Tuesday, March 12, 2019

Infertility after Infertility

Naivety.

I was naive in thinking that if we could finally get our baby, I would be 100% happy and move on from the woes of infertility. While I am the happiest I've ever been, infertility is still rearing it's ugly head and effecting our lives.

Ever since having Merbaby, I've had this overwhelming feeling of happiness and pure joy. I know it's pretty cliche to say, but being a mom completes me and makes me feel whole. I was born to be a mother and I love every bit of it. It's hard to describe but I just keep getting this deeply saddening feeling when I think that this could be it. One and done.

I absolutely loved being pregnant and the birthing process. I'm not ready to say goodbye to this part of my life. Thinking that I'll never be pregnant or experience birth again absolutely breaks my heart. It tears me up inside to think about the fact that I'll never get to nurse again or watch a tiny human grow and learn new things each day. I don't want all of the new, first-experiences to also be "lasts." I love motherhood and I want more of it.



I was engulfed in these feelings during early fall. It was nagging at me and I felt overwhelmed by it so I decided to do something. I contacted the fertility clinic and arranged to have some updated testing done. I was hoping it might offer some closure on this part of my life... that I'd see my results and realize that pregnancy just isn't an option. I could close that door and move on.

I met with my reproductive endocrinologist in October and we made a plan of what tests to take. I explained my feelings and thoughts to her. She was ready to dive back into treatment but I told her we just don't have the money for it. I needed her to look me in the eye and tell me the truth about my natural/cheap options. I needed her to help me move past these feelings. Despite my efforts to control the tears, they started flowing as I sat there in that office begging for a solution. An excuse to keep trying. A reason to give up.

Background information: At the time, Mr. Merman and I had been "trying" again since May (I'd started having cycles again in March/April). It wasn't an extremely concerted effort but I was tracking my cycles and timing intercourse accordingly. If we were really busy or had a lot going on during that fertile period, we would just let that month slide. Mr.Merman and I talked and agreed to just have sex and see what happens without focusing whole-heartedly on it... aka: Don't let it run your life like it did the first time around. 

The RE did tell me that after a year of no results, my chances got lower and gave a little speech about the chances of a natural pregnancy with my diagnosis but explained that it's not impossible. So, we decided to move forward with the updated testing and go from there. No pressure. I was assigned a nurse and sent on my way to discuss the logistics with her.

The following cycle, I had day 3 testing done to get updated AMH, FSH, TSH, estrogen levels, and an STD panel. They did an ultrasound to update the AFC (antral follicle count). And I had another HSG (yuck!). Here's the hard part- all of my results improved! It is totally normal for these numbers to fluctuate but it did not provide the closure I was hoping for. My FSH is normal now!?!? That's HUGE!

Results:

AMH:
Jan. 2016 = 7.4
Nov. 2018 = 9.64
(normal is higher than 1.5)

FSH:
Jan. 2016= 12
Nov. 2018 = 8
(normal is 11 or less)

AFC:
2016 (multiple counts) = averaged 7-9 follicles
Nov. 2018 = 13 follicles

Estrogen and TSH came back normal and in a good range. No STDs.

HSG Results
The HSG came back normal, for the most part. My tubes were clear and everything was in place. However, the left side of my uterus had a big black splotchy area, which could be caused be scar tissue. An HSG doesn't check for these types of things but it could be indicative of something going on in there. The doctor preforming the procedure said it could also be a bubble of air from the ink entering my uterus. After seeing the scan and results, my RE ordered a SIS (saline sonogram) to have the inside of the uterus checked out. The doctor performing the HSG spoke with me very briefly but we did determine that my "placenta dig" could have caused scarring in the uterus. (Check back in my blog for the after-birth story to read about that stubborn placenta- Placenta Dig Post).

MONEY PROBLEMS
Unfortunately, we just don't have the money for all of this. We're still paying off the IVF loan we took out for Merbaby and now we have the added (outrageous) weekly cost of daycare. Needless to say, we just don't have much wiggle room for my infertility costs.
My initial visit with the RE wasn't covered by insurance so that was $250 out of pocket. The ultrasound wasn't covered and only parts of the bloodwork were covered. Insurance didn't pay for the diagnostic portion of the HSG so I'm currently fighting that $400+ charge and having insurance reevaluate it. Within two months, we were coughing up hundreds of dollars (nearly $1,000) just to get some diagnostic testing done. Because of this, I haven't been able to meet with the doctor to discuss results, my husband has not been in for an updated semen analysis, and I've put off having the SIS done.



Thoughts About  My Uterus
Initially, I was pretty bummed at the prospect of having yet another issue that could cause problems conceiving. It just seems so unfair to have yet another thing added to the list of "reasons I can't get pregnant." If the SIS shows that I do have scar tissue, we'll have to schedule a procedure to have it removed. More money, more treatment, more invasive things being stuck in my lady bits, BLAH! It just makes me want to scream sometimes.



I do plan to have the SIS done this spring or summer. I'm just waiting til we figure out this $400 charge and build some savings back up. (An emergency room visit, Piper's vaccines and flea meds, and HOA dues have added to our list of financial burdens for the next few months). I've had time to calm down but hate knowing that I could be missing that one good egg that might drop and fertilize. What if there is scarring and it can't implant? What if it does implant but the scarring prevents it from staying attached or growing correctly? I have so many of these thoughts going through my mind each day. I'm just ready to know for sure.

I'm also curious of Merman's semen analysis. It was excellent before but he's lost a lot of weight in the past year (almost 60 lbs.) and has been exercising and eating healthy. All of this likely has an impact on his reproductive health. Hopefully it's a good one!

Meanwhile
I'm enjoying life with Merbaby and focusing on every little second I get with him. I've started tutoring twice a week, before school starts. It's early and I miss out on waking Merbaby up. But the extra money will help us pay bills and stay afloat.

I'm doing a lot of research to see how I can increase my chances of conceiving naturally because paying for treatment is NOT an option. I've ordered It Starts with the Egg by Rebecca Fett and plan to read that to see what reasonable improvements I can make in my life. I've started doing more research on MTHFR and learning what it means. I've found out that it effects about 70% of white women and about 50% of the population. I may have to do an entirely separate post on what I've learned from my "research" and talking with medical professionals on this topic. It's something I definitely want to have tested but again, it costs money! Insurance doesn't cover the testing so I will just wait and wonder. I'm absolutely fascinated by what I'm learning though.

I'm continuing to track my cycles. They are picture perfect (which is even more infuriating). I did take a few months off from tracking when it started messing with my emotions. I don't want to cry every time I start my period so I took a little break to get my head right. Because my cycles are so predictable, I knew when I was ovulating and when I was about to start so we still had intercourse, but I wasn't testing or putting anything in my tracking calendar. It helped a lot! I'm no longer bummed out when my period starts. Thinking about our lack of money also helps me stay calm. We would not even be able to afford daycare for a second child.

All of the baby toys, equipment, and clothes have been packed up and stashed in the basement. I'm giving it 5 years before we get rid of anything and call it quits. I'm not ready to give up!


All in all, infertility sucks and it never goes away. It will always be a part of our lives and our story. I hate it but I'm learning to grow from it. The love and appreciation I have for Merbaby is truly magnified because of the journey we went on to get him. Infertility really puts things into perspective and makes you realize how lucky you are to have made it through to the other side. It may have broken the bank, but was worth every single penny. I'd do it 100 times over if I knew my little guy was the result.