Surprise!

Guess who’s back?

In light of my Asherman’s Syndrome and unexplained infertility diagnosis, we were certain our family was complete when Baby R was born. Two and a half years later, we had the surprise of our lives when we discovered we were expecting the unexpected – a spontaneous pregnancy with no medical assistance! Knowing that any pregnancy with the great amount of scar tissue in my uterus was sure to be high risk, we were very cautious and guarded.

To make a long story short, Baby M made a dramatic entrance at exactly 26 weeks. Due to complete placenta previa, a sudden and major hemorrhage along with complete dilation necessitated an emergency c-section which turned into a cesarian-hysterectomy. Baby needed two double transfusions within two weeks of his birth. His NICU stay was full of ups and downs and downs and ups. After 121 days, Baby M came home and we scrambled to provide care as two medically untrained parents. At 13 months actual age (10 months from due date), he is thriving and we are so thankful to everyone who supported him and our family.

For those with Asherman’s or a low AMH or unexplained infertility, I wish I had advice or some solid piece of evidence that could help you along your journey. Unfortunately, I have a bunch of odd and really random experiences with a surprise twist ending. A diagnosis of Asherman’s, low AMH or unexplained infertility does not necessarily mean you will never birth children – my three children and I are proof.

I never would’ve believed someone if they’d told me the story would end this way. I know it might seem silly to come back yet again to add to it, but I took such comfort in knowing I wasn’t the only one experiencing infertility, or Asherman’s, or low AMH or a “surprise baby” and I owe so many people for that. I hope that sharing my story can pay it forward.

Finding balance.

Sometimes, I clean. Almost always, I cook. Rarely, I bake. Often, I am in the moment, enjoying and soaking it in. Sometimes, I fall apart. Many times, I take a deep breath and try again, or walk away. More often now, I’m reading scripture. Always, I love, even if I don’t like the behavior, I love the other human beings trying to do their best like me, even if it’s sometimes, almost always, rarely, or often.

Trying to find a balance between my professional goals and my personal life; fun and the desire for home-made meals, cleanliness, tidy rooms, and a well-behaved and happy toddler; wife and mother and daughter and neighbor and friend.

It’s a first for me since quite a while back. I’m finally able to look for a “normal” balance outside of the IVF realm.

In the midst of IVF, there is no balance. While life is going on outside of treatment (family, professionally, globally), that treatment is all-consuming. Medications. Appointments. Complimentary treatments requiring more appointments to aid the medications or relieve symptoms. More medication: needles and pills and suppositories and supplements and patches and more needles… and more pills.

And the hot/cold highs/lows and crashes.

And the tears. The guilt. The loss.

But the toddler, he is proof that all that stuff can work. He is ridiculously intelligent and challenging and I don’t even care if I only think that because I’m his mom – because I’m his MOM. Something I once thought was quite possibly impossible. I’m so thankful.

 

Be still.

Exodus 14:14 “The LORD will fight for you; you need only to be still.”

So, I’m doing my best… Bedrest day 1. My clinic required two days back when we transferred baby J, but now they say just one. Since the transfer in March with one day of bedrest did not work, I’m going back to two days (nobody told me to, I just decided it was best to go with what worked before).

Baby J is at daycare and hubby is at work.

By the way, look at the size of that embryo! The others we transferred were never coming out of their shell like this one. The dense part near the bottom center is the baby and the rest will turn into placenta. The transfer was smooth. No need to give time for the bladder to fill and no need to empty any off the top. In the past, I’ve needed just a little more time or was overfull. Guess that repetition has helped me.

Trying to find funny stuff to watch over the next two weeks. If you have any recommendations, please let me know! I’ll watch “Sisters” for sure. Anything else?

Jimmy Fallon is my “go-to” right now. Here’s one for you all:

http://www.nbc.com/the-tonight-show/video/first-textual-experience-with-sting/3107263

Jimmy is hilarious, but Sting… well, he’s Sting… sooo good. And yes, all I’m doing in bed right now is eating.

FET eve.

Last night, March 13, I took my final Lupron shot in this protocol. It began on February 10, so that seemed like a long time! Some tips I’ve learned about the tummy shots: sit down and lean forward so you can get a good pinch of skin near your belly button; put the needle to your skin, inhale, then as you exhale, insert the needle; let go of the pinch, and push the plunger. I avoided almost all bruising by doing it this way.

Last week, I started my PIO (progesterone in oil) shots and continued my Delestrogen shots – both IM (intramuscular) in the upper, outer quadrant of my backside. I also added one trigger shot (hcg) to my backside and continue the hcg shots a couple more times this week but in my tummy like the Lupron. I don’t mind the ones in the tummy as bad because I can see and have more control of the needle, oh, and they aren’t nearly as deep. BUT, if you have to do the IM shots in your backside, sit down. This is the first time I’ve tried sitting and it works so much better. I think the muscle is maybe more relaxed. No, I do not like the PIO shots.

