Treatment Cycles and IVF # 1 Mega Disaster

I started my first cycle of Clomid with IUI in April, 2015. It all seemed quite embarrassing and unnecessary to me. I kept thinking how young I was and how I really did not need these treatments. It would just happen on its own…soon…just like it did the first time. Yes, I still could not get over how easily I had conceived and delivered the first time.

The first cycle failed, then the second and finally the third. It was June, 2015 by this time. I was frustrated to say the least. We had been trying for over a year to get pregnant on our own and now these unexpected fertility treatments hadn’t worked out either. And that’s not counting the previous 3 years of using no real birth control other than just timing and withdrawl even when we weren’t really trying. I was sick and tired of the treatment failures. I really thought we needed a break from all this. But my husband was getting impatient by the minute. He couldn’t get over the fact that his 29 year old wife could not get pregnant even with fertility treatments. He showed me through his online research how my high FSH and my mother’s menopausal age of about 43 years old had a strong correlation with the age when I would have menopause. A fact which is quite true in fact, but I just did not need to hear it now. You know how they say – ignorance is bliss. I don’t think he meant to hurt me, but my husband unknowingly kept giving me examples of his mother, sister, aunts and female cousins who conceived their children in their forties. Poor thing – He just could not understand how and why with everything being normal (other than the god forsaken FSH level ofcourse), we couldn’t give ourselves and especially our son the joy of having a sibling. Neither could I. But now I know. Trust me. Even if the tiniest thing goes wrong in your body, it can wreak havoc and make it impossible for your body to function the way you want it to.

Even the doctor categorized my infertility as “unexplained” because even with the borderline high FSH, it did not seem like I had any extreme fertility issue. I mean I had a reassuring AMH, my periods were regular – bang on time!, and during the IUI sessions they had done repeated blood tests showing normal LH levels and ultrasounds clearly suggesting that ovulation had just taken place. Anyhow, the doctor suggested we go in for IVF which is ofcourse the ultimate fertility treatment. I did not feel mentally ready for it after the continuous IUI failures but my husband suggested waiting longer would probably only make the situation worse rather than better. After all, our son was already 4 years old in July 2015. All his friends and cousins had siblings and he kept wondering why we couldn’t get a “baby” in our family too. I honestly felt really bad for him. We were also overall very frustrated with ourselves and with these unexpected disappointments that life had brought along our way. We kept having fights on and off. I obviously got moody with all the pills and emdications I had been taking on and off. Although I was not in favor of going in for IVF right away, I decided my husband was right. We should probably go ahead and do it as much as I dreaded it.

In August 2015, I started my first IVF cycle. I did not tell a soul. Not even my own mother. I was too embarrassed and somehow too unsure of the outcome. I really did not want my mom wprrying about me – knowing her sensitive personality and her high blood pressure condition. The doctor started me off with a very low dosage of Gonal F – only 150. After a few days of monitoring I asked her how my response to the medication was. She said I was responding well. My Estrogen level was high according to her so she brought down the dosage for Gonal F to 100. I kept going in for the daily ultrasounds in the mornings. My usual doctor was off duty for some reason during this time so I saw 2 of her other team of doctors. I was a little bit surprised that  I only had 6-8 follicles in the ultrasounds. I was expecting 15-20 follicles especially with stimulation. I figured the more eggs they would retrieve, the greater the chance of a viable egg being found. The doctors kept saying 6-8 eggs/follicles were completely normal and everything looked great.
Finally came the day of my retrieval. I was terrified of the anesthesia and the procedure itself. But sadly it all ended before I knew it. The doctor on duty that day was not my usual doctor. I had seen her for some of my ultrasounds and always got a cold feeling from her. So that was a bad start in a way. Anyway, I gained consciousness as I was coming out of the OT and onto one of the beds. The doctor immediately came up to me and gave me the bad news. Her voice still echoes in my ears when I think about that devastating day.
“We could only retrieve 1 egg which was a bit disappointing. But we’ll be watching it overnight and see if it fertilizes.”
Yes, you heard me – ONE EGG!!! At 29 of age, with very low dosage of medications I must say and the doctor keeping optimistic and repeatedly saying  -You’re young, You’re young. You delivered one normal child, etc etc. All I was left with was ONE, immature egg that DID NOT fertilize over night and that was the END of my first IVF cycle.
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Guilty as charged – on 1 count of infertility!

