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Thursday, September 13, 2012

Fertility Issues

Fertility Issues:

Sorry for the delay, my blog decided I was spam.

Ok I have talked about Celiac Disease before this but that was not the only purpose of this blog.  This post is about fertility and my struggles with it. 

My husband’s lifelong dream is having a child.  It is one of the main reasons he joined the military since we could not afford fertility on our own.  It took me a while to want a child I wasn’t ready, however, about the age of 23 my husband finally convinced me that that it would be a good thing.  So we started trying.  We tried for a year with no success and then I went to the doctor where I was told I had Severe PCOS (Poly Cystic Ovarian Syndrome), as well as Endometriosis.  We took a good long look at what it would take for us to have a child and found we simply couldn’t afford it.  So when I was 24 and he was 27 he joined the military. 

Once we arrived at his first permanent duty station I got myself into the OBGYN clinic on base.  The only thing they could do for me was Clomid or letrozole.  We gave Clomid a shot for 3 months at largely increasing doses.  Not only did that not work, it made my moods very unpredictable and it made being around me hard to handle. They preformed my first HSG or hysterosalpingogram and found that I had a no blockages but something showed up weird.  A MRI later and we knew that I also had a uterine septum.  Having done everything they could do and they sent me to a specialist. 

The new Doctor was horrible.  He convinced me that I had Diabetes even through my Glucose tolerance test clearly said I did not.  He put me on a no carb diet and informed me that the reason I was so large was because of my eating habits, and that I needed to lose weight before he could do much.  I spent years working out with little to no weight loss and I ate just over 1000 calories a day prior to this but I did go carb free also I did lose the amount of weight required for him to perform the surgery.  The surgery lasted over 5 hours; I went in for a simple septum removal and ended up having seven surgeries in one.  Including one that most likely saved my life, yes I knew I had endometriosis, but I didn’t know that it could turn into cancer. I remember clearly sitting across from the Doctor and him telling me that he had good news and bad news, the bad news is that I had cancer, the good news is that I am cured and I no longer have it.    

A few weeks later I underwent my second HSG just to make sure there was no scaring in my tubes from the surgery and we moved to letrozole since Clomid hadn’t worked. During this time I went to my primary care doc who took a long look at everything I had been told by my fertility doctor.  She had them draw a lot of blood tests and when I came back a few days later she informed me that my cholesterol was so low that I was going to end up killing myself on the diet I was on.  That I was not diabetic and that the reason I was overweight was not my eating habits (she had me explain them) but was because my hormones were messed up from the PCOS.  Also, that I was skinny for a person with Severe PCOS.  It was one of the times I got to listen to one doctor yelling at another doctor.   Back on a normal diet and continuing my treatments I started Letrizol.
The letrozole worked and I became pregnant for the first time.  I was excited when the test finally read pregnant, I had worked now for nearly a year with fertility doctors and I had my first positive pregnancy test.  The only person I told was my husband since he was leaving in a few days for a seven month deployment.  On the day that he left I started bleeding heavily.  For Women looking to know the signs of a miscarriage it included heavy cramping as well as heavy bleeding, however it can feel like a heavy period.   I went immediately back to the doctor who told me I was “Fine” but just to be sure they took a blood test.  My HCG results came back under 5 and I was told that I had lost the baby.  I was told it was a “missed pregnancy” which was his way of saying a chemical pregnancy since my period was due the day before I started bleeding.  I was devastated, not only had I lost the child but now I was alone to deal with my grief.  Fertility stopped while my husband was deployed since the military will not pay for artificial insemination. 

Seven months passed and homecoming arrived.  I was so excited to see my husband we both had slowly healed from getting our hopes up.  We went back to the OBGYN at the base to go back into privatized fertility.  This time we asked for someone else since I didn’t want to constantly be told that I was diabetic.  We were given our assignment and went to our first appointment.  The doctor not only did the consult but was able to get me started on a fertility regiment right away. After an HSG, I was on letrozole as well as menopur and ganirelix with an HCG trigger shot.  The first time I was able to get pregnant.  Again those lines showed up on the test and so I went in for blood confirmation.  Yes my numbers were doubling very well.  About half a week passed after my period was due and nothing was wrong.  I was gaining a lot of weight but I thought that might be normal since a lot of web sites said it was normal. I was afraid to tell even my husband about the baby since I didn’t want to lose it.  Well that came crashing down when I had to go to the ER, I couldn’t move I was in so much pain.  While in the ER, they did a basic pregnancy test and I couldn’t hide the results from my husband who was with me.  He looked so happy as well as worried.  By this time I was more than 30 lbs heaver than when I started the pregnancy and I was only four and ½ weeks in.  For anyone who has had this issue they know exactly what it is.  I had Ovarian hyperstimulation syndrome, Not only that but I had a really bad case of it.  I had gained too much weight too quickly.  I had almost 30 lbs of water weight in pockets of my abdomen. 