I was given orders to quit taking Cialis (yay!) and Pentoxy last week, but I will continue the estrogen pills morning and night, adding prednisone morning and night also. The past four days, I’ve taken Medrol – I don’t remember what this one is for at all – but I only take it four days.

Tomorrow is the big day. Another big day to add to all our big days.

I told baby J today that we would get to meet his brother or sister tomorrow and that we would bring home pictures (of our embryo) to show  him. Then, I told him, in about 8 months, we get to meet his brother or sister in person.    !!!

I don’t know if he understood any of it. It doesn’t seem like a normal conversation to have, but maybe, people in our situation have these kinds of conversations with their children. I don’t want to conceal the process as I have nothing to hide. I’m not ashamed. I don’t have guilt about IVF. I’m so honored to have the opportunity to conceive and give birth to my child.

I don’t say much about my faith, but I just can’t wrap my mind around how we got here this time. I understand the science of it. I understand the process. We’ve been through so many obstacles, low AMH diagnosis, MTHFR diagnosis, tried IUIs, IVF, and then one more obstacle: Asherman’s Syndrome. Last year, at this time, I had NO UTERINE CAVITY. It was adhered together, flat like a pancake, growing no endometrium. The surgeries opened and helped clear the scar tissue, but the endometrium was so badly damaged that it wasn’t responding well to hormones. On the ultrasounds, you can see scar tissue deep in the uterine tissue, which obviously causes a problem when it needs to grow a functional layer to slough each month.

But here we are with a 7.2 lining as of last Tuesday. The past two months’ lining didn’t even make it to 6.

Science can only do so much. We know this. We don’t have all the answers.

This is God stuff.

Tomorrow is God stuff.

Science can coordinate all the events, but life begins only with God.

If you could, say a prayer. Pray not for me, but for all of us, that we all find the God stuff. There is enough glory given to the gore and other stuff barraging us all the time.

Let’s give the glory to God.

Pentoxifylline and Cialis.

I just have to put it out there, because I haven’t found any other account of it.

If you are also experiencing these two, please please comment and share your experience.

These two are not my friends right now, but they are part of my plan to grow a healthy endometrial lining for our upcoming FET.

Last month, I also took Pentoxifylline and suffered from a nasty headache in the migraine territory, accompanied by nausea and dizziness. It lasted about two days, but when I learned to take it WITH food, it seemed to ease up and go away. I was also taking Viagra suppositories last time, so it could’ve been my body adjusting to both of those.

This time, the Viagra suppositories have been replaced by oral Cialis. I don’t know if that makes any difference, but here we are, and I’ve been struggling with all-over aches from my neck to my knees, but mostly moderate to severe aches in my lower back and hips. I finally found sleep last night by sleeping on my stomach. Today, I managed the morning just fine but gave in to some help from Tylenol this afternoon. So. Much. Better.

I have an early ultrasound and blood work in four days, so I’m hoping I can hold on until them or that the aches would subside by then.

Anybody?

I’m just so curious to see if anyone else in on this stuff. I can’t see that there are any studies going on and I always wonder about the long-term results from all these meds. I guess I’m off the standard prescription for IVF and FET patients and I’m now onto the somewhat undocumented stuff. Fun. ha.

I kinda have to psyche myself up for my next dose of fun. Makes surgery not seem like such a bad alternative.

Okay, okay. This will all be good. We will learn from it and I hope these crazy meds will make a beautiful lining together. Which will grow a beautiful baby. Who we can spoil with love and kisses. Can we really be that lucky?

The day after Day 10.

So, at the day 5 ultrasound and blood draw, my lining was at 6mm and estrogen was on the low side. The lining needs to be at 8mm before transfer. The decision was made to increase one medication in hopes that everything would shape up by day 10, which was yesterday.

Yesterday, baby J and I loaded into the car at 6:15am to get him off to daycare and me to the clinic for my 7:30am appointment before my 7:45am meeting at work. The ultrasound showed fluid in the uterus and an inconsistent lining (some places at 8 while others were 6). It also showed remaining damage (deep in the muscle) from the original surgeries that completely closed my uterus and caused the Asherman’s Syndrome. Doc doesn’t know why there is fluid accumulating, but told us that uterine scars (usually from c-sections) sometimes weep. All of this was explained today when our doc examined me again to see everything in real time.

FET is cancelled.

Doc has a new plan for medication and hopes to do a mock cycle next month as I don’t have the time to take off work for a FET. He will then get to see how my body reacts to the new plan for meds and how long it takes to get the lining where it needs to be for the best chance of a successful FET. Stay tuned because you won’t believe what meds I get to take next time around.

My doc is working hard to fix another doc’s mistake.

