and my husband to make a plan.

In September (last month), I started back on Femara. And today, somehow, I have finally found the courage to put this story up on my blog.

My pregnancy in March was the farthest along of all my losses. According to my doctor, I was almost 6 weeks. I was so close to hearing a heartbeat. So close to seeing my baby growing on the ultrasound. I will only know my child through those few weeks I had with him or her, feeling a presence inside of my womb and loving it–loving it more than I thought I had the capacity to love a thing I’d never seen.

As of right now, I am on my second month of Femara (this time around). Counting last year, I believe this is my 7th round… maybe 8th. I’ve lost track.

I am currently 2 or 3 dpo. I don’t know for sure because I’m not temping anymore. This time around, I am not going to let this consume me. I am, however, taking progesterone suppositories. Because my last miscarriage did prove that I have a progesterone deficiency.

I have plenty of stories from my “in-between” time, as I now call it, and I will post them as the time is right. They are stories of strength bestowed by friends and strangers who were there for me, who let me borrow their courage and surprised me with their wisdom. They are also stories of hurt and of ignorance, of people that hurt me deeply by not even trying to understand.

In the journey of infertility, there will always be both. Good and bad. Light and darkness.

I know that infertility is a fight that is difficult to understand if you haven’t been through it. And that is no one’s fault. But please, on behalf of not only the grieving parents but also the children who are lost, please be kind. The world needs more kindness.

Tonight, I light a candle for my three angel babies. And I pray for the happy day when I take a healthy baby home.

Why I Love My RE

I walked into my reproductive endocrinologist’s (RE) office on Tuesday resigned to inform him that I was going to take a break. I hadn’t yet determined the length, but I had determined that I was done trying for the immediate future. I was going to apologize, thank him, and say something of a goodbye.

When he walked into the exam room, he must’ve seen it in my face. I’m sure the nurse had passed on the little bit I’d divulged of my reason for coming in (“The Femara stopped working”) and so he sat down, empathy written into every line on his face, and said, “Let’s bump up your dose.”

Perhaps some would have been put off by his forwardness. He didn’t ask. He didn’t suggest. He gave me my next step and rolled over to the computer to input the prescription. And it was perfect. All I needed was for someone to tell me it was okay to keep going, and as soon as he gave me that permission, I was ready. We’ve been working with him since April and, although I’m sure he has countless patients, he has this astounding way of reading us like a book at every appointment.

We talked for the next half hour and came up with a plan that gave me back my hope (which, if you’re on this journey with me, you know that hope is such a precious and rare commodity–it’s so easy to lose yet so necessary to keep trying).

I’m on progesterone now to kickstart my period. When my period starts, I’ll call in to schedule an ultrasound for cd13. I’ll take 7.5mg of Femara on cd3-7 and we will trigger when the time comes, with an IUI approx. 36 hours later. I’ve never done a trigger shot and so I’m both nervous and excited, and underneath all of that is a surety that this is the month. I’ve had that surety before and I’ve been disappointed before, but I’m letting the surety stew because it makes me happy and hopeful and if in the end this all crashes and burns then so be it. I can take it (I think).

I hope you have an RE who knows you and knows what is best for your situation. If you don’t, my advice is to find a new one. There aren’t a shortage of RE’s in the world. Perhaps you have limited options due to your insurance plan, but it’s worth pursuing every option. A good RE could be the difference between your take-home baby (THB) and an empty womb because a good RE knows you and your unique circumstance well enough to make the best judgment call on treatment.

P.S. If you’ve done an HCG trigger before, please ease my worries. Tell me it isn’t painful and tell me it didn’t give you crazy side effects like constant nausea or an eleventh toe. (Kidding about the eleventh toe… sort of.)

P.P.S. My RE told me that the liver is the only organ other than the brain that can learn, which is why Clomid and Femara can “stop working” at certain doses. The liver learns to filter out the medication. When you bump up the dose, you add just enough to shock the body into responding, buying yourself more time before the liver learns to filter out the added medication.

Make Believe

I think of pregnancy like I do of unicorns. I imagine it in precise detail, from the tiny stirrings of life to the waves of nausea, my skin stretching taut around the tiny fingers and hands and arms and legs, the second heartbeat fluttering like dragonfly wings… but I don’t believe it will ever happen. Pregnancy, like the unicorn, exists in a faraway fantasyland. In Neverland. Oz.

I have dreamt of the day I give birth. I dream of that day in numbers. 7 lbs 3 oz. 8 lbs 4 oz. 22 inches. 19 inches. 3:39 PM. 2:48 AM. But the numbers melt to zeros when I wake up empty and aching. And I realize that giving birth is as much a mystery as London or Milan or Sydney, which exist, presumably, on this earth, but which I have never known. There are lives that I’ll never know. Perhaps I will never know birth, either.

As a girl, I played make believe. I played with dolls. I rocked them and fed them and believed wholeheartedly that I was their mother. Now, as a woman, playing make believe feels a lot like grieving. The exhilaration of possibility is gone. Playing make believe isn’t about what could be, anymore, but what isn’t.

Our Secret’s Out

Fourteen months ago, my husband and I made the life-changing decision to begin trying to conceive. With tears in our eyes and hope in our hearts, we said goodbye to the daily pills and the neatly-packaged condoms. What we thought would be a quick journey has led us here–grieving, scared, childless.

