Second Test Results

My second blood test results came back great! My hcg levels had increased from 638 to 1400s in 48 hours! This was great news! We were then set up with an ultrasound for two weeks later when I would be 6 weeks pregnant. We would then be able to see our little offspring on and possibly even see a heartbeat.

At this point everything was really starting to settle in that this was real and we were really on the road to being parents in 9 short months! :) 

D-Day!

Once the 16th day after the IUI came I almost couldn't sleep I was so excited and nervous. I think I woke up about three times throughout the night and finally at 5:30 AM got up and tested. I can recall being very nervous by having to use the bathroom so bad I didn't have any stage fright.

I was given a generic pregnancy test from my RE so it had only a line to look for. I dipped the stick appropriately and waited the recommended time to see if the extra line would appear. Immediately I could see two faint lines which meant I was pregnant. I told my husband to come see what he thought as I wasn't sure if I was seeing things out of belief or if the lines were real. He said he couldn't tell but it looked like there was two lines. 

We decided to run over the grocery store and pick up another test just to be sure. So at 5:45 AM we ran over to buy another test. I bought one that was a little more explicit on the results; a cross vs. just lines. So once again I took the pee on a stick test twice and quickly the cross showed up! At this point, I was really excited and also in disbelief. Was I really this lucky to get pregnant the first time going through fertility treatments?! 

Of course right at 7 AM when my doctors office opened I called with the news and curiosity on what to do next! I had to go right away and get a blood test taken. I went to a local lab and got my blood tested before work so I could get the results back that afternoon. 

D-Day continued

Of course after the first pee tests and after talking to the doctors office we updated the people that knew today was the day for us to test. A group message for my family, a test to my husband's mom, and a few text messages later in the day to those few girlfriends who knew what I was going through. Everyone was so excited but knew we still had awhile to  go before we were in the clear and could really share the news!

I got the first blood test results back around 2 PM (beta was 638) that day and immediately scheduled my follow up test two days later. This second blood test would measure the levels of hcg. These levels should double every 48-72 hours while pregnant and continue to increase until the second trimester. This test would show whether a healthy pregnancy was developing. 

Two Week Wait: Week Two

The second week was a little less eventful but we had plenty of activities going on that kept our mind off the unknown. I did however have to go into the doctor’s office one week after the IUI to check my progesterone levels. This was a short and sweet appointment and only had to leave a little blood behind to be tested. The results really weren't going to tell us anything except whether my body was producing enough progesterone in the event I was indeed becoming pregnant. 

I wasn't allowed to test until 16 days after the IUI. Most people are told to test after 14 days but I guess since they weren't entirely sure when I would have ovulated they rather you be safe than sorry with a false negative. So I knew the closer I got to that date the more likely I would see blood in the result I was no pregnant so naturally I was checking very closely every time I went to the bathroom. By the time I made it through Monday with no hint of not being pregnant I felt a little better and slightly hopeful but knew I still had one more day to make it through and I had no idea how my body would react to anything since I have not had a period in several years. 

Two Week Wait: Week One

The dreaded two week wait plus two days was upon us. I knew this time would be hard and I of course asked many of my friends who had been through this time on advice. Some said to just try to stay busy, and one said she researched baby stuff. I personally knew putting the cart before the horse wouldn't work for me. Heck, after dating for several years I never really started planning our wedding until after the proposal was complete. So I tried to stay busy and tried to stay as active as I could by doing yoga and walking.

Unfortunately, the two weeks were quite eventful. I ended up coming down with major tooth pain and having to get a root canal done at an emergency dentist. This is obviously not ideal in my current situation but I didn't know what else to do. The pain was so bad and nothing would work to ease it. So I went into the office knowing that the procedure was okay for someone who was expecting although most doctors recommend not having these types of procedures during the first trimester if at all possible. I figured I would classify this procedure in the category of a mother not knowing she was pregnant and drinking a lot before the first missed day of her period. And I had to get this done; the pain was the worst pain ever!

After the procedure I had a lot of pain due to the procedure although it was way less than before. I had started taking Advil but shortly realized that Tylenol was the better choice in my current situation. Opps, three days of Advil, sorry potential future child! 

Monitored Closely

After the first four days of injections I was brought back to the doctor's office to be monitored for progress. An ultrasound was performed to see how well my ovaries were simulating on the medication. The first ultrasound didn't show much but it did show that the medicine was doing its job which was to start growing a follicle. After the first monitoring appointment I was sent back home with another three days of injection protocol and a follow up appointment in a few days.

