Unexpected Blessings

There is nothing "Fun" about infertility, but I will say that having trouble TTC has brought me some unexpected blessings. IF can knock the wind out of your sails, so today I wanted to share some of those blessings as a reminder to myself of the things I have gained during this process of losing so much. 

1) A closer relationship with my mother. I was always a daddy's girl, and while mom was a SAHM for most of my childhood, we were never super close. She wasn't the kind of mom I could gossip with. She also went through infertility struggles while trying to start a family, so for the first time in my life, I've been able to bond with her over a shared journey. She had several failed IVFs and two ectopic pregnancies that almost killed her before she and my dad decided to adopt me, so it's nice to have a mom that "gets it".

2) A side of my husband I had never seen. He has become so fiercely protective over me. He is SO patient, so kind, and so willing. On our wedding day, one of his vows is that he would meet me where I was, with his hands ready and heart willing, always. He's always been supportive, but to know that I don't have to be alone when I cry, to know that if I need a snack or chocolate to know that he's there for me regardless has been amazing. Sure, I've vented about the times when he wasn't immediately there, but those are the exceptions, not the rule.

3) Friends I would have never had. It's weird that the ladies who "get me" and who have supported me through this journey are folks I've never met. Some of them... I don't even know what they look like. But I know they are there and that they are behind me each step of the way!

4) Friends who have opened up. Since "coming out" during NIAW, I've had several friends message me and open up about their infertility journeys. For some it was female friends who reached out. The one who REALLY surprised me was a male friend of my husband's who I know only casually. He messaged me to share what he and his wife had been through, and offered to be "That guy" for my husband to talk to about all things IF related. I feel SO blessed to have them in my life! 

5) A new outlook on life. Yes, I want to be a mother but I've come to realize that being a mother isn't the end-all be all of existence. If for some reason it never happens for me I know that I will be just fine. 

Two Steps Forward- One Leap BACK

So today has been a long day for many reasons. The hubs and I both over-extended ourselves doing yard work before either of us were cleared to do so post-op. It was just such a lovely day. That decision landed both of us in urgent care- him with bleeding, me with suspected pneumonia. With a 2.5 hour wait, we decided to come home and just tough it out.

The truly hard part of the day was the pregnancy announcements. Several of my friends posted their u/s photos on facebook today. Two of them have been married less than a year. Announcements don't normally bother me, but for some reason these did- it may have just been the rapid succession.

I'm not proud to admit the thoughts that I had- the immense anger and hatred I had toward these women whom I love dearly. I know deep down that I don't hate them, that I simply hate myself for being unable to achieve what they have come across so easily. I spent a good hour having a big ugly cry and I feel better- not great, but better.

The thoughts have recently been crossing my mind with my hyperplasia situation that I'm not even sure if I want to pass on my genes. I feel like I cannot in good conscience knowingly pass that propensity on to another generation. Adoption as a first and only option is looking better and better, but I know DH really wants a biological child, so I'm not ripping the ute out yet.


Hopefully this week brings happier news and happier posts.

Sick as a dog

Just as I thought I had made it through surgery with no issues, it looks like the "allergy flare up" was actually the start of a nasty nasty head cold.

I feel like I've been hit by a bus. And that's saying something because I normally handle colds like a champ. I'm trying to survive my work day without getting everyone and their cousin sick, and more or less keeping to myself in my cubicle. Thank goodness my teammates took over my case load for the week in anticipation of my surgery. I don't know what I'd do without the amazing and supportive group of folks I work with.

I just hope I don't get DH sick- he's still recovering from his tonsillectomy and he's in the "danger zone" this week- at the point where he could hemorrhage and go downhill.

Boy- when it rains, it POURS

It was like having my uterus power washed

So yesterday was my D&C and Hysteroscopy. I've not figured out if it was better or worse than I was expecting.

But perhaps I should rewind for a bit and explain what led up to this quasi-emergency surgery.


After a biopsy in January showed simple endometrial hyperplasia, I was put on Provera (synthetic progestins) for 90 days in hopes of slowing endometrial growth and allowing my body to self-correct the overgrowth. Simple endometrial hyperplasia is just a slight overgrowth of the endometrial lining- much like when you wait a bit too long to mow your lawn and it gets floppy. The OB said there was a less than 0.5% chance of it every becoming cancerous.

