Wednesday, April 12, 2017

My PCOS Infertility Resume

Anytime infertility comes up in conversation, it can often turn to questions of "what have you done, what have you tried, and what has worked?" As someone who spent hours upon hours googling "how to get pregnant with PCOS," I scoured blogs, medical journals, and websites devoted to fertility in hopes to discover my cure. And while of course it isn't that straight forward, I do think that more examples out there, the better. So here is my resume of exact treatments and medications that we went through from the first cycle until our miracle cycle.

Started out by getting treated at my OBGN.

Round #1 - January 2016
50mg Clomid and timed (scheduled) intercourse
Result: Took a blood test which confirmed that I did not ovulate. No pregnancy.

Round #2 - March 2016
100mg Clomid and timed intercourse
Result: Took a blood test which confirmed that I did not ovulate. I did go to the ER during this cycle due to intense ovary pressure. The ultrasound confirmed I had a few follicles maturing. So my body did respond to the Clomid somewhat, but not enough to ovulate. No pregnancy.

We then transferred to a Reproductive Endocrinologist (AKA a Fertility Clinic). Before beginning treatment

Round #3 - July 2016
Femara (forgot dosage, but it's an oral medication similar to Clomid) and Ovidrel (a trigger shot to induce ovulation). Intrauterine Insemination (IUI) and timed intercourse. Also needed estradiol to thicken my uterine lining. Took progesterone after the IUI until my pregnancy test.
Result: A follicle did develop to maturity, but no pregnancy.

Round #4 - August 2016
Femara (a doubled dose from last time), Follistim injections to assist in follicle maturation, and Ovidrel. Needed estradiol again, and also took progesterone per protocol. IUI and timed intercourse.
Result: At first, a bunch of follicles started to grow with no sign of one or two leading the pack, concerning my Dr that we would have to cancel the cycle. Had to start the Femara and Follistim regimen all over, which resulted in one mature follicle before we did Ovidrel. No pregnancy.

Round #5 - September-October 2016
Femara, Follistim injections, one Menopur injection (a fluke because I needed one more Follistim shot but both the clinic and I were out, and the only comparable injection they had was Menopur), and Ovidrel. IUI and timed intercourse. Followed progesterone protocol.
Result: Two mature follicles and a singleton pregnancy! This cycle was slow and steady, so it was a long cycle of slowly increasing my daily dose of Follistim. I was at the clinic for ultrasounds and blood draws every day to every other day for 3 weeks straight! But well worth it for our little miracle.

Please feel free to ask any questions! I am not a medical professional by any means but have done a decent amount of research on fertility and PCOS. Also please share your own success stories down below. My hope is that my experience can be one of many for women to reference when delving into the infertility world.

Love and Blessings,

Annmarie

Thursday, March 2, 2017

Pregnancy After Infertility

I never thought I'd write this post. Firstly, because I never thought that I'd become pregnant. And secondly, because I didn't realise how different a pregnancy after infertility is than a typical pregnancy.

While on our final round of fertility treatment, Brad and I had both resigned to the fact that we would not have biological children. Brad has later told me that he was already prepared to "do damage control" after this cycle failed (cue the water works). I had a big pile of paperwork that a caseworker had sent us to start the foster-to-adopt process. I had even started a foster care registry to prep for a foster baby, as I knew how fast that process could go once it started.

Little did I know that God had other plans and that this final round would work.

The morning that I decided to test, I was so sure that it would be negative. I didn't tell Brad that I was testing. I took the test, set it on the bathroom counter, and went back to bed instead of waiting for the results. That's how positive I was that it would be another negative.

When I woke up about an hour later, I glanced at the test. I couldn't believe what I saw. Rubbing my eyes, I look again and saw it: two lines! Since it was kind of early, the second line was very light. I posted a picture of the test to one of my online infertility groups, asking them if there really was a second line there. I also texted a photo to one of my best friends to get her opinion. After being advised to get another test, I drove to Wal-Mart. After taking two more tests, both having two lines, I fell to my knees and started bawling. I prayed and prayed, thanking God.

I told Brad that evening when he got home from work, and we both held each other and cried tears of joy. We were going to be parents!

But the joy was short-lived. For me, when everything regarding your reproductive system has not gone to plan, you start to believe that there is no way that this could work out. Miscarriage statistics run through your mind. Instead of being excited and relieved for being pregnant, I was terrified. I had already accepted that I would not have biological children and was excited for growing our family another way. And of course I was excited that I was pregnant, but I was also riddled with fear that it was too good to be true. Plus my diagnosis of PCOS (polycystic ovarian syndrome) raised my miscarriage risk more than the average women, which did not help ease my mind.

