Val (USA): Our infertility story of IUI, IVF and PGS testing.
Our story starts out like most. My husband and I started dating when we were in high school: typical jock and cheerleader, I laugh when I think back about it. We were 16 at the time with the whole world ahead of us. We waited until we were 26 (yes, 10 years later) before we got married. Graduated college; him for firefighting, me for nursing, and we bought our first car and house together. To us, we had checked off everything on our "let's be adults" list with the exception of a baby.
We went to the dreaded "why aren't we getting pregnant naturally" appointment with my then-regular GYN. I had never been on birth control and my periods were always irregular. Looking back, I find it unusual that I never worried about getting pregnant before; it's not like we were being "careful." It just wasn't something that we had been necessarily trying for but not preventing either. Anyways, we were told to start Provera to jump start a regular period cycle and then we started our first round of Clomid. Nothing. We tried the same cycle for three months; after the third month, we met with the doctor who suggested that we switch to Letrozole, as it worked the same as Clomid, just with a little more *umph*. Same thing, three months of cycles....nothing. Then came the "I think we need to send you to a specialist."
My husband and I were sent to a reproductive center, the name of which I will leave out at this time because of my following not-so-nice comments. Our very first consult we spent $400+ for a nurse practitioner to go over reproduction with us. We were scheduled for testing for each of us. My husband did his sperm analysis and I had a saline sonogram and ultrasound to look at my uterus and ovaries. I remember receiving the call with our results. Joe's sperm analysis came back completely normal. His little swimmers were gold! I, on the other hand, was diagnosed with PCOS, Endometriosis and Atypical hyperplasia. I was given a 1 in 10 chance of conceiving on our own. With that, our nurse practitioner asked us to come back so I could have what would be the first of many D&Cs.
Now this is where my story gets a little eerie. We had absolutely NO, none, zip, zero fertility treatments here. After my first D&C I had to wait six weeks and was told that we had to do another, then another. Three total D&Cs and then I was told that I would need to see an Oncologist for my hyperplasia because it looked cancerous.
At that time, I was done; I wanted to find someone else. I wanted to hear some other answer than what we received. My husband was so supportive and we had friends that had done fertility treatments with doctors at KU Medical Center. I called and asked for a consult with a doctor that my friend had recommended. The first time I met Dr. Holoch, I knew it was a hit. She answered all of our questions and explained that a consult with a GYN Oncologist was not a bad idea. So there we were, on to another specialist. We had one last D&C and were discharged to start any fertility treatments after the six weeks for recovery. No cancer seen.
Back to our fertility doctor at KU we went. A two-hour drive to Kansas City in hopes of good news. I was so excited we were here: we had come so far and this was finally it. We were scheduled for our first IUI. I did all the usual "research", i.e. I read basically everything on Pinterest to make this successful! Haha I know, I know but I really just wanted some behind-the-scenes type of information before we started anything official. I had an ultrasound shortly after my cycle had started to see if I had any growing follicles. We needed a follicle equal or bigger to 16. Our first scan was at 10, three days later 13, three days later 15. Once we hit 15 we were stuck. We had two more scans and my follicle stopped growing. My doctor allowed us to do a trigger shot (Ovidrel) and continue with our scheduled IUI. I remember how excited we were driving up there. I was so sure this would work.
IUI (intrauterine insemination) is such a fast procedure and I think that is one thing that I underestimated. I think I expected some kind of grand finale to happen or some musical-like scene whilst they inseminated me. I walked in thinking how everyone in the waiting room, all the nurses, even the guy emptying the trash, should be excited for us. Let's just say that is not at all how it went. We checked in, Joe was called back to do "his part", we waited for about an hour for them to spin it and collect the good sperm, then we were called back to the room where our nurse Jenn placed a speculum and then proceeded to inject my husband's sperm into me. I was told to continue to lie down for thirty minutes then could get up and go about my day as normal. Even with the IUI you have that dreaded Two Week Wait. The first time was hard but that's expected. Literally two weeks after our first IUI, aunt flow (AF) came. My heart was broken. I felt like I did everything I could to ensure that this would work and we had our big fat NEGATIVE. Our second IUI, I had bleeding a week afterward and then full-blown period so that wait wasn't as difficult, just sad that it didn't work.
