Hi I’m Amber I just turned 25 two days ago. I have a wonderful DH, Graham who is also 25. We have been TTC for 24 cycles. Someone suggested to me to start a journal. At first I didnt want to but the more I though about it the more it sounded like a good place to vent so here it goes.
When I was younger I always though that I didn’t want to have kids. I though being an Aunt would be enough but once I turned 20 and was in a serious relationship my thoughts began to change. In 2001 I was diagnosed with a Pituitary Tumor. If you are going to have a tumor in your brain this is the one to have. Mine doesn’t do too much. Every year I have to have tons of blood work done and an MRI to check what it is doing, but so far it is just hanging out so we just watch it. I was told at my first apt, with the Endo who follows me for my tumor that I may run into problems when I am ready to have children. At that point I was not ready so I didn’t give it much though. But slowly the idea of children of my own started sinking in. I have more school I want to complete but my DH and I decided to start “not trying, but not not trying” so I went off BCP. After a few months of that we started getting more active in trying. I told myself in the beginning I would not get worried until I was finished with school and settled in our careers before we got really aggressive. That helped keep off the pressure but after a year I was concerned. I work on a mom/baby unit and for being around so many pg women I was surprised to see how many of my fellow nurses have fertility problems. I watched one of my friends go through 8 IUI’s and 3 IVF’s without ever getting pg. I got scared and decided to see an RE. I am very lucky because the clinic that was just voted the best fertility clinic in the nation is in my town. I made an apt and was thinking that we would go through the testing and learn everything was fine and then be able to keep trying without pressure. Well that went right out the window!
The first cycle with my RE we did all the routine stuff……FSH, HSG, Post coital, SA’s, u/s…… A few years ago I had an ovarian cyst and I learned at that time that I had a bicornated uterus. I am one of those people who look up everything to know everything there is to know about my conditions. Since I work with OB’s I was able to get lots of opinions on it, most came back as it was no big deal. I was excited (maybe excited is not the right word…) to get my HSG done so I could see exactly what my uterus looked like. Bicornated uteruses are described as “heart shaped” like someone took their thumb and pushed in the top to make it indent a little. So that is what I was expecting to see. What I saw though was nothing like that. My uterus is far from normal. It looks like a very deep V. A P.A did my HSG. She looked very concerned so I asked her what she thought. She said from her experience women with uterus like mine were not able to carry a full term pregnancy and I would require surgery to get it repaired. I broke down crying right there!
My RE though did not seem as concerned. He said an HSG is not a great indication of what is really going on. There as a possibility that instead of being bicornated it could have a septum (a normal uterus with a thin layer of tissue growing down the center), which is easily removed and I could go one to have a healthy pregnancy. If it was a true bicornated (which he said most women are not) then there is noting that can be done. There is a surgery for it but the risks greatly outweigh the benefits and most doctors would not even consider it an option. I felt a little more at ease…especially since one of the pg.org girls just had that surgery to remove a septum a few months prior and I could lean on her for support. So my RE decided to do a hysteroscopy to see exactly what was up there, so to speak. The hysteroscopy was fairly uncomfortable but was over quick. Dr. Surrey was not happy with what he saw. There was indeed a very deep V to my uterus. It was so deep that he could not see it all. The bottom part looked very promising to be a septum so he gave me 2 options. The first, to go in and have a lap done so he could look at it from above and below to determine what it was. If it was a septum then it could be removed at the same time. The second was to have an MRI. I opted for the non surgical approach and went with an MRI. The MRI showed that my uterus was defiantly bicornated. I was pretty let down about that. I have taken care of women that have spent most of their pregnancy on strict bed rest in a hospital for months! I have seen the tiny preterm 28 weekers that have such a huge struggle to get well and grow up healthy. I know no one ever thinks they will have nothing but a routine healthy pregnancy but for me knowing exactly what kind of battles lay on the other side was nerve wrecking! I was even more nervous that Dr Surrey would tell me that it was not in my best interest to carry a child. But he never did. He told me there is no reason we cannot proceed with me getting pg. I needed to keep a realistic approach on things and understand that I may end up on bed rest and I may end up with a pre term baby, but there are also women out there (not a lot but a few) with uterus similar to mine that go on to have no problems and have big healthy full term babies!
