I have wanted children since I can remember. I have always been drawn to children and thought for most of my life that I wanted my career to be centered around working with kids. Little did I know the struggles I would face as I started on my path towards motherhood.
Reflecting on my journey I have realized a few things. I didn't have my first period until I was 16 years old. Now I don't think this is a horribly late age, but I don't think it is the majority of women's experience. I know it wasn't for my sister. But the fact that I didn't have my period until I was 16 isn't really the issue. I think it was that I had my period once, maybe twice during that year. At the time, I just felt blessed. Honestly who asks for cramps, back pain and bleeding?! I had also heard that when you first start your period it may not be consistent, so I wasn't worried. I became more concerned as time went on and the pattern continued. It was slightly frustrating that I would never know when a visit from Aunt Flo was coming. I began to question if I should get checked out when I was entering my early 20's. I was given reassurance by loved ones that it wasn't all that abnormal and so I didn't get checked. I just figured it would work itself out. I have some regrets about this now, but hindsight eh? The lesson I learned from this: Trust your gut, especially when it comes to your body and especially when there is nothing to loose and knowledge to gain. So what if I went to the doctor and they told me everything was normal and I had nothing to worry about. Worst case I was out a $20 co-pay, but at least I would have knowledge and peace of mind.
But I can't change the past and I don't know if I would. I have, after all, learned many lessons through this journey and I think I am better for it.
As Matthew and I began trying to get pregnant we had typical feelings: excitement, nervousness, fear, etc. But as time went on the biggest feelings I experienced were frustration and disappointment. These feelings weren't strong at first but as my journey continued they were at times constant companions. I first went to my ObGyn for fertility help in late spring of 2011 when I was just finishing up graduate school. My OB immediately started me on Clomid, which is an ovulation medication. I did three rounds of this medication, increasing the dosage each time to no avail. At this point Matthew and I decided to move to Seattle and with the stress of a new job and the frustration of seeing many of my friends and family easily get pregnant and struggling to do the same, I put finding an ObGyn on the shelf. It hurt too much and I was scared of facing infertility, so I tried hiding for a while.
Looking back this is something I needed, and many who experience infertility have these moments. It is important to let yourself breathe and take a break when it all seems like too much. At times I think I took too long coming back, but each break gave me clarity and in different ways increased my determination to gain control, understanding and peace with whatever would come.
When I finally decided that I was ready to fight again, I felt inspired to see a specific ObGyn. It was a bit random how I found her. I went to my insurance website and typed in ObGyn in the search engine within a close radius to my house. Her name was not first on the list, but it definitely popped out of the page at me when I saw it. Funny thing is, that although I didn't ask for recommendations from anyone, many of my friends also were seeing this ObGyn(Dr. L) and all gave rave reviews. It was a blessing to have her as a doctor. I knew at our first meeting that the Lord had sent me to her for a reason. She looked at my history, including my experience with Clomid, my lack of periods and surprisingly the blood clot (DVT) that I had in 2010. She asked if I had been tested for any clotting disorders. I said I hadn't because my primary care physician said that I had enough risk factors to explain the blood clot; first, I was on an estrogen based birth control and second, I had been traveling. Dr L. looked at me and said, "Really? There are plenty of 20-something year olds who are on birth control and travel, but they don't get blood clots, so why do you?" I was a bit taken back, but she made an excellent point! She then suggested I get blood work done to test for clotting disorders and to test my hormone levels to see if they could find a reason for my lack of periods/difficulty getting pregnant. I can't remember if it was at the same time or after the blood work came back, but I also had an ultrasound of my ovaries. With the results of the blood work and the ultrasound I was given two diagnosis: Factor 5 Leiden and Polycystic Ovarian Syndrome (PCOS). The Factor 5 Leiden is an inherited clotting disorder and PCOS is one of many syndromes/diseases that can cause infertility. This news was both empowering and daunting to hear. While it scared me to hear that there was not only one reason that it may be hard to get pregnant but also the increased risk of miscarriage because of a clotting disorder, it also gave me a path to start on. This new direction gave me hope. They say "knowledge is power" and I definitely found it to be empowering.
With the PCOS diagnosis Dr. L wanted me to see one of her nurse practitioners (NP) who had worked with a fertility clinic in the past. The first thing we did was put me on Metformin. At first I was confused about being put on a medication I had associated with diabetes, but the NP explained that with PCOS, hormone levels are off balance and Metformin affects insulin which is a hormone. The hope was that by affecting one hormone, the other hormones would also get in sync, at least I think that's the idea. Overall, they put me on Metformin with the hopes that I would begin to have a regular period. The NP informed me that this would more than likely take at least 6 months to happen, at which point we would again try an ovulation medication like Clomid.