At the second appointment, the stimulation results seemed to be very good. I had one follicle that was measuring around 18.5mm and it was expected to grow at least 2 mm a day until ovulation. At this time we pretty much knew that unless another follicle happened to grow in the next few days or that my egg when released happened to split our chances for multiples was very slim. This was a relief and also sadness at the same time as we thought having twins would have been neat but we were also just happy that the process was working and we were on the right track. We also figured having one kid at a time was probably the better route!

 I was given instructions on the next few days of protocol which included a few more days of the hCG hormones and then an ovidrel shot that would make me ovulate. Due to the results of my coitus test, the decision was made to perform an IUI the day following the ovidrel shot. This would give us the best chances on getting pregnant this round. So although it wasn’t the most glamorous way to make a baby we knew it was the best way to get to the end result. So Monday morning after the ovidrel shot I traveled into the RE office and the IUI was performed. I had to hang out in the office and relax for about 10 minutes following the procedure then was on my way to work with instructions to go about my day normally.

At this time I knew something was happening in my body. I was feeling very bloated and full in the abdomen region. I had cramping and subtle pain every once in a while and I knew that this was a good sign although it was rather uncomfortable. I actually almost feel like I felt ovulation occur in my body but who knows. I knew things were happening like they should so I tried my best to stay positive and not think about it too much.  We had 16 long days ahead of us to get through until we’d find out whether this cycle was successful or not.  

Brave

Ever since I can remember I was always the one strived to put on a brave and strong face for anything that was thrown to me in life. I'm sure this wasn't always the case but as I grew up that was the way I was taught to react. I'm not sure if is an oldest child trait or not but either way I'm sure it was something I was taught by my father. He would always put me in situations I did not feel comfortable in such as meeting people I didn't know, answering the company phone, and calling businesses or people for things he needed taken care of. And of course he acted the same way. I do not ever recall seeing my father cry and he always wore a brave face.

This lesson transferred into my personal as well as professional life. Personally, I'm the one who rarely cries when hurt or in sad or happy situations, hides any emotion related to being apprehensive or nervous, and over all wearing a tough skin.  So now in the infertility situation I found myself in I tried to carry that brave face into all of my doctors appointments and procedures. I entered them all with confidence and the realization that I was ready to accept whatever the medical professionals had to say. I went to pretty much all of these appointments solo and no offense to my amazing husband but that was the way I preferred it. It was easier to be brave alone then with someone by my side.

This all made perfect sense as I reflected on the first time I performed by injection alone. I escaped from a party we were having in our house upstairs to do the injection alone and all by myself. The original plan was for my mom to do the injection again but I had been given some strong encouragement from a friend that I could probably do it on my own and that brave persona I have came out strong and I was ready to give it a try. So I went up to the master bath, got everything ready, and went for it! Of course my heart was beating and I was shaking my the time I was done but I did it. I did it on the first time and on the first try and had no issues. I was pretty proud of myself at this time. And I was also glad that I had gained by independence back. I was going to be able to do the injections myself and make it through the next few weeks without having to rely on someone else to administer the medication. This was a huge relief moving forward!

           Here's my injection goodies!

....and we're off!

My first step in this process was to first do another progesterone challenge. I then was told to order my prescription medicine for when we would begin simulating my ovaries with FSH and LH to help me have a cycle. Unfortunately, neither my prescriptions nor any infertility treatments were covered by my insurance so all of our costs after diagnoses were out of pocket. Because of this we opted to find the cheapest route for the prescription medicine. The doctor was able to send me to a common website where a lot of his patients bought prescriptions from overseas in the UK.   So I ordered the very expensive medication from this website and realized there was no turning back now!

This time on progesterone I took a different type of medicine in hopes that my period would appear. Ten days later nothing happened, no aunt flow. So I called the doctor they said to come in for an ultrasound to check everything out. My husband and I went to the doctor’s appointment. The doctor said everything looked good and that the reason I didn't have a period was due to the condition I had. He said it was time to start me on the hCG (human chorionic gonadotropin) injections.  I was glad I had injection training earlier that week as I was instructed to start injections that night! At this time a lot of emotion came over me including excitement and apprehension. We were actually starting this journey and this was all becoming very real.

