Monday, November 16, 2015

What is Infertility


Although more common than most may realize, infertility isn’t typically something that people think about until they aren’t getting pregnant as quickly as they had anticipated.  I’m not an exception.  Before experiencing infertility, I wasn’t aware of very many people that had been affected by it, and if I was, I didn’t understand the struggle of it.  It wasn’t until my husband and I weren’t getting pregnant as easily as we had hoped, that I began to notice so many others that were in the same boat as we were.  As many as 1 in 8 couples experience infertility, whether it be through having difficulty conceiving or difficulty sustaining a healthy pregnancy.1 Chances are, if you’re not the one who is diagnosed with infertility, you know at least one person, if not more, that is.    
Infertility is recognized as a disease where the male and/or female reproductive systems do not function correctly.2 Not only does it affect individuals physically, but it can really take an emotional toll on them as well.  Depression and anxiety are common with couples that are faced with infertility, as they often feel a sense of failure, which then impacts their overall self-esteem.3 
So what determines whether or not a person is diagnosed with infertility?  Most couples generally get pregnant within 6 months of trying. This number then increases to 90% of couples after 12 months of trying.  Individuals are typically diagnosed with infertility if they are unable to conceive after a year of trying without any form of birth control, after six months if the woman is older than 35, or if they are unable to sustain a pregnancy through live birth.4  
The main and most obvious sign of infertility is not being able to get pregnant.5 However, there are many other signs that one may consider, especially if thinking about going to see a doctor prior than trying for the full recommended year. These include:
·      For females…
o   Irregular menstruation
o   Previously known fertility problems
o   Being over 40 years old (over 35 if you’ve been trying for 6 months)
o   A diagnosis of endometriosis or pelvic inflammatory disease
o   Recurrent miscarriages
o   Having had cancer treatments
·       For males…
o    Previous known problems with sperm or low sperm count
o    Scrotum swelling,
o   A previous vasectomy
o   Problems with ejaculation
o   Having had cancer treatment

This covers only a small aspect of infertility.  We will cover many more topics such as different diagnostic testing, diagnoses, treatments, individual experiences, diet, and so much more throughout this blog. 
References:

1Mayo Clinic Staff.  (2014, July 2).  Definition.  Retrieved from http://www.mayoclinic.org/diseases-conditions/infertility/basics/definition/con-20034770

2Fast Facts About Infertility.  (2015, April 19).  Retrieved from http://www.resolve.org/about/fast-facts-about-fertility.html

3Hidden No More: The Hidden Emotions of Infertility.  (2015).  Retrieved from http://www.resolve.org/about-infertility/what-is-infertility/hidden-no-more-the-hidden-emotions-of-infertility.html

4Mayo Clinic Staff.  (2014, July 2).  Symptoms.  Retrieved from http://www.mayoclinic.org/diseases-conditions/infertility/basics/symptoms/con-20034770

5Mayo Clinic Staff.  (2014, July 2).  Symptoms.







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Rachel and Pete's Infertility Story