As I had mentioned, I already had set up an appointment with a Gynecologist to have myself checked. Again, once the gynecologist saw my previous pregnancy records and my young age (28), she suggested everything was probably fine. Just in case, she ordered some Hormone blood tests. Most people know it as Day 3 testing. When my results came out I had an FSH of 10!!
10 people as in the double digit number TEN – at age 28!!!
I can never forget the letter I received in the mail noting the FSH of 10 along with the comment – Ovarian Reserve may be slightly low. That was my death sentence. Just like a “Guilty” verdict from the jury, I was deemed infertile. The ultimate and defining reality of my life.
I’m not sure how that reserve works but until now – almost 2 years after the test and atleast 2 and a half years after vigorously trying month after month – NOTHING has worked out!
Did I mention – I never used any birth control – EVER!!! Other than maybe timing and withdrawl!!
I had never felt so disappointed in myself and in my body. Being almost 10 years younger than my husband, I was the one with a fertility problem.
And it’s not something that I can control. It’s not even my fault that I was amongst probably the 1 % of women who suffer from Premature Ovarian Aging in their twenties! I sure as hell didn’t factor that into my life plan. Neither did a breast cancer patient in her early thirties or a brain tumor patient in their twenties. But it happens. Shit happens and you have to deal with it! That’s life – if it doesn’t kill you, it only makes you stronger.
Anyway, as soon as I received the results, I got my game face on – ready to battle infertility in the face and set up an appointment with my RE in January 2015. During the month of December 2014 I ordered my first ovulation strips online. On cycle day 14, I got a positive sign for my LH surge. We tried to conceive during my fertile window. And baam – 12 days later, I had my period!
I seriously didn’t understand what could have gone wrong. Only to find out that there are an infinite amount of things that can go wrong.
I met an RE close to our house in January 2015. She seemed like a nice lady and spent a good hour with me and my husband. She assured us that I was young (only 28 at the time) and I had conceived my son naturally and carried him to term so it should hopefully happen again regardless of the borderline high FSH of 10.
She ordered some basic tests including AMH and an HSG – a test in which a dye is passed through your tubes to check if there is any blockage preventing fertilization from occurring. The AMH came out at 3.1 ng/ml which was reassuring. I was due to go in February 2015 for my HSG. As scared as I was for of this test, I went in and got it done. The test came out clear. Little did I know that this was one of the first procedures I would have to go through as part of our ongoing efforts to conceive our second child.
And so began the real and seemingly unending trouble. The doctors visits, the rounds of blood tests, ultrasounds, medications – oral, vaginal, intra muscular,  subcutaneous – you name it, the treatment cycles and all the ups and downs that go in between

The trouble begins…

At the back of my mind I always knew that I wanted another child. I had saved my maternity clothes, I had carefully packed and kept some of my son’s baby clothes so that the next baby could use them. Some of his nice baby toys were all packed up and ready for the next sibling to use. It was only a matter of time until we decided to have that second baby and all those things would come into use.
Considering how unplanned and easy my first conception, pregnancy and delivery were, this seemed like a piece of cake. So once I had convinced myself we were ready for baby no. 2, the first 2 or 3 months we just stopped using any birth control – which meant basically not using the occasional condom and no withdrawal – our two main birth control methods. I had never taken the birth control pill since I was always very cautious of using medications or anything that could interfere with my internal body systems.
The 4th month, we tried timing our baby making efforts around the middle of my menstrual cycle – around the time of ovulation. I still didn’t think we needed ovulation predictor kits or anything like that. I mean wasn’t it as easy as 1, 2 and 3. My period cycle had always been very regular. So when I didn’t get pregnant the first month of having sex particularly around the middle of my cycle, I knew something was wrong. Because honestly, I didn’t think we needed to put in any more effort. I set up an appointment with my Gynecologist regarding conception of my second child. This was around August of 2014 and considering the busy schedule of doctors and the apparent non-urgency of my situation, I got an appointment for November of 2014 – about 2 months later.
During this time, I had also set up an appointment for a regular physical for my husband who hadn’t gone to the doctor in the past 3 years. When my husband went for his physical in October 2014, he mentioned to his doctor that we had been trying for a baby for the past few months and it hadn’t happened yet. The doctor discovered during his physical that he had a varicocele – which sometimes results in secondary infertility in men. Essentially, a varicocele is like a twisted vein but hinders blood flow in the testicles, similar to the varicose veins many people have in their legs. It sometimes results in pain in the affected area but in my husband’s case this was luckily not the case. He recommended my husband to meet up with a Urologist and Endocrinologist. We got an appointment in November 2014 to see an Endocrinologist and a Urologist. During the waiting time, my husband was super freaked out that he might need to get a varicocelectomy – which is surgery to get rid of the varicocele. He kept imagining he has an extremely low sperm count and what not. He was constantly reading up online about varicoceles and secondary infertility in men and watching youtube videos of surgeries. Honestly, as much of a blessing the internet is for looking up medical information, it only stresses your more.