I knew the first injection would have to be done by my mother in order for me to get comfortable on how it would feel. I knew my husband giving me the injection was not an option as he was not good with needles what so ever. I was told to administer my medication between the hours of 6 – 10pm. I decided for the first one it would be easiest to get it out of the way and do it right at 6pm. So at 6pm we traveled over to my parents’ house with my medicine and needles.  I mixed the medicine and then changed the syringe needle. I numbed the upper hip area on my right side with an ice cube for the injection. My mom wiped off the area with an alcohol swap and performed the injection. This procedure was actually not as bad as I thought it might have been. It kind of stung as the medicine was injected but other than that I immediately walked around after the needle was removed in hope that I would get the muscle moving and relaxed again.  I then went on with the rest of my evening and didn't even notice what was done to me.

The first injection was down. I had three more days of the same procedures and then I was going back to the doctor for an ultrasound to see how I was responding to the medicine. And at this time I was absolutely limited on my activity. I was only walking and doing yoga as I didn't want anything to happen to my ovaries on accident and I figured I spent all this money on medicine and doctor appointments I better do everything in my power to ensure it works! 

The big hurdle

At this point I was struggling with what decision and direction to go. Do I try to solve this in a natural way or do I proceed with a reproductive endocrinologist? The reason for this was because I grew up in a household that used mostly alternative medicine since I was about ten years old. Western medicine and visits to a M.D. wasn't the norm in my family. My mother chose to take us to a chiropractor who was also a homeopathic doctor. In fact, I don't think I've even had an over the counter medicine in over 20 years except when I had my wisdom teeth out. I was really torn on whether I felt using heavy duty drugs to try to get pregnant. And I was really afraid of how particularly my mother would react. At this point she did not know of anything I was going through or any information about my condition.

I luckily was able to lean on my husband and the few friends who knew what was going on for advice. After one specific conversation with one of my best friends I was able to come to a conclusion. I was going to proceed with treatment and with the doctor who I had just met with. 

Now the hard part was ahead: tell my mother. Unfortunately, the timing of this decision was right before a major holiday and a big international delayed honeymoon with my husband. I went through around several ideas on how I would tell her including writing a letter but ultimately decided in person when I got back would be the best. 

I first told my sister, which is typically how I get a good feeling on how my parents will react on different things. I also knew my sister would support me in whatever decision I made. I then told my mom by stopping over her house for lunch. Except I had been battling a bad stomach bug all week so she ate I sat and hung out. After catching up since I hadn't seen her in a few weeks I finally broke down and told her what was going on. She of course was supportive but had lots of questions. Mostly questions of the risks involved and other things I've done to try to fix the issue which had included six months of several homeopathic methods which didn't seem to make one difference at all. I explained to her that I was tired of spinning my wheels and spending a bunch of money on natural treatments that didn't seem to be working at all. I was ready to try something different and I was willing to make the sacrifices I knew I had to in order to start a family. She thankfully understood my decision and even volunteered to attend the injection training the following week with my incase I needed help with administering the medicine. That was probably the best feeling in the world at that time. I felt so much better after having this hurdle out of the way and this talk off my chest. 

Giving up my favorite hobbies

I knew once I got pregnant I would have to change my lifestyle a bit but after everything I've learned I quickly realized my life would have to be changing a lot sooner. I knew if I decided to go through with the treatment my physical fitness routines would be drastically changing. So in order to really prepare myself for the changes regardless of the route I went I decided I'd give myself a deadline. My deadline was a CrossFit competition here locally and after the competition I would start making changes.

I pushed myself really hard to perform well at the competition. I called it my last hurrah and I sure did make a great last performance. I ended up placing 2nd overall in the scaled division. This was the icing on the cake but I knew that also meant my time had come. I would be giving up CrossFit and soccer. And of course running and anything else that could be high intensity. I was pretty much going to be limited to walking, elliptical, yoga and some light bodyweight exercises. 

I know it sounds so trivial to give up exercise and some might be rejoicing to stop exercise but for me it was a rough thought to overcome. As many people know exercise is a part of me. It's my de-stresser. It's my favorite hobby. It's been a big part of my life for the last few years. It's brought new opportunities and friends. I have a full set up of CrossFit equipment in my garage for gosh sake. I knew this was going to be a rough change but I also knew it would all be worth it in the end!

I wanted a family more than I wanted or needed CrossFit, soccer, running, or whatever I wasn't able to do. I would just find a way to love walking and yoga instead. I decided to look at this new adventure in a positive way. 

Second Opinion

After the experience at the first RE office I was open to looking into different doctors and their opinions about treatment for my condition. I luckily was able to find a doctor who a friend has used and been successful with twice. This doctor came highly recommended and also known as one of the best RE doctors in the city. I was able to get in for a consultation pretty quickly and was very interested in learning what he had to say.