So 90 days (many tears, a few broken dishes, and several apologies to my husband) later I went in for a repeat biopsy. OB had difficulty getting a sample, which she took to mean that it had worked. So lucky me, LUCKY ME I was subjected to TWO endometrial biopsies.

Many people have asked what that experience is like. I found a great youtube animation (not for the squeamish) that highlights the procedure.

http://www.youtube.com/watch?v=at-CfWUiClg

Basically, OB inserts a solid catheter type implement into your uterus, and suctions out lining in a sweeping motion. Most women suggest taking 600-800mg of ibuprofen before the appointment. My first biopsy was a rather unfortunate surprise, and it was about a 1/2 day recovery in bed with some of the worst cramps of my life.

The second biopsy was slightly less horrific- I took 800mg of ibuprofen 20 minutes before my scheduled appointment time. It still felt like she had inserted a shop-vac into my uterus and turned it on high, but there was less cramping afterwards.

She said to expect the biopsy results in two weeks. I was leaving for a work conference in Nashville a week later, so I expected to hear back sometime after my return from the conference. The first indication that I should have known something was not right is when AF showed up unexpectedly the night before my trip. By the time I arrived in Nashville, I was soaking through a super+ tampon every 30-45 minutes. I didn't want to miss the conference, so I figured if the bleeding kept up, I'd fly home early and go to the hospital.

And then I got the call from my OB. Instead of my lining reverting to normal, it progressed into complex hyperplasia. Instead of just being a bit overgrown in a few spots, my endometrial cells were crowding each other out and creating dense patches of thick brushy overgrowth. It went from being that neighbor who didn't mow his lawn for 2 weeks to that neighbor who mows his lawn once a summer. I don't remember the entire conversation at this point, but she threw out "oncology consult" "need for a D&C and exploratory surgery as soon as you're back in town" and "don't panic yet".

Don't panic yet. Immediate surgery+ oncology consult= freaking out

So I kept changing my tampons and decided to fly home early. By the time my plane landed, I was bleeding so heavily that I had clots running DOWN MY LEG INTO MY SHOE.

Stop and think about that for a moment.

I called my OB, she said to quadruple up on my progestins and pray that it slows things down.

So I took 4x my regular dose, got behind the wheel of the car and prayed I didn't ruin my car's upholstery. It was a long 2 hour drive home from the airport.

By that evening the bleeding had slowed (but not stopped completely) and I was starting to feel a bit more human. We were able to get my D&C/hysteroscopy scheduled for that next Wednesday (yesterday).


The day of the surgery I had to be at the surgical center by 8:30 in the morning for an 11:30 procedure. Honestly, the surgery was over and done with by 12: 15 and I was home by 1:30 or 2:00. The doctor said it was like blazing a trail through the wilderness up in my uterus, but she feels that she got 95% or so of my lining. The best news is that there were no visible tumors, no fibroids, and no polyps. I'm glad to know there are no fibroids or polyps causing the bleeding, and the fact that there were no visible tumors leads us to believe that if there *is* cancer that we caught it at a stage early enough that a hysterectomy would take care of the whole problem (but the hysterectomy is obviously the last resort)

It wasn't too bad, the pain never peaked over a 3 or a 4, but I felt like I had been hit by a MAC truck. I slept from the time I got home until 7 PM, woke up for a few hours to eat dinner and then fell asleep again until 7AM today. I'm feeling much more human, still crampy and still tired, but I could have probably gone to work if I had someone to drive me.

The best surprise- I was prepared for heavy bleeding and spotting based on my last week, but I've not needed a pad in the last 12 hours. Here's hoping this is the reset my body needs, and it can keep itself in check the next 3 months.

Pending the pathology results from the lab at the regional cancer hospital, the plan will either be to do 3 more months of higher dose progestin therapies (if there is no atypia) and hope that it fixes the problem, or move on to more aggressive therapies with a gynecological oncologist (if there is atypia seen). Going back to the lawn metaphor, atypia would be the dandelions and crab grass of the endometrial lining. Starts small, but left unchecked chokes all of the good grass (lining) out and destroys your lawn (endometrium). Which in this case, would signal uterine cancer.