My story is probably similar to many others that are struggling with infertility, but nonetheless it is my own.  After my husband and I had been married for just over a year, we decided we wanted to start trying for a baby.  Four weeks later, after taking numerous pregnancy tests, I got a positive.  I felt like the luckiest person alive, and apparently the most fertile.   We were beyond thrilled, and everything seemed like it was falling into place in perfect timing. 
I waited three impatient weeks for the ultrasound to come around, looking forward to seeing the little gummy bear I had seen in others’ ultrasound pictures. I had never been to an ultrasound appointment before, so I had no idea what was to be expected.  The ultrasound began and I kept waiting for the technician to say something. Instead, it was very quiet.  After a few minutes of looking around, she turned the machine off and said, “You can go put your clothes on in the bathroom, and then the nurse will tell you your results”.  This wasn’t exactly what I had pictured for an ultrasound, and part of me knew then what was to come. However, the other part of me was so full of hope and wanted to be na├»ve to what was going on.  The nurse came in and explained that there had been no heartbeat, and that there were two possibilities as to why. Either I wasn’t as far along as we had thought or the baby had stopped developing at six weeks.  It took a while for this to sink in, but I still tried to error on the positive side hoping that maybe, just maybe, the second option was it.  They said to come back in after two weeks and we would try another ultrasound.  The nurse then drew my blood to check my HCG levels, and said to come back in a few days to see if the numbers had increased. If they had, that was a good sign things were developing as they should.  A few days later, my blood was drawn again, and my HCG levels had increased SIGNIFICANTLY.  I had feelings of relief and an increase in hope, praying that somehow things would be okay.  Two weeks went by, and it was time for the second ultrasound.  The technician looked around, in silence, and then turned off the machine.  As hard as I tried, this time I couldn’t hold back the tears.  The technician couldn’t either.  The doctor talked to me about possibly having to do a d&c if I didn’t miscarry on my own. So from that point on, I just began to pray that it would happen naturally and was almost relieved when it did. 
As difficult as miscarrying was, Pete and I were optimistic and weren’t going to let this experience discourage us. We knew we would be able to start trying again in a couple of months.  We had lots of hope due to how fast it had happened the last time, and even planned it perfectly so we’d be able to make a onesie with the words “Made in Mexico” written on the front. I skipped an entire month after having had two perfectly regular cycles.  It wasn’t until after that that I began to realize how irregular my cycles were.  After a year passed, I decided it was time to go see an OBGYN to figure out what was going on.  We did a few lab tests which came back normal, and I wasn’t told much more than, “You’ve been pregnant before, I’m sure you’ll get pregnant again soon.”… “it could possibly be due to stress- sometimes after a miscarriage, things stress you out that wouldn’t have before.”…, along with, “you guys are young, there’s no rush”, etc.  I had emphasized PCOS runs in my family and was something I wanted to have checked on, but practically had to beg to take the glucose test to check my insulin resistance.   Those results came back normal for me as well.  This was an emotional time for me to say the least, and my husband and I felt very alone in trying to figure out why we couldn’t have the baby we wanted so badly. 
It has been 3 years since then.  Thanks to our OBGYN and infertility specialists, we’ve learned a lot of things and have been very confused by more.  I eventually did get diagnosed with PCOS, and to our surprise, my husband with low motility and a low sperm count.  We’ve tried various modern day treatments such as clomid, letrozole, IUI’s, gonal-f, metformin, and even a random Robutussin cough syrup for my husband to help with fertility.  More natural approaches have been taken as well including diet, acupuncture, and herbs.  And now, here I am, exactly 3 years later, amidst a break of beginning infertility treatments, and I just found out I’m pregnant.  I have so many emotions and feelings running through my head right now. Disbelief, excitement, fear, overwhelming happiness, gratitude, and of course exhaustion and nausea. I can’t tell you what we did, because I have no idea (well, I’m sure you know the basics).  We weren’t trying anything specific; I had a stomach ulcer and I was living off of watermelon, fish, cinnamon rolls, black licorice and pretzels.  A really well balanced diet, right? We were in the process of moving. In fact, my husband and I were apart more that month than were together. But somehow, a miracle happened.  I’m only 6 weeks along right now, and only time will tell what happens next, but I feel an immense joy that we’ve gotten this far. One of the first things I did was call my infertility clinic to let them know, and they were just as excited for us, as we are, that we were able to get pregnant on our own.  Our infertility journey I’m sure isn’t over (although I hope it will be at least for the next 7 months), but I’m very grateful for the people that have helped us get to this point. 



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Kamryn and Abe's Infertility Story


My husband, Abe, and I met and dated all through high school, so by the time we got married it didn’t take us long at all to feel like we were ready to start a family. It started out as “let’s just not prevent” but after a few months and realizing my cycle was not functioning as it should, we were in a doctor’s office discussing what was happening and what we could do about it. After several unsuccessful rounds of Clomid, a mass was found on my ovary. I underwent laparoscopic surgery where I was diagnosed with Stage 4 Endometriosis. That surgery lead to another surgery, a laparotomy, where the majority of the endometriosis was scraped out or cauterized. This second surgery was supposed to have solved my inability to conceive. So, immediately after I healed from it we did several IUI’s, all of which failed. During an ultra sound in our last IUI we discovered another mass on my ovary and knew that the endometriosis was back. This was extremely discouraging for Abe and I and I remember feeling so defeated. It seemed like I had put my body through so much already and to not have success like we imagined we would was heartbreaking. It was at this point that we decided we would move to IVF, a step we were both excited and terrified to take.
            Our first round of IVF didn’t end how we had hoped it would. My body didn’t respond well to the stimulation meds and the doctors were only able to retrieve two eggs, one of which fertilized. We did a day three transfer for our one little embryo, which was graded B/C. We knew the odds were against us, but in the end when we didn’t achieve pregnancy, our hearts and hopes were still crushed. Despite this, we knew that trying again was essential. Therefore, we set up another consultation with our doctor. During that appointment, he brought up the idea of using an egg donor.
            Using an egg donor is something I never thought I would have to do, and at first I really struggled with the idea. It was an emotional process that took several weeks, but in the end, looking at the statistics, my husband and I both knew it was the best next step we could take to have a family. We selected a donor, which is actually very much like what you see on television. We were given a list of donors with their basic traits and told to select 10-12 potential donors. Then, we were given full profiles based on our selections. The profiles had just about everything one would ever need to know about the donors. From there, we narrow it down to one. For us, it was really simple. My husband and I immediately agreed on the same donor. Then, we found out she was available for the month we needed, which sealed the deal for us. Once we selected our donor, our second IVF journey began. It was much like our first round of IVF. I was still taking injections to make my body think I was going to ovulate, but really our donor was doing all the hard work. This cycle we had 28 eggs retrieved, 20 fertilized and by day five we had 11 perfect Grade A eggs. We transferred two and were lucky enough to have 9 embryos to freeze.
            Several months ago we found out that our second round of IVF using an egg donor was successful and we are expecting twins! A little girl and a little boy. After a two-year journey and so many struggles that sometimes I didn’t think we would make it through, we are finally going to have a family! We hope and pray every night that I continue to have a healthy pregnancy. Looking back I feel incredibly grateful for the journey that we took to have a family. But mostly, I feel extremely blessed to live in a world where medical advances are available, that make having children possible for couples like my husband and I.
           


