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Fertility Update — Blood tests, Ultrasound, HSG

November 8, 2017 by Alina Avery Leave a Comment

I left off our fertility story after we made our first appointment for a visit to a Reproductive Endocrinologist to figure out why we weren’t having any luck trying to conceive and what our possible options are moving forward.

We chose Boston IVF/IVF New England, which used to be two separate organizations, but have merged into one. It’s honestly a bit confusing since there are so many office across Massachusetts, New Hampshire, Rhode Island, etc. and they all have different names. We chose our doctor, Dr. Wright, based on the recommendation of a friend of Matt’s sister. Her office is a bit farther away, but honestly there were an overwhelming number of options so it was nice to have a little guidance. And to me, feeling confident and comfortable with our doctor is worth the longer drive. When we were making the initial appointment I also made sure that we could change to a different office or a different doctor if we felt things weren’t working out, since our first appointment would also be our first conversation with our doctor.

Luckily, Dr. Wright was great and answered all of our questions. We didn’t feel rushed or belittled or judged and she took our history, listened to our concerns, gave us more information on our options, both short and long term. She was also knowledgable about our insurance and what would or would not be covered. I appreciated that, since a lot of times it seems like doctors don’t concern themselves with insurance and let the billing office handle it, which can lead to a disconnect between what treatment you can afford and what you are given. Especially since fertility treatments can be so expensive, it’s nice to know that everyone is aware and conscious of cost. We spent about 45 minutes discussing our case and then met with an admin to go over the suite of tests that Dr. Wright had ordered and how and when to schedule them.

For me, I was told to call the office on the first day of my next period to schedule blood tests and an ultrasound for day 3 of my period. Then sometime between day 5 and day 12 of my cycle, I’d go back in for an HSG or a “dye test”, where they’d inject a contrast dye into my uterine cavity and then use an x-ray machine to make sure my tubes were open. For Matt, he’d do a second semen analysis and also a blood test. My period wasn’t due for another 3 weeks, so it was back to waiting. I don’t think I’ve ever been so excited to get my period and probably never will be again.

I’ve always been (weirdly) totally fine with needles, so the blood draw was the easiest part. They did an STI panel, tested my hormone levels, and sent some off for genetic testing. The genetic testing is to determine if Matt and I are both recessive carriers for certain genetic mutations or diseases, so if we end up doing IVF, they’ll be able to screen the embryos to make sure they aren’t affected. In my opinion, it was a little early to be concerned about that, especially since we don’t have a family history of any of the issues they’re screening for, but if they’re taking blood anyway might as well tack that on.

The ultrasound was slightly less comfortable. It’s an internal test, so they have a wand they use to measure your organs and count antral follicles, which is a way of measuring ovarian reserve or the number of eggs you’ve got left. They also make sure there aren’t any ovarian or uterine cysts and that the lining of the uterus looks appropriate for where you are in your cycle.

Finally, the HSG a week later was definitely the least comfortable, and definitely the weirdest. I told Matt after that it was kind of bizarre to see an x-ray of my pelvic bone. I mean, I know I have a skeleton, it was just strange to see it projected on a monitor! The whole procedure only took about 60 seconds, but a very uncomfortable 60 seconds.

For Matt, it was very straight forward, all he had to do was go into a special room to “produce” into a cup. . We scheduled our visits so we could go in at the same time. I thought that the HSG would take longer and Matt’s specimen production would be relatively quick and he’d end up waiting for me, but my test was actually super speedy and we had to wait a while for a room to open up for Matt.

The initial results are mostly posted on our patient portal, and from my compulsive and incessant Googling, all the numbers seem normal, and both my tubes are free and clear. The genetic testing takes longer, and we don’t have Matt’s results yet, but from his first test back in 2015, we know at least roughly what we can expect. Our next step is to schedule a follow up visit with the doctor, but the next availability isn’t for a few weeks, so we’ll have to be patient. The waiting is definitely the worst part, especially since we’ve made the decision to go ahead and seek intervention. I wish I’d known that sooner so I could have prepared myself for the timeline. It seems obvious now, but I thought that it would be relatively quick between our first appointment and starting treatment, even if the treatment itself took a while. It’s a special kind of torture. When I brought this up to Matt he was surprised that I was surprised at how spread out everything is. He (rightly) expected a much more drawn out timeline.

So I guess the next post will be any news from the follow up and what our course of action will be. I also might do a quick update on the cost we’ve incurred so far, since I know that’s a factor for a lot of people. Luckily we have excellent insurance, but I’m still bracing myself for a bill.

