All posts tagged subfertility

Fertility Journey – Part 4 (My Alien Baby)

Because you want the world to know that you just left the fertility clinic!

What I like most about Dr. Chang is that she doesn’t waste any time. The day we arrived for our consultation she was counting egg follicles and taking blood.

Of the tests she ran I was most curious about the CA-125. I hoped the blood test would confirm whether or not my years of suffering from painful menstruation were due to endometriosis. The scary thing about this test is that  “CA” stands for Cancer Antigen. Putting me and Cancer in the same sentence is an unsettling and uncomfortable combination, but a necessary evil all the same. This test is primarily used to determine the likelihood that a woman might have any of the following cancers: ovarian, endometrial, peritoneal and fallopian tube. But it’s also used to pre-diagnose uterine fibroids, endometriosis, pelvic inflammatory disease and cirrhosis.

Is the CA-125 test accurate?

There are confusing aspects of the CA-125, according to the Mayo Clinic.

“A CA 125 test isn’t accurate enough to use for cancer screening in all women — especially premenopausal women — because many benign conditions can increase the CA 125 level. What’s more, CA 125 levels are normal in many women with early-stage ovarian cancer.”

Furthermore, when used to diagnose endometriosis some studies claim that the test seems to be most accurate in identifying women with severe endometriosis rather than those with less advanced forms. CA level ranges vary as well. Some medical professionals set the limit at 20ml, some 30, and some 35. This is interesting because my level was 34.

“We can almost assume,” Dr. Chang said when reading me the results, “That you have endometriosis because a 34, combined with your history of severely painful periods, can lead us to that conclusion.”

There was more. Not only did Dr. Chang nearly corroborate my hunch that years of suffering and elevated Cancer Antigens almost guaranteed that I had endometeriosis, a condition that can contribute to, if not cause infertility, but she also found something growing inside me. I had landed on planet subfertility with a thud and it appeared that I wouldn’t be visiting baby country any time soon, at least not until these issues were addressed and resolved.


Sonohysterography & That thing growing inside me

After reviewing the slides from my HSG, Dr. Chang noticed what might be a polyp or fibroid in my uterus. To be sure she decided that a Sonohysterography could help her get a better view. This would also help her determine whether or not we could proceed with egg stimulation and IVF.  Additionally, she planned to conduct an endometrial biopsy for two reasons, 1. to determine whether or not my endometrial lining was developed enough to support embryo implantation and 2. To stimulate new cell growth in the uterus which improves IVF success rates.

While I was interested in the sono results, I was, and still am, terrified of the endometrial biopsy. I waited for Dr. Chang and poked around the office for clues of what to expect. I saw a bevy of torture tools laid out (pictured here). As a result, I began praying that I indeed had a polyp. If so I’d need surgery instead and would be sparred the biopsy. Surgery meant I’d be asleep in dreamland when any slicing and dicing of my uterus occurred.

 

The Results

Not only is my tube blocked and it’s likely that I have endometriosis, but we did indeed confirm the presence of a rather large polyp, or my very own alien baby, growing inside me right where a fetus should be.

During the ultrasound I remarked, “It looks huge!”

At first Dr. Chang disagreed. “It’s not THAT big” she said, until capturing more angles of the weird looking growth, “Oh wait. Maybe you’re right. It is pretty big.”

She proceeded to ask if she could use the aforementioned images at an upcoming medical conference. The bad news is that my alien is acting as an Inter Uterine Device (IUD), another obstacle on the road of our fertility journey. The good news is that my uterus is a perfectly shaped specimen as if drawn by an artist. Dr. Chang was pretty impressed. There is nothing like a female anatomy compliment when you’re stirrup-ed in and half-naked with a wand up your cooch. I might start telling people that I’m a uterus model.

What next?

I was then  instructed to schedule a surgery with Dr. Collins to remove the pesky polyp. Dr. Chang also prescribed birth control pills. This seemed weird. Wasn’t I trying to HAVE a baby, not stop one before it started? I learned that birth control pills are used to prevent hyperstimulation of the ovaries during an IVF cycle. Also, according to Science Daily, birth control can help time egg retrieval.

