My Fertility Journey
This is my story.
Had I known what the year 2017 held in store for me as I embarked on this fertility journey, I would have waited longer to try and get pregnant. You’re probably thinking, well that doesn’t sound all that encouraging. And maybe it isn’t for some, but for others I’m hoping that sharing the realty of my experience will help those struggling with infertility who feel they need more options than conventional fertility treatment.
My husband and I began trying for a baby immediately after getting married. If you’ve read my AIP story here, you’ll already know that I have a long-standing history of amenorrhea. So even before officially tying the knot, we were not really all too concerned about having unprotected sex and possibly getting pregnant. To no surprise, after 6 months (Sep 2016-Feb 2017) of actively trying, nothing happened. My husband and I had already decided we were going to make a big move from Miami to Toronto in March of 2017, so we waited until we finally settled in Toronto to seek help. Given my history, my new gynecologist in Toronto didn’t feel it necessary to wait any longer to begin fertility screening and treatment.
Screening between April and May involved bloodwork, ultrasound, genetic testing, and a sonohystergram. It was required that I menstruate in order to run these exams, so I was prescribed Provera (medroxyprogesterone) to stimulate a bleed. I took it for two cycles, both of which left me bedbound with terrible abdominal pain and extreme insomnia. When I say insomnia, I’m talking 72 hours awake before resulting to sleeping pills. For the most part though, all my tests came back normal. My hormone levels (FSH, progesterone, and estradiol) were on the lower side, but still fell within “acceptable” reference ranges. My gynecologist chalked up my amenorrhea to PCOS and offered to start me on oral ovulation medication right away.
Pause. Back this story up just a little bit.
Throughout my adult life I had been told by some of my doctors that I had PCOS and by others that I most definitely did not. Just two months prior to starting fertility treatments, I had surgery to treat pelvic congestion syndrome. The surgeon took a peak at all my female “parts” to ensure everything was in working order and he explained that I did not in fact have PCOS, I just had a lot of follicles on my ovaries because I never ovulated. Fast forward to this moment, when my new gynecologist attributed my amenorrhea once again to PCOS. I challenged his theory and he basically said that follicles + amenorrhea = PCOS. It was essentially given to me as a diagnosis of exclusion.
Whether I had PCOS or not, didn’t really seem to matter to my gyno because either way he was going to “treat” me with fertility meds. It didn’t really settle well with me though, so in June I began seeking treatment from a naturopathic doctor. She took one look at my lab work and had A LOT to say about my hormone levels. She pointed out that my FSH, progesterone, and estrogen were not within acceptable ranges, especially for pregnancy. My prolactin was unusually low and my sex-globulin binding hormone was unusually high (both of which were not even mentioned to me by the gynecologist). She also didn’t agree with the PCOS diagnosis because I had none of the other designated symptoms. We agreed to start acupuncture and Chinese herbal medicine to try and kick start my hormones. I did both for about a month, but stopped due to increasing pain in my abdomen.
After a month of natural therapy, I was anxious to give traditional fertility treatment a shot because I really, really wanted to get pregnant. It was already June, I had literally made trying to conceive my full-time job, and truthfully, I was consumed by the notion that I had to get pregnant as soon as possible. I transformed my whole life to support this notion. I changed my exercise regimen, my diet, and even my beauty and cleaning supplies to support my hormonal health. I’m sure many of you can relate to this feeling, that the less likely you are going to conceive, the more you feel like it needs to happen. It felt and honestly still feels, that I’m being robbed of my rights as a woman. I do not know that this feeling will ever go away.
So, I returned to the gynecologist and began fertility medications. I took Provera to get my period and then Clomid (clomifene) to induce ovulation. Oh dear Clomid. I have a lot of not-so-nice things to say about you. I won’t digress too much, but I’ll just mention that Clomid was banned from Canada shortly after I took it. I was just one month too late from saving myself from all its horrible side effects (irritability, sadness, depression, anxiety, fatigue, panic attacks, mood swings, and lots more). Clomid also takes up to 6 weeks to completely leave your body and therefore the side effects can linger just as long.
