Monday, September 29, 2014

RE visit recap AKA what we know now

Warning! I'm talking about my lady bits, fertility treatments, and conception. 
If these things don't interest you then feel free to skip this post.
After several terrible comments I feel the need to post this next bit even though I shouldn't have to...
This little blog is like an open journal for me where I write about what is going on in my life and connect with those in similar situations.  Part of this is my experience with Infertility among other things.  I do not mind healthy open discussions about Infertility or anything else I write about but keep it friendly please.  No intentionally hurtful comments will ever make onto this blog so don't even waste your time on them.   
I have dragged my feet in writing this but here it is.

 a quick recap on how we got here this time around...

Once Bear turned a year old I made an appointment with my primary care manager (PCM) to discuss having another baby and my history of infertility.  He ordered some blood work that showed normal levels of everything and suggested going on birth control for several months to help regulate my period.  I declined Birth Control as it has never helped in the past and asked to see an specialist based off of my prior history of infertility.  The PCM ordered a a final test an internal ultrasound to make sure physically there was nothing going on that would prevent me from conceiving.  Physically nothing was wrong but the tech did find a small cyst on my ovary that would likely go away on its own.  Regardless he gave me the referral I wanted.  I then made a few calls and got the same specialist we used last time when ttc Bear. 

So just over a week ago we headed to the specialist or Reproductive Endocrinologist (RE) and sat down to discuss trying to conceive (ttc) another baby.  Here is what we found out...

The exact diagnosis I was labeled with is "unexplained secondary infertility"  previously I was diagnosed with "unexplained primary infertility."  Why the change? well simply put, the secondary term is used because I delivered a baby.  After baby any infertility problems are considered secondary infertility despite me having the exact same problem as before.  This means that the exact same reasons I was unable to conceive naturally before still apply today.  Nothing as far as that has changed with me only the title of it has changed.  

What did you have before you may be wondering for those just joining me...  I never had a regular period my whole life.  Not on Birth Control or any other thing that the doctors have tried.  I would only get a period every 3 months naturally.  How the body basically works is if you don't get your period then you didn't ovulate.  No ovulation means no chance at getting pregnant.  On those rare third months when I did ovulate, sperm and egg could very well have met and combined but once it reaches the uterus it finds an inhospitable environment and the body will reject it.  In other words I would get my period without ever even knowing if fertilized egg even existed in my body or not.  After a year of TTC I was put on very high does of Clomid by my OBGYN and still nothing happened.  So I was referred to an RE.  With a combo of meds (oral medication and injections) we conceived Bear on a cycle were the odds of me getting pregnant were next to nothing.  The day we found out I was pregnant also happened to one month shy of the 2 year mark of us ttc.  God works in mysterious ways.   

What are my chances of getting pregnant?
The odds of me conceiving naturally without any interventions are less than 1%.  I wasn't shocked when I heard this once again but it still stings a bit. Using the course of fertility treatments we used before with timed intercourse it brings me up to the same 15-20% everyone else has each month when ttc.

What type of treatments are we doing?
The course of treatment I will be on is very similar to before.  The use of Femara or clomid, Follistim injections, and an HCG trigger with timed intercourse.  Femara and Clomid are oral medicine that will be taken in conjunction with Follistim injections.  Doses will be determined by the doctor depending on how my follicles react to the medicine.  Throughout all of this I will be getting internal ultrasounds to monitor the follicle growth in my ovaries.  If overstimulated then treatment is stopped and we abstain so that I don't turn into the next octomom.  If I am under stimulated (lack of progress) the doctor can increase dosage but after a certain amount of day but at a certain point of inactivity or progress you just need to call it quits for that month.  This just so happened to be the type of cycle that Bear was conceived on however the odds of pregnancy are slim.  The RE may or may not add in progesterone shots based off of my previous pregnancy history and me being high risk.  That will all be worked out during my first cycle. 

Why timed intercourse and not IUI or IVF?
Well there are two reasons for this.  The biggest reason is that tricare (our insurance) will pay for the office visits and vast majority of the medication only when using timed intercourse.  At least for us and our situation.  The cost of fertility treatments is very expensive and Tricare won't cover anything when using IUI or IVF.  Not the office visit, not the medicine, nothing.  Secondly, you wouldn't jump into the more invasive procedures if the less invasive ones worked!  If something changes then the whole situation would be reevaluated.  For our situation IUI isn't any more effective than timed intercourse so there is no need to waste money on that.  IVF would be the only other option but again it is invasive and costly.

