Wednesday, July 22nd, 2009

Fertility Adventure – The Full Story

Ever since I told the world about being pregnant a couple weeks ago, I’ve received a huge amount of email from women who are trying to get pregnant, have been trying for a long time, or are thinking about it in the future, and they want to prepare. Until recently, I wasn’t sure it made sense to blog about the private and sometimes emotional details of my experience, but as a result of the strong response from so many women, I’ve decided to share the full story, in the hope that it might help anybody out there who is having problems getting pregnant or who is planning to put off having a baby until later in life.


Let’s go back to last summer (2008). My husband and I decided that it was time to start preparing our bodies for “trying” to have a family. I remember it like it was yesterday. Our goal was to up our game considerably, taking our diets to a new level and really prepping our bodies, and becoming as healthy as we could be for the 6 months prior to deliberately trying to conceive. Gone were the glasses of occasional organic wine and dark vegan chocolate. Gone were the spontaneous visits to Starbucks for the very occasional treat of a decaf soy capp. Arriving were more green juices as well as taking hair/body care products and home cleaning products to an extra super green and healthy level. I had my amalgam fillings removed. I took a month-long detox potion for removing metals and mercury from my body. I consumed milk thistle to really clean my liver (along with plenty of icky dandelion root in my green juices). I stopped coloring my hair and I started taking prenatal vitamins. I started researching pregnancy and reading books like Ina May’s Guide To Childbirth. Etc Etc…

The thing was…. as I was preparing for this, I started to become extra eager and excited to move our December Game Plan up a few months. So, after waiting a month or so for the metals to leave my body (I didn’t want anything bad showing up in breast milk if I could help it), we decided, what the hell… let’s “stop trying to prevent pregnancy” right now (but still make it a very casual endeavor). Of course… once I was in that mindset it was hard to slow things down. I went ahead and bought a Clear Blue Easy Fertility monitor. I mean, after all, we might as well start tracking my ovulation… the research I did states that it can take a couple of months to get to know my cycle anyway. The first time I saw that cute little egg on the monitor, I was like, “Honey!!!! Let’s try to make a baby!!!” It was show time! Suddenly, our mindset changed to “let’s really try and get pregnant.”

The following month I started my period. Bummer. Naively, I thought it’d take the first time. Naive indeed. Grossly naive. Suddenly… I was on a mission. I kept telling myself after that first failed attempt that it’s perfectly natural to have it take a little while. Meanwhile, my clock is ticking (I was 32 years old at the time) and I was thinking ahead and practically salivating for the next opportunity of ovulation. A couple more months went by without any success. By then I was really wondering why. I seemed to ovulate fine. My periods were pretty regular (every 28-30 days), and I was in excellent health. With each passing month, I started to get really sad on the day Aunt Flow came to visit. I won’t go into the details of how devastating it can be, but you ladies out there who have tried unsuccessfully to conceive know exactly how intense the blow feels. It knocked me down a couple of times.

But… I am a resourceful person, so I started doing research on “fertility diet” and seeing what I could come up with to help the process. To most people, it would be perfectly natural to wait almost a year before taking any next steps or being concerned, but I felt the need to move things along. I wanted to know I was doing everything I could to improve our odds. Enter: lots of vitamins and supplements. Around the time of November and December, I started buying all kinds of vitamins and supplements. Yes, our diets were full of nutrition, but I wanted to make sure I was covering all of the bases. I put my husband on a number of different things to improve semen and I started taking extra vitamins to help overall female fertility. Another month went by with no success.

December comes and was closing to an end when I came across a fertility book on TCM (Traditional Chinese Medicine) that I devoured in one sitting. I found more supplements for us to take and I started adding a little lightly cooked vegan food to our diets. Next step: acupuncture. I found an acupuncturist who specialized in fertility and I immediately made us appointments. Again, I knew at the time that I might be doing all of this prematurely, but I just didn’t feel comfortable sitting around and waiting. After all… it’d been a handful of months by this time and I wasn’t getting any younger.

