Our Infertility Journey

Going through infertility is probably one of the hardest things I've had to deal with in my adult life. It's kind of weird because it's not a life-threatening condition, per se, but it is a disease. One that people often suffer in silence with. 

However, infertility has also proved to be a great blessing. How? If it wasn't for being on this journey through the waters of infertility, I would have never met the amazing community of ladies who are going through the same thing. We all belong to a club that we wish we weren't a part of, and each wait for the day when our membership is revoked. We can't wait to be kicked out of the club.

I don't think I've shared our own infertility journey, and if anything, it needs a little updating. 

We got married in July 2009 and because we dated long distance for three years, we wanted to spend the first couple of years of marriage as a couple. We knew we wanted children, but we wanted to savor the time just the two of us. 

In 2012, during my annual well woman exam at my OBGYN's office, I was officially diagnosed with PCOS - polycystic ovarian syndrome. I had the symptoms: trouble losing weight, craving carbs, unwanted facial hair, thinning hair, irregular periods... All "manageable" symptoms through nutrition and exercise, but annoying nonetheless. Since we were not yet trying to start a family, I continued on the pill to regulate my cycles.

In 2013, we were ready to start trying for a family. I came off the pill and knew that it could take a couple of months for my hormones to regulate. We made it to the end of 2013 with no success.

In 2014, after about a year of trying, we saw my OBGYN to try some medicated, timed intercourse cycles. We did Femara/Letrozole and also tried Clomid. I seemed to respond decently to the medication, but no pregnancies. 

In June 2014, my OBGYN referred me to a reproductive endocrinologist - the office whose Letrozole and Clomid protocols she was following. I made the appointment and went to my first RE consultation.

I went to the consultation by myself and walked away overwhelmed and unimpressed. The doctor I met with didn't take any time to get any of my history (which I thought was important) and quickly launched into a standard protocol of Clomid and trigger shot.

At the time I wasn't as familiar with medicated cycle protocols as I am now, and I felt like the doctor was not listening to me. My OBGYN had suggested that I had a uterine lining issue (it was thinner than ideal), and told me to tell the RE. Well, he didn't even listen to that. I felt like I was wasting my time if he was just suggesting the same thing I had already done at my OBGYN's office.

I was annoyed. I didn't like that he didn't get to know me at all. I felt like a number and he was just giving me the standard plan of care. I felt like if I was going to have to pay out of pocket for this anyway, I needed to like my healthcare provider.

Needless to say, I did not return to his office ever again. 

At the end of 2014, I did return to my OBGYN's office for two more medicated cycle attempts. When our final attempt had no progress, we decided to take a break from medicated cycles. Around the same time, I also started seeing the nutrition testing specialist through my chiropractor. We started supplementing what I was deficient in to help rebalance my hormones.

I continued to see the nutrition testing specialist through the beginning of 2015. I was a lot of vitamins and supplements, and I felt like if I could help my issues in a natural way, that would be great. 

After about a six month break, I started to look into a new reproductive endocrinologist. There were a few top offices in our area that I found.

I had a couple important criteria I wanted in a doctor:

• female doctor
• experience with PCOS
• compassionate, empathetic, kind

While I know that male doctors are probably just as qualified as female doctors, I believe that female doctors understand these issues on a level that a man cannot. I feel way more comfortable with a female doctor and it helps when she can empathize (NOT sympathize) with me.

In July 2015, I made an appointment with an RE at a new practice. Based on her online profile, she seemed to fit most of my criteria. The personality component would be determined at our consultation.

Well, long story short, I LOVE our RE! She fits all the criteria and really appreciated that she spent about an hour with us going over our family histories, our personal medical histories, and personally did my first baseline ultrasound. I was impressed. She was kind and carefully reviewed our case to give us her honest suggested plan of care.

In August 2015, while waiting for my cycle to start before we could move forward with the plan of care with our RE, I was on cycle day 40...and I took a pregnancy test. It was positive! I had never seen a positive test before! Coincidentally, the RE's office called that same day to have me come in for routine bloodwork. I told them that I had a positive home pregnancy test and they said they'd do a beta Hcg test as well.