Additionally, Dr. Chang said that I might be a good candidate for a two month cycle of Lupron which increases IVF success rates for women with endometriosis. She gave me a run down of the side affects and they didn’t sound good. Lupron would shut down my reproductive system sending me into a temporary menopausal state. A glimpse into menopause at 32 didn’t sound like an exciting way to spend the beginning of 2013.

I went home that night and read the numerous Lupron horror stories out there. Weight gain, acne, and anxiety to the point of needing a sedative, were listed by people who had used it for just a short amount of time. I could hardly imagine what longer term use could do. There had to be another way.

Endometriosis & Laparoscopy

I’ve been told by many doctors over the years that the only positive way to diagnose endometriosis is though laparoscopic surgery. So, after speaking with Dr. Chang about my polyp and the possibility of Lupron, a light went on. What if Dr. Collins could perform a laparoscopy while she was removing the polyp? I’d already be under anyway I surmised. And after years of suffering I wanted to know for sure.

Dr. Collins agreed she could use the surgery to further explore my abdomen and remove any adhesions. She cautioned, however, that Dr. Chang might still recommend Lupron depending on the severity and prevalence of the adhesions or endometriomas.

I then discussed my Dr. Collins conversation with Dr. Chang. She too liked the idea. In fact, she asked to assist Dr. Collins so that she could get a first hand look at the inner workings of my reproductive system. I would have two gorgeous and brilliant female doctors working together to help heal me. I felt and feel lucky, especially because my husband and I have insurance that will cover most of the costs of all of these procedures. I can’t imagine what we’d do otherwise. Save up for a laparoscopy? IVF? Pray for a miracle?

Surgery Countdown

As my surgery countdown begins (7 days!), my heart goes out to the women all over the world who suffer from painful periods every month, the kind that leave them vomiting and moaning in pain. Endometriosis can be a debilitating and life altering condition and I wish more funds were allocated to researching its causes and cures. My heart also goes out to the women who can’t afford fertility treatments, but desperately want children. When treatable medical conditions prevent one from realizing the dream of motherhood, insurance companies should do their part and pony up the funds.

Luckily my heart is gigantic (because of all the cardio) and so I have one more very large piece to give away… for my husband, family, and friends who have been amazing through all of this. I’d tear out the rest of my heart and let you eat it if you really wanted to, because without you I’d be a manic mess (without my heart I’d be even worse off, but you get my point). Thank you for being there with encouragement and kind words, for listening and loving me. Baby or no baby, pain or no pain, you make life worth living and then some :).

Fertility Journey – Part 1 (The New Abnormal)

As I stripped down for the lovely Jules of Queen Bee waxing on Culver Blvd. I noticed her checking me out. It wasn’t my exposed thighs she was gaping at, however, but the gauze and band-aids at both of my inner-elbows. “What happened to you?” she asked. This was my first time with Jules, but I’ll admit I was eager to share the details of how I had spent my afternoon. I’m the type who likes to get it out, as evidenced by this blog post. This doesn’t entirely stem from a need to be understood, but also a need to understand. If a half-naked girl stood before me, bruises that resembled track marks peaking from behind glaring white bandages, I’d be dying to know what ailed her. You get what you give, so I was ready to dish it. “Well, let’s just put it this way,” I answered, “You’ll be the second woman today to touch my lady parts.” “OBGYN?” she inquired. Nothing fazes a proprietor of the Brazilian Wax. “Nope. Fertility specialist. And they took 6 viles of blood!” I answered, getting on her torture table cautiously, as if my tentative movements might encourage her to go easy on me. It’s safe to say that I am more afraid of my monthly waxing ritual than of the more invasive medical procedures that are sure to mark my next three months. Hormone shots in the ass? Sure! No problem. Hair being ripped from my nether parts? GASP. (Though the Queen Bee staff are far and away the BEST I’ve ever had). “Tell me everything,” she replied. And I knew Jules would be my waxer at Queen Bee from then on.