Are multiples likely / you mentioned octomom is it possible?
With the use of any fertility treatments one is more likely to conceive multiples.  However precautions will be taken to avoid anything over triplets.  Think one to two mature follicles that may or many not each release a single mature egg that can possibly be fertilized is the goal.  Hence why over-stimulation and abstinence go hand in hand.  No one, especially not me, wants to be octomom or anywhere close to it!  Heck, the idea of twins scare the crap out of me so forget about anything higher.  Please do not take what I am saying the wrong way!  The goal of this process is to conceive a single healthy baby.  That is and will be our goal throughout this process.  It is the goal of everyone going through this process but the possibility of multiples are there.  If god blesses us with multiples after strictly following doctors orders than we will take it one step at a time from there.  

Will I get Preeclampsia again?
The hard truth is that no one knows the answer to this but the risk of preeclampsia is there with any subsequent pregnancy I may have.  Knowing my history my doctors will more than likely be keeping a closer eye on me.  I may even have to take blood pressure medication earlier than expected to help prevent preeclampsia from presenting.  I may need to be on bed rest for a period of time.  Who knows?  For now its all an unknown.  

Will I deliver prematurely again?
God I hope not.  Since preeclampsia was the reason Bear was born 6 weeks early it could depend on if Preeclampsia presents again.  So the answer to this is again I don't know.  There are a lot of unknowns when it comes to infertility, pregnancy and delivery.  

Are you high Risk?

Yes I am and will always be considered high risk based off of my history with preeclampsia during my pregnancy with Bear.  It will mean more doctors appointments than normal.  More than one typically sees when using on post doctors and possibly more than one sees when using civilian doctor.  I could even (even Praying I do) get referred out to Maternal Family Medicine or an OBGYN that specializes in high risk pregnancies.  Specifically the one that delivered Bear.  He was a fabulous straight forward, no fluff doctor that I would be lucky to get again.  

Will I have have another C-Section?

Lets get me pregnant first.  But since this question keeps coming up I suppose I need to address it.  The possibility is there.  It depends on too many factors to know at this moment how I will deliver any future baby.  Getting a Vaginal Birth After Cesarean (VBAC) is less likely with multiples or if I get preeclampsia again or any other number of things that could possibly happen.  Then there is also personal preference.  I will get some say, depending on the situation, to decide if I want to try for a VBAC or a repeat C-section.  For us, as long as me and the baby are healthy then that's all that matters.  Not how the baby came into the world.  Once I am finally pregnant I may put more thought into this but for now this is what you are going to get.  No use putting the cart before the horse.  

so onto the bad news...

Sadly my chances of miscarriage have increased since the last time we were ttc.  Quite frankly I was too stunned trying to mentally come to terms with that statement and keep myself together to ask the doctor why this is the case.  Honestly, I am not sure the answer even matters as it won't change this fact.  This scares me more than anything else said the whole appointment.  High risk I expected. Risk of Multiples OK we'll deal with it.  Increased chance of miscarriage shut me down.  I'm not sure how I'll be able to handle that.

Then the what ifs started to roll on in on the rather silent ride home.  What I join this horrible club?  What if I'm pregnant when Hubby's parents are down here for thanksgiving and we can't or shouldn't say anything?  How am I going to hide a pregnancy when everyone will be drinking?  What if we tell them then something happens and I lose the pregnancy?  What if it happens and they are here?  I couldn't begin to know to how I will deal with it just us, let alone deal with hubby's overly emotional Mother at the same time.  What if I worry and nothing happens? or worse yet my worrying causes something to happen.

I'll stop there.  Clearly it is a deep dark rabbit hole I need to avoid.  

What I will ask of you is Prayers.  Prayers this processes doesn't take us years again.  Prayers I keep my sanity throughout this process.  Prayers to help the RE make the perfect calls in regards to my fertility treatments.  Prayers that we may actually conceive again.  Prayers for a Healthy new baby.  And most of all Prayers for Bear as his world will get flipped upside down throughout all of this.  


  1. Hugs friend! You know that I can relate to much of this and am always here if you need anything.

  2. Sending you tons of prayers and well wishes.


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