Later that day, it was confirmed that I was indeed pregnant, with an hCG level of over 9,000! (If you're new to beta numbers, that's super high! I didn't really know at the time how high that was). The following week, we went in for our first ultrasound and we got to see the gestational sacs...there were two! But only one looked to be growing. However...based on the date of my last period, it looked like the size was a little bit behind, so they had me come in the following week to check again.

The following week, there was no progress in growth. The doctor seemed to be cautiously optimistic about it, and had me come in the following week. She said that if there were no changes or heartbeat the next week, then we'd have to discuss options.

Well, in September 2015, I miscarried. Our baby stopped growing at about 5 weeks. We never got an accurate reading/measurement and never saw a heartbeat. I opted to take the medication to help move the miscarriage along after waiting two weeks to miscarry naturally. You can read about that here.

After the miscarriage, I had to wait for my cycle to return. My first period post-miscarriage was insanely heavy. Like...crazy heavy. The second cycle was a little bit more normal.

In November 2015 after my cycle started, I had my original testing done (that didn't happen because we took a detour with a positive pregnancy test), and that included an HSG and hysteroscopy. My doctor found a polyp during the hysteroscopy and my tubes were clear following the HSG. I experienced minimal pain with both, but I have a higher tolerance for pain.

In December 2015, I had a hysteroscopic polypectomy to remove the polyp. It was pretty easy. I was nervous about the anesthesia, but it turned out to be an amazing nap. I went home that morning and had another great nap. I felt pretty good the next day.

At the end of December, we tried a Letrozole cycle with trigger, except during my Day 12 soon, I had already ovulated.

We did a Letrozole + Ovidrel trigger at the end of January 2016.

In February 2016, we did Letrozole + Follistim + Ovidrel trigger + IUI.

In March 2016, when I went in for my baseline, they found a cyst lingering on my ovary, after having a super light period.

About two and a half weeks later when I thought my cycle started again, they saw the same cyst, but it was smaller. So I had to wait until it cleared.

My normal cycle started at the end of April 2016, however, because I was going to be out of town and unable to come in for monitoring, we have to wait until the next cycle.

I feel like waiting is the story of my life lately!

So here we are...waiting....waiting...waiting.

I'm a professional at waiting!

My Experience with Misoprostol for Miscarriage

We found out the news about two weeks ago. Our baby had stopped growing at 5 weeks 5 days. We never found or saw the heart beat. My doctor allowed me to see if it would pass naturally and if in a week nothing had happened, she would give me a choice. A medicinally-managed miscarriage or a D&C. Not a decision that anyone should ever have to make.

A week went by and my doctor's office gave me a call to check on me. During that week nothing had happened yet, so they presented me with the options.

I opted to go with the less invasive version. While I don't know much about D&C's, I just didn't feel like it was the right option for me. As much I wanted to just wait it out for a natural miscarriage, I knew that the stress from waiting was only going to make me more stressed. So, I chose the medicine to induce it.

This is an account of my experience using Misoprostol/Cytotec to miscarry. Please note this is my own experience. Growth stopped at 5 days 5 weeks and this week would have been the 9th week.

It's about to get real. If things make you queasy, this is your warning to turn back now.

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I went to pick up the prescription for Misoprostol as well as the painkiller Tylenol #3 (with codeine) for pain management.

I was pretty nervous about it. The nurse had told me that I would be receiving two doses. I would take one dose at bedtime and if nothing happened, I would repeat the dose the following evening.

And of course, what do you do when you're about to take medication that you've never taken before and the nurses can't predict what your personal reaction will be? You take to the internet, of course! I'm really thankful for the couple of personal accounts I found of other women who chose to take Misoprostol to miscarry. It made me feel less alone, more prepared, and at least have some idea of what was going to happen.

I was instructed to insert four misoprostol tablets vaginally before bed. I was also given the option to take two Tylenol with codeine for pain management - I opted to take them.

I consider myself pretty lucky that I rarely ever get menstrual cramps before or during my regular periods. That being said, I was nervous about what was going to happen.

