A New Year: Roads That Have Unknown Direction
Those of you that know me and my sisters know that it is not very easy to have a baby (although it may look like it now with six nieces and nephews)... but trust me when I say they did not come easy. Both of my older sisters struggled to have children of their own for years, but they are both now blessed with two beautiful babies. We thank God for them everyday- they are little miracles of their own (rotten miracles of course).
In saying all of that, I have always known that I might have trouble getting pregnant (considering the genetics). I have never had regular cycles my entire adult life, and I also experienced some of the same symptoms as my sisters. My regular physician diagnosed me with Polycystic Ovarian Syndrome (PCOS) - a hormonal disorder among women. Women with this disorder have enlarged ovaries that contain numerous small cysts located on the outer edge of each ovary causing it difficult to become pregnant. With treatment and hormones pregnancy is a good outcome in women with PCOS. Steven and I decided early on that we would not prevent in case we did become part of the "infertility" world. We gave it nearly a year of trying on our own... then we knew it was time to see a fertility specialist. My physician referred us out to a fertility specialist here in Charleston, and our first appointment was in October 2013.
"The Uncomfortable Stuff"
As I mentioned before this blog will contain it all! So if you're uncomfortable hearing technical medical terms now would probably be the time to stop reading :)
We had our first appointment with our fertility specialist, Doctor S., on October 21st. It was my first initial testing day (blood work & ultrasound to see my ovaries), and it was also Steven's lucky day to give a little of his "manhood" for testing. Let me start this off by saying that Steven and I are not always the most "serious" people when it comes to "adult" things. We are two of the biggest kids I know, and that is exactly why we enjoy life so much! We started the day off pretty early- Steven had to be there 30 minutes prior to my appointment to give a semen analysis. We sat in the waiting room for what seemed like hours when really it was probably 10 minutes before being called back. When you first go to a fertility specialist the whole process feels awkward. I remember that I kept thinking that Steven was going to be so nervous. I am pretty sure I asked him if he was going to be able to "go" under pressure. Bless his heart... Maybe I was the one that was incredibly nervous.
The following images are clips from a few of our text messages that took place that morning while at the doctor's office. Remember earlier when I said we are two big kids? Prepare yourself.
Me: It is SO awkward here. Lol. How did it go?
Steven: I say that it's worse because your procedures are done by a doctor. I stood in a room that's probably covered in sperm and had to go in a cup!
Me: LOL!
Steven: Terminology applies especially after all the words I'm about to hear in this appointment. New rule for this visit. Every time the doctor says vagina we both have to repeat it like we are an echo.
Me: I feel like we are 12 year olds hearing the words penis and vagina for the first time. Lol. I'm saving these texts to show our kids one day! Haha!
After getting our initial giggles out the appointment when under way! Our nurses made us feel so welcome, and they were very professional about their job. During the ultrasound the doctor showed us the "foggy" areas within my ovaries which meant "polycystic looking.." All symptoms looked and seemed to reveal PCOS just as my physician had suggested. Doctor S. then took us through an hour "sit down" meeting discussing our next steps, medications, procedures, costs, etc. Lets just say that if Steven had not been there I'm not sure I would have remembered a word she said. It was SO overwhelming. Anyone who has been to an appointment such as this one will know exactly what I am talking about. My advice for those of you that are just starting out and are possibly considering seeing a specialist of any kind- hit the record button on your phone! Trust me- you'll be thankful later.
STEP 1
Step 1: Doctor S. prescribed me a drug called Provera which is used to treat amenorrhea (lack of periods). Considering I never have a cycle (unless on birth control) this was definitely an issue. She said that I should start a cycle within 7 days, but 7 days came and went. I had to go back in to the office to have an ultrasound done to see what was actually going on. I had a grapefruit size cyst forming which was causing me an enormous amount of pain. Provera was "feeding" this cyst which is why it was becoming so large. Come to find out everyone forms a small cyst right before a cycle, but as you bleed that cyst goes away. I wasn't bleeding; therefore, the cyst was staying and getting bigger. The doctor reviewed my estrogen levels which were very high so she was certain that I would bleed eventually and the cyst would rupture on its own. Day 13 was a bad day, I finally had a cycle & somewhere along the way the cyst ruptured. Steven and I were in Washington, D.C. for our one year anniversary. I was in so much pain I could hardly move, but I was determined to keep walking around that gorgeous city! By the end of the trip I was finally feeling better.
