Wednesday, April 10, 2013

I was/am infertile.

*This is a post to avoid if you don't want to read about periods, my sexual activity, and PCOS. Definite TMI but I want the information out there.

I was infertile and I suffer from secondary infertility now.

Wow, that was hard to write. The emotional and spiritual issues associated with all of that will have to wait for another post. I feel I need to clarify some things about me:

I was as infertile as they come. Unable to conceive. For years. Many, many years. It was my issue. Without embarrassing my husband and putting information he doesn't want on here, let's just say he and his stuff excels in this area and leave it at that.

Some background: I was a late bloomer. I got my period at 12 and it has NEVER BEEN REGULAR. Not one. The periods differed in severity, some months when it finally came it was nothing, sometimes it was MAJOR and crippling. But more times than not, it was nothing. The first year I was dating my husband, I remember we noted that I had only 4 periods that year and we had sex that year. There was no way I was ovulating. You might be wondering "why would she be taking that chance not using birth control without a diagnosis or knowing for sure. I always "knew". I don't know how else to explain it. I was sexually active for many, many, many years before being married and never used any form of birth control. I wasn't diagnosed with PCOS (poly cystic ovarian syndrome) until I was 19 but I always knew. I have always been "stocky"- overweight, whatever, very Italian looking, thick head hair, short, tomboy, had a period of bad acne in college, etc.  I was also raised by strict Catholic parents and birth control and sex was not discussed. Birth control was not available to me. I was supposed to just abstain. Except I was premiscous. My entire life was controlled, except for the times I was able to be sexually active and hide it from my parents. That was my rebellion. I was naive and uneducated.  I spent years just hoping that "things would work out" and I wouldn't end up pregnant. I didn't even want to be married or have children, ever. In fact, I contemplated having an abortion if I were to ever get pregnant prior to meeting my husband at 19. But even then, then I somehow knew conceiving would be a challenge. In college when my husband and I had been dating for over a year, contemplating marriage, and I wasn't feeling well, I decided to be checked out. I went to a doctor and explained all of the lovely PCOS symptoms, had blood work done, said I read up on it and wanted to get on birth control to regulate myself and make sure I didn't get pregnant (haha) in the beginning of our marriage.

My blood work came back with HIGH testosterone and high insulin levels. I was diagnosed with PCOS and insulin resistance based on those results alone. I have never been hairy, never had actual cysts on my ovaries (although I'm SURE I have but it just hasn't been documented), never had skin tags or a lot of the other things that come along with it. But they said I had it just the same and that a lot of women don't present with all of the symptoms and that it's completely individual.

I was also told that "you may never be able to have children. Conception will be difficult at the very least." It was blunt and said very coldly. If I didn't already have a clue, I would have fallen apart at that appointment. And that was back when I didn't want children!!

I was placed on 500 mg of Metformin/Glucophage twice daily which was fairly new and controversial at the time. I was also placed on birth control. I immediately lost 20 pounds within a two month period due to the Metformin and it TORE my stomach up. I had a love/hate relationship with it and I would go on and off of it on a whim. Same with the birth control.

After we were married, I tried to 6 months to a year without BOTH and I gained 50, yes FIFTY pounds in that 6 month- 1 year period. I also came home every day and went straight to bed. My periods were irregular again and I had no libido and no energy. Not good for a new marriage.

I made a drastic decision that I was just sick of myself, went back on the Metformin and birth control, went on the SOUTH BEACH diet, was strict and stuck with it, and ran every day. I'm not sure how I did it. I have never and may never have that kind of self control/management again. Having my husband on board also helped. South Beach was new, the hype was all over and HUGE, low carb stuff was available everywhere (even at Hardees and McDonalds!!) and I saw immediate results. IMMEDIATE. Within the first three days. I've dieted a lot over the years, and this is the ONLY way my body can lose weight. The only way. I HAVE TO cut carbs. Nothing else works. And it's hard because I CRAVE carbs, even on Metformin. It was terribly hard but seeing my body change and my energy increase was so reassuring and that's what kept me going. I also think I have some major auti-immune issues going on and that it was a miracle I ever had any lasting pregnancies, but I do believe the South Beach helped with my inflammation and flares back then so that whatever is wrong with me in that regard was kept at bay (I'm only now going through testing for all of that, yes after completing our family, that's a whole other post though) I was about 23ish when I South Beach and all of that jazz and it had nothing to do with my biological clock at the time. I thought babies were way off and still wasn't sure if I wanted children. The drive to do this was strictly to feel better.

We made a huge move to Florida around that time and decided as soon as we moved down there that we wanted to start a family. We weren't ready but for some reason, BAM, my biological clock was a-ticking. I think starting fresh there, the sunshine, being lonely... they all were reasons I wanted to have a baby.