Unfortunately we also learned some more devastating news at that appointment. There is a new test that is out called an AMH (Anti mullerian hormone) which is still very new but they think that it is able to tell you exactly what the ovarian reserve is. They want the results to be 1.01 or greater for you to ever to be able to have a child. Most women have levels of 2 or 3 and as they age the levels drop. Most of the drops do not occur until the mid forties and women get closer to menopause. My results though are 0.94. My RE told me we needed to start getting really aggressive with our treatments because he could not tell me how long I had to have biological children. He said he would like to see me pg within the next 6 months. After that 6 month mark I may not be able to have children at all. Usually I am a pretty emotional person. I cry when I get frustrated and angry, I cry when I am happy and when I am sad but this news did not stir up emotion. I was shocked. I learned this when I was 24, my fertility is not supposed to be an issue at 24! The clock is not supposed to start ticking yet. My DH was with me when we learned this and he was there when Dr Surrey said he thinks IVF is our only option. I was pretty colleted during the meeting. It was like I had stepped out of my own body and went into nurse mode. I talked like I wasn’t talking about myself and my lack of a future for my second child. Dr Surrey told us to take some time to think about what we wanted to do. I asked if this was due to my tumor and he did not think it was releated. I asked what we would do in the mean time if we decided to wait a few months to come up with the 16,000 that we didn’t have to pay for IVF. I inquired about IUI’s and he said we could defiantly try it. He did not sound optimistic but he said we could try. IVF for us would not be that simple either though. Because of my bicornated uterus I cannot support multiples. So while doing the IVF they will only implant one embryo at a time. Previous u/s has shown that even with Clomid I only have around 9 follicles a cycle. Normal for someone in their 20’s is around 15. If you have 6 or less the odds of getting pregnant are slim to none. So because I do not have a lot of eggs available and the quality of the ones that I have are not great AND since they will only implant one at a time there is a good chance we would have to do IVF several time. But because my FSH is high Irun a risk of releasing multiple eggs, so IUI's ru nthe risk of having multiple babies, something that is not an option. So we went home with a lot to think about.
In the back of my head I had always been picturing the worst case scenarios. So I was not too surprised to hear this news. Still shocked to have an actual medical professional who is the best in his field say it out loud but in some sense I saw it coming. Graham on the other had been blown away. I had been telling him about this for a while but he really didn’t get it until the doctor said it. He drove me home and we didn’t say too much about the appointment. When we got home he stayed with me for a bit then had to go to work. When I was alone I had a breakdown. I was so angry and upset. How could this really be what is going on in my life? I had always imagined myself with several children of my own. My life was going perfectly. I had a good job, and I was, after a mandatory 2 year wait list finally going to start the P.A (Physician Assistant) program in the fall. I had a great husband, our own home which we had fixed up and decorated how we wanted. I have 2 horses that are my life! We had just bought DH a new truck and had just landscaped our front yard. Everything was going so well. But now I felt as if everything was crumbling. If we had found out 2 months earlier about having to do IVF we could have been in a place financially to be able to make it work. Money would still be tight but we could make it work, but now all I could think about is the cross road I stood at. On one side was my life as I knew it and on the other side was my baby and I could not have it all. I decided that I can always go back to school later so I officially took myself out of the PA program. There was almost no way I could have finished such a rigorous program pregnant anyways…even if everything did go well. I have to keep the though in the back of my head also that I may have to sell my horses, although we are trying to make it work with me keeping them. It has been 2 weeks since we found out about my infertility. My DH and I have had a lot of struggles. Not just about having a baby but every aspect of out marriage was strained. It was only for a couple days but it felt like years and those days I was pretty sure I was going to end having to so this alone. Already in these 2 weeks I think our marriage has gotten stronger. I have my moments where DH can say or do nothing right and I think he has learned it is not him that I’m angry at.
Although theses past few weeks have been so difficult and surreal feeling I am glad that I know about all this now while we can do something about it. I have had a few moments a month ago where I wanted to stop trying so hard. Stop temping and testing and stressing over my chart…just take a break for a year then try again. I am so glad I didn’t do that. That there was that little voice that kept me going. Otherwise it would be too late. DH and I have come up with out game plan. We have decided to try 1 or 2 cycles of IUI’s before moving on to IVF. if the IUI results in twins or more we will cross that bridge when we get there. I start my Clomid today and take it day 5-9 then go back on day 12 to see how my follicles are responding and how close to Ovulation I am.
I am trying to stay relaxed, but I have huge knots in my back from stress…..I think I’ll go get a massage over the weekend. I’ve never had one before and I think I have it coming.