The appointment with the Urologist was first. He gave my husband a very grim picture. He suggested that my husband start taking Clomid right away starting that evening and come in for a corrective surgery for the varicocele right away. After the surgery it would take about 3 months for his sperm parameters to come to normal. When my husband told him that we had conceived our first child effortlessly, the first month after we got married, the Urologist suggested that it was probably a fluke. Just a one in million chance because no matter how hard he tried now, my husband’s sperm were not capable of much now. One of the possible explanations according to this doctor were that the varicocele was too small at that time or had developed after our son was conceived (about 4 years ago). Mind you, all this was said without looking at any semen analysis. In fact, this doctor did not even suggest any semen analysis to be done prior to the surgery to find out if the sperm parameter’s were even affected by this varicocele. We had a bad feeling from this doctor – much the feeling you get from people who make way more money than they need to and still are greedy hawks. Just wanting to take advantage or people who are in a bad situation medically – I mean did he seriously not make enough money being one of the top Urologists at that hospital? All he wanted was to make some money from a surgery and not give any honest advice. I’m so glad we decided to get a second opinion from a REAL doctor. My husband chucked the Clomid prescription and started searching for another Urologist. He got an appointment for December 2014.
In the mean time my hubby’s appointment with the Endocrinologist had come up. When he met the Endocrinologist, he assured my husband that it did not seem like anything was wrong with him and suggested that he get a semen analysis done. Finally, he gained the strength to get a semen analysis done. It seemed extremely weird and demeaning to have to ejaculate in cup, put himself on the spot and get his soldiers tested, but it had to be done to get rid of this mental stress and agitation. As soon as my husband came out after the devastating experience of ejaculating in a cup – he was again super freaked out that his semen volume was very low and so on and so forth. He kept researching the internet online once again and coming up with all sorts of negative results in his mind.
Then, came the much awaited Urologist # 2’s appointment. A very well renowned Urologist indeed. When she read the semen analysis, she told my husband that his results were off the charts. He had an extremely high sperm count. The Urologist ordered another semen analysis from her lab with a more strict criteria for checking sperm and this time the results were even better. She told my husband that the varicocele had not impacted his sperm parameters at all and hence did not recommend any corrective surgery since the varicocele was not bothering him at all. What a sigh of relief that was. The Urologist also suggested that I get tested to check if there might be a problem on my side which was preventing pregnancy from occurring.

Life is not fair…

Who said life was fair? As a kid, I believed in God, religion, morality – especially karma. It just made sense to me. If you are a good person you will be rewarded for it whereas bad behavior by you will be punished. But somehow my recent life experiences have perplexed me and my simple belief in life’s perfect balance of good and bad doesn’t seem to hold true, at least not for me.
For starters, why do I have to start writing an infertility blog in my twenties? The years which are considered to be the most fertile for most women are the years I have to suffer from infertility for medical reasons that only a woman in her late thirties would suffer from. What can I say…it looks like my ovaries are aging way faster than my numerical age.

