Thursday, July 21, 2011

Our (fertility) story ... so far

I always knew in the back of my mind that I would need help getting pregnant.  When I was 21 I was diagnosed with Poly Cystic Ovarian Syndrome (PCOS) which, at the time, was a pretty rare condition.  It is something getting more and more awareness by patients and doctors so more and more women are at least being told what is wrong with them, there really isn't too much that can be done at this point, but just knowing there is a reason for all of the horrible side effects that come along with this condition is a start.

My first indication that I had anything abnormal was a single black hair that started growing on my chin when I was in college.  I started tweezing it, which was easy enough but slowly the hairs multiplied.  And then my period would occasionally skip a month...or two...when I missed six I knew it was time to talk to the doctor.  I had several doctors tell me that they just didn't know.  A dermatologist told me that the hair growth was because I was just "unlucky".

Eventually I did find a gynecologist who immediately recognized the symptoms and gave me a diagnosis that explained the hair growth, missed periods and weight gain I had recently been experiencing.  Other side effects of PCOS including hair loss and infertility would remain to be seen if they develop.

My cycles were put back on schedule with birth control pills and I started taking metformin, a diabetes drug, for the weight gain and to help with staying regular.  Turns out PCOS patients also have insulin resistance issues (which also is a factor in the weight gain).  Things were OK for a long time.  At some point I switched to the birth control ring that is left in all month versus the pills that are taken everyday as I had an issue remembering them.

In January 2007 Jeremy and I took a weekend trip to Niagara Falls.  It was a stressful drive as you can imagine, through Canada in the winter and the day after we got home, I started feeling like I had a horrible chest cold, but nothing else was wrong.  Very long story short, I ended up in the hospital with 2 Pulmonary Embolism...AKA blood clots in my lungs, yes plural, one on each side.  I could have easily died if it wasn't caught, which is a whole other story.  But it did get blamed on being on the hormones from my birth control combined with long car rides and I was told I could never be on birth control again because the active ingredient is a hormone that could now kill me.

So I, of course, go to the worst possible scenario...if I can't be on birth control, I can't have a regular cycle, if I can't have a regular cycle, there is little chance I could get pregnant, assuming I am not already infertile from the PCOS.....however, I didn't have a lot of time to dwell on that because I was getting married in 5 months!

After a great first year of marriage (and a surprisingly regular cycle without the drugs) we started talking about babies.  I figured that it would be a struggle for us because the odds were stacked against us to begin with, little did I know what was coming.

We started trying, rather we stopped preventing it in April 2008 while traveling in Australia.  After we got home I found a reproductive endocrinologist, or fertility specialist in my insurance plan and made an appointment.  Usually doctors say to try for at least 6 months to a year before getting concerned, but again, I just knew that we would need assistance so I figured I would skip the middleman.  The day of our first meeting with the doctor in late June 2008 I started getting bad cramps and I figured my period was coming.  Over the next week the pain in my lower abdomen grew more and more intense, it felt like there was a giant gas bubble in my lower left section, but nothing helped it.  There were times I could barely walk, but I figured it was my period coming because there was some blood.  At a follow up ultrasound appointment with the fertility doctor a week later I mentioned it and she took some blood to test for pregnancy just in case.  A few hours later I got the call that I was indeed pregnant but the pain and her doing an ultrasound that day and not seeing an embryo meant that it must be a tubal or ectopic pregnancy and I had to get to the hospital for emergency surgery to remove it. Also, this meant I had gotten pregnant in May 2008.

I had heard of an ectopic pregnancy and I kind of knew what it meant but I thought it was one of those weird things that hardly ever actually happens (although with my track record, I don't know why I was surprised at all).  So my husband took my to the hospital where the doctor brought me into surgery and a few hours later I was home to recover.  She tried to just go in through my belly button but wasn't able to remove the mass (that is what they called the pregnancy) so I did have another bikini line incision.  It was a tough recovery, a lot of rest and a lot of pain.  I was just so grateful that I had only found out I was pregnant that day, at the same time I found out that it would be removed.  I never had a chance to get excited or attached to the idea, so it wasn't as big of a loss as it could have been.  Also, the doctor was able to remove the 'mass' and repair that tube it was in so my chances of getting pregnant in the future were not diminished at all.  She said had the tube been damaged beyond repair, my chances would only decrease by a few percent anyway.  I guess the body adjusts.

We were instructed to take the next month off of trying for recovery and we decided to get right back at it in August.  In September 2008 I became pregnant again, only this time I was monitoring it very closely and I knew immediately and was able to work with the doctors, the fertility doctor and my hematologist (who put me on blood thinner shots right away because pregnancy actually thickens your blood and the chances of clots). and nine (or so!) months later we had a beautiful, healthy baby girl.

We decided 2 years was a good space and in November 2010 we started not preventing pregnancy again, I figured I would start keeping track of ovulation and everything in the new year, which I did.  I have never really trusted the ovulation predictor kits because of my skewed hormone levels from the PCOS I can never count on them 100% to be accurate, and on top of that I had what seemed to be a relativley normal period in mid-January.....however on February 18, 2011 I was woken up at 6:30 am by an intense pain in my lower left abdomen.

I knew right away exactly what it was, or at least what I had a horrible feeling it was.  I tried to go back to sleep but the pain was so intense, I finally got back up and knew what I had to do....the lines on the pregnancy test showed up almost immediately and my worst fears were confirmed.

So somehow I got Anna to my parents and got myself to my doctors and, very long story short again, I ended up in emergency surgery for 6 hours and 5 days in the hospital after that.  But I still had hope, I knew that my left tube where this pregnancy had been (again) was not able to be saved this time, but emergency repairs were made to my right tube, which was found mid-surgery to be disconnected for unknown reasons, in hopes I would still be able to conceive naturally.

3 months of recovery later I had a test done to see if that right tube was indeed repaired and it was not.  I could not believe it.  I had always had a positive attitude about the entire situation because I figured it would all work out OK, it had to...why wouldn't it?  Haven't I been through enough already?  Well, I guess not....and that brings us to today and our impending meeting with a fertility specialist.  Have not decided which one yet - I feel kind of an alliance to the doctor we started this whole journey with, but my current gynecologist is recommending the one who did the most recent emergency surgery on me and is connected to the hospital I would hopefully give birth in.  Either way it is going to be very expensive so I am avoiding the whole thing, but it is time to get moving.  More to come

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