We decided to have a semen analysis in January to rule out any potential problems. I wish we had done this in the beginning because it’s an inexpensive test and, in our case, it didn’t yield very good results. My husband’s count was fine but there was a potential problem with the swimmers’ morphology (shape) and motility (swimmyness). Long story short… this seemed to be the reason we were struggling with fertility. Well, at least now we had something to work on. I learned that it takes 72-90 days for sperm to generate, meaning anything we did to boost my husband’s numbers wouldn’t take effect for a few months. Hmmm… wait and see. Meanwhile, we started our acupuncture treatments (weekly) and the doctor put us on Chinese medicine (herbs) to enhance the different aspects of my menstrual cycle as well as help improve the motility and morphology of the semen.

I knew we had to give the Chinese medicine some time to work. They like you to give it at least 3 months. I was happy to do so, because I wanted more than anything for our fertility adventure to be as natural as possible. Plus, I’d read so many great things about TCM. Three months came and went. No pregnancy.

It got harder and harder each month. At the point that I had a plan for something new, like I did with the TCM, my heart was much lighter because I knew we had options. But, when each option didn’t pan out… it became another crushing blow. It’s an emptiness and sadness like none other. I found that with each menses, I experienced a harsh grieving.

So… I went back into research mode. I wanted to keep giving the TCM a chance to work, but I was very impatient. You see, I want 2 kids (heck, maybe 3) and I know that the older I get, the harder it will be. Once a woman reaches the age of 35, the chances of success decrease. By this time, I was 32 1/2 and starting to freak out. If I were to get pregnant by age 33, then be pregnant for 9 months, then deliver and breastfeed… then try to get pregnant again… it could take another many months… and on and on. Suddenly I’m 35 or 36 and could be struggling to have a second baby (we were already struggling to have the first). Hence, I started checking into other options. I went for an HSG (hysterosalpingogram: basically an xray of my uterus and fallopian tubes) to rule out any possible complications with my girlie bits. My HSG was normal.

As most of you can probably guess… I’m not an advocate of drugs. I used to take quite a few in my teens and early 20s for migraine headaches but all of my headaches pretty much disappeared with my raw vegan diet. Ever since, I’ve done everything I could to avoid drugs (prescription and over the counter). I stopped taking birth control about 8 years ago. Even though I traditionally have a painful day-1 of my period, I tough it out with a heating pad (and sometimes tears). I don’t want drugs anywhere near me.

Well, after our lack of success in getting pregnant, suddenly I was open to hearing other options. I started researching assisted reproductive technology and decided that we should try an IUI (intrauterine insemination). We found a reproductive endocrinologist in Tempe. He actually told us that our only real chance of getting pregnant due to my husband’s sperm would be to undergo IVF: In vitro fertilization. That’s where they take out many of my eggs – using lots of drugs to stimulate the production of them – and they inject them each with a sperm from my husband. This injection process is known as ICSI (pronounced “ick-see”).

I was devastated, to say the least. We had gone in to see the doctor to chat about IUI, which is a minor procedure. I was not even ready to entertain the idea of IVF. So, the IVF was a big blow because that would require LOTS of awful drugs, and an increased chance for twins (I don’t really want twins), and a lot of money… it could cost as much as $20,000 for just one try… and the odds of it working are about 50% depending on various circumstances. Ouch. Once they retrieve my eggs, then any future IVF attempts would be about half the price, but still… thousands and thousands of dollars.

I started crying. Right there in the doctor’s office, sitting across from him at his desk. He swiftly whipped out a box of cheap Kleenex. I had actually startled him with my crying. He was all business up to that point. Stating statistics and odds of conception based on our semen numbers without much explanation as to the procedure itself. This just left a bunch of questions in our minds, but he said there was a class we would take where we would get all of our questions answered about IVF and then some.