Trouble in Make a baby land

Jules got the short version of all of this, but the details of how we ended up at Southern California Reproductive Fertility Center are a bit more complicated. The Oxford Journal section on Human Reproduction says that if you have been trying to conceive for more than 6-months you may be considered sub fertile. More specifically, this means that  “Most pregnancies occur in the first six cycles with intercourse in the fertile phase (80%). After that, serious sub fertility must be assumed in every second couple (10%).”

For us, almost a year has flown by. I’ve been able to mark hubby and I’s trying time by the beautiful happenings I’ve seen unfold on Facebook. Bump pictures, labor and birth announcements, and newborn baby pics were reminders that oh yeah we were supposed to be making one of those! And the celebrity bump pages in every gossip rag, who’s not pregnant in Hollywood right now? Further hammering the point home, two particularly close friends have given birth in the last month or so and I’ve had the privilege of hearing about the ups and downs of new motherhood: Their breast-feeding woes, their sleepless nights, their changed bodies. It’s frightening and exciting in the way that only things so tightly intertwined with the purpose of life can be, like falling in love, getting married, and of course, being pregnant and having a child. Just thinking about these events can make your gut tickle with anticipation, delight, and awe-inspired fear because through them your life can change forever in deliciously painful and meaningful ways. Gulp.

So it wasn’t until baby making didn’t happen that I realized how much I really want it to. I was ambivalent about having children before, as if I were making the choice between two drab paint colors for my guest room.  “Maybe. Maybe not,” I’d tell people nonchalantly when asked about having kids. Then to others, “Only one please.”  While later sharing my anxiety with the hubster, “I mean, do we really want the responsibility? Little brats try to put their fingers in light sockets and stuff.” I could picture our unborn three-year old son buzzing with a blue electrical current, hair frizzled out like a cartoon. I could picture all kinds of horrific scenes that involved kidnappers and rare childhood diseases and… So I, we, just tried not to think about it. We planned not to plan, to “see what happens” and to “let nature take its course,” without dwelling on the horrors of parenthood. The expense. The weight gain. The crying. The aforementioned neurotic nightmares. We wouldn’t let fear stop us from trying, but we felt it was best to leave it up to chance.

———————–

And then something changed, as somethings are apt to do. The part of me that was unsure about being a mother disappeared. I began to realize that the fears and sacrifices of parenthood would be totally worth the reward of seeing 1/2 me and 1/2 him combined into one NEW person. One that we could love and nurture and help grow into a productive, hopefully proactive, member of the human race! Around that time our friend’s babies were born and it was clear that nature’s course wasn’t flowing in the direction of a positive pregnancy test for us. “Something is wrong,” I told my doubtful, doctor avoid-ant husband. The calm man that he is tried to reassure me. Had we been doing it at the right time every month? Had we been trying long enough? Should I be standing on my head after intercourse? Yes. Yes. and No. Later, however, I tried the head standing anyway just to appease him, while secretly hoping that this pose would be the magic baby bullet. (Baby and bullet probably don’t belong in the same sentence, so forgive me).

Our unfruitful trying time, coupled with my borderline obsessive compulsive internet research, made me come to terms with the fact that further exploration was needed. To me exploration should be reserved for long hikes in the Sierras and wandering through unfamiliar towns in search of the best coffee shop. Adventures into the great unknown of my uterus are not my idea of a good time. Since tubes and dye and x-rays would be a part of the medical profession’s mission to unearth the jewel of fertility from my va-jay jay, hubby and I agreed that heshould be explored first.

The Great Mystery of Spermatozoa

The Free Dictionary defines spermatozoa as: “The mature fertilizing gamete of a male organism, usually consisting of a round or cylindrical nucleated cell, a short neck, and a thin motile tail. Also called sperm cell, zoosperm.” Zoosperm? Really? Can you imagine if I shouted that out during baby dancing? “I want your Zooooosperm!”  But seriously these mature fertilizing gamete are half the battle when it comes to making another human being. According to the University of Iowa, “in 50 percent of all infertile couples, a male fertility problem plays a role in the couple’s inability to conceive.” To me this statistic seemed like common knowledge. After all, it takes two to tango and we are no longer medieval pawns trapped in a culture where delivering one’s spawn, specifically a son, would instantly elevate a woman’s status from threatened to respected. Unfortunately, however, the vilification of women for fertility problems continues to be an issue internationally.