The next few days I had to go back into the office for Doctor S. to run more blood work on different days of my cycle to determine my follicle stimulating hormone (FSH) levels, etc. A few days went by before I heard anything from the nurse, but she did call with some not so great news. A normal person's FSH levels are between 5-7. A person with PCOS has levels around 2-4. My FSH levels were 0.25. My first thought was, "Yikes!" The nurse went on to try and explain what this meant, but honestly, I was not listening. I knew it was not great news, and she was using big words like hypo-something and another. The phone call was a bit of a blur. She said that Doctor S. would go over everything with me on my next visit.
Hysterosalpingogram (HSG) A.K.A. The Dreaded Dye Test
Steven waited in the waiting room on this one. My sister told me to be sure to take Ibuprofen before... I forgot. There is a SUPER long definition to this type of testing, but I will put it in "Tess Terms" and I like to call it. A dye or contrast material is inserted through the vagina (there's that awful word) and into the uterus. The dye goes through the fallopian tubes. Pictures are taken throughout to see if there is any kind of blockage that would prevent an egg moving through a fallopian tube to the uterus. The test only last about a minute, but it hurts. My fallopian tubes were clear so nothing to worry about there. As I sat up Doctor S. started to tell me about the FSH test results. I should have stayed lying down because the next thing I know I was asking for Sprite and crackers. After I recovered she went on telling me that I am no longer being diagnosed with PCOS.
My new diagnoses is called Hypogonadotropic hypogonadism (HH). The
title alone made me want to vomit. So here we go with "Tess Terms" again... my FSH levels were incredibly low which meant one thing. My brain (the pituitary gland) is simply not producing the follicle stimulating hormone that everyone needs in order to have a cycle, ovulate, and get pregnant. Since my brain does not produce the hormone then the ovaries are not receiving it which causes some of the same symptoms as PCOS which is why I was misdiagnosed. HH is very treatable for people that are NOT trying to get pregnant. You simply take birth control because it regulates that hormone causing you to have one. However, in people that ARE trying to get pregnant those hormones must be injected in you. In some cases there could possibly be a tumor on the pituitary gland blocking the hormone. She ordered an MRI of my pituitary gland with contrast. We decided it'd be best to call it a day and meet again after we had the results from the MRI. I was mentally and physically exhausted.
Words to the wise: do not go home after you've just been given a new diagnoses and WebMD yourself on every website possible. Steven gave me one day to look everything I wanted to look up online- one day. After that one day I had diagnosed myself with everything from diabetes to cancer. The internet is the devil. After that one day I promised him I would let it go and trust my doctor and not WebMD. Haha... Nurse Steven trying to look out for me (he really does have his nursing degree folks).
MRI results & consult with Doctor S.
My MRI results were clear. Whew... what a relief! However, what is causing this blockage? Doctor S. answered it right away- there is no known reason. Some people just do not produce the hormone, and I am one of those unfortunate and unlucky people. How do we fix it? FSH injections which help increase egg production and Luteinizing hormone (Lh) injections to assist with ovulation. I will take these injections everyday leading up to Intrauterine Insemination (IUI). We will start these injections at the beginning of January 2014!
Preparation for Step Two: Concerns, Worries, and Excitement
We'd be lying if we said we did not have concerns. There are many risks that are possibilities that could happen while taking the injections. Just like my sisters I could develop ovarian hyperstimulation which in some cases (just as my oldest sister) could cause the ovaries to rupture completely. The doctor will monitor this by weekly ultrasounds. If this happens we will have to wait 2-3 months to even try again, that is, if the ovaries do not rupture. This is one of my biggest worries after watching my sisters go through such a thing.
If all goes well with the injections then it's time for IUI. Intrauterine Insemination (IUI) -- in "Tess Terms" is where a certain amount of washed sperm are placed directly in the uterus around the time an ovary releases one or more eggs to be fertilized. The rest is all a God thing... the process is pretty much a boost to place the sperm where they need to be in order to fertilize. Whether they actually fertilize or not is totally in God's control. Please pray that once this procedure is completed that God takes over.
A lot goes on in step two. It could very well be our last step or it could be the first of many steps. Steven and I are well aware that this first round of injections may not work at all, but we are and will remain hopeful. It's strange the way your life goes about in this certain cycle. As a young teenager I used to dream about my wedding day. I dreamed of the white dress, the flowers, the man I would marry one day. My dreams came true when I married Steven. My dream of the perfect wedding came true... then I had a different dream- a new dream. From the day I first told Steven I was in love with him I dreamed of having a baby and starting a family with him. For over year now (which we know doesn't even compare in comparison to some couples out there) we've tried for that dream to come true. The next year is going to be a year of many new adventures for us. We are starting a road that we have no idea as to what direction it might eventually lead.