In my head I was thinking, “Are you kidding? A fucking class? Is there a quiz at the end? I want my questions answered now. Why am I paying you $300 for a consultation? A 5-minute look at my uterus and to tell me that based on my husband’s numbers we need a $20,000 procedure to have even a chance at building a family?” I didn’t say any of that, of course, but in hindsight, maybe I should have. So… off we were shuffled to the next room where he looked at my uterus. That turned out fine. The doctor saw one of my follicles developing nicely for day 8 of my cycle, which is probably where that cycle’s egg was going to come from. We left the doctor’s office, with our heads reeling with all of this new information about possibly having to pursue IVF. I was a wreck.

Because my husband does indeed have some good swimmers (just not as many as we’d like), I decided that I still wanted to give the IUI a try. It was so much easier of a procedure and way less expensive (less than $1000). My doctor wanted me to take drugs to increase our chances (drugs to stimulate more eggs as well as a trigger shot to release the eggs so they can time it precisely). I said no to the stimulating drugs for multiple eggs and yes to the trigger shot. We had the IUI in April and I was instructed to take a pregnancy pee test two weeks after the procedure. It was negative. The anguish was swift to hit me in the chest and gut, I didn’t even have time to think. The hard thing this time was that we used a doctor. We took it to another level and it still didn’t work. The emotional pain was so hard. Up until that time, the past 8-9 months were a roller coaster ride. Up two weeks, down a few days, up a little a few days, then just damn shaky – you get the idea. I wasn’t sure I could take any more. But, in the end, I knew I could… I wanted a baby so badly.

By then, I’d had some time to think about the IVF option, but I was totally freaked out by the drugs and the price. We started researching the shit out of it and came across many interesting little-known options. Our research took us to a blog where a woman was writing about all of the different fertility options around the world. She had contacted many of the clinics and asked for details about their procedures and pricing, which she posted on her blog. Thank heavens for this lady. It was on her blog that we learned about a cutting-edge facility in Guadalajara that seemed very promising. Not only did this clinic offer the traditional IVF for MUCH cheaper (about 25% the price of the Phoenix doctor’s IVF, and using newer technology), but they also offered a procedure called Mini-IVF™. The Mini-IVF is similar to IVF but it’s a much simpler procedure (more holistic in approach), fewer drugs, has similar chances of it working as compared to traditional IVF, less chance for twins or multiple birth, and is less expensive than even their traditional IVF (only ~$2500 per cycle)!

The philosophy behind Mini-IVF is an emphasis of quality over quantity. Fewer drugs are needed in this method because they don’t stimulate as many follicles to produce eggs; thereby getting better quality eggs. The particular doctor who does this in Mexico was trained in the United States at a clinic called The New Hope Fertility Clinic in New York. In addition to the Mini-IVF option, Mexico (and New Hope Fertility in NY) also offered a much better technology for storing the unused eggs that are retrieved and fertilized, and these embryos can then be used in later transfers, if desired (or needed!). They use a flash freezing process for freezing the embryos called vitrification. It has a 98%+ survival rate versus the common slow freezing method which most places around the country still use (giving only about a 55% survival rate). The doctors at these clinics were famous in their field and had invented many state-of-the-art techniques, so these clinics were really ahead of the curve and this new form of IVF was much more attractive overall. My heart didn’t feel so heavy as all of this new information started coming in. I started to feel hope again. My spirit started to lift. The question was: Should we go to New York or to Mexico?

We decided on Mexico. It was least expensive overall (especially when you consider travel, hotel, food, etc) and the Guadalajaran doctor’s emails (in flawless English) were the most thorough, frequent, timely, friendly, and informative of any healthcare professional I have ever interacted with. I got the kind of personal attention from the doctor that you only see in the movies… and he was not even officially my doctor yet! Yes, we were headed to Mexico for a month, for the next leg of our Fertility Adventure!