Let me start by telling you my life story – I was a good little girl. I did everything on time. Graduated at 23, worked for a consulting firm in Chicago for a year. I was a virgin – got married at the age of 24 and got pregnant the second month after we got married. 9 months later – on the exact due date told by my doctor, my son was delivered. That’s how perfect my first pregnancy was. An unplanned but completely normal, zero risk pregnancy and delivery.

I still remember the first and ONLY time I got pregnant. It was completely unplanned. A sudden shock rather disappointment for me at the time since I thought I was a highly fertile 24 year old who could reproduce at will. I mean we had barely been married for 2 months. Had sex a handful of times and there I was – pregnant. How embarrassing I kept thinking at the time. – How would I tell all my friends we were stupid enough not to use any birth control. Now of course I think – how lucky! Oh…how time changes you and your definition of good luck and bad luck.
I had always wanted to wait at least a year before trying for my first child. Get to know my husband, spend some time by ourselves – just the two of us and then jump onto the journey to parenthood. There’s nothing wrong with that, I keep telling myself. It’s OKAY to want things in life a certain way. I wasn’t a sinner by wanting that. I’m not going to lie, I was very thankless the first time I got pregnant. It didn’t fit into my above mentioned life plan. I had even considered aborting the child because at that time for me reproduction was as easy as shitting every morning. Little did I know what life in store for me in a mere 4 years to follow. Anyway, as shocked as my husband was too at my sudden pregnancy, he was adamant we keep this child. In hindsight, this was the best decision someone ever made for me.
Then how did I get here – to a situation where I’m 29 and deemed infertile by doctors all over. Most infertility blogs I read online are by 30 somethings, rather 35 to 40 somethings. Women who followed their dreams, or married late until they found Mr. Right or were busy in pursuit of their careers – all valid reasons for starting a family a little late for a woman – from a biological standpoint, and hence the possibility of suffering from short or long term infertility. But what did I do wrong according to my biological clock – or at least the biological clock that 99% of women follow?
Why did I out of all had to have a coincidental pregnancy at age 24 to be given the false illusion that I am a highly fertile 20 something who could have a second child whenever I decided much like every other woman I know of my age?
The time I was pregnant I was just getting to know my husband. The first two years after my son was born, I was so busy with him (especially due to my husband’s busy work schedule during that time) that I did not even consider having another kid. My husband on the other hand had started trying to convince me to try for another child once my son was two years old. A decision I wish I had agreed upon. But due to normal ups and downs in our relationship during that time, I did not consider that at all. For starters, I really wanted my husband to give more time to the one offspring that we did have. Also, I was trying to convince him to start looking into getting a house if we were looking into expanding our family especially since he had enough savings to pay off the house. Bear in mind, that all this time I was thinking that I AM in control of my fertility. I will choose when I want to have my second child so I can call the shots. My first pregnancy was unplanned. But this time – now it was all up to me. Now, I was going to decide when I wanted to have my second child. Oh, how empowering it felt – I WISH I could have that feeling again.
I didn’t have a job outside of home, since I got married. As much of a shock as it was to be pregnant right away, once the reality sank in, I knew I wanted to be a stay at home mom. I had always wanted to be home with my kids (or kid if that is God’s will) when they were younger. I did not want to outsource the partial job of mom to a babysitter, although there is nothing wrong with that at all. It was just not in my plan. My husband never agreed to getting a house. Instead he decided to invest his money in purchasing an apartment and renting it out. I agreed. It was his money (sort of) and he could do as he pleased. I did not want to fight any further over having a house.
Around the time my son was about to turn three, I decided whatever our minor differences, house or no house, we had to start looking into having another baby and a sibling for my son. They would already by three and a half to four years apart in age. I had never wanted my kids to have a big age difference. A mistake my parents had made and one that my father (may his soul RIP) always guided me against. I have two older brothers. My older brother is 8 years older than me and my oldest brother is another 6 years older than him – making it a 14 year age gap between me and my oldest brother. That’s a lot! He was almost like a father to me, especially since my father worked in the merchant navy and was away on ships and oil tankers for as much as 6 months in a row.