We ask that you pray for us both as we start this next step. Please pray for our doctor and nurses as they prepare to possibly help bring our baby into this world. We know this may be a very long road, but we are so thankful that our family, friends, and loved ones are going to be right there with us every step of the way. We thank you from the bottom of our hearts.
-T & S
"The Uncomfortable Stuff"
As I mentioned before this blog will contain it all! So if you're uncomfortable hearing technical medical terms now would probably be the time to stop reading :)
We had our first appointment with our fertility specialist, Doctor S., on October 21st. It was my first initial testing day (blood work & ultrasound to see my ovaries), and it was also Steven's lucky day to give a little of his "manhood" for testing. Let me start this off by saying that Steven and I are not always the most "serious" people when it comes to "adult" things. We are two of the biggest kids I know, and that is exactly why we enjoy life so much! We started the day off pretty early- Steven had to be there 30 minutes prior to my appointment to give a semen analysis. We sat in the waiting room for what seemed like hours when really it was probably 10 minutes before being called back. When you first go to a fertility specialist the whole process feels awkward. I remember that I kept thinking that Steven was going to be so nervous. I am pretty sure I asked him if he was going to be able to "go" under pressure. Bless his heart... Maybe I was the one that was incredibly nervous.
The following images are clips from a few of our text messages that took place that morning while at the doctor's office. Remember earlier when I said we are two big kids? Prepare yourself.
Me: It is SO awkward here. Lol. How did it go?
Steven: I say that it's worse because your procedures are done by a doctor. I stood in a room that's probably covered in sperm and had to go in a cup!
Me: LOL!
Steven: Terminology applies especially after all the words I'm about to hear in this appointment. New rule for this visit. Every time the doctor says vagina we both have to repeat it like we are an echo.
Me: I feel like we are 12 year olds hearing the words penis and vagina for the first time. Lol. I'm saving these texts to show our kids one day! Haha!
After getting our initial giggles out the appointment when under way! Our nurses made us feel so welcome, and they were very professional about their job. During the ultrasound the doctor showed us the "foggy" areas within my ovaries which meant "polycystic looking.." All symptoms looked and seemed to reveal PCOS just as my physician had suggested. Doctor S. then took us through an hour "sit down" meeting discussing our next steps, medications, procedures, costs, etc. Lets just say that if Steven had not been there I'm not sure I would have remembered a word she said. It was SO overwhelming. Anyone who has been to an appointment such as this one will know exactly what I am talking about. My advice for those of you that are just starting out and are possibly considering seeing a specialist of any kind- hit the record button on your phone! Trust me- you'll be thankful later.
STEP 1
Step 1: Doctor S. prescribed me a drug called Provera which is used to treat amenorrhea (lack of periods). Considering I never have a cycle (unless on birth control) this was definitely an issue. She said that I should start a cycle within 7 days, but 7 days came and went. I had to go back in to the office to have an ultrasound done to see what was actually going on. I had a grapefruit size cyst forming which was causing me an enormous amount of pain. Provera was "feeding" this cyst which is why it was becoming so large. Come to find out everyone forms a small cyst right before a cycle, but as you bleed that cyst goes away. I wasn't bleeding; therefore, the cyst was staying and getting bigger. The doctor reviewed my estrogen levels which were very high so she was certain that I would bleed eventually and the cyst would rupture on its own. Day 13 was a bad day, I finally had a cycle & somewhere along the way the cyst ruptured. Steven and I were in Washington, D.C. for our one year anniversary. I was in so much pain I could hardly move, but I was determined to keep walking around that gorgeous city! By the end of the trip I was finally feeling better.
The next few days I had to go back into the office for Doctor S. to run more blood work on different days of my cycle to determine my follicle stimulating hormone (FSH) levels, etc. A few days went by before I heard anything from the nurse, but she did call with some not so great news. A normal person's FSH levels are between 5-7. A person with PCOS has levels around 2-4. My FSH levels were 0.25. My first thought was, "Yikes!" The nurse went on to try and explain what this meant, but honestly, I was not listening. I knew it was not great news, and she was using big words like hypo-something and another. The phone call was a bit of a blur. She said that Doctor S. would go over everything with me on my next visit.
