Hypothyroid

I’ve had several days now to think about this whole “underactive thyroid” situation and a few things keep coming to my mind.

1. I hate taking medicine. Typically, the only time I take any kind of medicine is when I have a headache or period cramps, otherwise I tend to just tough it out. I certainly tried to avoid all medications during my pregnancy last time. So to be told that I essentially must take this medication for the foreseeable future including during pregnancy just makes me nervous. How much research has been done on the safety of this medication during pregnancy? I just don’t like it.
2. Increased risk of miscarriage. Those words scare the bejeezus out of me. Having had several friends who have experienced pregnancy loss at varying stages, I just don’t know how I’d survive that. My friends are so strong- if I were in that position, could I be as strong?
3. Stupid question, but How? How did I have perfectly acceptable thyroid levels just a couple months ago and now when we’re actively trying to have another baby do they have to be all wacky and bad? It’s frustrating, and makes me wonder if we should just skip trying to get pregnant this cycle on our own because of all the risks.

I’m taking my meds every morning, and my prenatals and vitamin D every night, so I’m doing everything I can to give Little Dron #2 the best shot. I guess that’s all I can do!

-DD

Testing Continued…

We’re on our way to crossing off a lot of those tests Dr. S requested of us!

Last week, Rob did his semen analysis and blood test. They took two vials and he felt a little woozy… it’s a very good thing that I’m the one who’s better with needles! (They took 6 vials from me last time, and take at least 3 every time I step foot in the office.)

I’ve never had THIS many vials taken. (I just love the colored tops!)

Yesterday I had my saline sonohysterogram, aka saline infusion sonogram, aka SIS. I had one back in 2016 before our IUI, so I was vaguely familiar with the procedure. I didn’t have any sort of negative feelings about it, so I assumed that it must not have been that bad last time. The goal of the SIS is to make sure my uterus is in good condition to carry a pregnancy, and since I’ve had some things in my uterus since 2016 (ya know- placenta. Baby.), they wanted it redone to make sure I’m still good to go.

I described the SIS in this post, but just a quick overview of this time around.

After checking in at the front desk, I was called back to the ultrasound room very quickly, even before my appointment time! The ultrasound tech explained things to me, and then left so I could get undressed. When she came back, she wanded me and checked my uterus and ovaries prior Dr. S coming in. Since we were alone, I asked her to measure my follicles because I was curious. She obliged and commented that I only had one follicle on my left ovary (none of note on my right) and that it was 12mm. I was slightly disappointed that there was only one follicle, since last SIS I had quite a few. I wanted to know how big so I could make a guess about when I’m going to ovulate! I’d say I’m still about a week away, which is fine.

Then she left and came back with Dr. S. First, speculum went in and he cleaned my cervix. He warned me that it would be cold and scratchy, but I felt absolutely nothing. He put the catheter in next, speculum came out, and wand went in. They injected the saline into my uterus and poked around a bit taking some ultrasound photos, and then everything was done! Just a few minutes altogether. It was super quick. No one made any remarks this time around, except a passing “Looks good!”, so hopefully everything is ok. I watched on the screen while they explored my uterus and I didn’t notice anything, so hopefully that’s a good sign!

I was a little crampy the rest of the day, and when I stood up water gushed out like my water breaking, but no pain. I spent most of the afternoon on the couch watching movies!

Once again, we’ll have to wait to get the results at our consultation with Dr. S. I have to keep reminding myself that patience is a virtue!

-DD

Thyroid Problems

In my mind, my early cycle blood draw during this testing cycle was just a box to check off on our way to Little Dron #2. I fully anticipated everything to come back comparably to last time (February 2016, the cycle before we conceived Kara). I feel the same, and I just had a blood test back in September with normal results. So I was quite unprepared when Agnes, my nurse, called to tell me I needed to start medication immediately.

To take you back a few months, I did indeed request a blood test with my primary care physician back in September. I realized I was losing weight a bit faster than I liked and quickly found myself at a shockingly low number. I lost my pregnancy weight fairly quickly, and then stabilized over the summer. But towards the end of the summer I started losing more, and was concerned.

I visited my GP to ask for a thyroid test to make sure nothing was off. I suspected the weight loss was related to breastfeeding, but wanted to rule anything out. My blood test checked out and my thyroid was totally normal. Pretty soon after, I refocused on gaining weight and found myself in a comfortable range again.

