Year One

I had trouble getting pregnant in the past so I knew when Andrew and I started trying, we would need help.  With that said, I had never been tested to see what was wrong, if anything. I explained our situation to my OBGyn at UC Davis and given our advanced ages (ouch!), she referred us to a reproductive endocrinologist (i.e. infertility doctor) without trying minor treatments herself.  

Dr. Goud at California IVF began all the testing on Andrew and I.  We both had lots of blood drawn including hormone levels. All the labs including the semen analysis were fine so we then went on to schedule my first saline ultrasound (saying it was unpleasant is being generous). It was one of those situations where they tell you it’s going to mild cramping and you just know your uterus is going to do so much more.

Dr. Goud found a uterine polyp and saw that I had more than normal ovarian follicles.  He told us I had Polycystic Ovarian Syndrome (PCOS). (More to come on PCOS next week in the Education >> Infertility section.)  Of course I instantly went to google and started researching PCOS. I had friends who had it so I’d heard of it but this was the first time I heard a doctor say I had it.  I wasn’t really upset about it, yet, because I read so many positive things about women with PCOS still being able to become pregnant.

Because I had a uterine polyp in the area where embryo implantation needed to happen, Dr. Goud recommended I have the polyp removed.  In June 2015, I had my first infertility related surgery. The surgery went well but there was some significant cramping afterwards. The anesthesiologist told me in recovery that Dr. Goud gave me a new uterus (if only that were possible!).

After a couple months rest, it was time for my first infertility treatment: Intrauterine Insemination (IUI).  I went in for my baseline ultrasound and got the clearance to take the follicle stimulating hormone, letrozole.  I went in a week later to see how my follicles were progressing…they weren’t. Being new to this process, I was devastated because I thought this cycle would be cancelled and I’d have to start over (if only my 2015 self knew what was in store for us in the coming years).

Thankfully, the cycle wasn’t cancelled and Dr. Goud prescribed more letrozole and a repeat ultrasound a week later.  After the next sonogram, the doctor told us my body was finally ready to proceed with the next step which was to trigger my follicles to ovulate using an injectable medication, HcG.  Being a nurse, I was fully prepared to teach Andrew how to give me the shot but he watched all the videos and listened very intently to the instructions the nurse at the clinic gave us.  

The IUI was on a Saturday and I could take a pregnancy test 10 days later.  That 10 day wait was excruciatingly long but the first of many long waiting periods we would have to face.  I was instructed not to use home pregnancy tests and to come in for a blood test…well, I didn’t listen (who would?).  I used 2 sticks and both were positive. To say we were excited is an understatement. I remember thinking how lucky we were to have the IUI work right away especially after reading how many tries women had to endure before something was successful.  But that wasn’t us, it happened on our first try.

The blood test was obviously positive as well and the doctor told me to come in for a repeat HcG level to make sure the level had doubled.  Unfortunately, it did not increase like it should and I had to have the test repeated again. Looking back, this was the first red flag something was wrong.  

The test was repeated 2 days later and it was right on track so we breathed a sigh of relief.  I started feeling the “normal” symptoms of pregnancy: breast tenderness, occasional nausea (thankfully, only occasional), and fatigue.  I think the symptoms that surprised me the most was the degree of fatigue, the oral aversion (meat was NOT happening), and the constipation.  This may be TMI for most people but up to this point, I had only had constipation less than a handful of time so I was not prepared for the backup that was happening.

I began writing little letters to my baby.  I thought it would be nice to give the letters to him or her when they were older.  Sometimes it was just the symptoms I was having or a conversation Andrew and I had about our future.  Mostly, the letters were about the love that was growing everyday.

I had my first ultrasound to check the status of the pregnancy in the middle of October…and here comes the second red flag.  We were supposed to be 8 weeks and 1 day – we know this specifically because of the exact timing of the IUI. Unfortunately, the fetus measured 7 weeks.  We asked the doctor at UCD what this could mean but she brushed it off and stated everything else looked fine. She saw the heartbeat and it was at a normal rate.  Again, we breathed a sigh a relief.

Over the next 2 weeks, I continued to experience pregnancy symptoms but also I was having cramping and some spotting.  I must’ve called the clinic every other day about my symptoms but they kept saying everything I was experiencing was normal.  They, however, must’ve gotten sick of my calling, though, because they finally made an appointment to come in to put my mind at ease.

2 weeks after my first ultrasound, I went in for the second one.  My regular doctor was not available so I saw Dr. Phelps instead. (I mention her for a very specific reason which will you will see why in a bit.)  She performed the sonogram and it was evident from the her face that something was wrong. I don’t know if it was the nurse in me or a mother’s intuition that made me recognize the look but it was obvious to me something was seriously wrong.

Dr. Phelps had us go to another location to get another sonogram with a stronger ultrasound machine.  The sonographer did a very thorough job since the ultrasound seemed to go on for at least an hour. She told us that the doctor would call us with the results but it was the end of the day so we didn’t know if that would be the same day or if we would have to wait until the morning.

On the drive home, we got the call from Dr. Phelps.  She told us that there was no heartbeat. She also stated that the measurements of the fetus were smaller than the ones taken previously which indicated that the heartbeat had probably stopped shortly after our initial ultrasound.  

With this news, the whole world seemed to stopped.  Andrew and I were still in the car, pulled over on the side of the road trying to process what was happening.  We sometimes still pass by the place where we got the news and it brings all the painful memories back. Neither one of us need to say anything, we just both turn our heads to look at the place where our hearts were torn apart.

Dr. Phelps stayed on the phone with for quite a bit making sure we understood exactly what was going on and allowing us time to grieve and process.  She gave me several options with which to proceed: allow the miscarriage to pass naturally although she couldn’t say how long that would take; prescribe medicine that would induce the miscarriage to happen but the cramping from this option can be very painful; undergo a procedure to remove the tissue but I would only be mildly sedated; or to have a D&C to remove the tissue under deep anesthesia.  

I knew it would be too difficult to watch the tissue and blood pass even though I knew logically that the fetus was too small to see.  And the thought of being fully (or even partially awake) during the removal of the tissue actually made me throw up. So, I chose to be completely unconscious when they removed the products of conception.  Dr. Phelps rearranged her schedule (we found out later that she actually cancelled meetings the day of surgery) and made herself available to perform the procedure.

The nurses and anesthesiologist were very kind to me that Friday, the day they removed my baby from my body.  They were very gentle and spoke very softly to me the whole time. Of course I don’t remember much from the procedure – I don’t even remember getting home afterwards – but I’ll never forget the tenderness and patience shown to me that day.

The following weeks were tough.  It was hard to even get out of bed to move to the couch much less do anything more than that.  Andrew grieved too but he was mostly tasked with taking care of me. I feel sorry now for not verbalizing to him that he it was ok for him to not look after me and also be a grieving parent…I think I was too much in my own sadness to see that was necessary.

We learned later that they had tested the products of conception and found no genetic anomalies.  We also found out the baby was a boy.

There were more tests done on Andrew and I to see of we had genetic abnormalities and if I had issues with certain clotting factors that only become a problem when you’re pregnant.  Thankfully, all the labs came back normal but on the flip side, we will never know why we lost our first baby which brings its own kind of anguish.