The Journey to Motherhood
For a long time, I kept my struggles and what I was going through largely a secret. While I was going through fertility treatments, I didn't post or write about it (which at this point I do actually regret) and mostly kept everything to myself. I shut down and pushed people away. To be honest, I was quite depressed near the end of our treatments - that shit is hard. Infertility is hard on your body, your mental health and your relationships - not to mention, your bank account. Before I talk to you about the actual process, I'm going to tell you a story.
Many years before I met my now husband, and we decided to have a baby - I had an inner knowing. I knew two things. 1) I was meant to be a mother, and 2) that this would not come easily to me. I always had this feeling deep inside, that I would struggle to conceive. I don't know why, but I just knew. I think part of that came from the fact that my monthly menstrual cycle had always been a nightmare. I got my period at 10, and then it disappeared, and then reappeared with a vengeance. I suffered for YEARS. I would miss an entire week of school every single month, for years. I went on the pill to hopefully feel better at 13 (something I wish I hadn't done, but the pill is another story). I remember writhing in pain on the ground with debilitating cramps, crying my eyes out and heavy periods that just got worse and worse. Nothing seemed to help. Cut to my adult years, and I was diagnosed with endometriosis, adenomyosis, and then PCOS. I somehow managed to send the first two into remission with a huge lifestyle and diet change, but the PCOS held on tight.
So when I met my husband, in the process of divorcing my ex, I made it very clear to him (hey, I know you want kids - but I may not be able to) that I knew I would struggle to have children, because by this point doctors had told me it was a huge possibility, and I believe in full transparency at the BEGINNING of a relationship (not once you have committed). He thought I was worth whatever struggles we may face (and boy have we struggled), and we started a whirlwind romance. Shortly after we started dating, and we kinda just knew this was the real deal and that we were in it for the long haul, we made the decision to stop preventing pregnancy. We weren't "trying", but we also weren't not trying. We realized after several months that any normal couple, probably would have had a bun in the oven by now, so I decided to just get everything checked out.
If you are a Canadian reading this, you will know that our healthcare system is both a blessing and a pain in the ass. Its a blessing because I could get tests run without spending a dime, but its a pain in the ass because sometimes you gotta wait - and sometimes it's a long time. It took a couple weeks for me to get an appointment with my GP, and I ended up seeing our nurse practitioner (she's fantastic, just so you know). She sent me for specific blood work, and I had to go on a specific day of my cycle (which just so happened to be that very day). I rushed in to get bloodwork, and was waiting for the referral to see an endocrinologist. My nurse practitioner A, called and let me know that the current wait (as of 2019) was 18-24 months to see an endocrinologist for next steps (see- pain in the ass). Now, because she's fantastic, she set up a video consult for her to speak to an endocrinologist about my results and about what other tests to run. This was a huge relief for a number of reasons, but the biggest is this: that biological clock you hear about, well its kinda actually a thing, and mine was ticking faster than ever. When the endocrinologist got back to her, they let her know that next steps would be to refer me to a fertility specialist right away. I remember that day, and the feeling of my heart sinking deeper into the ground. I cried, no, I sobbed. This was not the news I wanted to hear as a 26 year old, but it was the news I was expecting. So she sent my referral.
It took about a month for me to get the referral and to get an appointment, which is actually super fast. I got referred to HART Fertility near McMaster University, and was nervous, scared, excited and unsure of what was to come. Before I jump ahead in the story, lets talk a bit about the logistics of fertility treatments (specifically as a Canadian). As a Canadian, we are extremely lucky that a lot of the testing and procedures are covered. For instance, every blood draw, every ultrasound, my HSG test - were all covered. In the US, couples usually pay for ALL of these and then some. For context, there were weeks I went for bloodwork and ultrasound 3-5 times. IN A WEEK. That would have added up quickly if I was paying for it. My husband and I didn't pay a dime for those tests, and we didn't pay for our appointments, or the HSG, or the extended bloodwork they sent us for to test for STI's, genetic diseases or underlying conditions. The only test we paid out of pocket for was a semen analysis, which cost us $150 (my husband passed with flying colours). So when we got our diagnosis, all we had spent for everything was $150. Not bad. I got diagnosed with PCOS, and anovulatory cycles (aka I didn't ovulate). So basically what was happening in my body, was that I was releasing lots of eggs, but my hormone levels were not strong enough to make any of them mature - so each month, when I got my period, I was not getting the chance to have any fertilize, but also wasting a bunch of eggs. Not ideal.