So imagine my surprise when Agnes called and told me that my thyroid levels were higher than they’d like and I would need to immediately begin taking thyroid medication. And then, that I’d most likely need to continue the medication throughout pregnancy because of the dangers an underactive thyroid poses:

Hypothyroidism can also interfere with the development of an embryo (fertilized egg). This increases the risk of miscarriage. Also, if you are pregnant and your hypothyroidism is not treated, your baby may be born preterm, weigh less than normal, and its full mental capacity may be reduced. (from Hypothyroidism handout from reproductivefacts.org)

I’m still really wrapping my head around this. I was definitely not expecting anything to be wrong this time around, so I’m just baffled how things took such a turn in such a short amount of time. I filled the prescription and will start taking it tomorrow. (And to top off this great news, I have to get the name brand version, which insurance does not cover… awesome!)

 

I’m really hoping everything else is ok. It’s looking like we won’t get the results of any of our tests for a few weeks when we meet with Dr. S, so I’m concerned about hearing bad news from him and how I’ll react. I’d much prefer to see all the numbers and look things over before we sit with him. I’m not a great listener and I worry about shutting down if I get anymore unexpected news.

Please keep your fingers crossed that all of our other tests are normal and we can get the show on the road for Little Dron #2!

-DD

Hello Old Friend

So I mentioned that the other day I had my early cycle bloodwork and ultrasound baseline testing done. I’ve done this many times before, so it wasn’t new.

It started off with a urine sample. Easy enough.

Then I got my blood drawn. They took 6 vials I believe and I had to fast for it. I’m a champ at getting my blood drawn (excellent veins and no fear of needles or blood), so I had no issues. The phlebotomist was a very bubbly woman who talked about how her daughter is as fair-skinned as I am, and we had a lovely conversation. I brought a banana and hot chocolate with me to bring my blood sugar back up, but didn’t need it immediately. I ended up waiting until I got to the car.

Finally, I got to the ultrasound room and got to say hello to an old friend.

Hi Wand. We meet again.

Can’t say I’ve really missed the transvaginal ultrasounds, but ya do whatcha gotta do.

The ultrasound tech is actually the same one from 2016 (I guess I should have expected that, but didn’t), and it was nice to see her again. She’s sweet, and gentle (which is important!) and told me everything looked as it should while she was measuring my uterus. I made some small talk about how I really admire that she knows what she’s doing because looking at that black and white screen with black dots and measuring parts I can’t see looks like it takes real talent. She laughed politely, and then I was on my way! I was hoping she’d tell me how many follicles I had, but I didn’t ask and she didn’t volunteer that information, so for the rest of the day I was stalking my online patient portal for the results.

I hate waiting for results, but it appears we’ll need to wait a couple weeks until our in-person follow-up appointment with Dr. S. It’s going to be a long few weeks!

-DD

 

Unexpected Feelings

So I went today for my baseline bloodwork and ultrasound in our testing cycle. My fertility clinic moved locations since we were there for Kara, so even though I was quite familiar with the protocols for this particular appointment, there was a hint of uneasiness when I drove there this morning. Part of it could have been that I was nervous to be on this journey again; definitely part of it was excitement. I’m sure that part of it was the fact that I hadn’t eaten in almost 12 hours (fasting blood draw needed) so I was a little jittery. All of these feelings were familiar, though.

The one feeling I did not anticipate at all greeted me in the waiting room.

I signed in at the front desk and went to sit and wait with the 2 couples and 2 women who were waiting to see the doctor and go in for their testing. I remembered immediately how Rob and I felt just 2 short years ago, especially around this time. I said a silent prayer that all their wishes for the new year would be granted, and went to sit down.

Like everyone else, I pulled out my phone to occupy me during the wait.

And BAM.

Right on my phone lock screen is a photo of my adorable daughter. Smiling. Beautiful. Happy. Precious.

And WHAM.

GUILT.

Like huge, massive amounts of guilt.

Smacked me across the head.

Here I am, sitting in this waiting room with all these families wishing, hoping, and praying for a baby, and I have a perfect one at home.

I immediately had the urge to suggest they all go ahead of me. Much like you would if you’re standing in line at the grocery store and the person behind you has 3 items and your cart is full to the brim.

I wanted to tell them, “I’m good. You go ahead! They’ll get to me later. You go first!”