Along with the Metformin I also started taking a baby aspirin to decrease my risk for clotting, Vitamin D because when my blood was tested it was found to be low and a Prenatal Vitamin just in case. There were times that I felt like a pharmacy and as things progressed I only took more.
The Metformin was hard to take at first because it would make me nauseous, but eventually my body became acclimated to it. Along with the drugs, I was encouraged to increase my physical activity. This spurred Matthew and I to start running together and eventually sign up for a half marathon.
Well, in my case, it took much longer for the Metformin to help regulate me. I actually didn't see any signs of regulation until March of 2013 and at that point I was about at a 60 day cycle, but more on that later. After at least 6 months (I actually think it was longer than this, but I can't really remember, it all blurs together) on the Metformin the NP and I decided to give the ovulation medication a try even though I was not having a regular cycle. The plan was to induce a period using a progesterone based medication and then begin the Letrozole(a "sister" drug to Clomid) in hopes that it would get me to ovulate. All of this is fairly time consuming and requires one to go to the doctor a few times within a very short period of time. I was very lucky to have a great manager at work who allowed me to create my own schedule, so it was a bit easier to make all the appointments.
There are three doses with this ovulation medication, so the plan was to start with the lowest dose and work up if needed. After taking the Letrozole I would go into the doctor and have an ultrasound performed to see if it did its job (meaning see if I ovulated). The plan was to attempt three doses and if there were no signs of ovulation to send me to a fertility specialist.
This process is not only time consuming, but very emotionally draining. I really had to begin to face my infertility and the possibility of never becoming pregnant. There were days that all I wanted to do was cry and many times I would do just that on my way to and from work. Random things would set me off, a song on the radio (Mumford and Sons, I Will Wait was a big trigger and help for me), a sign/billboard, going to the temple and participating in the ordinances and hearing the blessing promised that I had yet to receive, talking with a friend or family member about their children, or hearing about yet another person that was pregnant. At first I would hold back this emotion or stuff it down, but it got to a point where I couldn't take it anymore. I needed the release. In fact it typically made me feel better and in ways gave me the strength to continue. There were many times that I would hear a song on the radio that would make me feel like God had heard my prayers and was sending me a message to trust Him. It was in these moments I would crank up the radio and sing/cry at the top of my lungs. This might not be something that works for everyone, but one of the best pieces of advice I can give to someone else going through something similar is to find a release for your emotions. Find somewhere you feel safe expressing them without having to worry about time or other people.
On a similar note, find someone to talk to. You may not be like me and like to share your experience. It can painful and really it is nobody's business, but talking about things can be very therapeutic. Often just saying how you feel and feeling like you have been heard can lift the burden. Three pieces of advice:
1) Find someone who has been through something similar. I am fortunate to have met a few other women in my church group who have had fertility issues and who gave me a listening ear and a shoulder to cry on. I also am fortunate to have a friend, who although does not live close, invited me to an infertility group via Facebook. Hearing others' stories and ways they have coped or even just a place to vent when someone says something stupid(and this WILL happen) was a great way to get past some of my emotional downs.
2) Find someone who will listen rather than give advice. It is good to have advice, but it is nice to have the advice given after you have asked for it. Sometimes, just having someone listen is really helpful. Saying something out loud helps me to process in a different way and often helps me find a solution and/or peace.
3) Unfortunately you will come across those who have not experienced the pain of what you are going through and will inevitably say something hurtful, although most of the time unintentionally. Try to let it go and if possible try to find the humor in what they have said. I'll share two experiences:
- This first experience was easy for me to find humor in. It is amazing the things people will say to you when they find out you are trying to have children and having difficulty. I had this co-worker that I adored and that made me laugh on a regular basis, so I wasn't too surprised that her reaction and advice made me laugh when she found out about my infertility. She actually asked me what positions Matthew and I had tried and gave a few suggestions of positions that are "known" to be the best for getting pregnant.