I came off my birth control (this is an important fact I will talk about in a minute) and I picked up an ovulation kit that September/October we moved just to see if I was ovulating. I had one period after coming off of the birth control, ovulated on time according to the kit (I was still so much less informed than I am now) and we did the deed. I got pregnant right away, didn't realize it like so many women wish, took a pee test a week after my period was supposed to be due, and it came back positive. WHAT? SO easy now that I knew what my body needed! Wow! I went in to the doctor that next week, it was now November, and found out I was 8 weeks and 5 days pregnant. We saw the heartbeat! My very first pregnancy, how awesome right? Unfortunately, this story doesn't end well, my sweet sweet Ian was lost at 22 weeks.

After we lost Ian we conceived N fairly easily after about 4 months. I did have to go on and off birth control for about 1-2 months.

Let me say no, and I have NO IDEA why this is- could be the PCOS and/or the auto-immune issues but it needs to be said. I've seen some other women experience this too. I have ONLY EVER BEEN ABLE TO GET PREGNANT COMING STRAIGHT OFF BIRTH CONTROL. Withing the month, either no period and I got immediately pregnant or had one cycle and then got pregnant. I'm thinking it regulated my body in a way that only birth control could do and my body, no matter what diet and exercise regiment I'm on, does not regulate itself to allow a "sticky" or long lasting pregnancie. Over the last few years I have gotten pregnant a few months after going off birth control (2-4 months) but they have ALWAYS ended in first trimester miscarriages. I DON'T think it's just a fluke.

I don't know if having my first somehow "kicked my reproductive system into gear" but I was surprised that we got pregnant with Nathan so easily. It could have been that my cervix was still very soft and effaced and the sperm just got right up in there. We will never know. We thought it would take longer.

Another thing that I feel needs to be documented with reproductive immunology booming now. I have had hives (some HORRIBLE all over my body and some barely there) with every.single.miscarriage. I always knew when those pregnancies were doomed. Except of course with my first pregnancy, my first loss, at 22 weeks, because that was not an early miscarriage and was due to incompetent cervix and Beta strep/Group B strep.

So back to my first and "easy" pregnancy. I was a naive new pregnant woman, not wanting to ask too many questions and make a stink with my concerns, at a group practice HMO that had sub-standard care with doctors I never saw more than once. First symptom when I KNEW something was wrong and should have spoken up- I had a RAGING fever at 11 weeks, that had me in shakes, chills, and hotflashes, feeling almost dead for days and they said "Don't worry about it, your immune system is lowered during pregnancy and you will be more susceptible to being sick". I was passing out, dizzy, and out of breath constantly, blacking out, seeing spots, and had a tender abdomen the entire time. I was told, "It's all normal". I had unusual thoughts of impending doom, anxiety, night terrors about losing my baby, sleeplessness, violent outburts and I was told "These are pregnancy symptoms." I tried to suck it up. I was impossible to live with. I knew deep down that something was very wrong but again, I was naive and uneducated. I had NO IDEA how wrong it could be. And I will stop here because I want to tell the rest as part of Ian's story.

I suffered from secondary infertility after my second was born, N, and it took us five years and a horrendous miscarriage to conceive C. I also suffer from it now, but we are done growing our family. I feel I had some chemical pregnancies inbetween there but I wasn't considering them pregnancies at that time. I have been pregnant since C multiple times and I have lost them at various times during the first trimester. I STRONGLY feel that there were THREE specific reasons I was able to conceive C in July of 2010 and that they all had to be "in line" in order for this to occur. I feel I know my body well after all of this so here it is.

The first, is that I had a miscarriage and emergency D&C on January 1st 2010. I see literature now showing that women with implantation problems and possible auto-immune issues undergoing IVF have a "injury" to their lining in order to help with that. Doctors will put a slice or do a D&C if I'm not mistaken to aid in the chances of implantation. I also think the first cerclage Shirodkar stitches I had placed with N so soon after losing Ian (which some pieces have been left in there, can't be retrieved) and the Teflon tape they used to keep it shut, may have interfered with me getting pregnant for many years. I feel that having my cervix stretched with the miscarriage and D&C in January somehow aided in my conceiving C in July. I have NO other reason to believe this other than a feeling I have. No doctors have mentioned either the cerclage or the tape affecting future fertility.

The second, is that I had came straight off of birth control and didn't even have a period when we conceived C.

The third is that I was not having ANY auto-immune flares of any kind. Which was unusual for me. It was just a good month, no allergies, no hives, no tiredness, no joint aches and pains, no hair loss, no edema, none of the lovely auto-immune issues that I face daily and have for years.

Call it luck, call it divine intervention, call it what you may, but I do REALIZE what a miracle it is that my body brought two living children into the world, particularly my second living child, knowing the full extent of how fucked up my body is (and I'm still learning).

I hope this helps some of you who are struggling with the same. This is SO MUCH LONGER than I intended!

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