Infertility & Next Steps

I found a very old blog post which documented our steps to conceive a baby back in 2007.   As it is so much a part of our lives and the reason we have our two amazing, beautiful children, I have to include it here. 

ME: Polycystic ovarian syndrome, have tried Clomid 3 times, anovlulatory, have been taking 1500 Metformin for months and in summary = unexplained infertility. 

December 18, we met with my RE for the first time. During this meeting we discussed my PCOS, our history and what treatment(s) we have had. 

Prior to recommending IUI or IVF, my RE wanted to ensure that all was in order PRIOR to the next steps. She recommend a full work up of blood tests, Cystic Fibrosis testing, HSG test, etc. Of course, she’d need a sperm sample from my husband to ensure no complications from his end.

When that blood work returned, there were two items that needed to be addressed. My body didn’t test for immunity against MMR (Measles, Mumps & Rubella – who knew this disease still existed??) and I was indeed a carrier of a mutated gene for CF. Immediately, worry set it.. what would be the chances that our child could be born with CF? Well, after much research and discussions, I was told that my husband would have to be tested to see if he too was a carrier. As studies have shown, if both parents are carriers, there is a 25% chance that their offspring will be a carrier. However, if only one person is the carrier (in this case me) and I pass the ONE mutated gene along to the child, the child will be FINE, just like me. So the next logical step was to have my husband tested for the gene and I would get a MMR shot to ensure that was in order. Side effects from not being immune is that children can be born blind. Measles is a virus which causes a rash, cough, runny nose, eye irritation, and fever in most people, but can also lead to pneumonia, seizures, brain damage, and death in some cases. Mumps virus causes fever, headache, and swollen glands, but can also lead to deafness, meningitis, swollen testicles or ovaries, and death in some cases. Rubella, also known as the German Measles, is generally a mild disease, but can cause serious birth defects in the child of a woman who becomes infected while pregnant.

January 22, Nils was tested for the CF gene. We would not be learning of the results for 3 week or so… so in the meantime, we waited and decided NOT to actively TTC. With the recommendation of my RE, we decided to get an appointment on the books for a Genetics Counselor who could advise us of our options should Nils come back with a postive CF gene. This appointment was set for February 28.

Meanwhile the same day, January 22, I went for a HSG test (Hysterosalpingogram) In summary, this is a very common fertility test that most women struggling with infertility will undergo. This test uses x-ray technology to create a picture of the uterus and fallopian tubes. Colored dye is injected into your uterus. This dye then travels up through the fallopian tubes and out into the abdominal cavity, allowing them to see if there is any blockage in your tubes. The best part of this test was the instant gradification…. my tubes were just fine. 

January 22 – February 4 We took off for a trip to Holland, Belgium & Ireland to visit family. 

February 14 (VALENTINE’S DAY) we had a follow up appointment with my RE to discuss the outcome of the CF test for Nils. Great news… he was NOT a carrier. We did however, decide to continue to have the meeting on February 28 with the Genetics Counselor as the RE informed us that there was a chance that a son conceived who carried my one mutated gene, could have a problem with his Tubes (sperm) when he’s grown. After our meeting, it was advised that this was not conclusive and no evidence was available to back that theory. At the meeting with my RE we discussed that the best treatment for us was that we’d begin the SHOT treatment to stimulate egg growth, induce ovulation and have an IUI. 

February 20, we met with the UltraSound Specialist who would explain how exactly the process works and what to expect. After she did an ultrasound to look at my ovalries, she showed me the needles, bottles of liquid and how to give MYSELF the shot. At first I was probably white as a ghost, thinking about how exactly would I be when it came time to give myself this shot. She thought it might be a good idea if I were to have a trial run with water. So she showed me how to draw the luquid out of vile… using the BIG needle… thankfully, really quickly the BIG needle was replaced and there was a much smaller one. That would be the one that I stuck in my belly. So as she handed me the needle I sat down, leaned forward, took a bit of my belly, pinched it and inserted the needle right in & the water went in. Wow, it stung! She suggested when it came time for the real thing, I would ice up my stomach for 10 minutes or so to help with the stinging. It was not the needle, rather the liquid. That was it, I was a pro. She was going to be going on vacation the following morning for 1o days so we agreed, she’d place the order for the medicine and that I’d begin to take the shots on Thursday, March 1, so that when she returned we’d be ready to come in to start being monitored nearly daily.