Two weeks until I know what's going on. It'll be a long two weeks.

An Introduction

I've been thinking about starting this blog for quite some time, and with recent developments, I've decided there is no time like the present.

A brief history of us

My husband and I were married in August 2011 in Bermuda after learning that my father had cancer. Originally they said it was no big deal, but we weren't willing to take the risk of Dad not being there. It was the best decision ever. He died just over a year later.


At the annual appointment with my OB, we decided it was time for an endometrial biopsy. The results weren't great, but they weren't terrible. My lining was classified as simple endometrial hyperplasia, and I was started on 90 days of provera to hopefully put my endocrine system in check. The hope was that at my follow up biopsy, all would look good, and I'd be ready to move on to fertility treatments.

Unfortunately, that would not come to pass either. My second biopsy looked worse than the first, being classed as complex endometrial hyperplasia. From here, I have a D&C and hysteroscopy scheduled, followed by further hormone treatments if no evidence of cancer is seen.

This is not the happily ever after we imagined, and there are many days that I start off shouting EFF YOU UTE!

This journey isn't going to be puppies and rainbows, but my faith will guide me and DH on our journey to become parents.

I hope you'll stick around for the good, the bad, and the ugly

Why you NEED an RE, NOT an OB for Infertility Treatment

My second biopsy appointment was an experience I will never forget. I went armed with a notebook of knowledge that I gleaned from the 3T board, and questions I had for my OB regarding her plans for my infertility treatment. She had talked a good talk at my first appointment about monitoring and making sure I didn’t over-stimulate, so I was excited to prove the 3T ladies wrong with a big “HA- Look at how awesome my OB is.

Instead, I realized that while she is a great OB, she is completely ignorant when it comes to the diagnosis and treatment of infertility. Our conversation went like this:

Me: so what are the steps from here?

OB: Well, we need to get you ovulating. So as long as the biopsy looks good, we'll start you on Clomid after your flow arrives.

                I knew from the 3T board that starting clomid without testing is a big no-no.

Me: Will we do any testing first?

OB: That is unnecessary

Red Flag: Totally necessary! The clomid won’t do jack for me if my tubes are blocked. No point in going through all of this is the eggs can’t get to where they need to be!

Me: But what about an HSG for me and a SA for DH?

OB: Those aren't necessary at this point in the process. Again, we want to do minimal cost  first. There's no reason for that much testing this soon. You're worrying too much.  We will do an ultrasound on Day 14 to see how you are responding.

Red Flag: OB’s can talk the talk and make it sound like they are “monitoring” clomid cycles to people who are not educated on what true monitoring looks like

Me: But no CD 3 ultrasound? What if there are cysts?

OB: That's normally not an issue.

Red flag: Cysts can be a HUGE issue, and starting a cycle with cysts can cause irreparable damage to your tubes

Me: But what if there *are* cysts, since you said I have PCOS tendencies- I'd prefer to not end up in the ER with a very large cyst rupturing.

OB: It's not our normal protocol. That's a lot of money that doesn't need to be spent. 

Red Flag: It’s worth it to me! It’s my health we are talking about. An ounce of prevention is worth a pound of cure

Me: But what if I have a blocked tube? The Clomid won't do me any good

OB: That's probably not your issue

Red Flag: The OB has never even done an internal diagnostic such as an HSG. It’s highly presumptuous to say that I don’t have a blocked tube.

Me: But what if it is- how do you know it's not, and I don't want to waste one of my 6 cycles of Clomid

OB: The "6 cycles of Clomid" is a myth. As long as you respond well, there's no max

Most doctors agree that more than 6 cycles of clomid can lead to incredibly thin lining making pregnancy nearly impossible to achive, and there is conflicting evidence with a possible cancer link.

Me: My biggest concern is thinning my lining

OB: Research shows that a thin lining has no effect on achieving a pregnancy

                That’s a flat out lie!

