Hello!
Today's a happy day because my husband gets back from a work trip he's been on all week. I'm usually able to travel with him, but this time I was too pregnant. I hung out with my family that lives in town quite a bit, but I still missed him!
I'm not quite sure what to write about today. I've probably done enough about Gilmore Girls for a while, hah. I guess I can talk a little bit about my pregnancy? Plus maybe the path to get here, since it did take up several years.
Right, so! My husband and I got married in the summer of 2013. We always knew we'd want kids eventually, but we both agreed to wait at least a year before even considering trying. During that year, I was on the combined pill. It did not agree with me. I was nauseous all the time and had no appetite. I dropped a dangerous amount of weight. It retrospect, I can also see that it really affected my moods. I was fairly depressed, and it made my anxiety much worse as well. So in July of 2014, I came off the pill. We still weren't quite ready to start trying yet at that point though, so we used other methods of prevention.
We started feeling more ready for a baby in early 2016, so we did the "not trying, not preventing" thing for a bit. Then when it still wasn't happening, I began to take a bit more of an interest in how reproduction actually works. I educated myself on ovulation and fertile windows, and we got a bit more serious about trying. Then in July of 2016, we learned that my husband had a tumor in his bladder. The doctor was sure it was cancerous, so when he took it out, he also put some chemo into his bladder. My uncle, who is an oncologist, thought it would be wise to take a bit of a break from trying to let any potentially lingering chemotherapy clear my husband's system. We waited for a bit, and then got back to trying.
In the spring of 2017, I realized that we'd had 12+ cycles of good timing with zero positive pregnancy tests. I got all my notes together and presented them to my GP at my annual exam. She recommended I start the process of getting diagnosed with a reproductive endocrinologist (RE). I made an appointment, and we started all the initial testing. We found out I had subclinical hypothyroidism, but basic bloodwork and a semen analysis didn't turn up anything else. My husband had another surgery to remove another bladder tumor in between some of this testing, but no chemo this time so no time off of trying.
I went in for an HSG, which is a procedure in which they put dye through your reproductive system and do an xray as it spreads out. If there's a blockage in your tubes that's preventing sperm from meeting egg, then the dye won't go through and they'll be able to diagnose you with that problem. It turns out that this test can ALSO show when you've got something weird in your uterus.I had a uterine septum, which is a division in your uterus that happens when it doesn't divide properly while forming. My RE recommended surgery to remove it because it greatly increases miscarriage risk (partly because it restricts space for a growing fetus, and partly because if the embryo implants on the septum, it won't get enough blood flow because the septum isn't nourishing like the wall of the uterus is). She also recommended that we look for endometriosis at the same time as we removed the septum because endometriosis is often correlated with uterine septums. Symptoms of endo include heavy, irregular periods, very painful menstruation, bloating, and in some cases, infertility. I gave the okay for her to look for endo and remove any that she found, though I wasn't actually expecting her to find anything because I always thought my pain during periods was within the normal range.
I had my surgery in early fall of 2017. It turns out, I had stage 3 endo. Whoops. I took the rest of that cycle off, but my RE recommended we hit the treatment hard after my next cycle began. She said that my best bet of controlling regrowth of the endo was to get pregnant within six months.
I did not get pregnant within six months, despite the use of high doses of letrozole (a drug that induces ovulation or in my case "super" ovulation, which just means more than one egg is ovulated), a trigger shot to cause ovulation to happen at a certain time, timed intercourse, and eventually intrauterine insemination. We ended up having to take ANOTHER break in between all of this because my husband had yet another bladder tumor to remove, this time with more chemo, and my RE requested 90 days for it to clear his system before we resumed treatment. We took the break and then resumed treatment, but I wasn't responding as well to the medications. Then, my husband and I decided to move, mainly to be closer to a very good doctor for the type of bladder cancer he has (though bonus is that we're also closer to family).
When we moved, I switched REs to someone in our new city. By this point, we'd done enough cycles of femara that everyone agreed that if it was going to work, it would have already. We were ready to move onto IVF. We did all the classes, did some additional testing, signed all the paperwork, and ordered all the drugs. We started stimming in mid-May (this is what it's called when you give yourself a bunch of shots of various hormones to stimulate your ovaries to mature a lot of eggs). I went in for retrieval at the end of May, and they were able to get out over 25 eggs, which they attempted to fertilize and mature into embryos over 5-6 days. In some cases, you can do a fresh transfer of an embryo five days after your retrieval, but I was at high risk of OHSS (ovarian hyperstimulation syndrome, which is basically when your ovaries release tons of fluid after an egg retrieval and it makes you pretty sick), which is made worse if you get pregnant from a fresh transfer. Plus, my husband had ANOTHER surgery on Day 6, so timing would have been a bit too hectic anyway. I did end up with some pretty severe OHSS symptoms. It was miserable and didn't fully go away until my next period started about two weeks after retrieval. But on Day 6, I took my husband into surgery and obsessively checked my phone for updates regarding our embryos. We found out that 8 made it to freeze, which was really exciting! I then had to take a bit of time off for my cycle to work itself out.
We started a round of lupron injections to help calm my ovaries down, and then we started medication for a frozen embryo transfer (FET). I found out that the reason that I most likely reacted so poorly to the combined birth control pill back in the day was because my body apparently hates synthetic estrogen. They gave me estrogen patches to wear because estrogen helps your uterine lining to grow so that it's ready to accept an embryo, and I felt really sick while I was on it by itself. I started progesterone in oil (PIO) injections, which hurt WAY more than all the injections up to this point, which sucked. BUT starting the PIO did at least cause my nausea to decrease, which was nice.
Five days after starting PIO (roughly mid-August of 2018), I went in for my embryo transfer, where they place the embryo directly into your uterus. About a week and a half later, I got my first ever positive home pregnancy test in the middle of the night and sobbed hysterically for a bit. I waited until my husband woke up because I didn't want to be a jerk. He knew I was testing that day, so he asked if it worked, and I said yes. He said, "Good," before snuggling back up with me and falling back to sleep, hah. I went in for a couple of blood tests after that to confirm that it was really positive and to check the doubling time (if HCG doubles in 48 hours, it indicates that the pregnancy is ongoing). Then we tried to pretend nothing was different for the next few weeks until our first ultrasound.
This ended up being longer than I was expecting, so maybe I'll cover the actual pregnancy in a different post. I hope this wasn't too boring to read!
-Leah