Guest Author: Keeley Russell
The Not Knowing
Making a baby should be easy right? Well, in my case I found this to be quite the opposite. Ever since puberty I have known that there was something “off” with my body. I have never had regular periods. I was on birth control for over 10 years to attempt to regulate it. However, birth control and baby making do not mix. At the beginning of 2017 my boyfriend (husband now) and I had been trying to conceive naturally for months and something wasn’t working. I felt so alone and broken. Sometimes the feeling would overwhelm me and come out of nowhere. I would come home everyday, sit on my kitchen floor and cry. Or I would be driving home and a song would play about having a child and I would fall apart. I knew that something was off, and that my body was trying to tell me something.
Last summer, I went months without a period and we hoped that I might be pregnant. One morning, I was sitting on the couch and suddenly I felt immense pain. I was in so much pain that I could barely move and there was a lot of blood. The pain lasted a few more days and we decided it was time to go to the doctor to check it out. I went to the gynecologist to talk to her about this incident. My usual doctor was out and the one we saw was not helpful at all. She said that it was probably just a cyst and would not run any tests or talk about it further. Instead she prescribed Medroxyprogesterone to attempt to regulate my hormones and attempt to make my 70 day cycle become more regulated.
We tried these hormones for months to no avail. They regulated my cycle; however, it was what is called a withdrawal bleed (not your normal ovulation). The entire time that I was taking the Medroxyprogesterone I was using the daily ovulation test sticks. I would pee on the stick religiously every day at 4:00 P.M. In over 5 months of using these tests I only ever had one positive ovulation stick. I was sick of having my heart broken every day by a little stick. Whether it was the daily negative ovulation test or the monthly negative pregnancy test, I kept on trying. I guess you could say I was a glutton for punishment, but I was still so hopeful that one day it would be positive. Throughout this time, I was trying anything that I could find on the internet for tips on “how to conceive naturally.” I tried essential oils, Maca Root, changing my diet, and even fertility teas to no avail.
I tried to talk to my gynecologist during this time, and again she was not helpful, so I went to two other gynecologists. They all told me the same thing and were less than helpful. You are young – 26 at the time- come back after you have been trying for over a year unsuccessfully. However, what they refused to listen to or understand is that my husband is in the military, and I will not always be able to consistently try like most non- military households can. They also wouldn’t take into consideration that I have had issues with my hormones and cysts my whole life. It is my experience that the clinic I was going to had no sympathy for women who were struggling to conceive. I knew I needed a change.
I asked my friend for a referral to a different office and doctor. This doctor was the first one to truly listen to me and to truly want to help me. By this time, it had been 10 months of us consistently trying and only 6 months before my husband was set to deploy. I knew we were on a short timeline, and we needed to figure out a way to fix the problem. My new gynecologist took the time to sit with me and explain that all he could really do is provide the pills much like the other doctors, however, he believed that now was the time for me to consider being sent to a Reproductive Endocrinologist. He explained that they can run a lot more tests and offer a lot more help. Yet, I had to understand this would probably be on our dime. He wrote a referral hoping that my insurance would cover some of the road that lay ahead of us. This gynecologist was more helpful to me in the 30 minutes that I talked with him than my previous four were in the months prior to this moment.
My fiancé (at the time) and I went to the Reproductive Endocrinologist the next week. We had a long sit down with our doctor and discussed all of the tests that we needed to take in the upcoming weeks. We were quite upset to find out that we needed to take thousands of dollars’ worth of tests before anyone could really help us. While we were upset at the time, it makes sense. Fertility Clinics offer amazing routes to help couples get pregnant, yet they come with a very high price point. It is best to have all of the possible information about your bodies and where the disconnect is occurring before making your decision in this area. All of the tests that I had to do where meant to be done during your menses and were a HSG – Hysterosalpingogram, a Transvaginal Ultrasound, a Pap Smear, a TON of blood tests, and a Sonohysterogram. All of these tests seemed very overwhelming and a little painful at the time, but they all piece together to determine how your body is interacting during your time of the month and if everything is in working order. While I was off spending two grand, my fiancé’s only tests were a STD blood panel and a Semen Analysis. So basically, the men get it easy!