And just then, swine flu broke out. We opted for New York instead.

SO! … with apologies to anybody with whom we didn’t tell the Big Secret to (which was almost everybody)… THAT is why we were in New York for the month of June. We were there to make a baby!… Literally. :) (Our cover stories were true too, incidentally. We conveniently also had business to do in the Big Apple.) It’s probably pretty obvious why I wasn’t forthcoming with this information. It’s truly personal. I’ve had an incredibly challenging year with respect to all of this and I simply didn’t know if it was smart to share it for my emotional well being. I had to do a lot of soul searching as to whether I wanted to put so much of my personal life out to the world. But, when the process worked(!), I was so overjoyed. I thought to myself, “This might really help someone else. I should tell the world.”

Even though this blog post is extremely long… there are a lot of details that I’ve left out (such as how the actual procedure was). Well, I actually took some photos and video of some of that stuff… not the actual procedure, but, for example, the interesting story about my first self-injections, with a HUGE f*cking needle, — it turns out the pharmacy gave me the wrong needle, one that looked like it was meant for a horse! I may post it… anyway, at this point, I’m happy to share with you as much as you’d like to know, either publicly or privately. Feel free to comment below or email me directly.

Basically, the clinic and the staff were great. The doctors are brilliant and I felt like I was in the most capable hands in the world. I may write another post with more details about the clinic and experience if you’re interested. I’m bummed that I had to take some drugs (but not as many as with traditional IVF) and, yes, I still have to take some (perhaps throughout the first trimester… believe me, I’m drinking a ton of green juice to help alkalize the acidic effects they may have). The cost was much less than traditional IVF here in Arizona (even with the NY trip).

And, most importantly, you know the trip was a success. There was a lot of doubt that we’d even get to have a “fresh” transfer (transfer while we were there in June), because typically the fertility drugs cause the uterus lining to thin out too much for immediate implantation. However, my uterus measured to a thickness that they were willing to try. I was glad. And, it worked. (Future transfers have a higher chance of success because 1) the uterus is even thicker when it’s in a normal, non-drug induced cycle, and 2) before they freeze the embryo, they wait until it grows to day 5 – meaning it’s going well – and the fact that the embryo survives freezing and thawing means it’s strong. The fresh transfer I had in June was with an embryo that was 2 days old.)

We successfully retrieved five embryos, one was transferred, leaving four to grow to day five before freezing. Three of them made it to that stage. Woo hoo! This means that if this pregnancy attempt doesn’t work, we have more embryos left. And, if it does work, then we have more chances for a future baby (using an embryo that had an egg retrieved from a young, 33-year-old person, me). Side note: I think it’s amazing that women who want kids but who want to wait until they’re older can retrieve and freeze eggs (or fertilized embryos if you have a partner) at an age that isn’t too old. This dramatically increases the chance of pregnancy… it’s the age of the egg that counts, not the age of the mom!

Here is the very latest update: I’m afraid I have some sad news to report. Today, I went for my third week of blood work to test my pregnancy hormone, my progesterone, and my estrogen levels. The numbers aren’t very good. There is a chance I’m still pregnant, but I better prepare myself that I might have lost my little Monkey.

Yes, it’s a difficult day, obviously. But, honestly, I can’t dwell on it. I’m so happy to have had as much success as I’ve had with the Mini-IVF process and it gives me hope. If we go back for another treatment, the chance for success is even higher. This is the closest I’ve been to having a baby and I’m so grateful to have been this close. We’re almost there (even if we have to try again). Looks like we might be back in New York in August. I have to keep doing things as normal this week (acting as though I’m pregnant, just in case) and take another blood test one week from today, as well as get a sonogram, to confirm whether I’m pregnant or not.

If you’re interested in learning more about Assisted Reproductive Technology, I highly recommend checking out New Hope Fertility’s website and reading the following book, How to Get Pregnant.


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