Me: But what about bloodwork and an SA?

OB: The SA isn't necessary- you're clearly not ovulating

Me: but what if we're in the 30% of couples who are dealing with issues from both of us, again, I'd prefer to not waste time and resources if we don't resolve all underlying issues.Plus, we're going on vacation in July, and if DH has any sperm issues, I'd prefer he avoid the hot tub

OB: That's not necessary. A hot tub won't affect his sperm count.

 Me: And as for bloodwork,  wouldn't it make sense to do a CD3 blood draw with DHEA-s and LH/FSH to rule out adrenal hyperplasia, since we know I'll be on CD 3 soon? 

OB: You present with typical PCOS symptoms. I don't think that's necessary.

ME: But in ultrasounds in the past, they have not noticed the typical string of pearls follies indicative of PCOS

OB: you don't have to have cysts to be diagnosed with PCOS.

ME: But if my DHEA-s is elevated, and it's adrenal hyperplasia, which presents with similar symptoms, the treatment would be different

OB: I don't think that's necessary- but if you insist... *sigh*

Infertility is expensive. I get that. DH and I are 100% OOP for all treatment. But for me, the extra couple grand is worth my long term reproductive safety.

OB’s specialize in keeping you pregnant, and making you un-pregnant at the end of 9 months. They are NOT fertility specialists- they’re surgical specialists. That’s why reproductive endocrinology is its own specialty.  You wouldn’t go to a brain surgeon to deliver your baby, just because they also know surgery. This is the same thing!

Infertility Glossary

There are tons of abbreviations commonly used in the Trying to Conceive (TTC) and Infertility (IF) world So here is a glossary for reference.

3T/TTTC- Trouble Trying to Conceive (Infertility)

AF - Aunt Flo (menstruation)

AI - Artificial Insemination

AO – Anovulatory

AR - Assisted Reproduction

ART - Assisted Reproductive Technology

BC - Birth Control
BCP - Birth Control Pills
BBT - Basal Body Temperature

BFN or BF0 - Big Fat Negative (home pregnancy test result)

BFP - Big Fat (or Effing) Positive (home pregnancy test result)

BW or B/W - Blood Work

CB - Cycle Buddy
CBEFM - Clear Blue Easy Fertility Monitor
CD - Cycle day

CM - Cervical Mucus

CP - Cervical position

D&C - Dilation & Curettage

DH - Dear/Darling Husband

DPO - Days past ovulation

ENDO – Endometriosis

ET - Embryo Transfer

EWCM - Egg White Cervical Mucus

FET - Frozen Embryo Transfer

FMU - First morning urine

FRER - First Response Early Response

FSH - Follicle Stimulating Hormone

HCG - Human Chorionic Gonadotropin

HRT - Hormone Replacement Therapy
HSC - Hysteroscopy
HSG – Hysterosalpingogram

ICSI - Intracytoplasmic Sperm Injection

IF – Infertility

IR- Insulin Resistant
IRL- In Real Life

IUI - Intra-uterine Insemination
IVF - In Vitro Fertilization

KU- Knocked Up

LAP – Laparoscopy

LH - Luteinizing Hormone

LP - Luteal phase
LPD - Luteal Phase Defect

MC - Miscarriage
MF - Male Factor Infertility

O - Ovulation
OB – Obstetrician

OPK - Ovulation Predictor Kit

OV – Ovulation

P4 – Progesterone

PC - Post-Coital (after sex)

PCO, PCOD - Polycystic Ovary Disease

PCOS (POS) - Polycystic Ovarian Syndrome

PCP - Primary Care Physician
PCT - Post-Coital Test
PG - Pregnancy or Pregnant
PI - Primary Infertility
PIAC - Pee In A cup

PNV - Prenatal vitamin
POAS - Pee On A Stick

RE - Reproductive Endocrinologist
RPL - Recurrent Pregnancy Loss

S/A - Sperm/semen analysis

SHG – Sonohysterogram

SI - Secondary Infertility

TI - Timed Intercourse

TTC - Trying To Conceive

TSH - Thyroid Stimulating Hormone

US or u/s - Ultrasound