Saturday, December 10, 2011

Our Secondary Infertility Journey (so far)

This post has been a long time in the writing.  I joined this wonderful community of Catholic women bloggers, several of whom have struggled with primary or secondary infertility, as a way to support myself emotionally and spiritually and maybe, just maybe, to give someone else support.

After our son, Junior, was born we needed to postpone another pregnancy for a little while.  While I was ready to get pregnant again right away (well, as soon as AF returned which was only 3 months after giving birth.  I didn’t BF…there were reasons; I’ll leave those for a different post), my doctor advised me to wait until the due date for baby #2 was at least 18 months after the birth of Junior.  I had had a C-Section and she wouldn’t allow me to attempt a VBAC if the due date was less 18 months after Junior’s birthday.

Mr. Amen had been layed off from his job just days before Junior was born.  Though he had been looking for a new job, the recession had really taken its toll on our state and he was unable to land a new gig.  As 2009 came to a close with Junior past his first birthday, I longed to start trying for baby #2.  We kept thinking a new job was just around the corner for Mr. Amen, but each month passed jobless.  Finally in March 2009 we decided that we didn’t want to put our plans to expand our family on hold forever…afterall, I certainly wasn’t getting any younger.  We decided to put our trust in God and go ahead and conceive again.  After all, it had been a snap to conceive Junior.

Oh, how naïve we were.


I wasn’t ovulating regularly; I had short luteal phases when I did ovulate.  We’re talking 7-8 days.  My doctor talked to me about starting Cl.omid to get better ovulations and help lengthen my luteal phase.  We weren’t quite ready to take that step yet.

In early October 2009, Mr. Amen landed a new job.  We were thrilled and just knew another blessing in the form of a baby was right around the corner.

At the end of October we learned that we were expecting.  Overjoyed, doesn’t quite cover the emotions we felt.  We had made it through some very difficult times over the past 2 years and everything was falling into place at long last.  We were due on the 4th of July.

My blood work showed low progesterone, so I started Cri.none 8% (a vaginal suppository of progesterone, usually used during fertility treatments such as IVF).  When I was approximately 7 weeks along, we got home from Mass and I went to the restroom where I discovered I was spotting.  I was alarmed and told Mr. Amen who suggested I just take it easy that day, sit down and put my feet up.  I lounged around all day and didn’t have any further spotting.  Figuring all was well, I went to work on Monday.  During the morning, I went to the restroom and again found that I was spotting.  I called my (new, wonderful, amazing, Natural Family Planning only) obstetrician and he asked me to come in right away to be checked. 

Of course, when it rains, it pours.  I called my mother to ask her to pick up Junior from daycare and take him to his doctor appointment for me because I might be late.  I said I would meet her there.

I saw one of my doctor’s partners because he was completely booked (honestly, he’s always completely booked and darn near impossible to get in to see without an appointment months in advance).  She examined me and took me back to see the ultrasound technician.  As soon as the image flashed on the screen, I knew something was very wrong.  There was a sac, but no baby and no heartbeat.

I was told I had a blighted ovum, was miscarrying and that I could expect it to happen anytime over the next several days.  I left stunned, calling Mr. Amen when I reached the car to tell him the sad news.

I didn’t have time to really feel it yet though because I had to hurry to the family doctor for my son.  My mom was there with him and stayed for the appointment with me.  She was asking a million questions, as always, wanting to know why I was late.  I said I had to go to the doctor and get my blood drawn.  She asked which doctor and not wanting to get her hopes up, I told her that I had gone to my endocrinologist.

After Junior’s appointment we went to my parents’ house and Mr. Amen met us there.  We told my parents what was going on and we all had a good cry about it.  Tuesday evening, my parents invited us over for dinner so I wouldn’t have to cook or clean up.  While we were eating I started feeling more and more cramping until I broke out in a sweat.  We packed up and headed home.  Tuesday evening was the worst of the pain.  The cramping was incredible (I usually have a pretty high pain threshold) and the bleeding was heavy. 

I took a several days off work because I was so sad.  Explaining to my boss why I was suddenly off for three days with no notice was not exactly pleasant.  I did tell him the truth of why I was not coming in and he was very understanding, even sharing that he and his wife had experienced a miscarriage as well.

In our families, only my parents and Mr. Amen’s mother knew of our loss.  I couldn’t bring myself to tell my sister, brother and his wife.  They had just had their third sweet baby and we didn’t want to make everyone sad at the holidays.

