“Patience is a form of wisdom. It demonstrates that we understand and accept the fact that sometimes things must unfold in their own time.” -Jon Kabat-Zinn
Hopefully, for those of you that can’t relate to the infertility aspect of all of this, can find some inspiration from the essence of the quote above. When things aren’t happening the way you expected, find some positivity in the fact that all difficult things take time and effort to achieve. If you truly want something, work for it, put in the time, and it WILL happen.
I wrote my last post about my TTC journey at the beginning of May, one year after we began trying to start a family. I think the difference between now and then is my ability to accept the things I cannot control. The past four months have felt like an eternity, yet equally, like I blinked and they have passed. Do I want to be pregnant? Abso-freaking-lutely. With all my heart and soul and then some. I wanted to be pregnant a year ago! The difference now is that I can wait. I don’t plan on giving up on that dream anytime soon. I know that although we’ve hit some road blocks along the way, and we’re going to keep tackling them until I wake up one day, pee on that damn stick, and see that positive test result I’ve been dreaming about. Better believe y’all will be able to hear me scream all the way out in Georgia when it happens. Anyways, here’s the rundown of how I spent my summer.
After another unsuccessful month on our own, back in May, we made the decision to enlist some help by contacting Advanced Fertility Care in Scottsdale, Arizona. We started with a tele-med consultation with our fertility specialist to talk about things we had tried so far, our health and medical history, testing that would need to be done, and possible treatment options moving forward. We left the appointment with a plan- lots of scheduled testing that would, hopefully, eventually lead to a decision for treatment, and a lot of hope. Our doctor had agreed that we were both very healthy, young, and in a prime position to find success in our journey.
Before testing, our specialist concluded that we would most likely be great candidates for an IUI. IUI stands for intrauterine insemination, or a form of artificial insemination. This procedure places sperm, via small catheter (virtually painless), directly into the uterus around the time of ovulation to help facilitate fertilization of the egg. We also talked about using a fertility drug, such as Clomid, to guarantee ovulation, as well as the possibility of a trigger shot, to nail down timing of ovulation. A trigger shot is a hormonal injection, given the day before an IUI procedure, that stimulates the ovaries to release an egg to be fertilized. Then, on the day of the IUI procedure, a sperm sample is given and taken to the center to be “washed,” removing all bacteria, chemicals and extra fluid, non-motile and poor quality sperm. This leaves a highly concentrated, highly motile sperm sample to be used in the procedure. After learning all of this information, we felt super confident that this was the approach that would work for us. We were so excited!
A couple of days later, I had my first appointment at the fertility center for testing. This first round of testing included a sonohysterogram, a hysterosalpingogram (HSG), as well as bloodwork from both Shawn and I. Yeah. Prepare yourself, I am literally about to become a human science experiment over the next few paragraphs.
First up was the HSG. The HSG is an X-ray procedure used to look at the uterus and fallopian tubes. The doctor injects iodine into the uterus to show the pathway to the fallopian tubes is clear. I was literally able to see on the screen in the procedure room the iodine go into the uterus and then spill out either side of the fallopian tubes. This was a good sign, as there are clear pathways to eggs in each of my tubes. Keep in mind that in the past I had an IUD (intrauterine device to prevent pregnancy) placed in my early twenties, so no, these procedures didn’t hurt. It was uncomfortable, yes. I had some slight cramping, and I had to get used to it becoming a normal thing for MULTIPLE people to view my lady parts, but NOTHING compares to the shitstorm that was the IUD placement. Side note: Don’t get me wrong, my IUD was amazing. It allowed me to get rid of the pill which was putting a bunch of hormones in my body everyday, and it did its job while I had other priorities in my life, but holy crap, it sucked getting it put in. Anyways, I digress. The HSG wasn’t a biggie, and we found out that my uterus, ovaries, and fallopian tubes were looking good so far.