After all of the results were back we went in to discuss our options. We found out that I have PCOS (Polycystic Ovary Syndrome). She described it as the following: I can make eggs, but they keep growing. Normally, once a month when you ovulate, your egg grows and then drops to hopefully become fertilized. My eggs do not “drop.” They merely keep maturing until they form into cysts. She said that due to this our options were very open. We could do what is called an IUI (Intrauterine Insemination) with hormones, such as Clomid. We had the options of doing timed intercourse with IUI or IUI with AIH (Artificial Insemination with Husband’s Sperm). She also presented the idea of IVF (In Vitro Fertilization) to us at this meeting. During the meeting of information overload, we decided to go ahead with the IUI process.
Yet, a few days later we received the price quotes for the three different options and this sparked an entirely new discussion. How were we ever going to afford a baby? Infertility is not commonly something that your insurance will assist with. At the time I was teaching full time and my husband was (and still is) in the military. Neither insurance would cover any of the costs, but our clinic does offer a 30% military discount. This helped us out IMMENSELY. For the IUI options we were looking at between $1,500 – $2,500 a cycle. For the IVF process, not counting the medication, we were looking at $10,500. One thing that was huge in our decision-making process was the percentage rates of success. For IUI’s the success rates range from 4-5 % with timed intercourse to 7-16 % percent with medication. For IVF the national success rate is 47.5%, but our clinic has a 71% success rate within the first year of transfers. After weighing the costs and the odds, we decided to go straight to IVF.
My husband and I want a baby more than anything. It has been my dream, for as long as I can remember. We know so many people who have done IUI for years, only to see that it didn’t work for them and they needed to go to IVF after. We decided, financially, it was better for us to invest in the higher success rates and not put our family to chance. It is a large sum right now, but it’s possible in the long run that we are saving ourselves the finances and heartbreak of months without success. It is also very possible that it could have been the opposite, but we decided this is the best route for us. But, at this point my husband was deploying in 4 months and we needed to begin our process.
We wanted to start right away, but sadly, month after month, we kept hitting delays, one of which was the Zika Virus. We planned our Honeymoon for April in Jamaica. After planning and paying for the trip, we discovered that men need to wait 6 months after going to a Zika Virus infected country and women need to wait 8 weeks to try to conceive. The Zika Virus is no joke and we could not risk harming our potential babies. So, my husband did his part before we left and we froze the sperm to use once the 8 weeks had passed upon our return. Which brings us to where we are now.
IVF Stims & Egg Retrieval
Three weeks ago, I ordered my medication and sat around all day waiting for the box to arrive! When you have $3,500 worth of medication, some of which need to go straight into the fridge, on the way it is hard to do anything but wait around impatiently. As soon as I received the box, I unpacked it all – and it was INTIMIDATING. Everyone’s medication and dosage has the potential to be different but the Stimulation Medications that I was prescribed were Follistim, Menopur, Ganirelix, Prenyl, Leuprolide, and Doxycycline. Needles make me very nervous and seeing how many that I would need to use over the next few weeks freaked me out a little bit.
We had to wait on lovely aunt flow to start, then we began a few days later! I went in for my Baseline Ultrasound and Bloodwork ready to conquer this beast! They found that I had 13 antral follicles (the measure of your egg supply) at this point, which were less than I had a few months prior. I was bummed by this thought, but since I have PCOS they informed me that it is likely that number will double by the end of Stims. At 8:00 P.M. we were ready to conquer these shots. My husband was my lovely nurse and walked me through the first two like a champ. My grandma is diabetic and the Follistim pen looks like is her insulin pen. I told myself that if grandma can do this every day of her life, then I can do it for a few weeks! The Menopur shot stung, but I was anticipating that, so it was not too bad. The two shots became part of our nightly routine quickly and easily. We learned a few days in that it is much better to lay down while doing them. I have a history of fainting, so it was just easier to take out that risk for us. We learned that if my husband pinched my stomach tight then I barely felt the needle at all when it was going in. Around day 6, we added the third shot Ganirelix. I am one of the lucky women who get a slight allergic reaction to this shot. It wasn’t too bad–just a small, itchy rash. The rash only lasted an hour and then it went away completely. We powered through the first 7 days of shots like rockstars! By this point, I didn’t really have any side effects except bloating and being a little overly emotional.