My first meeting with this doctor was great. He was very honest and was straight to the point. He said yes, you do indeed have HA and explained that there was really only one pathway for me to get pregnant. He would immediately direct me to injectable medication. He stated that no other lower dose oral treatments would work for my condition. This immediately took my by surprise since that was not the impression I got with the first doctor.

He also mentioned that if I had come to him first he would not have recommended a MRI due to my medical history and also physical activity history as an athlete. He was absolutely positive something happened to my hormones and hypothalamus when I lost 20 pounds in spring of 2012. And that for some reason by body did not readjust over time nor when I gained some of the weight back.

He stated that even if I did gain weight back there was no guarantee that my cycle would come back either which was one of my questions. He said he actually did research on this topic as a fellow. He saw several ballerinas bounce back with a cycle after being injured and not able to dance but soccer players and runner were hit or miss. Some gained a cycle back and some didn't after reducing their amount of exercise. This made me feel a little better about the lifestyle I had accustomed to with following a clean, mostly paleo diet and doing CrossFit which I had thought was healthy and good for my health.

After my meeting I knew I now had some thinking and consideration to do as there were risks, sacrifices, and lots of money involved in the treatments that were recommended.

What is Hypothalamic Amenorrhea?

Hypothalamic Amenorrhea (HA) in brief is a condition in which menstruation stops for several months due to a problem involving the hypothalamus. Hormones obviously play a crucial role in every step of a successful pregnancy. The hypothalamus in the center of the brain controls reproduction. It produces the hormone, gonadotropin releasing hormone (GnRH). GnRH signals the production of other hormones needed for the egg to mature and for ovulation, such as follicle stimulating hormone (FSH) and after ovulation, progesterone luteinizing hormone (LH). In turn, FSH and LH signal the ovaries to produce estrogen. Estrogen thins the cervical mucus and, along with progesterone, prepares the uterus for a fertilized egg. Sometimes the hypothalamus stops producing GnRH, which in turn, will reduce the amount of other hormones produced (FSH, LH, and estrogen). Ovulation and menstruation stop, resulting in infertility.
(source: http://www.shadygrovefertility.com/hypothalamic-amenorrhea)

So this is what the science behind my condition and how my brain doesn't work correctly to produce the hormones needed to have a cycle. A fun fact about this condition is that only 5% of the population has this condition but it is treatable. So at least I have that going for me even if I am in the minority!

The back story....part 1

I should have started this blog about two months ago but here I am finally finding time and the courage to write this all down. My husband and I wanted to start a family shortly after we got married. we knew were going to wait until the beginning of the year due to some end of the year international travel.

Our story started when I finally started to investigate why I wasn't having a regular monthly cycle. And when I say not having one I'm not talking irregular I'm talking none, zero, zip. In fact, I hadn't had a natural one that wasn't induced by birth control for over two and a half years. So my ob-gyn recommended me to a reproductive endocrinologist (RE) to figure out what was going on. After some medical history, blood tests, and an MRI of the brain, it was confirmed I had hypothalamic amenorrhea. In a nut shell hypothalamic amenorrhea is a condition in which menstruation stops for several months due to a problem involving the hypothalamus but more on this later in another post.   

If I had known more and cared more to really find out what was wrong with my body I probably would have realized this is what I had awhile ago when I was given the progesterone challenge which I indeed failed. But at that time of my life that kids were the last thing I was worried about and I really didn't know what kind of trouble I might be in when it came to actually wanting to get pregnant. Reproductive health wasn't on my mind nor priority list and my ob-gyn didn't seem to think it really was a problem so I went on doing my thing. Hindsight 20/20 I should have further investigated but I didn't know what I didn't know. 

So that brings us to my diagnoses and what I needed to do to move forward with starting a family. The first RE I went to who ultimately first diagnosed me mentioned all the typical fertility methods and the progression he would recommend for me. First the most common clomid, then something stronger, then injectables if those two didn't work, and then of course the ultimate course of action IVF. Unfortunately, I did not mesh well with the doctor nor the medical staff at this RE office. After several frustrations trying to get through to talk to the medical staff I was on the search for possibly another RE. At this time is also when I started to share my condition with a select number of friends who I knew had been through some kind of fertility struggles and started to learn more. 

I cannot be more thankful for those friends that have been placed in my life in the last few years that were so willing to open up and share their experiences. It can be said that people come into your life for a specific reason although at the time you may not realize exactly why. I now 100% believe that saying and I cannot believe how lucky I've been to have those friends who have been so supportive since day 1 of my journey!