First Trimester

After years of fertility treatments I found out I was pregnant on May 22nd. I had a blood pregnancy test done that day and the nurse called my husband with the results. People find it funny that my husband was the one to tell me I was pregnant but I was just too scared to get bad news alone. At this point we told our inner circle of people but kept it to the bare minimum.

May 29th I went into the fertility specialist to have a Viability Ultrasound. This is common after IVF to ensure that you are actually pregnant as many of the fertility drugs can cause false positives. It is also done because not every pregnancy will actually progress to a baby. At this ultrasound we found that the pregnancy was viable. Not only was the pregnancy viable but its twins!

I was only five weeks a long so they could not see heartbeats but the could see two sacs each with their own spine. On the way home from our appointment we called the few people we had told about our pregnancy to tell them that there was two.

On June 6th I went back in for another viability ultrasound since the heartbeats had not been seen on the first ultrasound. It was on that day that we heard their heartbeats for the first time. 

Baby A

Baby B

The doctor let us know everything looked great and gave us a referral to a Maternal Fetal Medicine Doctor (MFM) a specialist in high risk pregnancies. We were given a due date of January 25th and instructed to continue all medications including the progesterone shots until the second trimester to increase the probability of a successful pregnancy. I went on feeling great I didn't have a lot of morning sickness and I was able to easily resolve it by eating a popsicle. I attribute never having much morning sickness to feeling sick during the years of fertility treatments - haha. I had a different perspective on what sick was. After this appointment we told the rest of our family and close friends about the pregnancy but still kept it pretty private.

June the 17th I was in extreme pain and thought there might be something wrong with the pregnancy. We called the fertility clinic to see what we should do. The on call nurse said the pain wasn't in a location that was a concerned while pregnant. It could be a sign of something else like appendicitis so we should go to the hospital. At the hospital they did an ultrasound to check on the babies.

Since everything was okay with the babies I went in for a MRI to see if there was something else going on. Everything came back fine and we were told to get into the MFM right away for a double check.

June 21st we went in for our first appointment with the MFM. Another Ultrasound was done at this appointment to double check on the status of the babies. This was the first time I had not had a Transvaginal Ultrasound during all the fertility treatments and the pregnancy up to this point.

Baby A

Baby B

I had continued to be in a lot of pain which she explained to me was because our babies were growing at a faster than average rate. The stretching associated with this was the source of the pain and was not going to go away. The rest of the appointment went on like a normal obstetrics appointment would. We talked about how to have a healthy pregnancy, what to expect, and I asked questions. There was two big things I asked about. One was if it was going to be safe for me to travel because I was leaving on vacation in a couple of weeks. The second was if I was going to be having a c-section. The doctor said that even with the pain it was completely safe for me to travel but i would need to wear a belly brace from this point forward. She also told me that twins does not mean you must have a c-section. We were also given a new due date January 4th. This new due date was our twin due date. A twin due date is given because multiple gestation pregnancies are less likely to go forty weeks. 

In July we went on vacation to California to see my grandfather for his ninetieth birthday and tell him in person that I was pregnant. 

We had a great time. We went to San Francisco,

we hiked through the giant sequoias in Calaveras Big Trees State Park,

and enjoyed some time at Lake Tahoe.

Once I returned from vacation I had the last appointment of my first trimester. On July eighteenth I went in and everything looked great.

We were a third of the way there and the largest risk of miscarriage had past. It was at this point that we announced our pregnancy to the world.

Post Notes On Fertility Treatments.

Fertility treatments are not for everyone but there are some things I think it is important to know if you decide to go on this journey. It is important to find a doctor and clinic you feel comfortable at. The doctor and clinic you choose should feel confident in its ability to help you. If things are not working out with a particular doctor or clinic you should not hesitate to switch. The treatments are all about your family and you should never feel guilty that you don't want a certain doctor. I am very grateful to the doctors and nurses that helped me through the fertility treatments. I was much happier when I had people who were understanding and tolerate of the mood swings and worries that go along with trying to get pregnant.

It is important to learn the terminology that will be used throughout your treatment so that you can have a clear understanding of each step. It is also crucial to learn how to read the test results and understand what you see on the ultrasounds. As time went on I learned more and got better at identifying key points on an ultrasound so that the treatments got easier for me. Learn how to understand the Society for Assisted Reproductive Technology reports. Looking at these reports helped me to find a different clinic for my second opinion. These reports also showed me that the second clinic I visited had higher success rates with people that have conditions like PCOS than the first clinic despite the first clinic's higher overall ranking.