It was a bizarre feeling. I obviously want a second baby. Badly enough that I’m back to making this baby in the cold, sciency way. Our family isn’t complete, and this is something that Rob and I have always pictured and desired. But in that moment sitting there, frantically turning my phone screen away so no one would see my baby on the front, I felt like I should be happy with what I have and let these families have their babies first.

My discomfort with this thought did serve as a good reminder to me, though. Couples that have children easily are not maliciously getting pregnant, and they’re CERTAINLY not stealing my opportunity for a baby away. I need to bottle this guilt that I have up and remind myself of it whenever I feel that twinge of jealousy bubbling up over another pregnancy announcement. Just as I can’t give my opportunity for a baby to those couples in the waiting room with me, I can’t expect those pregnant couples to be anything less than ecstatic when they’re expecting.

Yet more feelings that infertility brings out of the woodwork. I keep thinking I’ve got this infertility thing figured out, but it always surprises me. I’m on a different side of it now, and I have to keep in mind that this journey will not be the same as my last. As much as the processes, people, and acronyms are familiar, it does not mean that the feelings will always be similar and expected.

-DD

1st IUI- Update 10

Quick update… it’s been a week since my IUI, so I had to return to the clinic to get another blood draw.

This one was to test my progesterone levels, to make sure they were high enough to support implantation and embryo development. Last time my levels were at 8, which was high enough to confirm ovulation, but really too low to support conception. The doctor said that they like to see them between 10-20.

I got the call from my nurse like always, but couldn’t answer it. I checked my voicemail in a free minute and Agnes said that my progesterone levels are at 16.5! Double what they were last cycle!!

Several things contributed to higher progesterone levels this cycle- Clomid tends to help; the trigger shot probably triggered a more effective and forceful ovulation, which can positively impact progesterone.

I feel like FINALLY something went super right! I was so excited to get that report. There’s still no way to know if I’m pregnant yet… that’s next week’s blood test! (Pray for me that I’ll be able to sleep… I’ve been struggling!)

-DD

1st IUI- Update 3

Well, that was quite a day.

7:55am- Pulled in the parking lot at work. Dropped my toast peanut butter-side down on the pavement. Thought this was the start to a super crappy day.

8:52am- Upon leaving one of my morning meetings, got a phone call from the fertility clinic. Checked the voicemail. Nurse calling to say insurance came through. Can I make it to the clinic before 11am?

8:53am- Run to one of the other teachers who’s been through this to ask her opinion. She says “Go.”

8:54-8:57am- Run around to the teachers to tell them I have to leave and I’ll take their kids when I return. They were soooo supportive.

8:59am- Get the ok from the prinicpal to just pick up and leave as the school day is starting.

9:05am- Make it out of the parking lot and on the road. Call the nurse to let her know I’m on the way. And also email her. Call Rob to tell him we got the green light. Call the clinic to schedule my appointment so they know I’m coming in. Sit in traffic.

9:30am- Run up 3 flights of stairs to the office.

9:32-9:45am- Ultrasound and one vial of blood. In and out in a flash.

10:05am- Back to school, pick up my students, and continue on with the morning like nothing happened.

11:45am- As soon as my last student leaves for lunch, put my coat on and head out AGAIN to drop off the prescription because I need to take it tonight.

12:15pm- return to school and scarf down as much food as I can in the 15 minutes I have left for lunch.

LONNNNGGGGGG afternoon and evening at school. Rob picked up my prescription because we had to stay late.

I’m exhausted. What a rush of feelings today. Now I’m SO SO SO SO SO happy and relieved that we didn’t have to sit this cycle out.

And day one of Clomid is under my belt!

-DD

What does Unexplained Infertility mean?

One of my sisters asked me the other day what “unexplained infertility” meant. What does it mean that they don’t know what is causing our infertility? Well, I thought the best way to answer that was to talk about the causes of infertility and discuss all the ways that someone can be infertile. It’s like defining a word by explaining everything it doesn’t mean.

To start, the World Health Organization defines infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” (Such a happy definition, right?)

According to research, it can take a healthy couple up to a year to conceive. I (emphasis on the I) believe this is limited to couples who practice what’s called NTNP (not trying, not preventing). Basically- let’s ditch the birth control and see what happens. Most couples who pay attention to fertile signs, use ovulation predictors, or specifically time sex for the times when the woman is about to ovulate, will get pregnant within the first 6 months.

Infertility comes in many varieties, but can mostly be sorted by male infertility and female infertility. Some couples experience a combination of male and female infertility.