It wasn’t my plan to discuss this here, but I can’t resist. “When a Kyrgyz couple remains childless,” the Institute for War and Peace Reporting explains, “it is generally the wife who is encouraged to seek fertility treatment. Husbands commonly reject suggestions they might be infertile, and some even remarry in the hope of having a child.” Yikes. How would you like to be dumped because you can’t serve up a baby at your husband’s command? Talk shows in the middle east must put Jerry Springer to shame. Reason number 5,000 than I am grateful to be an American. Yet, even in modern lands like the UK women are blamed for a failure to procreate on demand. One article from 2008 titled, “Why women can be blamed for their own infertility,” would probably cause a riot if it were published today considering the 2009 spike in social media use.  The author says, “Although male infertility is on the increase, and men must consider the role their lifestyle plays, too, many women simply need to relax a bit more.”

The article may make some decent points about stress, drugs and alcohol use, but this statement reflects an ideology that is still prevalent in western society. On several occasions, friends and family members have told me, “Just stop worrying about it so much.” I wonder how many women out there trying to conceive have heard these same words, only to find out that their partner could be to blame? Or that there really is an underlying medical condition? That they were right to worry? In our case, being “right” never felt so bad.

Rather than spending paragraphs explaining how our general practitioner’s office sent us clearly abnormal sperm analysis results on a Friday (right before closing) without an explanation or a phone call, I’ll simply tell you one 1/2 of the Case of the Missing Brooker Baby was solved that weekend. Apparently hubby’s sperm are wacky looking and sleepy, with only 5% rapidly progressive. Rapidly progressive sperm are those that “[have] more fertility skill due to their capability to reach the oocyte and to penetrate the membrane. Normally [these] are the ones selected with the swim-up procedure for [artificial insemination].” While 78% of hubby’s sperm also have a mid-piece defect, hours of research revealed little more than his sperm may not have the energy they need to make it to my eggs.

My weekend of crying and freaking out, was completely warranted unfortunately. The following Monday, we received an emotionless email from my husband’s doctor (we will be switching by the way), with a list of urologists she recommended. She didn’t explain what we could expect. She didn’t assure us that these things could be treated. She simply sent the email with no regard for how Friday’s results might have made us feel. Combining this information with my concern that I may have endometriosis, a condition I’ll get into in a later blog, we were shattered. The American Society of Reproductive Medicine explains that, “A totally normal couple at our ages (30 and 31) has about a 20% chance per month of getting pregnant.” What then are the odds when you’re abnormal?

Abnormal is the New Normal, but only if you’re a sitcom

This fall the New Normal debuted, a show about two gay men who engage a surrogate to help them realize their dream of having a child. Hilarity ensues as the media does its best to portray healthy homosexual relationships and blended families. NBC talks about how this show helps demonstrate the “reshaping” of the American family as we know it. I haven’t watched yet, but I’ll admit I’m curious and I appreciate anything that can help legitimize same-sex unions. Love and let love, I say. Unfortunately, my life and the lives of so many others struggling with fertility issues cannot be compartmentalized into a 30-minute slot of well-timed jokes and perfect hair and make-up. The journey to having a child has only just begun for us at the realization, two weeks ago, that we were not the new normal at all, but instead her underpaid and less-celebrated sister – Abnormal. Yet, once we stopped feeling sorry for ourselves we snapped into problem solving mode. Can we improve hubby’s sperm?” we mused, researching Walnuts, and Maca Root, and Pynogenol.  “What if something is also wrong with me?” we wondered, perusing articles on infertility and endometriosis. The questions keep coming like cars down the 405, but the answers have been more difficult to obtain. Join us on our journey as I explain what happened at the urologist in Part 2, then talk about my HSG, a procedure to view the inside of the uterus and fallopian tubes, in Part 3. My goal is to be a resource to others, while I attempt to sort out my issues with infertility and potential motherhood through fertility treatments (fingers crossed). Abnormal may not be the new normal as NBC would like us to believe, but it’s our normal. And here’s to discovering the blessings that working with Southern California Reproductive Center and being abnormal might bring.