Joe and I talked for several weeks following our two negative attempts at IUIs. We went back and forth on our next options. Our doctor advised us that we could make another attempt at an IUI or start taking steps to IVF. To me, IVF was such a scary thought. I knew friends that had gone through the experience and I remembered how many shots they were getting and the money they were spending. On our salary, there was no way we would be able to afford the treatments, medications, two hour drives up there and the time we would need off from work. I was scared this was the end. I was scared I would never be able to birth a child of my own or make my husband the amazing father I knew he would be.
We finally came to the acceptance that IVF was the path we NEEDED to take. We were bringing out the big guns. We once again met with our doctor and went over our IVF packet. It was a booklet of things we needed to know about the IVF process, a list of medications that we would be using and the cost. The total cost of IVF was $13,750 without PGS testing. If we wanted PGS (genetic) testing it would be an extra $2,500. This amount would cover the cost of ultrasounds, office visits, lab tests, 1 single egg retrieval and 1 single transfer, NONE of this included the cost of medications. The packet that we received had CAPEX loan information for those seeking to become pregnant and were receiving treatments. Naturally, because the total cost of IVF was half the price of my annual income, we filled out the loan information and waited to hear if we were approved. Because of my family history, we decided to also go through with PGS testing. We knew this would increase the cost of IVF but we wanted to make sure that we threw everything we had at this. My younger brother has down syndrome, and because of this our doctor advised us to go through with PGS. We were also told that most pregnancies end up in miscarriage due to some abnormality with the fetus. We prayed and waited for weeks. Once our approval came through and we signed our consent forms we were scheduled for our first baseline sonogram to see how many follicles we were working with.
Everything went according to plan. We started STIMS, we had a total of 22 eggs retrieved. With those 22 eggs, 13 were fertilized. Every third day we were updated on their survival. Each day they decreased, 13 to 9 to 5 to 4. After 2 weeks we were called by an Embrologist from the clinic where our PGS took place. Our final count for embryos was 3. It seemed like such a low number, but I had to remain hopeful. This gave us three chances at our future to become parents.
With this sliver of light at the end of the tunnel, we were scheduled for our very first transfer. Progesterone in oil and Estrace were called out to our choice in pharmacy. I would start Estrace three times daily. If you aren't familiar with these, it's a vaginal pill you insert. Yea, not fun but at this point, you think well we have come this far. Lol. We had two more sonograms to check my lining of my uterus to make sure I was "habitable." After we received the go ahead, I started daily intramuscular injections (on my bottom) of Progesterone in oil (PIO). If you have never had to have these let me just say they are no joke. You can have terrible bruising and knots under your skin. I strongly recommend asking your doctor to use a heat pad or ask if it is OK to rub the area of knots.
My husband and I are scheduled for March 13th, 2018 for our very first transfer. Our first hope at becoming parents of our own baby. I'm scared, nervous, wondering if this will make me a failure if we do not have a successful cycle. IVF is not for the faint of heart. Infertility is a mind game. It's a roller coaster of ups and downs. The most important thing I can stress to anyone going through this is that you are not alone. There is a whole community out there of supportive women and men that are going through the same things. Whether this is your first, third or eighth time trying to conceive, there are so many people out there that want you to succeed, that will follow your journey, that know your pain. Trust your instinct, believe in your body, and have faith that you and your spouse will survive this.
My thoughts and prayers are with anyone going through this. There is a special bond that we all share. Baby dust and sticky embabies to you all!
You can follow Val’s journey on Instagram @val_raygoza0531