Tag: chronic endometritis

Second opinions

4 Comments

The rollercoaster of emotion hasn’t stopped since my chemical pregnancy. Although I’d said before going into this IVF cycle that it would be our last one, I’m reevaluating the options. I feel pulled to continue IVF because I’m emotionally very connected to a successful pregnancy when I’ve only experienced unsuccessful ones for no obvious reason.

Last week I met with my doctor as a post-mortem this third IVF cycle. He’s a lovely, obviously caring man who has more than 30 years of experience with infertility. He’s the Peyton Manning of reproductive endocrinologists. He’s got that time and many wins under his belt; he’s consistent. Then he has a patient like me. During our appointment he referred to me, albeit very kindly, as an anomaly and his personal project. He’s determined to make me a mother in the same way that Peyton was determined to come back after neck surgery and win another Superbowl. No, this metaphor isn’t over-the-top at all, I don’t know what you’re talking about.

manning

As I anticipated, there’s not yet a good explanation for why five perfectly normal-looking embryos haven’t resulted in a sustainable pregnancy. He showed me the math of it and it was incredibly depressing.

So how does he recommend we move forward? The simplest possible response is another biopsy to check for my old nemesis chronic endometritis, and while we’re painfully removing my uterine tissue, reserve a sample for the ERA test, too. My lining is, perhaps, optimal for embryo transfer too early or too late for the standard progesterone window. The ERA test has been growing in popularity in the infertility community (I’d actually asked about it prior to my chronic endometritis diagnosis), but my clinic has only performed the test three times to date as they tend to be pretty conservative on new tech and labs.

Given that we have one remaining embryo, Kristoff, he also suggested that I consider another stim cycle to create more embryos and PGS test the whole lot of them to weed out the shoddy ones. We considered PGS in our first go ’round, but the added cost prevented us from moving forward.

Again, none of these recommendations came as a surprise.

What’s next? We’ve decided to get a second opinion. I really like my clinic, my doctor, and of course the greatest nurse on the planet, but my husband and I both feel like we’d be remiss if we didn’t at least talk to another doctor before making a decision. So I’ll be meeting with another doc, who has successfully helped two friends get pregnant via IVF, in a few weeks. His clinic also has a great reputation, and I’ve heard their treatment protocols are a bit less conservative, too.

 

One last time: Olaf and Anakin

5 Comments

I’m in a weird place fertility-wise.

After several months of considering and discussing our next steps, we’ve decided to do one more FET before pursing non-treatment options in earnest. I didn’t come to this decision lightly, of course. I say I here, because it was primarily my call. My husband has graciously allowed me to steer the ship since we began fertility treatment two and a half years ago, and he weighs in when he has strong feelings one way or another about something. While this decision-making compromise can feel lonely for me at times, I’m ultimately grateful that he understands it is important for me to dictate what happens to my body. The feminist in me has trouble with that phrasing, but I’m going to leave it be. Infertility is complicated and does affect both partners.

Much of the continuing conversation about how to proceed happened between me and my therapist, actually. Last fall, after our second failed FET, my therapy sessions started to revolve around moving forward. I questioned whether I was ready to try again. What if that meant another failure? Or worse, another miscarriage.

One of the very important things I had to start working through was if I could forgive my body for failing me. Following my diagnosis of chronic endometritis earlier this year, I started to make peace with myself. This was the reason I wasn’t pregnant and once it had cleared, I felt almost renewed.

That feeling of renewal was short-lived.

I’ve worked hard in therapy to better understand myself and accept that, without unlimited resources at my disposal, perhaps my body cannot sustain a pregnancy. I’m still working on this acceptance. In many ways, it feels just as emotionally painful as my miscarriages. Accepting that I can’t do what I want is as much a loss.

So the decision to conclude our treatment following this last IVF cycle didn’t come easily. But we’re preparing to move on.

My period should arrive this week, we’ll shell out the cash, and I should begin the preparation to transfer two of our last embryos, Olaf and Anakin (Kristoff will remain frozen for the foreseeable future, provided O and A survive the thaw).

So I’ll be here, singing “One Last Time” from Hamilton under my breath. Apt and giving me all the feels.

Later days, endometritis

6 Comments

The super annoying, potentially infertility-causing house guest in my uterus is finally gone! Following my third (and heaven willing my last) biopsy earlier this month, my chronic endometritis has cleared. Boatloads of antibiotics did the trick.

The day that I got the good news, I was actually terrified that it would be bad. I just had the worst gut feeling that the condition was still lingering, and had, perhaps, gone too long untreated leaving my my uterus permanently inhospitalable.

I’m incredibly thankful that doesn’t appear to be the case.

While the coast is currently clear, I’m eager to move forward as quickly as possible. “Quickly,” though, in infertility land almost always means waiting for your next cycle to begin. After some back and forth with the doctor and input from the most amazing nurse in the world, my husband and I landed on returning to IUI for just one more cycle.

That decision was primarily driven by financials (IUI is pocket change compared to IVF), but also by the tried-and-true approach of “well it worked before…” Said with a shrug, of course.

giphy

Both times that I’ve been pregnant were a result of IUIs. Since both of those pregnancies ended in miscarriages, though, we’ll this time supplement the IUI with progesterone shots (Crinone suppositories historically haven’t worked for me).