After taking some time to heal physically, in January, we forged ahead with trying again.  This time, with Cl.omid.

Round 1
Dosage = 50mg on CD 3-7.  It didn’t help much.  I did experience some lovely hot flashes during the night, and my luteal phase was a whopping 10 days.

Round 2
Dosage bumped up to 100mg on CD 3-7.  Again, not much help.  Hot flashes were more intense and a few headaches.  Luteal phase = 12 days.  My doctor suggested PreS.eed, but honestly, it wasn’t needed…I’ve always had great CM.  That’s one thing my body does well.

Round 3
Dosage left at 100mg on CD 3-7.  Hot flashes and headaches continue.  Luteal phase = 8 days.
I called the doctor’s office after this round.  My doctor thought we should up the dosage and see if we got better results.  Unfortunately, he wasn’t around to provide a script for a higher dosage and their office policy is that the other doctors won’t mess with writing new/different scripts for fertility drugs for each other’s patients.  The nurse urged me not to waste the next cycle and just take the 100mg again and we could increase the dosage next cycle.

Round 4
Dosage = 100mg on CD 3-7.  Hot flashes and headaches same as before.  Luteal phase = 5 days.  Seriously, 5 days.  Awful.  The higher the dosage, the worse the results.

My doctor suggested moving on from Cl.omid to Fem.ara.  Mr. Amen and I talked about it over and over and we weren’t ready to go on to this new drug.  So we decided to take a rest for a cycle to think it over.

Rest Cycle 1, I didn't even ovulate and my "cycle" was only 22 days.  We stopped daily charting on CD 18 this cycle.  We really needed a break from the stress of it all.  I was extra emotional from everything that was going on and just needed a break.  Plus work was brutal, I was swamped and needed to give my full attention to my work instead of obsessing over my charts.

We still weren’t ready to up the ante to Fem.ara yet, so we decided to rest for another cycle and then make a decision. 

Rest Cycle 2, much to our surprise resulted in a positive pregnancy test on CD 26.  We were resting in the sense that we weren't pursuing fertility treatments, but we were still trying.  Our due date was 02/09/2012.  Again, I had low progesterone and started Cri.none 8% right away.  Just past 6 weeks, I went in for an ultrasound.  The baby measured 4-5 days behind, but we could see the heartbeat.  My doctor was happy and so were we.  At 8 weeks, on June 29th, my husband and I went in for our nurse OB appointment.  We had an ultrasound scheduled first to make sure everything was OK with the little bean.  When the screen lit up, I knew immediately.  The ultrasound technician grew very quiet and quickly took a few measurements.  I was already crying and Mr. Amen was growing restless because he couldn’t tell what he was seeing and wanted the tech to point out the baby to him.  The tech said, “you will be talking to a doctor today before you leave.  Do you want me to just tell you what I see?”  I said yes because Mr. Amen had no idea and I couldn’t say it.  She informed us that the baby had passed away just after our last ultrasound.  She left the room and we both broke down.  The doctor we saw was very kind, told us our options and we opted for a D&C on July 7th. 

We also had to go across the street to the hospital to get me a shot of Rh.oGam since there had been a heartbeat.  I’m allergic to that shot, so we had to stop to buy Bene.dryl to take before getting the shot.  When I got there for the shot, they had to draw blood to check to make sure I really had Rh negative blood.  We waited about 20 minutes and the nurse came out and told me I didn’t need the shot because I had Rh Positive blood.  Considering my raw emotional state, I think I did a pretty good job staying calm while I explained to her that 1) I do have negative blood, 2) I’ve had negative blood my whole life, 3) the R.ed Cr.oss says I have negative blood, 4) I have the same blood type as my mother who has negative blood, 5) I had the shot when my son was born, 6) please check your records again and 7) go get me the shot.  The nurse, then, went and got me the shot.

That weekend we went to a beach in Ontario, Canada for 4th of July.  I already had said I couldn’t bear to be home since it was the due date of the baby we had lost in November.  Now this.  We had a relaxing day at the beach with my parents.  Junior ran up and down along the “seashore” and when we got in the car to go home, he was asleep before we got to the main road.

The day of the D&C, we arrived at the hospital, they prepped me and it was over quickly.  Mr. Amen was really glad to talk to my OB, as he helped calm his nerves and told him the procedure went perfectly.  We had the baby tested to see if we could determine what was causing these losses.  When the results came back, everything was perfectly normal.