Finally, I feel it is important for anyone undergoing fertility treatments to find a way to cope. It can be hard seeing others around you get pregnant. You might feel bad that you don't want to go to your friend's baby shower but this is part of it. It can be hard to cope with the feelings particularly when for many people it seems to be a taboo topic. I found that speaking to a counselor and having a couple close family members to confide in helped me get through. I found it easier when I was just able to admit there was a problem instead of just trying to brush people off with generic answers. When someone asked me when Jon and I were ever going to have children I straight up told them we had fertility problems and were undergoing treatment. I felt a lot better when I could do this as opposed to giving a fake answer like we just aren't ready yet. One in eight couples will battle with infertility. This means that there are more people out there who will understand what you are going through than you may think. By being open and honest I received a lot of support rather than the pity I thought I was going to get. In turn I am as open and honest to others that ask me about my situation as I can be in order to support those still fighting the good fight. Although, in order to be completely transparent sometimes people did make rude comments to me and still do but the confidence gained through all the support helps me to brush it off.

For those of you here just to read about my journey through fertility treatments the story ends here. Thank you for reading and I really hope that in some way this will help you.

Step Four: One Option Left.

My husband had committed to being there every step of the way so that in case nothing happened we would be able to maintain a good relationship. From this point on he was there for absolutely everything. In December we met with our doctor for our consultation and made up our schedule to start the IVF process in January pending a medical board review that was mandatory for this clinic. We waited a couple of weeks taking the birth control that was prescribed to let my body rest and prepare. At the end of December we received a call telling us that the medical board had decided that we were not optimal candidates for the procedure and that we would have to pay a considerable amount more for them to be willing to accept us as IVF patients. My husband and I were devastated because we felt that if they didn't think that we were good candidates then we would likely not get pregnant and we would just be throwing our money away. After a few days had passed we decided to seek a second opinion and have our records transferred to another local clinic and go for a consultation there.

The doctor we met at the second clinic told us that he felt that based on our test results there was no reason why we should not be able to conceive a child. The only bad news was they could not get us in on the original timeline we had planned with the other clinic, so we would have to wait a little while longer. By February we had all of the paperwork signed, our IVF education courses taken, and all our fees paid and we were ready to go. I began taking a low dose of Follistim subcutaneously to begin growing eggs and then after ten days we went in for a transvaginal ultrasound, something you can never get away from during fertility treatments. The results showed that I had many eggs beginning to form which was great news, because during IVF you want a lot but not too many which can be dangerous. I had a blood test done to test hormone levels and waited to be called that afternoon with more information. The nurse called that evening to let us know everything was on track but to increase the dose of Follistim. This was so the developing eggs could get more hormones and to return in two days to repeat the process.

I went to the clinic a few times and each day I would go in the eggs would get a little bit bigger and there would be a few more developing. By this time because of all of the shots my stomach was bruised and I was running out of fresh spots to do the shots. I was several days past when they had estimated they would be doing my egg retrieval. Fear set in again that not even this was going to work so we were resolved to ask the doctor what could be done at this point. At the next appointment after being evaluated we asked the doctor what was wrong. He told us it was normal in some cases to go longer than the estimated time. The doctor was trying to be conservative so that I did not produce a dangerous amount of eggs. Increasing the dosage might push the eggs that are close to maturity over the edge or it could cause many more unmatured eggs to form. We discussed our options and decided that we would increase the dosage but I was going to have to come in for an appointment every single day. After a few days I began to get close to the goal and took a shot of Cetrotide to prevent ovulating to soon this medication caused a painful burning sensation for me. Shortly there after I had enough mature eggs for the egg retrieval. I took my Ovidrel shot and waited for Egg Retrieval Surgery.

The next morning I went in for the surgery where I was put under general anesthesia and my mature eggs were harvested. I was given the first of my Progesterone Shots to be taken as an intramuscular injection until either nine weeks of pregnancy or until it was confirmed I was not pregnant. The shots are not the only option but it was the best option for us. The shots are very thick oil solution and are done in the hip. For me these shots were so painful that some days it was difficult to walk and I spent many hours with a heating pad on my hips.

When I woke up the doctor came in and told us that they had harvested twenty-two eggs. Since I had produced so many eggs this was a good sign that I would have embryos to work with but I would need to monitor myself very closely at home for Ovarian Hyperstimulation Syndrome (OHSS). This was because of the large number of eggs I produced, fortunately I did not develop OHSS. The days following the retrieval I was in extreme pain. The lower part of my body hurt so much that I could not stand up straight and spent the majority of my time in bed. The day after the surgery the embryologist called to tell us that sixteen of our twenty-two eggs had been fertilized successfully. They would begin monitoring the quality and if the survival rate of the embryos was good they would try to get them to a day five blastocyst stage. He explained to us that a day five blastocyst has a stem cell sack that can be seen under the microscope, embryos with a stem cell sack will become a baby if they are able to attach to the uterine wall. Everyday the embryologist called us to let us know how they were doing. After four days we received a call that we had four good quality embryos that would be available for transfer the next day.