The average couple has a small window of opportunity each month to get pregnant, and about a 25% chance of getting pregnant if you get all the timing exactly perfect. Thats not great odds, but when you don't ovulate, or have an imbalance of hormones, etc - you basically have no chance on your own. So I became a guinea pig. Basically, for us, at least - the first cycle of treatment was starting small and seeing what my body would respond to. I started a timed and monitored cycle, with the medication called Letrozole. How this worked was I would take letrozole for a week, starting on day 5 of my cycle (or when told by the doctor dependant on hormone levels and follicles), and then I would go for regular bloodwork and ultrasounds to track the follicles and their growth, and finally to track a rise in hormones that would mean ovulation was near. THEN I would do a trigger shot. Each month of trying we used both letrozole and the trigger shot Ovidrel. Now, letrozole is covered under my regular benefits, but ovidrel at the time was not. That one injection is about $150 - for one needle. The trigger shot is important though because it forces your body to release that egg (ovulate), and then because you know when you are going to ovulate the doctors can tell you when to "time intercourse". This is an entirely unsexy and unromantic way of making a baby, and it can cause soooo much stress. They basically tell you to have sex every night (or day) for 3 days including the day of the shot. Then you start the dreaded TWW or the two week wait. My next appointment was 2 weeks later, when I would go in for a HCG or pregnancy test. I don't know what it is about the hopefulness of the first month, but my hopes and dreams came crashing down when it didn't "work" that first month. And then the process begins again, but next time we tried something different. Below is a breakdown of each month.
Month 0: This was the month that we just had all the testing done, so no drugs or anything like that. My husband had his semen analysis, I had bloodwork and ultrasounds.
Month 1: This month we did an HSG or hysterosonogram which tests for blockages in your uterus and fallopian tubes (not fun). Basically, its an in-office procedure where they insert a small balloon catheter in through your cervix, and also an internal ultrasound, and they flush your uterus with saline AND then continue to flush until the saline exits your fallopian tubes. This process checks that everything is clear, and they tell you it increases your chances of conception for about 3 months afterwards. I found it quite uncomfortable to be honest, and was super emotional + crampy for the rest of the day. This HAS TO be done after your period is completely done, so no spotting or anything. So I was being monitored through transvaginal ultrasounds and blood work. I also was prescribed letrozole, and took that from day 5 of my cycle and had continuous monitoring to check follicle growth. Once one of the follicles grew large enough with that and my blood work showed a LH surge, I was prescribed Ovidrel (an injection that forces ovulation to occur), and then you are told when to have sex for 3 nights. Cue TWW, and then negative pregnancy test.
Month 2: Same deal, but my body wasn't responding to letrozole. So I started another injectable, which I took for about 5 days. This one was called puregon. So I was taught how to do the injections, and did these every morning around 7am. Again, I was monitored with bloodwork and ultrasounds. In addition, this month I started metformin as well for my PCOS. And then we did Ovidrel and timed intercourse again. No success at this point. I had a conversation this month with my fertility specialist about diet, but I had already been following all of the recommendations for several months. In addition, I was drinking Lori Bregman's fertility smoothie, and on a number of supplements (I will write a whole other post about this and what holistic measures I took to get pregnant).
Month 3: I continued letrozole, metformin and puregon. When the follicle was nice and big, we injected with Ovidrel. Timed intercourse. This was a really stressful cycle and we fought a lot, and I just was obsessed with making this work. The specialist basically told us, if we didn't have success our next steps (in his opinion), should be IUI or IVF. This took a lot out of us emotionally. This month I also did BIE, acupuncture, cupping and I had been having regular chiropractic care during this time as well. I was willing to try it all. Low and behold, the month I specifically was like ya no way this is going to happen, and had basically let go of the outcome is the month the nurse calls with the "you're pregnant!" test result. I was in complete disbelief. I remember sobbing on the phone, and asking her over and over again if she was sure. She scheduled an ultrasound for 2 weeks later (around 6 weeks), and we confirmed we were pregnant! I called my husband and told him the good news, and it was just a blur.
I have to say - three months of treatment is NOT a long time. But it was physically, emotionally, and spiritually exhausting. For both of us. I wish I had wrote more about my emotions and the ups and downs, but I didn't. I wish I had documented it more, but I didn't. At this point, I am just immensely grateful for our beautiful son and hopeful for the future and hopefully and easier second time around when we are ready.