I’ve started the Clomid regimen. In previous cycles Clomid has flattened me like a pancake, although it has done what it’s intended to do. I decided I was willing to deal with the side effects one last time.

Mentally, though, I’m already checked out of this cycle. Although it has been successful in the past, Clomid + IUI has failed me twice, too. I expect it will again. My expectations are low — where I hope they will stay.

This will be my seventh attempt to get pregnant with medical intervention. That number seems very high, but also not high enough given that we’ve spent more than two years and thousands and thousands of dollars doing it.

Me versus antibiotics: A battle for my body

8 Comments

Warning: This post is mostly one long complaint. I’m aware I have it better than some on this infertility “journey,” and for that I am grateful. But right now I’m just going to bitch.

I’ve been a human pincushion. I’ve grown gotten accustomed to having any number of wands and OB tools shoved up my lady parts. I’ve had a D&C and a medically-induced miscarriage. And then there was that epic biopsy. I get it — infertility is pain (and I’m just talking physically here, I won’t dare scratch the surface of the emotional). Of all of the things I’ve undertaken physically, I’m currently ranking side effects from my endometritis antibiotics among the crappiest (literally and figuratively).

I am taking 2,000 milligrams of antibiotics per day, for two weeks. That much should knock an infection out of an elephant. For reference, 2,000mg is more than double the amount that is typically prescribed for a common infection, like a UTI. It is A LOT of medication. A lot of medication that has been incredibly unkind to my gastrointestinal tract. Any GI issue you can think of I have probably experienced in the last week. Sometimes several at once. When it’s not painful, it’s irritating nausea (etc.) that just never goes away. I haven’t felt like myself (or, let’s be honest, anywhere close) since mere hours after I took my first dose. I’ve resigned myself to the fact that I’m just not going to feel any better until the antibiotics course is over. THREE MORE DAYS HALLELUJAH.

As I said, I get it. This infertility business hasn’t ever been easy. But man if this doesn’t really suck.

shutterstock_120021052-1

Image from KevinMD.com

All hail me, the antibiotic queen

14 Comments

The last two months have been, shall we say, a bit confusing in Infertility Land. Following my second unsuccessful IVF transfer in November, my doctor was puzzled why three seemingly good (day 5 and 6) embryos had failed to implant. Statistically, given both my and my husband’s genetic screening are normal, it is extremely unlikely that they were all abnormal.

My doctor:

c869de79b728f8de041470b8f8e2ff14

The most likely candidate for failed implantation in my case (to recap: two failed IVFs, two miscarriages, and a boatload of IUIs totaling more than four years of unexplained infertility) is endometritis.

WTF is that and why does it sound just like endometriosis?

Endometritis is inflamed uterine lining, and I have it. Chronically. And how did we land on this diagnosis? With the most painful biopsy of my uterus I could imagine. I do not mince words here. I have a reasonably high tolerance for pain. I’ve had sporadic kidney stones since I was about 17 years old. I bite down and bear it. A uterine lining biopsy is no joke. I, in fact, nearly fainted. I sat up following the procedure, felt weird, and then hear my doctor and nurse yelling into the hallway for juice and a cold compress as they each grab my hands and check my pulse. It had slowed to about 50/bpm.

This endometritis thing is wack, but at least we’re starting to get some answers. I was asymptomatic, so there was no real reason to test for this before. It’s possible that I contracted the initial infection that lay essentially dormant when I had my D&C for my first miscarriage. The timing of that makes complete sense, actually. Nothing has worked since then. The number one complication of endometritis is infertility. Check! I got that.

I was relieved to have a diagnosis and something to blame the stress of the last few years of fertility treatments on. And thankfully, chronic endometritis is treatable. Just a course of antibiotics should clear it right up! Yes, there would be another painful biopsy waiting for me on the other side of that treatment, but so what?

I dutifully took my two pills a day for three weeks (thanks to a sinus infection prior to my treatment, my course of antibiotics was more like four and a half weeks). Then tried to keep my anxiety at bay for the next invasion of my uterus. You know what helps, though? Valium! The most wonderful nurse on the planet gave me one about an hour before the procedure and I’d slide that pain scale on down to a seven this time around. I was also pretty high most of the day, so I joyfully spent the following few hours in my bed.

Fast forward one week to yesterday… results day. No bueno. The tissue remains inflamed. Three weeks of antibiotics is no match for MY chronic endometritis!

giphy

So, ya know, that’s not fair. The next step is a double dose of antibiotics for two more weeks. And then we biopsy again. Cannot wait for that good time.

In all seriousness, I’m sad. Sad that this easy treatment for this condition we didn’t know I had didn’t work. Sad that the timing of all this effectively prevents us from having a child in 2017, even if I were to successfully get pregnant in my next FET cycle. Which, sure, is fine, but it’s just one more thing that sucks. I made an effort to start the year positively after the last few have beat the crap out of me, and it makes me question why I’m ever positive.

Yes, I’m selfish — I want a baby and I’m pissed that I’ve waited so long to get what I want. Only to just keep on waiting. Now I’m waiting with boxes of probiotics and Monistat to quickly clear the inevitable yeast infection.