My shots on nights 8 and 9 were harder, but this was because my stomach was so swollen my husband could barely pinch my skin. The needles did not want to go in easily or pain free at all. When I talked to my nurse about this she said it is because I am a smaller woman, so by this point my skin is too stretched out. Apparently, it is really common as well. The joys! On day 10 I went in for my ultrasound and blood test to find out that we now had 20 follicles and that we would be doing our trigger shots that night! It was up until this point that I thought my trigger shots were both in my stomach. Throughout this whole process I have been guilty of Googling WAY too much. According to Google everyone’s shots were in their stomach, so mine should be too right? WRONG!! The nurse mixed my shots and prefilled the needles for me and then explained my newfound fear. One of these shots would go in the stomach like normal, easy peasy. But the other, the Pregnyl, was an intramuscular shot that needed to be administered in my lower back. Needless to say, I was so nervous about this one. I kept telling myself this would be a prequel to the Progesterone in Oil shots that I will have to do for 11-12 weeks in the future anyways.
Both of the shots needed to be done within 1 minute, with one on the front side and one on the back, it was not perfect but we got it done. I iced my back for about 10 minutes and honestly I barely felt the shot. The only thing I felt was the bruise I had for a few days after. This whole time I did not ice the area for any of my shots except the Pregnyl. This is another fun fact that my prior Google adventures had led me astray on. Most information that I found recommended icing the area before you do your shots so that it would numb the area and hopefully be less painful. However, my doctor told me that I couldn’t do that (except for the Pregnyl). She said that it would affect the way that the medicine disperses so we did not risk it. To be honest, as long as you pinch the area tight you barely feel the needles anyways they are so small. I was so worried about all of these needles at the start, but in the end I worried for nothing.
Thirty-four hours later, I was back at the clinic: the big finale. The day of the egg retrieval was nerve-wracking for me. I wanted nothing more than for my husband to come sit back in the room with me until I had to go under. But, sadly my clinic made him wait up front and I sat alone for the most part waiting for the procedure to start. After a little while, I had a quick conversation with my doctor and then went into the procedure room. I remember talking about thinking of Jamaica then bam, I was out. I woke up to the Price is Right and my nurse standing by my side about an hour later. My doctor came in and told us that we got 22 eggs! This was more than we had seen on the ultrasound and way more than the original 13. I was so happy by this news and so ready to go back to sleep.
For me, the recovery from the egg retrieval was the toughest part. The first few days after the procedure I was having some pretty serious cramping. I basically walked with a hunch in order to feel somewhat comfortable. As the days progressed it was easier to walk and get around but the cramps were still there off and on. I could handle the cramps easily with some Ginger Ale and relaxing, but the bloating was pretty intense. Over the last two weeks my body had gained twelve pounds and three inches from the stims meds. Now after the egg retrieval, I was swollen on top of that bloat. After about seven days the bloat started to subside and I was beginning to feel normal again. While the week of recovery was brutal for me, it was all worth it when we found out how many oocytes (embryos) that made it to the freeze.
Infertility Makes You A Warrior
We now have FIVE amazing little embryos waiting to be transferred and hopefully give us the family we have been dreaming of. When I found out the news I cried. I was so grateful that all of the pain and pokes from the last week did not matter at all. They helped to make this happen and that is all that matters.
Something that I have heard over and over again in this journey: “Infertility is not for the weak.” This is so true. If you feel weak at the beginning, or you are like me and are SO afraid of needles, you will absolutely overcome any obstacle in your path if you just focus on the end game. Once we have our beautiful babies–and I say once because I can only be absolutely positive in this–then absolutely everything from the previous heartbreak and disappointments, to the cost and the pain, will all be worth it. There is nothing more precious in this life than a baby and it is a dream we will work towards, whatever it takes.