My path on birth control has been mixed. Without going into to many details I will say that I tried Depo-Provera (the shot) early in my birth control years, and it was terrible for me. I thought it was great, get a shot every 3 months, eventually your period will stop, easy! However, I didn't realize how much weight I would gain while doing it. There were a lot of factors that went into my weight, but Depo-Provera was definitely a strong contributor. I was disappointed that my doctor was not also paying attention to my weight gain, and perhaps pointing it, because really, when you are gaining weight you sometimes don't notice how crazy it has become until it's out of control. I eventually got off Depo-Provera and went on the pill. I know there are many different versions of the pill, and I was on a few throughout my time, I just don't want to list them all. Now it's time to get to the good stuff.
In January 2009 Joe and I decided to go off the pill. We knew we wanted to have a baby sometime in 2010, and we knew that sometimes it takes a while for a woman's body to adjust to not being on the pill and be ready to get pregnant. We also knew that it took my mom almost a year being off the pill before she got pregnant, so we thought we would be proactive and go off early. We weren't quite ready to get pregnant, we still had a few goals we wanted to meet, so we used other methods of prevention.
Things were going along fine until April 2009 when we went to Stake Conference (we are members of The Church of Jesus Christ of Latter-Day Saints). I remember sitting on the bleachers, (our Stake Conference was held at the Georgia Mountains Center, which is a convention center. The Gym area was set up with bleachers surrounding the main floor with chairs set up and then a stage in the corner.) and the bleachers gave a good advantage of seeing most of the people in attendance. As we were sitting there I remember seeing all these people with babies, or pregnant ladies, or even just young kids, and I had this overwhelming feeling that I was ready, I needed to have a baby! (not that it's unusual to see a lot of children at an LDS meeting like this one, but they were all standing out to me) Later that day I talked with Joe about it, and he felt similarly. So the pregnancy prevention stopped and we started getting excited!
Pregnancy wasn't happening right away and I wasn't having a regular cycle. In June 2009 I decided I would go see the OB/GYN and see what might be causing the problems. The Doctor suggested I take a progesterone pill to start my period and clear my lining. The hope was that it would trigger my cycle to start on its own after that. Things still were not regular and we were frustrated.
In September 2009 I went to my OB/GYN again to discuss my options. She suggested I do some blood work and consider starting Clomid. She thought I was healthy and since we wanted to get pregnant we might as well jump right in (my words, not hers). I discussed it with Joe and we decided we weren't ready for Clomid. We felt like we hadn't been trying for too long, and that perhaps there were some other things we could try first.
Throughout the next few months I talked with my mom about my concerns. We didn't want to spread the word that we were trying because we didn't want people to constantly be asking us about it, but I wanted some advice. Mom suggested I talk with my sister-in-law, because she also had some issues getting pregnant, and she also remembered that my cousin had some issues, and would ask her sister what the details were on that. My cousin actually had PCOS and went on Metformin to help with that, and my sister-in-law, who did not have PCOS did go on Metformin and also Clomid. Both got pregnant soon after these treatments. I decided that I would suggest these possibilities to my doctor at my routine exam in March 2010.
When I went to my appointment in March, my Doctor didn't seem very interested in discussing PCOS, Metformin, or other issues of trying to conceive. She said that my blood work that was done in June 2009 did not indicate that I had PCOS. I suggested we do an intrauterine ultrasound to see if PCOS showed up. After the appointment I was frustrated. I emailed with my cousin and she suggested we also have Joe do a semen analysis. I called the doctor's office and asked to have that set up. When I asked the doctor's assistant how it would be handled, specifically where could the sample be collected, she actually suggested the parking lot at the hospital! At that point I knew I wasn't working with the best team.
Joe actually did two analysis before my next appointment so that we could go over the results. We did not take care of the collection in the parking lot, but I wish someone would have told us how to handle that part more efficiently.
In April, we went in for the intrauterine ultrasound. The technician said that she actually saw that I was ovulating at that moment, nothing was said about seeing PCOS. We met with the Doctor after and she basically said go home right now and have sex. She did say that Joe did have a low count and suggested that he see a Urologist.
In May, Joe went to the Urologist to get some more blood work done. It came back that he had slightly low testosterone and that his semen count was low along with a low motility. Another semen analysis was run, along with some other tests.
In June, the Urologist suggested that Joe start taking Clomid. We thought that was strange, especially since we hadn't heard anything about men taking Clomid. At that point we decided it was time to go to a fertility specialist. I wanted to go somewhere that we would have a team working for us, giving us ideas and suggesting possible solutions. I also wanted to go somewhere that would take care of both Joe and me, I was done passing information between the Urologist and OB/GYN. I felt like those two Doctors were not thinking about our problem of infertility, they were just seeing us in their office. Any test or procedure done with my OB/GYN was suggested by me and I never felt like she was supporting me.