The doctor also ran blood work on me testing for all sorts of problems.  Everything came back perfectly normal.  My hyprothyroidism is well controlled, no other clotting factors or Rh incompatibilities showed up.  He tested for several other things…I can’t even remember them all, but everything was normal.

We were told we had to wait one cycle to start trying again.  We waited the one cycle, then the very next cycle we were pregnant again.  Our due date was 05/11/2012.  Because of my history, I was being monitored closely.  My first blood draw on CD28 showed hcg of 91 and very low progesterone.  I started the Cri.none 8% again.  Two days later, on CD 30, my hcg levels had more than doubled to 219.  Things were looking up for us.  On CD 43 (6 weeks) my hcg was 13,599.  Normally, they wouldn’t have drawn blood, but we also had an ultrasound that day and the baby was measuring 5 weeks instead of 6.  They thought that maybe I just o’d later than I knew I had.  Even though we had quit daily charting back in April, I was still marking CD 1, peak day and any mid-cycle bleeding on my charts.  I knew when I ovulated and I was distraught.

We went back a week later for another ultrasound.  The baby was measuring 5 weeks 6 days with a heartbeat in the 90s (should have been 7 weeks).  They adjusted my due date to 05/18/2012.  Two weeks later we returned for our nurse OB appointment with an ultrasound.  I knew I was 9 weeks, they said I was 8 weeks.  It didn’t really matter because the ultrasound showed that the baby had passed a few days after our last ultrasound; the baby only measured 6 weeks 1 day and there was no heartbeat.  We scheduled the D&C for 2 days later on a Friday. 

This time as I was being prepped for surgery, I broke down entirely.  Three miscarriages in less than one year.  I felt like a failure as a woman.  The surgery was over quickly.  The doctor said it went well.  I needed the Rh.oGam shot again, so they gave me some Bene.dryl, then the shot.  Luckily the Bene.dryl knocks me out, so I slept for about an hour and a half after surgery and then went home.

We had the baby tested again for chromosomal abnormalities, but everything came back perfectly normal again.  The doctor informed me at a follow-up appointment that the two babies we had tested were both girls.

I was given a note from my doctor to take an entire week off work to recover.  It was more of an emotional recovery period than physical.  I asked for more time than just one week, but my doctor knows me well and knew it wouldn’t be good for me to sit at home for long.  I would just think about the losses and stew in my sadness.  He sent me back to work, and that was probably a good thing.

Our next step was to take a baby aspirin daily with my pre-natals…just in case there is a clotting factor we haven’t identified.  I wasn’t tested for MTHFR, but my doctor said that by taking the baby aspirin we can head off that problem as well as others. 

We also had a saline hysterosonogram.  For anyone who hasn’t had one, this test involves the doctor placing a clamp on the cervix, feeding a balloon and a catheter into the uterus, then pumping the uterus full of saline.  Then, they do an internal ultrasound at the same time so they can view the uterine lining better and identify any problems with the lining or any malformations in the uterus.  The worst part by far, for me anyhow, was the cervical clamp.  That just hurt.  My doctor (have I mentioned how wonderful he is?) tried to put my mind at ease, and the ultrasound technician was very kind.  Still, it was just humiliating.  During the procedure, I experienced a lot of cramping and became lightheaded.  I had to use my breathing techniques I learned for labor to get through it without fainting.  Afterwards, my pulse was really slow so they gave me some apple juice to help me perk up a bit.  The funny thing was that when they handed the juice box to me, the straw was pointing right at the sleeve of my sweater and the juice shot right down my arm.  Nice.  As the mother of a toddler, you would think I would have seen that coming.

My amazing, Catholic, NFP-only doctor is also contacting a colleague who is Crieghton trained to get suggestions on how to help us.  One of my doctor’s partners also suggested that we visit a Maternal Fetal Medicine Specialist to see if he has any suggestions of things we can try or look into that we haven’t thought of yet.  We haven’t made that appointment though.  I think with everything we have going on right now with the house buying, the holidays, family birthdays, renovations, moving, switching daycare centers…we have a full plate and I don’t think I could fit in another doctor appointment.

So that’s our journey so far.  I recognize this is a little light on my reflections about our secondary infertility…I’ve given you almost entirely all facts.  I’ll try to address my feelings in a separate post.

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