- This second experience, was definitely more difficult to laugh about, but as I've gained distance from it, I've realized that it wasn't meant to be hurtful. I was at one of my best friends' baby showers (already a sensitive place to be) and we were all chatting about this and that. The women in the group knew of my difficulty with fertility and somehow the conversation turned to my situation. One of the women in the group said something similar to 'You should be grateful for this time that you have with your husband. You are getting to do a lot of things that you wouldn't be able to do if you had kids.' At the time this really aggravated me because I feel like people make the assumption that because I am sad about my difficulty having children, I cannot be happy or grateful for other things in my life. Of course I know and have taken advantage of the time I have had with Matthew, but that doesn't mean I can't be sad or frustrated about not having children. I can have complex emotions! I can feel happy and sad and grateful and frustrated all at the same time!
Anyway, back to my fertility treatments. So, around October/November of 2013 I had my first round of Letrozole and nothing happened. The plan was to try again in December, but when my period came on its own (great news!) I discovered that I would be out of town for the holidays when it was time for the ultrasounds (not so great news), so I told the NP that my second round would have to wait until after the New Year.
In early/mid January I began to feel nauseous. I thought, "Could it be! Did I get pregnant on my own without treatments!" I took a pregnancy test and it was negative. I was confused. Why was I nauseous if I wasn't pregnant. I hadn't changed anything in my day to day life. I went back to the NP and reported my symptoms. She had me take a pregnancy test and ordered an ultrasound to check things out. That is when a baseball sized cyst was found on my right ovary. It had actually moved my ovary from it's normal position and was the likely culprit of my nausea. Having a cyst this big is no small thing. It can actually be a huge emergency, especially if the cyst bursts, but with my history of infertility my ObGyn didn't want to do surgery if she didn't have to because it was highly likely that the surgery would result in me loosing the ovary. So, we took a gamble and hoped that the cyst would go away on its own. She told me all the signs and symptoms of the cyst bursting and said to go straight to the ER if I had any of them. We again had to forgo the Letrozole treatment and scheduled a follow-up in two weeks to see where the cyst was at.
Two weeks later the ultrasound came back normal and we were clear to try treatment again. The only problem was now the NP insists my cyst was caused by the treatment I had previously, and was hesitant to increase the Letrozole dose to the second tier. I tried to convince her that the cyst showed up so long after the treatment(at least 2 months) that there was no way they were connected, but she wouldn't listen to me. I decided that some treatment had to be better than no treatment and went along with receiving the lowest dose of Letrozole again. That treatment didn't work and there were no additional signs of cysts.
The next month I again had a period on my own and I realized that I was getting my period every other month. I was excited at the discovery and knew in my heart that getting pregnant was possible. This time the NP was willing to try increasing the dosage, but I didn't get pregnant.
When I went back in the following month, I expected that we would proceed as previously discussed and try a final round of Letrozole at the highest dose, but the NP caught me off guard when she said that she was referring me to a fertility specialist because she didn't feel comfortable giving me a higher dose of the Letrozole because of my cyst history. I was very frustrated, sad and angry. I didn't understand why she insisted that the medication and cyst had anything to do with one another. I felt she wasn't listening to me. I knew she was the medical professional with experience in this area, but I had learned so much about my body and I just knew that if we stuck with the plan that I would get pregnant. Still, she referred me.
I had had it. I told Matthew to forget about the medical professionals and fertility specialists, they didn't listen anyway and I would find another way to get pregnant. I refused to set up an appointment with the fertility specialist, but instead started to talk to friends about more holistic approaches. I was looking into herbs and essential oils and I was planning on meeting with a friend of a friend regarding more natural ways to deal with infertility. While I was angry at the medical community at large and looking for answers elsewhere, Matthew stayed calm and eventually convinced me to let him set up an appointment with the fertility specialist and give her one visit before shutting that avenue out completely.
The day of the appointment arrived and I didn't hold back my frustration. In fact, I let out all of my frustration and piled it on this poor doctor. I said everything that was on my mind and I basically told her what the plan was. In so many words I said, "I know my body and I know this will work. I'm not willing to try anything else until we stick to the original plan first, because I know it will work." I was a little taken back when she said, "I completely agree." In that moment she won me over. I then told her that I was expecting that my period would show up in the next week and she handed me a prescription. This experience taught me that no matter what, again, trust your gut and find a doctor who is willing listen to what you are saying and take it into consideration. If you feel like your doctor isn't listening or is brushing you off, find a different one. your relationship is a partnership.
At the end of May/beginning of June I had an inkling, but I decided to wait until after my birthday to take a test. On June 9, 2013, after 2 and 1/2 years of trying, I took a test that said I was finally pregnant.
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