A nurse at the ER took me back for my first ultrasound to see what was going on.  They did both an internal and an external ultrasound.  At some point in the ultrasound she stopped asking me about my “baby” and started talking about how my “pregnancy” was going.  This confused me, but it didn’t take me long to figure out that I had more than one whatever she was looking at.  Since they couldn’t do a draining procedure at the hospital I was in, I was sent back to my fertility doctor in order for him to drain me.  That was the only reason I didn’t get to stay in the hospital for a couple of days.  After I was drained the next week or so went well.  I was happy and we even told my parents as well as my in-laws that we were expecting a baby. 

On the Wednesday before Easter I started to spot, I called and was told that I was fine and that sometimes that happens.  On Thursday I started to spot red, they brought me in for a blood test and after a few hours wait time I was told that everything was fine and to rest.  On Friday I was lightly bleeding bright red so they scheduled another blood test for Saturday.  I came in and they took the blood as well as did an ultra sound.  I was more than six weeks pregnant at this time and was excited to hear the babies’ heart beats.  My world came crashing down when they couldn’t find any heart beat at all.  All I could do was sob, knowing that once again I had failed, that something I had done or something that I had not done had destroyed the little lives that I was holding inside of me. I held out hope that the HCG levels would come back good and that the tech was just incompetent.  The HCG numbers had dropped. They figured that the pregnancy went wrong on that Wednesday.   I started the physical miscarriage on Easter Sunday. Everyone else was so happy and celebrating life and I was dealing with death.  I passed one overly large placenta with two separate parts to it.  I had lost Twins.  This was later confirmed by the doctor who said that I had two dimples in my lining which indicates two placentas, that they had merged was not unheard of.   

I hated myself and my life for a few months, I couldn’t handle much of anything, I went through the motions and told myself that it was ok, really it was not.  How could I have done anything different, what could I have changed that would have made the difference.  What was so wrong with me that I couldn’t give my husband and myself one simple thing that everyone else could have without even trying?  We had to inform those that we had told about the loss, and were expected to move on. 

When the time came to try again, we did.  For more than a year we tried again and again every month or every other month with no results.  Then my husband left for an about an eight month deployment.  When he came back it was time to try again.  After the threat of yet another HSG, I was pregnant.  This time there was bleeding from the start and we had decided that we were going to lose it.  Well I did lose one, but my numbers came back saying that I was still pregnant.  They were able to shove me on estrogen and progesterone quickly and it saved the baby.  My numbers kept rising as a steady pace.  I was still bleeding but that was from the hormone supplements, right?

 It came time to listen to the baby’s heart beat and we had told no one that I was pregnant.  I told my husband but that was it.  Once again there was no heart beat, but the numbers had risen that day like normal.  We were well above the numbers that mean the baby should be able to be heard.  Then I was given the devastating news that it was probably ectopic, they wanted to know what I had eaten or drank that day.  Since the appointment was early I was honest that I had only had part of a glass of water.

 By two PM I was in for surgery for a possible ectopic.  When I woke up something was very different: I was listening to the nurses’ talk around the room for a few minutes saying how everything was perfectly formed they can’t guess why it happened the way it did.  The first words out of my mouth were asking about the baby.  The nurse looked at me sadly and informed me that it was an ectopic pregnancy and that they had to take the baby as well as my right tube.  I had kept hope that everything would have been fine however; the bleeding was not the hormones that they had put me on but the ripping of my fallopian tube.  I had bleed so much that my uterus and tube were full of blood, in a few days I would have died from internal bleeding.  I really couldn’t stop crying.  They moved me from recovery to a room to finish waking up for the anesthesia.  All I wanted to do was to go home.  My husband was in the room or out of the room letting everyone know what was going on.  When we got home my husband kind of shut down, he played his video game and left me alone.  All the help I got while recovering came from the other people living in the house.  Once again I shut down and went into a depression.  We had thought we had saved one of the two and it turns out that it would have been better to just let it die.  Then I berate myself for even thinking that, that yes I had lost part of my body but I had also lost my baby.  As hard as fertility was before, it was now harder since I had only half the chance. I was told on the surgery follow-up that the pathologist had ruled that nothing was wrong with my fallopian tube, it was a freak thing that had the baby catch their instead of the uterus.  It should never have happened.

 However, in terms of medication, the Doctor had finally figured out what would work in order for me to keep a child.  It was not that I wasn’t getting pregnant it was that nothing was sticking, most times not even long enough to get more than a lightly positive pregnancy test.  Well we had to move, so no we are in a different area for our military health care and were told that they will not send us out to a specialist.  They also will not give me injectables; I am too high a risk.  My only option is to do IVF or In vitro fertilisation; however, they will not pay for it.  So we are looking at a $7,000.00 bill that has to be paid up front.  Again we are in a bind where we cannot afford it and now there are almost no other options. 

As it stands right now I am doing the workups and desperately trying to find the money.  I just finished going through another HSG and we are taking it one step at a time.

For those that have never had an HSG let me explain a little bit.  They HURT, I mean really hurt.  Not only that I know I don’t have my right fallopian tube so there is no point in looking to see if it is open.  Also since they will no longer work with me and I have to have IVF why did they need another HSG?  Anyway, that is where everything is currently sitting.   That is a light overview of my fertility back story, and I do mean light, but now any further fertility posts should make more sense. 

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