We set up a time to go in and when we got there we discussed with the doctor that two embryos was the proper and safe amount to transfer. The remaining embryos would be frozen in case I did not get pregnant or we wanted to use them in the future. I was given a sedative and prepared for the Embryo Transfer.

My husband and I got to watch our embryos on a screen as they prepared for transfer them and as they were sucked up the catheter.

Once the transfer was complete we made an appointment to have a blood pregnancy test done 15 days later but before this date arrived I began bleeding. We called the doctor's office and they advised that we still come in for the test to be sure that I was not pregnant and I was not. This was one of the most depressing days of doing fertility treatments, I had never felt worse and now we were going to have to wait for awhile for my body to heal before we could get a chance to use the two remaining embryos that we had frozen. A few days later we went to see the doctor to get started on whatever our next step would be. At that time I received a prescription for Estradiol to begin taking on a certain date to prepare my uterine lining for another embryo transfer. On May 9th we were ready for the transfer and went in that morning with the hope that the embryos would survive the thaw and we would have at least one to transfer. As we were signing the paperwork the doctor came in and told us both embryos had survived the thawing process. Now I were ready to take a sedative and have the transfer. As before we got ready and went in to have the embryos transferred.

Again we went home and waited until we would have our blood test. We were more hopeful this time because there had been no bleeding but you can never be sure. On May 22nd I went in and had my blood drawn. Since Jon and I could not be together that day to get the results together and I couldn't bare getting bad news alone we asked the nurse to call Jon with the results. That afternoon Jon called me and asked me if I loved him. I said yes and he said good because you are pregnant with my baby. I broke down crying, after all the time, pain, and struggle I was finally pregnant for the first time in my life.

Step Three: More Pills More Shots.

Now that the doctors decided that the Clomid was not going to work they decided to try Femara, which works similar to Clomid but that I may not be as resistant to. I started the next cycle this time using the maximum dosage of Femara and returned for a transvaginal ultrasound which at this point after almost a year of having them done twice a month, almost every month had become common place. It is surprising what you can get use to but as my story goes on you will find that it is good that I got used to them. The ultrasound results did not show the growth of any eggs.

The next month was another round of Femara with Dexamethasone this steroid would hopefully make me more sensitive to the Medication.This cycle's first ultrasound showed that there was two eggs. We hoped that the addition of Dexamethasone was finally going to be the answer. When I went in for the second ultrasound two days later the eggs were gone. The doctor told me I must have ovulated earlier than expected and that I would need to have the blood test to confirm. The blood test came back negative I had not ovulated. I found out that my body had not continued to produce enough hormones to mature the eggs so they dissolved back into my system. Since the medications had worked I sat down for a consultation with the doctor to see what options there were.  He explained to me that we could try to use injectable medications to try to further the growth of eggs produced by the pills but that following a full injectable path is not recommended for people with PCOS. There is a increased chance of getting pregnant with high order multiples (triplets or more) with PCOS. High order multiple pregnancies are usually very risky or not very successful. He recommended at this time we start considering IVF because it was no longer looking optimistic that we would conceive.

We tried our next round with the Femara and Dexamethasone when there was an egg at the first ultrasound I began taking Repronex to continue maturing the egg. Once another ultrasound confirmed the egg was ready, I took my Ovidrel shot and again hoped for the best. When this didn't work the doctor asked my husband and I to come in for a consultation and to reevaluate my health. The evaluation of my health showed that I was beginning to show signs of Cushing Syndrome from all of the steroids and that we could not continue with the fertility treatments at all. During the consultation he explained to us that because of my declining health the only option really left for us was to take a few months off, get some additional testing done, and prepare for IVF. Turns out this actually ended up be a good time to take off from the fertility treatments because life got crazy over the following months. My mom had surgery and needed me there for help, my sister got married

and my husband and I celebrated another anniversary.

Then in October I ended up in the hospital with a blockage in one of my bile ducts and had to have surgery to have my gallbladder removed. The surgeon told me gallbladder problems are really common in people who have undergone fertility treatments for a long time. During our time off we had our additional testing done this included more in depth blood tests. There were tests for every hormone in the body, S.T.D. tests, and tests to show how many good quality eggs I may have left. I also had a Sonohysterogram which was much like the hysterosalpingogram.

It is preformed the same way except it is done using an ultrasound and they use saline to flood the uterus to check for abnormalities in my uterus. Even though this can be done with the hysterosalpingogram it wasn't at the time and the results of my hysterosalpingogram had expired over all of the time doing treatments and for IVF it has to be current. Once all the testing was finished we made an appointment for the IVF consultation.

Step Two: Pills, Pills, and More Pills.