Male Factor Infertility

• Low count- Not enough sperm
• Poor Morphology- too many sperm aren’t properly shaped and therefore aren’t genetically viable or aren’t able to penetrate the egg
• Low / Poor Motility- the sperm aren’t good swimmers, so they can’t make the swim to the egg

There are a lot of causes of the above conditions, but these three are pretty common reasons for male factor infertility (MFI). Even if everything in the woman is functioning at tip-top shape, if the sperm can’t make it to the egg, or if it isn’t a healthy sperm, there won’t be a baby. Many couples that have MFI will either need to try IUI or IVF in order to select the best sperm and get it to the egg!

Causes for/ Types of Female Infertility

Since so much (almost all) of reproduction takes place within the woman’s body, there are naturally a lot more things that can go wrong on the female side. The following are only SOME of the things that can go wrong…

• ovulation disorders- due to hormone imbalances, a woman’s body does not ovulate, or ovulates eggs that are overripe or not ripe enough (causes= PCOS, being underweight, being overweight)
• physical factors (endometriosis, blocked tubes, uterine issues)- blocked tubes do not allow the egg to travel from the ovary to the uterus to implant, endometriosis and uterine issues do not allow for successful implantation
• diminished ovarian reserve- there are not enough healthy eggs left; basically premature menopause

Unexplained Infertility

So basically, unexplained means that through all the testing, none of the above was found. But obviously there are still reasons why after a full 12 months, a couple has not yet achieved a successful pregnancy. Most couples who are unexplained uncover the cause of their infertility as treatments progress. Some of the following examples are causes of infertility that I’ve read about from couples who were originally diagnosed with “unexplained”.

• egg quality- it’s impossible to tell the quality of a woman’s eggs without taking them out of her body, so if this is an issue, it usually isn’t discovered until IVF
• hard shells- the egg’s outer layer is too thick for the sperm to penetrate
• implantation issues- sometimes a woman can get pregnant but not sustain the pregnancy because of issues in the uterine lining
• immunity- the woman’s body attacks the embryo
• fragmented DNA- a physical break in the DNA strands inside the sperm cause chromosomal abnormalities

For more on unexplained infertility, check out the link from Resolve, the national infertility association.

There’s no telling what’s causing our infertility at this point. And we may never know. But I don’t really care as long as we figure out a way to get us a baby! Feel free to ask me any questions about all of this! Making a baby is a more complicated process than anyone thinks.

-DD

SIS (not short for sister)

Monday morning I had my saline infusion sonohysterogram (SIS). It was pretty easy, as far as these things go.

I went to the ultrasound room and the nurse explained everything to me. I had already researched the procedure, so it was nothing new to me. I got undressed from the waist-down, per the usual when I get wanded. Then Dr. S came in with a medical student and I got propped up on the stirrups.

The speculum is always the most painful part. After he put it in and locked it in place, he spun it around, and THAT hurts. Like a wincing pain, not a screaming pain, but pain just the same. He cleaned my cervix and put the catheter in (neither of which I felt- Win!). Once the catheter was in, the speculum came out and I could breathe a sigh of relief.

The wand was next. The nurse did that part, checking my uterus and tubes before the saline was injected, though I didn’t feel that either! After the saline, they explored with the wand and took some 3D pictures of my uterus, tubes, and ovaries, and Dr. S remarked that I had “a lot of nice follicles” on one of my ovaries. These are the kind of compliments a woman likes to get from her fertility doctor!

All in all, the invasive part was over after about 15 minutes! Then we sat for a second and Dr. S showed me the ultrasound images they took. I asked questions about what was on the screen, and he answered all my questions (which I really appreciated). At the end, he said I had a “healthy looking uterus”, which is great news!

He asked when he would see me again to follow up, and I said we’d be back in a week.

It was not bad at all, thank goodness. I almost felt guilty for taking the whole day off work, but then I enjoyed relaxing at home! I also treated myself to a bit of a shopping trip at Target, where I bought some more food for my diet (read: high calorie, fatty, and sugary). Good news- I’m up 4.5 pounds!

Lastly, I want to acknowledge my wonderful friends who texted to ask how it went/ tell me they were thinking of me. You guys are awesome! You really know how to make a girl feel cared for and supported. I truly, truly appreciate it.

I’m looking forward to our follow-up consultation on Monday! Fingers crossed for a good plan!

-DD