Disappointed. Frustrated. Tired of crying. Enjoying my glass of wine and looking forward to some coffee and chocolate tomorrow. Maybe a mixed drink, too.

Day 1.

All systems go.

Ultrasound today checked lining and ovaries. No cysts. Lining is thin. Blood draw to check estrogen came back acceptable, so medications begin. Continuing Lupron, baby aspirin, folate, P5P (B6), methylcobalamin (B12), prenatal, vitamin D, calcium, and fish oil. Adding pills and patches for estrogen.

Another ultrasound and blood draw on Friday.

Hesitantly excited.

Medicating and Waiting…

“Can you be patient?” This question keeps coming back to me. My doc asked me this when we first sat down to discuss the Asherman’s diagnosis and upcoming treatment plan of surgeries and hormones. “Yup,” I said as I knew I had no other choice. If we want to try to have another baby, I need to have a functioning uterus. No other option is present but to be patient. I’m not a big fan of patience. I like to just push through, whether that means staying up later or working harder or calling for extra help. That doesn’t really work in this case.

It really is such a short period of time in the big scheme of things. It’s so short in comparison to so many other stories and heartaches I hear about every day. My diagnosis wasn’t as bad as it could be, but I can’t have any more children, not even with IVF if I don’t treat this and soon.

I was hoping to have an appointment yesterday that would allow our doc to take a look and see how things were healing. Was there scar tissue remaining? Did the lining recover? Do I need another surgery? Did the scarring lessen or is there additional scarring? That appointment was cancelled because my doc wants to see me after I’ve had more time on the hormones, building and sloughing the lining, and see where that takes us. So, I’ve another week on estrogen, a week on progesterone, hopefully my period starts and I can get an appointment on the books. I’m really looking forward to learning our next step.

Baby J is now a year and a half. He is a climber of everything all of the time with no fear, unless it’s time to sleep. He’s running and falling, eating anything we let him (even some things we wish he wouldn’t), hugs and blows kisses, points at our nose/ears/mouth/teeth/eyes-ouch, and empties every cabinet he can open.

He is a dream-come-true.

Asherman’s Syndrome

Another diagnosis to add to my infertility lineup. Premature ovarian failure, diminished ovarian reserve, low AMH, MTHFR C677T/C677T, and Asherman’s syndrome. I am so glad my doc required a meeting yesterday. He explained to us with the visual aid of the internal ultrasound in live time that my entire uterus is collapsed upon itself and stuck tight with scar tissue. Luckily, the cervix is open, so he doesn’t have to create a new one (sounds like fun, right).

He explained that he must stay in the right position during surgery so he can open up my uterus and “create some real estate.” He feels it would be beneficial to grow the endometrium as much as possible because that can provide a guideline for his incisions. I’ll be on estrogen for 21 days followed by prometrium for 5, then surgery, followed by another round of the same meds and a possible second surgery. Surgery will be laparoscopic, through my belly button and another port below my bikini line so he can get a good hold on everything. This also means my belly will be filled with gas to increase the area in sight. Yup, I’m nervous about it. Read more on Asherman’s and treatment here: http://www.ashermans.org/information/stages-of-ashermans/

How did it happen? It often occurs after trauma to the uterus from surgery (such as the two D&C’s I had to remove my placenta after baby J’s delivery). The question mark is why did my placenta stick in the first place? Maybe I am predisposed to scarring and there was nothing that could’ve been done to prevent it. I know the diagnosis could’ve been much worse.

My hubby has been a rock. He has faith that we will get through this. His love makes me stronger.

26 weeks tomorrow… and celebrating every day I’m still pregnant!

Baby will be 26 weeks tomorrow. Another step closer to being fully developed. Last Thursday was a big day at work. I drank over 64 ounces of water and figured baby was tired just like me. I woke up once in the middle of the night to do what I usually do in the middle of the night (emptying some of the 64 ounces) and he moved a little, not much, but a little. In the morning, I walked the dog, had my normal breakfast of cereal with milk and a glass of orange juice, and began my drive to work… all without feeling any movement from our babe. After consulting with my mother, I called the on-call physician who advised I go straight to the hospital to get things checked. A quick stop at work to get things prepped and off I was to the hospital, Labor and Delivery to be exact for decreased fetal movement. Emotions were so high. I was so afraid. It was not time yet.

I hadn’t pre-registered yet, so now that paperwork is done. I hadn’t toured the hospital, so now I know where to go. I was so not ready and neither was baby. It turned out that I was dehydrated and as soon as I got some water and monitors attached, he started attacking the monitor as usual. 

Lesson learned. Stay hydrated. Take it easy. When in doubt, get some protein and water and lay down on my left side in a quiet room to focus on his movements. 

Thanks for all your thoughts and prayers. He has quite a support system already!