Hmmnnnn where to begin?

Ok how bout with this….

That’s how I feel.

Like I am standing outside after the longest, darkest storm ever imaginable has finally passed and the brilliant sun light is just breaking the horizon and spilling all over me.

My RE (reproductive endocrinologist) appointment this morning was fascinating, shocking and scary all at the same time.  She took the first 5 minute to not only praise me for all of the work I have done to date when it comes to trying to conceive for the pregnancy that we lost in January, but also for the work from the past 8 months of trying  and for not waiting the 12 months that most doctors suggest before searching out an OB who specialized in fertility to get a jump start on all of the diagnostic testing of my reproductive system and my husbands sperm and still have it covered by insurance because it was through an OB .  But most importantly for taking the time to do all of the research I have done in order to advocate for myself, because she knows how much time that can take and how hard it is to tell a doctor what you want when it clearly has differed from what they were prescribing.

Then after telling me I have done everything right, that she is thrilled that I have made her job so easy-she then asked me how my marriage was with my husband.

Say what?

I’ll be honest, it threw me.  I couldn’t help but look stunned.  So after a couple seconds of a blank stare while my brain was trying to summarize the state of my marriage into words, she re-phrased her question to

“you guys have been trying to conceive your first child for nearly 2 years and during that time you have had month after month of perfectly timed intercourse using ovulation predictor kits ending in no pregnancy, once you finally achieved pregnancy you suffered the most traumatic event a pregnant woman can go through followed by 8 more months of fertility drugs, IUI’s, trigger shots and perfectly timed intercourse that has not yielded you a pregnancy yet-how are you guys doing with all of this?”

It was a great question.  It was such a good question, that I even said without thinking”That’s a really great question Doctor” and then chuckled because it is a learned response I had picked up from my best friend who is an incredible listener and also a teacher (no coincidence there) who would always say that when I asked her a question worth pondering and it would crack me up everytime-I coined it “teachering me.”  Miss T. did you just teacher me?

My doctors question after acknowledging all of the work I have done and what we have been through (and trust me it has been WORK, really hard work) made me confident that this woman was finally the right doctor for me.  She gets it.  She clearly sees that it isn’t simply the thought of not being able to have children that can tear you apart, but it is the whole process of trying to conceive with unexplained secondary infertility coupled with  losses of pregnancies that can rip a marriage completely apart.

It also made me have to say out loud stuff that I have only thought in my head.  It’s hard.  It’s really, really hard.  I won’t lie, we are a relatively new couple and we have had to face frustration and loss, and learn how to not only communicate with each other, but how each other deals with grief and loss so that we can not only support each other but not hurt each other in our own grieving process.  You are never prepared for situations like this.  I dare say no couple this new has the tools to handle this type of crap when you’ve only known each other for 3 years.

It is absolutely sink or swim.  And trust me, for a few months back this winter, I thought for sure we were sinking.  It took realizing what we were actually going through (both independently and as a couple) to allow us the ability to learn how to stay afloat together.  How to buoy the other one up when they are just so beaten that they can’t keep their head above the water.  How to tread to keep your own weight buoyed so that you aren’t dragging your spouse down with you when you can sense they are just barely staying afloat themselves.  Now almost a year after our loss, we are finally swimming smoothly along in tandem-but it certainly wasn’t an easy journey.  I am grateful that I have found a partner in life that cared enough about me, and us as a couple that he was willing to work at learning to swim together when it would have been so much easier to ditch me and save himself.  We are strong in a way I never knew was possible, and know that regardless of what life might throw at us in the future we now have the tools to get the job done.

After pouring over both my own records and the previous 2 doctors records my RE said what I have been thinking for the past 4 months…

I am concerned that it took you so long to get pregnant last year (9 cycles), and that it is taking you this long again (so far 7 cycles).  It is concerning for 2 reasons, the first being that with the amount of tracking, temping and well timed intercourse you have done you should absolutely be pregnant by now and the second is that if this trying to conceive business continues to drag on and not yield a pregnancy I am concerned about the amount of added stress it will put on both your body, your husband and how that will affect your marriage.  Your insurance is incredible.  My professional opinion is that if you are not pregnant next week, we move to IVF as your next cycles plan.

(me) Holy Shit Balls!!  So I am not completely crazy!!!???

(Dr) No you’re not, the earlier we move to IVF the better results we will have because time is not on our side.

(me) Ummmm ok.  Would you recommend anything else?  What would you do if you were me?

(Dr) You could do an entire cycle of injectable drugs where we will force your ovaries to make 4 – 5 eggs in that cycle to increase your chances of conception.  However, chances of being pregnant with injectables and IUI at your age with your FSH number are only about 15% and if you are pregnant chances are closer to 20% that you’d be pregnant with twins or 1% with triplets or more.  If it were me, I would start imeediately with IVF becuase  we control the quality of the eggs and the quantity. We take out a lot of eggs, but only put back the healthiest looking 2 embryos after fertilization  so your chances are about 40% each cycle of IVF that you will have a live healthy baby in 9 months, but no more than twins.

(me) Woah.  When do I have to tell you by?

(Dr) Talk it over with your husband, the nurse will give you all of the info you need-and call in to let us know what you want to do if your period shows up this weekend instead of a positive pregnancy test.

(me) If I am pregnant, would it be possible to follow this pregnancy here?  And if so, what is the protocol?

(Dr) Absolutely.  Call us when you get a postivie pregnancy test, we’ll bring you in for a beta pregnancy test to see your hCG level.  Then you’ll return in 2 days and re-test to make sure the number is doubling.  Then at 5 and half weeks we’ll bring you in for an ultrasound of your fallopian tubes and uterus to make sure the pregnancy is where it should be, occasionally there is some cardiac activity that early, but most times not which is why we will bring you in for a second ultrasound at 8 weeks to confirm a heart beat.

So that’s the plan man!  Either way pregnant or not, I feel extremely comfortable with this doctor and her plan and happy that we have a week to discuss which option we will go with if we aren’t pregnant on Saturday.

Advertisements