Next was the sonohysterogram. This procedure is an imaging study of the uterus where the doctor injects fluid into the uterus to allow them to view the lining and identify any abnormal growths or blockages that may exist. Again, I was able to view the procedure on a screen above me. The doctor pointed out the smooth parts of the uterine lining as normal and what we look to see. This allows an ideal environment for a fertilized embryo to attach. Then he pointed out a small polyp, or growth, typically non-cancerous, right in the middle of my uterus. He told me that polyps can decrease chance of pregnancy by up to 25% and that, most likely, the recommendation would be to remove the polyp before any treatments were performed. In other words, I would have to have a surgery before we moved forward with our treatment plan. Beyond this single polyp, my uterus looked great. Stupid freaking polyp. BUT, at least there was a possible answer of why we were struggling. Maybe once this was done, we would finally find success!
Lastly, Shawn and I had blood drawn for multiple tests including STDs, thyroid, blood type, and hormones. After a couple of days, our results came back all normal, and we also received a call from our specialist. He agreed with the conclusion that I would need to undergo surgery to remove the polyp in my uterus before we moved forward with our treatment plan. At this point, there were a few more tests that needed to be completed at the start of my next cycle, and then we would schedule the surgery. Following a successful surgery, we would be clear to do the IUI the next month.
Another two-week waiting period ensued. We went back to the fertility clinic at the beginning of my cycle to test for cycle-based hormones (another blood draw), and to do an ultrasound of my uterus. This ultrasound took a closer look at my ovaries to check my follicle count to ensure I had plenty of eggs. We were able to see 8-9 follicles in each ovary (the doctor said he looks for at least 3-5), indicating I had plenty of eggs. A couple of days later, we received the bloodwork results, and all tests were normal. After receiving the results, we decided to go ahead and schedule the surgery for June 30th. Let’s also note here that my luck is absolute shit, and it’s required to schedule surgery before ovulation (cycle day ~12-15). Because I had an earlier that expected period that month, we were going to be off by LITERALLY 2 days from this window. As a result, they had to put me on a birth control pill for two weeks before my surgery to ensure I wouldn’t ovulate before the surgery. The doctor assured me this shouldn’t have any effect on my cycle or my ability to conceive after surgery.
At the end of June, we finally made it to surgery day. I was nervous because I had never gone under anesthesia before, but excited that maybe this was finally the answer we had been searching for. My surgery went so smoothly. I went into the operating room, breathed in the gas, thought to myself "man, I wonder how long this will take,” and BOOM, I woke up, and we were done. The doctor told me that surgery went perfectly, they removed the polyp and sent it off to the lab (the results returned a couple of days later-benign), and I would be good to go on an IUI cycle next month. We were ecstatic.
A couple of days after the surgery, we made our way back to Georgia to visit family and friends back East. Before we left Arizona, I got a recommendation for a clinic in Atlanta- The Atlanta Center for Reproductive Medicine. I also got a recommendation from a neonatal surgeon that my Mom works with for the same fertility center and a doctor named Lisa Hasty. I was able to schedule a consultation with Dr. Hasty via tele-med on July 8.
During this appointment, we discussed all of our test results to date and developed a treatment plan. She agreed that we were great candidates for medicated IUI with a trigger shot, since we were working on a time crunch with Shawn’s possible job start-up looming. She decided that we would go with the drug Letrozole instead of Clomid, since Letrozole typically has fewer side effects, and since we had already used Clomid in the past. Essentially, both drugs have the same effect, in that they both induce ovulation. Letrozole has been shown to boost the growth and release of follicles in women who are anovulatory, and it can cause superovulation in women who ovulate normally, AKA me. Dr. Hasty also cautioned us that even with all of these tools in place, we were still only putting ourselves on even playing field with normally conceiving couples. That means we would only have a 20% chance of conceiving on this first round of IUI. Is that not crazy? All that work and there’s still a large chance that it won’t work. Anyways, she told us to be patient through at least three cycles of IUI, if the first round doesn’t work out, before we discuss other options.
The plan then, was to wait for the start of my next cycle begin taking Letrozole for five days, then we would have a mid-cycle appointment to check the maturity of my follicles and do more bloodwork to determine ovulation timing, administer the trigger shot based on these results, then FINALLY have the IUI. Shawn was also put on a supplement to increase sperm quality and motility, we were instructed to steer clear of alcohol, and otherwise, go about life as normal. Another waiting period began.