I’m going to give you a brief overview of our infertility journey thus far. I don’t share it to “brag” about our burden. My intent is not to compare heartache but rather to explain where we’ve been and where we are in the hope that one (or two, or more) of you will relate, and that you will find a place to feel less alone. I want you to feel less alone because I want me to feel less alone, so let’s feel less alone together.

We began our journey in September 2014. I stopped birth control and we began trying to conceive in a very laid-back manner. No testing, no temping, no nothing other than sex–and lots of it. We were bright-eyed. We had hope.

Fast-forward six months. March 2014. At this point, after several long cycles (40-ish days), I decided to start using ovulation predictor kits (OPKs) and taking my temperature with a basal body temperature (BBT) thermometer every morning. I discovered that I was, in fact, ovulating… BUT not until around cd25-ish. So I made an appointment with my doctor. I didn’t expect it to lead me down the road of infertility, but after a comprehensive blood test and an ultrasound, I was given a diagnosis that felt like a death sentence and an a-ha moment all at once: PCOS.

Let’s rewind a bit.

All throughout my teens I had irregular periods. My doctors reassured me that this was normal, and that my cycles would regulate on their own. Well. They never did. I was put on birth control at age 21 after skipping a period entirely and that worked to regulate my cycles for the 2 years I continued to take the pills. I expected my periods to stay regular after stopping the pill. Well, you know how that story plays out.

I received the diagnosis over the phone as I was running to class and so I had no time to sit with the news. For the next hour and a half, I half-listened to a lecture about Edgar Allen Poe while I felt the news sink into my skin and my bones and as I held back tears in a room full of people who had no idea how my life had just changed.

I had always been told that I “couldn’t have PCOS” because I was skinny. Because I didn’t have bad acne or excess hair or any of the other “telltale” signs (Poe pun intended). But what I didn’t know–and my previous doctors hadn’t researched–was that PCOS comes in various forms. I have what people often call “skinny PCOS” and while it is a milder form, it has still very much impacted my fertility.

The months following my diagnosis, my body stopped ovulating. It was as if it had received permission to take a vacation. “Well, now you know that these ovaries kind of suck… so let’s just shut those down for a bit.” Thanks, body. Around this time, though, we ordered a sperm analysis (SA) for my husband and the results came back perfectly normal. So that was reassuring. I was “broken” but my husband was perfectly fertile (which, of course, led to me blaming myself for not being able to give him children–but that’s another blog for another day).

I was referred to a fertility specialist… who was male. I knew he was male going in to our first appointment and I was not happy about it. I wanted a female doctor because I knew the inevitability of things becoming very personal. This turned out to be an unnecessary worry, because my doctor ended up being the best doctor for me. More on that later (probably in another blog, since this one is already quite long).

My new doctor/fertility specialist put me on Femara. 2.5mg. And I still didn’t ovulate. At this point, I was beginning to miss my long cycles, because at least I had been ovulating. But my new doctor was not worried. He bumped me up to 5mg and I ovulated. For the first time in months, I ovulated! On cd16, too! And, eleven days later, I saw two lines on a pregnancy test for the first time. (At this point, we’re at the end of June 2015, our 9th month TTC.)

I cried. I bought a little baby nighty to give to my husband to share the good news. I called my mom. I went in for an HCG quantitative test.

Then I heard back from my doctor. “Your HCG is at 5. This can happen in early pregnancy, but we have to run another test in two days to see if the HCG is doubling properly.”

At that point, I knew. I knew it was over. Even with the hope that a missed period brings, even after seeing Pregnant on a digital pregnancy test, I knew. I basked in the glow of pregnancy for six short days and when my second HCG test came back at only 8, I waited for the bleeding, which started the very next day. As much as it hurt–and oh boy, did it hurt–to see the physical sign of my pregnancy ending, it also felt like a huge weight had been removed. The pregnancy wasn’t viable and there was nothing I could do to fix it and at least my body could do this thing right–it could recognize a problem and fix it quickly.

For the next month, I wavered between absolute grief and a renewed sense of hope. At least I could get pregnant! It could happen! But… why me? Why, after struggling to conceive for 9 months, did I have to lose my baby? (9 months feels like so little time now!)

Fast forward to the end of the month, which brings two more pink lines. And a late period. And then, more bleeding. Chemical pregnancy #2.

Since then, we’ve continued taking one step forward and two steps back. I had my progesterone tested as the possible culprit of our recurrent chemical pregnancies, and that came back normal. I’ve stayed on the Femara and have been ovulating regularly, but later and later every month. We even tried our first intrauterine insemination (IUI) last month (which made me so hopeful)… but that ended with an all-too-familiar BFN (several of them actually, since I like to pee on every stick I own until I’m out).

As I write this blog, I am on cd22 of our 14th month TTC, and I have yet to ovulate. Not even a positive OPK. We’ve likely reached the point where the Femara is no longer working, which means we’ll either try bumping up my dose to 7.5mg or we’ll move on to the next thing or we’ll take a break.

At this point, I am physically and emotionally exhausted. I find myself getting so angry at pregnant women. I find that sex with my husband feels like a chore. And my ovaries… they hurt. They feel abused.

Maybe a break is what I need.

But I want a baby so badly that I’m afraid to stop trying. I don’t know if I can.

I don’t know anything anymore.

Which is why I started this blog. It’s as much for me as it is for you. I hope we can learn to cope with the grief that is infertility together. Because it’s too much to bear on our own.

Thanks for joining me on this journey.