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Friday, November 6, 2015

Shauni and Kyle's Infertility Story

 

 
      Being a mother is something I had dreamt about since I was a little girl. As my husband would say, it is in my DNA. It was no secret that I wanted to have children. As my friends began having children of their own, I would snuggle up their sweet babies and they would jokingly comment on how I have wanted to be a mother since I was like twelve. I would laugh and agree, but secretly I was insanely jealous. Finally, my husband and I felt as if we were ready to start a family of our own. To say I was excited would be an understatement. We already had our kids names picked out and I could not wait to hold our little one in my arms. However, month after month went by and still there was no baby on the way. Every passing month seemed to get harder and harder. I often called my mom bawling, because, yet again, I was not pregnant. I remember one particular time about a year and a half after we had begun trying to have a baby. I had discovered another month had passed and I was still not pregnant right before my brother’s football game. When I got to the game, I looked around and could not stop the tears from pouring down my face. There were so many little ones running around everywhere and I so desperately wanted one of my own. I felt defeated, angry, and hopeless. I called my mom on my way home that night. She then suggested that my husband and I make an appointment with an OBGYN just to make sure that everything was okay.

     The next morning I immediately began calling around until I found a doctor who could see us right away. I will never forget our first appointment. My husband and I were sitting there and in walked the doctor. He started talking to us and seemed like he was about to give us the low down on how sometimes it just takes time and to make sure that we were timing everything correctly. When he asked us how long we had be trying, I watched his expression change, his eyebrows raise, and then he excused himself for the room (not really the best sign). When he came back he presented us with multiple handouts and information regarding what testing could be done to make sure there were no issues.  I was to complete an HSG exam and my husband was to complete a sperm analysis.
Based on the testing, we discovered that my husband had slow motility and really low sperm count. As much as this diagnosis was devastating, it also brought some relief. There really was something wrong. We weren’t crazy and now we could do something about it.  We were referred to a Urologist and my husband was diagnosed with Varicocele. We were provided with information regarding treatment and surgical options. However, after doing some research and considering how low my husband’s sperm count really was, we weren’t sure we had found the right answer yet. Ultimately, we ended up scheduling an appointment with a Reproductive Endocrinologist. By the time our appointment arrived, I had done enough research (more like scoured the entire internet for every little bit of information) to know that our best, and really only, option was to pursue treatment through In Vitro Fertilization (IVF). Yes, the financial side was scary. Yes, the chance that it might not work was terrifying. Yes, the emotional and physical toll it can take was exhausting. But even worse, was the thought of not trying and not having the opportunity to have a family.

     We began our first IVF cycle the following month. Despite my intense fear of needles, I woke up each morning, stared at pictures of babies, prayed, and my mom or best friend would assist me with my injections.  On the day of retrieval, my doctor was able to get fourteen eggs, seven of which fertilized, which was a lot less than had been anticipated. By day three, we only had four embryos left. I began to panic as as many as fifty percent of embryos don’t make it from day three to day five. However, my doctor assured me that she felt that there would be at least one embryo to transfer by day five. So terrified, I waited and prayed. I so desperately just wanted my babies back in me where they belonged. The morning of our transfer I sat in the waiting room shaking as we waited to see if any of our embryos had made it. Thankfully, all four had survived. We watched as the doctor transferred the two healthiest embryos into my uterus. It really was an amazing thing to see. Our little girl is now eight months old. My husband and I love and adore her so incredibly much and we are so incredibly grateful for medical advances and the opportunity we had to begin our family through IVF.


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