For whatever reason, maybe it was the surgery or the birth control or moving across the country in the midst of everything or more shit luck, who knows, but I was about three weeks late for my period. Awesome. This waiting period was the absolute WORST. All I could think about was getting this process started, but my body had different priorities. On July 30th, it finally happened. I started my Letrozole prescription a couple days later, and the ball was finally rolling. We were instructed to begin home ovulation tests during this time, and to call if we got a positive test before my scheduled mid-cycle appointment. I went in for this appointment on August 10th. They did an ultrasound of my uterus to check the maturity of my follicles and determined that I had a dominant follicle that was pretty close to ovulating. We coupled this with bloodwork to check my luteinizing hormone level, which would indicate if a surge was occurring. An LH surge would indicate ovulation and determine that we were ready for the IUI procedure. The results from the bloodwork came back later that afternoon, and although my LH levels were normal and quite close to ovulation, they weren’t quite there. Since Shawn had to start traveling to California in three days, we decided that the trigger shot was our best option. We picked up the trigger shot from the pharmacy that night, and scheduled an appointment to have it administered the next morning.
On the morning of August 11, I received the trigger shot, and scheduled my IUI for the following morning. The next morning, Shawn drove his sample up to the center for washing. That process took about two hours, and then we both headed up to the center for my procedure. Thanks to Covid, I’ve had to do all of these appointments alone, since they don’t allow partners to attend appointments right now. Shawn told me that I needed to triple check that the sample was actually his before we went through with it. LOL. Good news: they got it right. In an extremely romantic 3 minutes following the sperm verification, I laid down on the table, had a speculum and catheter inserted into me, and was injected with super sperm. The doctor told us that we had a great sample (plenty of healthy, motile sperm), which had us both feeling at ease and very positive leaving the facility. Shawn left the next day to begin his drive out to California for the new job, and I stayed behind to finish out the process.
A week later, I went back into the facility for more bloodwork to check my progesterone levels. This shows whether or not ovulation occurred, and if my levels are high enough to support an early pregnancy, but cannot show whether I am pregnant or not. The pregnancy test blood draw would actually occur two weeks following the IUI. The results came back good! My levels were completely normal and showed that I had had a strong ovulation. All good news and kept us feeling very positive! I scheduled my flight for that Sunday to meet Shawn and start our life out in California.
Unfortunately, on the day of my flight, I started my period. Although it’s highly fucking discouraging, honestly every time that I start my period these days, I feel like this one was the easiest to swallow in a way. This time we had literally done EVERYTHING in our power to make this work. We felt like we were finally on equal playing field with everyone else in the world. Even then, being super healthy individuals, and getting the treatment, normal chances of conception are only 20% each month. We just weren’t very lucky. Maybe, this was our first REAL month of trying with all of the obstacles we had been facing removed. Looking on the positive side of things, most young, healthy couples will conceive within 6 months of starting to try. That means we should be pregnant within the next five months, so that’s what we’re hoping for now.
With another stroke of bad luck, our specialist wasn’t available for a follow-up via tele-med until September 16. That means we won’t be able to do another IUI this month, but we are hoping (unless we hit the jackpot and we get pregnant naturally this month), that she can recommend a fertility clinic either in Palm Springs, San Diego, or Los Angeles area that we can get set up with. Ideally, we would like to skip all the expensive testing and just go straight to the IUI, so that’s another reason why we are waiting to speak with her before blindly getting started somewhere out here. So that’s where we’re at, friends! Still not preggo, but still very hopeful that we will be soon.
You guys, I’m telling you, I have never manifested something so hard. I think about it night and day. I pray about it every night. It’s going to freaking happen. Yes, it’s frustrating. Yes, I have bad days where I can’t pull myself out of the dumps. Yes, it’s hard seeing so many people around me get pregnant. But ultimately, I believe I’m on this particular journey for a reason. I believe that we’re being tested, but that we are going to come out on the other end (WITH A BEAUTIFUL HEALTHY BABY), so much stronger, and as incredible, eternally grateful, loving parents. It’s just a matter of time. I can’t wait to be a Mom and for Shawn to be a Dad. I can be patient for that.