Fertility Journey

October 11, 2017 by Alina Avery 2 Comments

It can be relatively taboo to talk about fertility. I know for me at first, knowing we were having trouble getting pregnant felt like a personal failure, like I’d done something wrong or was somehow defective. Then I started thinking about it as any other health issue that you can’t control – acne, crooked teeth, nearsightedness, being left-handed (just kidding), and suddenly it didn’t seem like such a big deal. No one can control those things, and people use medicine and technology to fix them all the time. The truth is, more people probably struggle with fertility issues than want to say and it’s heartbreaking enough on its own, there’s no need to make it shameful as well.

So in an effort to be transparent, encouraging, accepting, and forthcoming, and with Matt’s support of course, I’ve decided to document our fertility journey and our effort to build the family we’ve dreamt of having.

I’ve always pictured myself as young mother and having a big family. I just always knew it was something I wanted, and Matt and I discussed it early on in our relationship. We were both certain that we wanted kids, and certain that we wanted them sooner rather than “some day”. I always assumed that the process would be easy for us. There was no reason to suspect that anything was awry since I’d always been regular, and when you’re constantly hearing that you need to be super extra careful because “all it takes is one time” for 10+ years, you figure things are gonna work out the way you want them to. That was not the case for us.

Matt and me at our wedding in 2015

We started “trying” around the time we got married, maybe a few weeks before to be honest, since that’s how the calendar worked out. When nothing happened right away, it was disappointing but not too discouraging. I was tracking literally everything on the calendar, taking my temperature every morning, trying to pinpoint the right time for everything. It was not very romantic! And I got a bit obsessed to be honest. I’d Google anything I thought could be a symptom, read post after post on message boards, compare my charts to those of strangers, like I was trying to find information that would help my case, as if I could convince my body that it was pregnant because of x, y, and z. We had also just up and moved to Boston and started new jobs, so we partially chalked our continued unsuccessful efforts up to stress and changing environments. But then things settled down and still nothing. Since it hadn’t been quite a full year, and we’re young and otherwise healthy, my primary care doctor told me it was too early to try any intervention, but Matt went in for his first analysis. It wasn’t good news, but it wasn’t hopeless. Maybe if we just kept on keeping on, and things were okay on my side, we’d get lucky. Spoiler: we didn’t.

Matt is a stellar uncle to our niece, Sophie

That was a bit of a shift in the mentality of it all. I went from feeling heartbroken and devastated every month to thinking “well, here we are again.” I started appreciating the extra time we had to save money, get settled, enjoy an unencumbered lifestyle. We bought a home, traveled spontaneously, ate extravagant dinners, stayed out late into the night drinking and dancing with friends, but there’s always that nagging feeling — what’s wrong with me? Is this going to be our month? What have I been doing wrong? We also started opening up and sharing with our friends and families about how we’d been struggling, which felt scary to talk about at first, and we definitely got our share of unsolicited and unhelpful advice, but sharing the burden and talking about the process has been oddly freeing. And as much as I want to think that I’m not a slave to social media, seeing old friends and acquaintances get pregnant and have babies, either intentionally or by accident (the accidents are the hardest for me — you mean you weren’t even trying?!?!) still feels like a pang in the gut. Luckily none of our closest friends are quite as ready as we are to start a family, so the immediacy of my jealousy hasn’t peaked, but I do have to remind myself that it’s possible and normal to feel both happy for and jealous of someone else, and sorry for myself all at once.

A recent trip to Italy, which would have been nearly impossible to take with a one-year-old!

I should also mention that I do feel somewhat lucky that throughout this entire time, I’ve never had a positive pregnancy test, meaning I’ve never had a miscarriage. I understand that with a lot of couples, the getting pregnant part is simple, and the staying pregnant part is hard. I feel lucky that I haven’t experienced that kind of loss and disappointment so far, but still apprehensive since all of that is still ahead of us, if we ever get there. I’m also thankful that we did want to start our family early, since age is definitely a factor. If things are going to be difficult, at least we have time to sort them out.

So this summer, just ahead of Matt’s 30th birthday, we decided that 2+ years of fruitless efforts is enough. We had our first appointment with a Reproductive Endocrinologist this week and asked all of our burning questions, discussed what the possible options are, and scheduled a comprehensive fertility assessment for us as individuals and as a couple. Soon we’ll perhaps have an answer to why nothing’s worked for us yet or what’s holding us back, and we’ll definitely have a plan as for what do we do next.