I took pregnancy tests every day to make sure that the second line was getting darker (a sign that the pregnancy hormones are rising). When my first blood test confirmed pregnancy, I was overjoyed for a moment. Then I realised that the second test would show if the levels were rising and immediately got immense anxiety.

The second test confirmed that the levels were rising appropriately. I was relieved, but also nervous because my clinic does three blood tests and I knew I had another one to "pass." I spent hours googling the odds of miscarriage by day of pregnancy, what normal blood test levels were, and ways to reduce the chance of miscarriage.

The third blood test also showed that my levels were rising as they should. Our first ultrasound was scheduled for 6 weeks pregnant. In the infertility world, I had heard many stories of women becoming pregnant and the first ultrasound revealing a not viable pregnancy. As excited as I was, I was still convinced that this was too good to be true.

As I had done many times before, I lay on the table at the fertility clinic awaiting the Dr. Brad and I were excited and nervous to get our first glimpse of the baby (who we started referring to as "Squishy.") When the Dr. and nurse came in and began the ultrasound, my heart raced. Until I saw the flickering dot on the screen. The nurse told us that that was our baby and that it already had a heartbeat. I was so happy, excited, and relieved. We heard the heartbeat and I started crying.

Squishy's first photo! Our 6 week ultrasound, which our Dr explained as "the most expansive ring we would buy."

I was so happy for that day. Then I realised I had another week until the clinic did another ultrasound. Another week not knowing if Squishy was ok or not. Another week for something to go wrong.

I was so sure that once I become pregnant, all the difficult emotions that came with fertility struggles would disappear. And I thought that after seeing the baby on the ultrasound, it would be happiness from there on out. But I realised that pregnancy after infertility was so much more complex than that.

7 week ultrasound
8 week ultrasound from the day we graduated from the fertility clinic

We saw Squishy again at the 7 week ultrasound looking great. And again at the 8 week ultrasound. We then officially "graduated" from the fertility clinic. I was offically taken off of the medication progesterone (a medication that is said to prevent miscarriage in the beginning of pregnancy, and a common practice at fertility clinics). While it would seem that I would finally feel relief, I didn't. I knew the monitoring from there on our would be less frequent. which made me nervous. I was still in the first trimester, which most people know as the most vulnerable time for a baby in utero.

A few weeks later I started bleeding. It was very light, but I was terrified and feared for the worst. I had not met with my OBGYN yet but was discharged from the fertility clinic, so I was unsure who to contact. I called both offices, who both told me that this was very normal and not to worry unless the bleeding got heavy or I started cramping. The OBGYN scheduled me for an ultrasound the following week. That was the longest week. While I didn't bleed after the initial incident, I was terrified that our baby wasn't alive anymore.

Thankfully, the ultrasound showed that the baby was healthy and at a perfect size. I had a sigh of relief. And while I was still very nervous, morning sickness had set in, which was a welcome sign that I was still pregnant.

The ultrasound after the bleeding scare...baby still thriving!

Once I hit the second trimester, I felt a momentary lift from the worry. I knew that the risks of miscarriage were much lower now. But again, as someone who needed so many different medications and interventions to even become pregnant, I was not sure of my body's ability to carry a pregnancy to term. The two things that gave me some relief was prayer, and the idea that at least I was pregnant for that day. If I focused on that, my mind was eased some.

I am now 23 weeks pregnant. And every day that I feel the baby, I feel so immensely blessed. I don't write this to complain because I know that I am so extremely lucky to be pregnant. Being in the infertility world for so long, I still have many friends hoping and praying to see two lines on their tests. I never want to seem ungrateful or like a complainer, because I am not. This pregnancy was so wanted, so worked for, and is so loved. Shoot, I cried tears of joy the first few times I threw up from morning sickness!

I thought that by writing this, I could share that pregnancy after infertility is an awkward spot. I feel like I still have one foot in the infertility world and another foot in the fertile world. My friendships with many of my friends who face infertility and are not pregnant yet are somewhat strained (which I totally understand, it's hard to have close relationships with pregnant people when you are having a hard time getting and staying pregnant). Yet I still don't feel like I fully relate to those who got pregnant "the old fashioned way." And if infertility alone is rarely talked about, pregnancy after infertility is addressed even less.

So my fellow "pregnant after infertility warriors", your feelings are valid. It is okay to not feel 100% excited or happy all of the time. Appreciate your blessing, but allow yourself to feel how you feel. Surround yourself with a great support system. And fall into God's arms throughout it all.

Love and Blessings,

Annmarie