March 1, Shot #1 – 75
March 2, Shot #2 – 75 
March 3, Shot #3 – 75
March 4, Shot #4 – 75 

Strangly I started to get my period on Monday, March 5. The period that barley comes for me in the span of a year & now it comes? She was baffled, couldn’t understand why I was bleeded as I (also out of the blue was bleeding on January 15.) I’m convinced the months of METFORMIN are starting to work. She discussed with me RE and decided to proceed on as planned with shot and monitor to see when it stops.
March 5, 8 am I arrive for blood work at the Lab (testing my Estrogen levels) and another Ultra sound to see how my eggs are growing. As I have PCOS (Polycystical Ovalary Syndrom) there are loads of unmatured eggs all over both. The goal of the shots is to carefully make a few of those folicles (eggs) grow to a certain size, then “mature” them. That night, I was told to give myself a double dosage. 150. The ultrasound showed that I had 1 folicle 7 mm.
March 6, I had a second double dosage 150.
March 7, 8 am back in for blood work and another ultrasound. This time we see that the 7 mm folicle is now 9 and there is a second one growing. That night was instruced to go back to a single dosage. Again the goal is not to have 10 full blown eggs that can ovulate. It is to have only a few. That is the tricky part… is controlling it so that only a few grow… very scientific.
March 8, single shot. 75
March 9, I go back in for Blood & Ultra Sound and was instruced NO SHOTS for the next two days. They have grown very rapidly and we don’t want them to get too big. There will be a natural increase in size from the past few days of treatment… so they instruced me to come into the office over the weekend to be monitored.
Saturday, March 10 we went in for Bloodwork and another US. This time I have three good size folicles that are essentially ready to be stimulated. Two were 17 mm and 1 was 15 mm. Next step was to induce ovulation.
Sunday, March 11 (After the lively POGUES show) I was instructed to give myself a different shot. This time it was HCG Trigger Shot, 5000. So within the next 48 hours, I would ovluate. Next step was we were going to have an IUI (Intrauterine Insemination) done.
Tuesday, March 13 8 am we had to arrive for Nils to give a “sample”. That was then cleaned, separated and would be inserted directly into my cervix during an office visit at 9:30 am that morning. All went as planned and I was back at work that afternoon.
Friday, March 16, I begin to take Progesterone Suppositories two times a day. Progesterone supplementation is a medication that is taken after ovulation and it corrects the low progesterone hormone imbalance. The lining of the uterus responds to the progesterone medication, it thickens and prepares for the implantation and support of a pregnancy. A woman will continue to use progesterone until the placenta has developed and is able to support the pregnancy. (10-12 weeks after conception).
NOW WE WAIT….
The soonest we know if we are expecting is 14 days after the IUI, March 27! Today is March 21. Yesterday I read that one person took a test after 6 days & it was positive. I just can’t believe it. Anyway after reading that I was so antsy, I went ahead and took a preganncy test. Big Fat Negative… however, I know that means nothing as it can take up to 12 days to implant. So… we wait. 

June 10th 2007

A long time has past since I last posted here. IUI #1 did NOT take. Found out that the sperm count was 1 million (so low!!)

We went on to have a second set of shots (f0llistim) but never got to the actual IUI#2 as I had a mild case of OS. (Over stimulated ovaries). If we did go forward, I had 5 very large ripe follicles that could have been very messy!

In early May we started our injections again… hoping that we can go through with with IUI#2 mid-May. Daily monitoring of the dosage, watching the follicles grow, blood work, the whole nine yards. Well, May 16th was the day, we had set up our IUI. All went well, we had 3 good sized follicles. I think they were 19 mm, 17 mm & 15 mm. Sperm counts were 17 million this time. So we left very confident that it was a success, but then the next two weeks of waiting really sucks! The nurse at the hospital told me to make an appointment on Saturday, June 2 to find out my results.

Every day you are so tempted to pee on a sick. Temped to see if the two little lines appear. But this time, it would be different. I would wait! I’m NOT going to drive myself crazy. Days go by, I think about it, but do not discuss it with my husband. If anyone who knew we went asks, I say, we now wait!

Thursday, May 31 my husband has to leave town for a biz trip to Europe. He’ll be gone for the minimum of 2 weeks, possibly longer. So sad for me as I knew I’d miss his companionship, etc.

That Thursday am I called my RE’s office to ask about my scheduled appointment on Saturday… specifically if she was able to call in & check the results and could call me on Saturday. The thought of having to wait til Monday (longer thn the 2 weeks was going to kill me). What appointment she says… why do you have that set up? I told her the nurse suggested it. She said, oh no cancel that & come on in my office immediately. We’ll take the blood work today at the lab & I’ll call you this evening. She was on her way out of town to Toronto so perfect timing … again, I have not yet even purchased a HPT… so to the hospital I went for blood work!

GUESS WHAT – WE ARE PREGNANT!!   I had to tell my husband we are having a baby over the phone 🙂

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