Hysterosalpingogram (HSG) A.K.A. The Dreaded Dye Test
Steven waited in the waiting room on this one. My sister told me to be sure to take Ibuprofen before... I forgot. There is a SUPER long definition to this type of testing, but I will put it in "Tess Terms" and I like to call it. A dye or contrast material is inserted through the vagina (there's that awful word) and into the uterus. The dye goes through the fallopian tubes. Pictures are taken throughout to see if there is any kind of blockage that would prevent an egg moving through a fallopian tube to the uterus. The test only last about a minute, but it hurts. My fallopian tubes were clear so nothing to worry about there. As I sat up Doctor S. started to tell me about the FSH test results. I should have stayed lying down because the next thing I know I was asking for Sprite and crackers. After I recovered she went on telling me that I am no longer being diagnosed with PCOS.
My new diagnoses is called Hypogonadotropic hypogonadism (HH). The
title alone made me want to vomit. So here we go with "Tess Terms" again... my FSH levels were incredibly low which meant one thing. My brain (the pituitary gland) is simply not producing the follicle stimulating hormone that everyone needs in order to have a cycle, ovulate, and get pregnant. Since my brain does not produce the hormone then the ovaries are not receiving it which causes some of the same symptoms as PCOS which is why I was misdiagnosed. HH is very treatable for people that are NOT trying to get pregnant. You simply take birth control because it regulates that hormone causing you to have one. However, in people that ARE trying to get pregnant those hormones must be injected in you. In some cases there could possibly be a tumor on the pituitary gland blocking the hormone. She ordered an MRI of my pituitary gland with contrast. We decided it'd be best to call it a day and meet again after we had the results from the MRI. I was mentally and physically exhausted.
Words to the wise: do not go home after you've just been given a new diagnoses and WebMD yourself on every website possible. Steven gave me one day to look everything I wanted to look up online- one day. After that one day I had diagnosed myself with everything from diabetes to cancer. The internet is the devil. After that one day I promised him I would let it go and trust my doctor and not WebMD. Haha... Nurse Steven trying to look out for me (he really does have his nursing degree folks).
MRI results & consult with Doctor S.
My MRI results were clear. Whew... what a relief! However, what is causing this blockage? Doctor S. answered it right away- there is no known reason. Some people just do not produce the hormone, and I am one of those unfortunate and unlucky people. How do we fix it? FSH injections which help increase egg production and Luteinizing hormone (Lh) injections to assist with ovulation. I will take these injections everyday leading up to Intrauterine Insemination (IUI). We will start these injections at the beginning of January 2014!
Preparation for Step Two: Concerns, Worries, and Excitement
We'd be lying if we said we did not have concerns. There are many risks that are possibilities that could happen while taking the injections. Just like my sisters I could develop ovarian hyperstimulation which in some cases (just as my oldest sister) could cause the ovaries to rupture completely. The doctor will monitor this by weekly ultrasounds. If this happens we will have to wait 2-3 months to even try again, that is, if the ovaries do not rupture. This is one of my biggest worries after watching my sisters go through such a thing.
If all goes well with the injections then it's time for IUI. Intrauterine Insemination (IUI) -- in "Tess Terms" is where a certain amount of washed sperm are placed directly in the uterus around the time an ovary releases one or more eggs to be fertilized. The rest is all a God thing... the process is pretty much a boost to place the sperm where they need to be in order to fertilize. Whether they actually fertilize or not is totally in God's control. Please pray that once this procedure is completed that God takes over.
A lot goes on in step two. It could very well be our last step or it could be the first of many steps. Steven and I are well aware that this first round of injections may not work at all, but we are and will remain hopeful. It's strange the way your life goes about in this certain cycle. As a young teenager I used to dream about my wedding day. I dreamed of the white dress, the flowers, the man I would marry one day. My dreams came true when I married Steven. My dream of the perfect wedding came true... then I had a different dream- a new dream. From the day I first told Steven I was in love with him I dreamed of having a baby and starting a family with him. For over year now (which we know doesn't even compare in comparison to some couples out there) we've tried for that dream to come true. The next year is going to be a year of many new adventures for us. We are starting a road that we have no idea as to what direction it might eventually lead.
We ask that you pray for us both as we start this next step. Please pray for our doctor and nurses as they prepare to possibly help bring our baby into this world. We know this may be a very long road, but we are so thankful that our family, friends, and loved ones are going to be right there with us every step of the way. We thank you from the bottom of our hearts.
-T & S
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