In July, we had an initial consultation with Atlanta Center for Reproductive Medicine (ACRM). After discussing all of our previous tests and histories, the Doctor agreed that Joe should take Clomid for 3 months and then do another semen analysis to see if it was helping. The Doctor did say that Joe's levels were definitely sufficient if we needed to proceed with Intrauterine Insemination (IUI), but at this point we could try Clomid to see if it would help bring the levels up even more. For me, he suggested I start taking Metformin to see if that would help my cycle at all. He also felt like I had symptoms of PCOS, which Metformin would help. We scheduled several blood tests for the next few weeks.
On July 23rd I started my period. At that point I started a round of blood tests with ACRM to see what was happening at different points in my cycle. July 26th I had blood drawn and another intrauterine ultrasound. During this ultrasound the technician pointed out the "ring of pearls" that were around my ovaries, which was the PCOS. On July 30th I had an HSG test. The Doctor put blue dye through a tube put in my vagina and then into my uterus, which would then flow into my fallopian tubes. Then we viewed my insides through a steady beam of x-ray. It was totally neat, I even saw my hip bones! Everything looked good, no blockage, and the Doctor indicated my uterus was a good triangular shape.
I was waiting to get the results of all these tests before I started Metformin, so I began taking the pill on August 6th at night because there was some chance it could cause an upset stomach. I started at 750 MG and then doubled it to 1500 MG on August 15th. I was scheduled to see the Doctor again on August 23rd to see how things were progressing, but something else happened. That weekend I ended up having lots of upper abdominal pain, and after a visit to the urgent care on Saturday with no fix and then the ER on Sunday morning, we finally figured out what was wrong. I had gallstones! I had to have my gallbladder out that Tuesday, August 24th, so I cancelled my appointment with ACRM.
I decided since I didn't really have any updates for the Doctor I would just wait until Joe finished out his 3 months of Clomid and last semen analysis then we would just do a review all in one visit.
The next 3 months were the most exciting months because I actually had a regular cycle, 3 months in a row, September 25th, October 25th, and November 23rd!
On November 3rd Joe saw the Urologist who indicated things were good with the Clomid and he should continue taking it. December 1st Joe went back to the Urologist who had him do two different semen analysis. Both results came back as good.
I was so excited about my regularity that I used an online ovulation predictor calculator to find our most fertile days, which were going to be 12/4-12/9. We were going to be in Disney World for the last time during those dates, so it was a great time to get pregnant!
On December 13th we had a consultation with our ACRM Doctor to review Joe's numbers. The Doctor was pleased with how the Clomid was improving things. He was also happy to hear that I had been having regular cycles, but then he mentioned that it is possible to have a period without actually ovulating. We did a blood test to see if I had ovulated, the result was negative. It was definitely a let down. I have since learned that if the serum progesterone test is not done in exact timing it will come back negative, indicating no ovulation has occurred. I think that since my cycles were not yet exact, my ovulation was missed during this test. But before we knew all that it was determined that we would wait for my next period to start then we would do a few more tests and start a round of Clomid in January.
Joe and I were sad that we possibly were not ovulating during those regular periods, but we were excited by the prospect of being able to start the Clomid regimen knowing we had tried in every way to conceive "naturally."
When I didn't have my period in December over Christmas I tried to not get my hopes up. We had been trying for almost 2 years, we had already done dozens of home pregnancy tests, I was sure that I hadn't ovulated, that's why I didn't rush to do another pregnancy test. At the end of December I started to think that maybe we had gotten lucky, and determined that on January 2nd I would do a pregnancy test. That morning I got up and without making a big display about it, I went and did the pregnancy test. It was actually our last one, and it happened to be a digital one that came in an ovulation predictor kit (which I was not good at using). When I saw the result I was shocked! I asked Joe to come in and tell me what it said. It was awesome! The feelings of shock, relief, excitement, and love were crazy! I was trying to keep my composure, I had been let down by so many pregnancy tests that I just couldn't believe it, even though the word "pregnant" was right in front of my face! I told Joe we had to go to the store and get more tests. So we did. I did one when we got home, and saved one for the next morning. They were both positive! Amazing! We were pregnant and we were thrilled.
We also had faith that we would be blessed, and that God had a plan for us, and we would get pregnant when the time was right for us.
I strongly recommend those couples that are currently struggling to get pregnant, find a team of doctors that they can trust, who will listen to your concerns and suggestions and give you appropriate advice. I think going to a fertility clinic is the best idea because the doctors there are specialists and they deal with people similar to you every day, unlike your typical OB/GYN.
I also suggest that couples not forget about each other during this time. It's easy to just focus on the infertility and forget about enjoying each other. During 2010 Joe and I decided to get an annual pass to Disney World. We had a few family visits that staggered from December 2009 to March 2010 and it made financial sense for us to get an annual pass. This gave us the opportunity to spend lots of time together, driving from Georgia to Florida, and then exploring the parks in different ways each time we went down. We also were lucky enough to have wonderful friends let us stay with them when we were down there. Even though we were struggling with infertility we were enjoying each other's company and strengthening our relationship.
If through all of this you still do not get pregnant, there are other options. I strongly believe in adoption. I know it's not for everyone, and you really have to be prepared for adoption, but I have seen adoption bless so many lives.
Try to stay positive. There will always be good days and bad days, but ultimately this experience will grow your relationship with your spouse.