12:00AM - At about midnight on Saturday night, I took the two Tylenol #3 and then inserted the four (total 800mg) Misoprostol tablets. I also set myself up with a pad just in case bleeding started in bed. I also laid out a towel on the bed under me. I got into bed and we watched a couple episodes of The League on Netflix. I didn't feel anything quite yet.

1:05AM - I started to feel slight cramping, but nothing too bad. I got up to go to the bathroom, and nothing yet on that front.

3:30AM - The cramps were getting stronger and starting to feel uncomfortable. I got up again to use the bathroom and there was some spotting. I figured that was a good sign.

5:25AM - The cramps continued, I tossed and turned, and then when I turned over one more I time, I felt the feeling like when your period starts. I got up to go to the bathroom and whoa...there was a lot of blood.

5:55AM - More cramps, more feeling of bleeding, get up again. More blood.

6:15AM - Get up again. Cramps feel worse. I go take one tablet of Tylenol #3 since 6 hours had passed. Try to get comfortable in bed.

6:30AM - Get up again, go to the bathroom. Still passing clots, pass what looks like could be the embryo (grey material with the clot).

6:50AM - Get up again. When I lay back down, the cramps are feeling unbearable. Can't get comfortable.

7:05AM - Get up again, this time I leaned at the foot of the bed face down, hoping that position would be more comfortable and bearable. When that wasn't working, I got up again and wandered around the bedroom, hoping to get things going.

7:10AM - Then I suddenly felt a clot or large amount of blood coming, and before I could sit down, SPLAT, looked like a toned down scene from Dexter. I passed a large clot, perhaps the sac.

7:15AM - After that last bathroom run, I feel much better and can finally get comfortable in bed.

7:45AM - Get up again, pass more clots, but the volume of blood is significantly less from earlier.

7:50AM-10:15AM - I'm able to sleep for the most part comfortably.

In about two hours time, I went through five pads, that were FULL and soaked.

The cramps finally subsided completely by about 12:00PM, so a full 12 hours after inserting the Misoprostol.

Now, my nurse had told me that if nothing happened from the first dose that I could do a second dose the following day. Since I felt like all my insides passed, I wanted to know if I needed to take the second dose or if just taking the one was okay.

I called my doctor's service and well, I have to take the second dose. I'm sure that just to shake out whatever is still left...though I feel like there's not much of anything! (Gotta keep a good sense of humor when dealing with gross things).

I'm really hoping that round two is less intense than round one. I'm hoping that since I've passed most, if not all the tissue, that the bleeding is a lot less and the cramping is hopefully not as severe. But who knows?!

In spite of the pain, I'm still glad that I chose the medicinal option over the D&C. Even with outpatient surgery, that still kind of freaks me out because I do know they have to put you under in some capacity.

Have you ever taken Misoprostol/Cytotec for miscarriage? What was your experience like?

Updated after second dose of Misoprostol:

The second dose of Misoprostol wasn't bad at all. I experienced the slightest cramping, but nothing in comparison to the night before. I was able to sleep through the night.

The thing they don't tell you (or at least doesn't seem too important) is that after you have bled out what feels like half your body volume in blood (okay, being dramatic), you continue to bleed for days after the event. It's kind of like having a normal period. And just when you think that you're done bleeding, things have reduced to spotting, you get a random bit of blood here and there. Like heaving spotting. It's annoying more than anything given the circumstances.

How to prepare to take Misoprostol:

It'll depend on how your doctor's protocol works, but if you're instructed to take it at night, here are my recommendations.

1. Eat a good dinner, but nothing that might upset your stomach.
2. Stock up on pads. Considering the amount of blood that gushes, tampons are not recommended.
3. Lay out a towel on your bed, just in case.
4. Keep a glass or bottle of water accessible.
5. Wear whatever makes you feel most comfortable, and easy when you need to run to the bathroom.
6. A heating pad - I did not use one, but I have heard that this can help with the cramps.
7. Decent toilet paper. Like, you don't want the thick, fancy stuff clogging up your toilet, but you also don't want 1-ply because you'll be bunching that stuff up like crazy anyway. A good, middle of the line toilet paper will do. 
8. Netflix or other distraction - if you can't sleep, I'd recommend finding a distraction - Netflix is always a great option...watch something funny.