Once all the essential tests were done I returned to the doctor to get started to finally try to get pregnant. In November I had my period induced once again and got my prescription for Clomid and Ovidrel. When the time came I began taking one pill of Clomid and coping with the side effects which for me including severe mood swings and insane hot flashes. My hot flashes were so bad I remember one night sleeping with the window open and a fan on with snow blowing in on me. On day 12 of my cycle I went in for a transvaginal ultrasound. 
This was done in order to verify if the Clomid dose was high enough to produce an egg. The ultrasound showed that I had a nearly matured egg which was fantastic news. The doctor felt that this was a good response and that I would likely get pregnant very soon because it was a low dose and it worked the first time. I set up an appointment for two days later to check on the maturity of egg. When I returned two days later for another transvaginal ultrasound and the egg had fully matured and it was time to make sure that I ovulated by taking the Ovidrel shot and then going to have my blood draw a week later to confirm ovulation.
That night I took the shot and hoped for the best that our efforts would be rewarded. Excited and nervous we entered what many people trying to conceive would refer to as the two week wait (the time it takes between ovulation and when you would either get your period or not). As you can assume my period came and we knew that I was not pregnant. We called the doctor to find out where we go from here and we were given a new prescription for Clomid and Ovidrel and instructed to follow the same instructions as we had the month before minus the ultrasounds and continue until we become pregnant. I took the Clomid and suffered through the side effects once again and on day fourteen took my Ovidrel shot and went in for the blood test a week later. The blood test showed that I had not ovulated and that I would need to have my period induced in order to try again. On the third cycle I would start coming in for the ultrasounds again just to make sure that the previous month was not just a fluke of some kind. When I went in for the appointment there were no eggs. Since I had not produced an egg again I was instructed to increase my dosage of Clomid to two pills and return for ultrasounds during this cycle. I took the pills and returned to the doctor. The ultrasound showed that on the two pills I had produced a nearly mature egg and as before I returned two days later verified the egg was mature and took my shot. I ovulated but did not become pregnant in this round either and went into the next cycle taking the two pills and returning for the ultrasounds. This ultrasound showed no eggs had formed again. I was increased to three pills for the April cycle and the same pattern followed. Naturally I was increased to four pills in June with the same results. The doctor explained to me that the patchy results we had been getting for the nine months were likely from my body building a tolerance to Clomid really quickly and that a new approach would need to be taken.

Step One: Testing.

Testing was the hardest part for me of beginning the fertility treatment journey. What made it so hard was eagerness to get started on trying to get pregnant and the fear that more tests may reveal more problems. The first test I had done was a hysterosalpingogram a test done to make sure that there is nothing wrong with the structure of the Fallopian tubes.  This test requires you to be on a certain day of your cycles and since I do not have regular cycles I had my period induced by medication and prepared for the procedure. The day of the hysterosalpingogram I arrived at the hospital and changed into a gown. I was taken to a sterile x-ray room and was cleaned so that the procedure would remain sterile. The nurses that were about to perform the procedure asked me if I had taken any pain medication prior to coming in I wish I had. I didn't know before hand but this is recommended because the procedure can be uncomfortable or for some people painful at times. During the hysterosalpingogram a catheter was inserted into my uterus for me this was the most painful part. I experienced a tremendous amount of sharp pain as the catheter passed the cervix. Once the catheter is in place a contrast solution is sent up the catheter.

I watched a screen of the x-ray along with the nurses waiting to see if the solution would in fact flow all the way up the Fallopian tubes and out into the abdominal cavity although I have to admit I didn't really know what I was looking at or looking for. This part is uncomfortable like strong menstrual cramps but was not intolerable. Once it was done I waited in a nervous frenzy for the doctor to arrive to give me the results. The doctor came in and announced that the test showed that there is nothing wrong with my Fallopian tubes and I could get dressed and go home to rest. The following days there was a lot of cramping as my body pushed the contrast fluid out but I was elated to finally get good results on something. I excitedly awaited my next appointment with the doctor where I would find out the results of my husband's tests and what would be the official beginning of fertility medications.

In The Beginning...

The best place to start my story is at the beginning. When my husband and I got married we thought it would be great to start a family right away.

We went to see a doctor to see about having children and it was at this point that we found out that because I always have had irregular periods something was obviously wrong. It was either going to be really difficult for us to conceive or maybe not at all. We were young and decided that maybe this just wasn't in the cards for us. We did not have insurance or the money to pursue it at the time and so we would move on with life unfortunately childless. Fast forward six years and a lot had changed including getting insurance that covered fertility treatments. After many long conversations my husband and I decided we would at least have testing done to find out what was wrong or maybe at least we would have a final answer. In May of that year I had a full panel of blood work done and went for an ultrasound of my ovaries. The test results showed that I have Polycycstic Ovary Syndrome (PCOS). PCOS is a condition in which a woman has an imbalance of a female sex hormones. This may lead to menstrual cycle changes, cysts in the ovaries, trouble getting pregnant, and other health changes At this point I was referred to a fertility specialist and this is where you might say the story gets interesting.