The whole cycle was incredibly stressful. My lining wasn’t thick enough, so I had to supplement with estrodial, which of course worsened my insomnia. I was running back and forth between the lab and the ultrasound office for cycle monitoring at the crack of dawn for almost 10 days straight. Just going to the cycle monitoring clinic feels like I was one in a herd of cattle waiting to be milked. It was not a pleasant experience my first go at it and I definitely recommend doing your due diligence before choosing a fertility clinic. Lastly, the progesterone suppositories required post ovulation gave me an infection. Needless to say, we did not conceive our first cycle.
It was now the end of July and I knew I needed to take a break. In full transparency, I was incredibly depressed during this time and my mental health was in the toilet (which I now know was partly attributed to the Clomid). I tried my best to take the month of August to recover, but physically I was doing very poorly. I still couldn’t sleep for days on end and I had extreme abdominal pain that was just not letting up. At the end of the month I ended up in the ER and was told I had pelvic inflammatory disease (PID). I took some broad spectrum antibiotics and anti-inflammatories and felt much better.
At this point, I sought a reproductive endocrinologist at Anova Fertility in Toronto. The RE believed that I did in fact have PCOS and that fertility treatment was the way to move forward. In October, he switched me over from Clomid to Femara (letrazole) and suggested we proceed with IUI (intrauterine insemination). Our first cycle had fewer hiccups, but was still unsuccessful. I want to give a small shout out to Anova Fertility for treating their patients wonderfully and making the cycle monitoring process relatively easy and comfortable. It really changed the whole fertility experience for me.
Our second cycle did not go as smoothly unfortunately. My Femara regimen was bumped from a single one-day dose to a step up protocol, which sent my ovaries into overdrive. Instead of ovulating 1-2 nice healthy follicles, I ovulated 13 erratic immature ones. The ultrasound techs thought I was an IVF patient. I even had to book double appointment times when I went in for cycle monitoring just so that the they would have enough time to measure all the follicles. My ovaries were so swollen I could barely walk without pain. Worst of all, I was told that the cycle was most likely not going to work and I would probably need to skip the following cycle in order to prevent the risk of developing cysts. Well, they were right about one thing. None of the 13 erratic follicles took that month of November and I was physically worse off than ever before.
When good ole’ Aunt Flo showed up just short of two weeks post my last IUI, the pain in my ovaries, abdomen, back, and hips became unbearable. I thought for sure I was having another PID flare, so I demanded an ultrasound and bloodwork. This time however, everything looked normal and there were no signs of inflammation. It took up until this moment, up until I could barely hang on physically, mentally, and emotionally, to finally be diagnosed with endometriosis. Given this new revelation, It’s hard to say for certain if I ever had or have PID, PCOS, or any number of diagnoses I have been given over the years. At the very least, I know that I can finally accept this new diagnosis as plausible given my history and the associated symptoms.
I remember walking out of my RE’s office that morning more upset than ever. The thoughts flying through my head were destructive. I knew what having endometriosis meant to my fertility, my pain, and my general wellbeing. In some ways I needed this revelation however, to push me out of the conventional fertility model and back to a more holistic approach to healing. I made a promise to myself that I was going to commit the next little while to healing, to prevention, to pain management, and most of all, to self-love. I was no longer committed to this idea that I had to get pregnant. Would it even be healthy for me to carry a child and raise an infant in such a broken state? For sure not. And that’s how I landed upon the autoimmune protocol. That is what gave me the courage to share my story with you.
[Disclaimer: It took me a very, very long time before I could find the courage to write about my health experiences. I'm taking a chance by sharing the ins-and-outs of my personal life in the hope that it will help others. I, myself, am grateful for all the strong individuals out there who have already shared their stories and who have served as the inspiration behind me sharing mine. Please be kind in your commentary and feel open to getting in touch with me through my contact page. Kindly, Amalia]