This is part two of our most recent infertility update. Please make sure you read part one so that we’re all on the same page before starting this part. If, at any time, you get confused, please make sure to go back to part one before asking questions (in case I already answered them).
This infertility update is a little different from my other infertility updates. I am not as emotional this cycle, so I wanted to do a comprehensive and logistical/informational update. This post is going to be about our infertility testing and get you caught up on the events that have occurred up to this point. It is going to be long, and there will be a lot of links to previous updates and Instagram posts so that you can get more details about certain parts.
Part three, and the final part, is where I will go into detail about our testing and treatments. Once it is published, it will be linked here.
I am not a doctor. This post is not medical advice. Do not change any aspect of your healthcare, without consulting any of your medical team, due to the content of this post. If this disclaimer is ignored, I cannot be held liable for any harm you may cause yourself.
The Beginning of Infertility
We started trying to conceive July 30, 2017. (All cycle dates are for cycle day 1 – CD1 – unless otherwise noted.) As I said in part one, I didn’t get any positive ovulation tests. I was also tracking other signs of ovulation that Ovia (my tracking app) said to track; I have never tracked my basal body temperature because my dysautonomia has caused my body temperature to be an unreliable indicator of anything. After about seven cycles, I went to my [old] gynecologist (also an obstetrician) and said I was concerned. It takes the average couple trying to conceive about six cycles (if they are timing intercourse properly). We were timing everything as correctly as possible, given that I wasn’t getting positive tests (without positive tests, we were going based solely on when Ovia said I should be fertile based on cycle length).
My [old] OBGYN wasn’t concerned and didn’t believe I wasn’t ovulating since my cycle was still regular – I could tell you when my period would start within a day or two. I’m wondering if something was preventing my body from properly producing LH or FSH, but we may never know since those were never tested. Since I was concerned, however, she decided to order an HSG and semen analysis before doing anything else. My prolactin level had been checked (and came back normal) when I had gone in to have a pre-conception consultation in February 2018. The doctor did recommend waiting until it had been closer to a year before we did the testing because it tends to be expensive.
After getting the testing, she said she could give me Clomid and progesterone. Unfortunately, I’m allergic to peanut oil and couldn’t use the progesterone she prescribed – turns out all the progesterone you get from a standard pharmacy is combined with peanut oil. Communication with the office was awful, as well. I decided to find a new OBGYN and used an OTC progesterone cream during the two Clomid cycles.
During this process, my mental health was taking a serious toll. I felt like no one was truly helping me, and I needed help. The weight of the process was entirely on my shoulders, as Dan was too busy with grad school and work to do anything else. Each negative test brought tears, confusion, and crippling depression.
I saw a new OBGYN, and she gave us the official “unexplained infertility” diagnosis. Together, we decided to finish trying the two cycles of Clomid my old OBGYN had prescribed, and my new OBGYN was okay with the progesterone cream I was using. Getting the diagnosis of unexplained infertility is where the story gets more interesting.
My new OBGYN decided to do some more testing. We had the results of my HSG and Dan’s semen analysis, and my old prolactin test, but that was it. She wanted me to get some other testing, and then she also wanted me to go to a fertility clinic for a consult. That consult did not go well, but I left with an even longer list of testing. That fertility clinic had done some testing, a resting follicle count ultrasound and an AMH level, but no one ever was able to get a hold of the resting follicle count, so we have no idea what happened to it. (I also never received a bill for it, so it seems they never put it into their system?) Thankfully, my OBGYN (which is now just “OBGYN” and not “new”) was willing to order the tests so that I didn’t need to return to the clinic.
We decided to go to a different fertility clinic for a consult. That consult was a night-and-day difference from the first clinic we had gone to! They decided to do a bunch of testing to get a better handle on what my body was or wasn’t doing. The test results, which I will go into detail about in part three, showed that my body wasn’t functioning properly. Because of that, I ended up leaving the clinic with a long list of supplements to start.
While reviewing our records again, in conjunction with the new test results, they noticed that Dan’s counts were markedly different between the semen analysis and the analysis they do with a sperm wash (for the IUI). I realized there was a negative correlation between Dan’s stress levels and his counts. When he was on summer break from graduate school, his counts were amazing; while he was in graduate school (and therefore sleep deprived and extremely stressed), his counts reduced to be less than 1/2 of what they were over the summer. Technically, the stress counts were still “good” but the decline concerned the doctor. Because of the decline, he was put on a bunch of supplements, as well.
Because of all the test results, we actually believe that we no longer fall into the “unexplained infertility” category. As you will see in part three of this post, the test results showed that I have multiple hormone abnormalities. We believe that the diagnosis is now “diminished ovarian reserve.” Having answers, while they’re not what we wanted, has been amazing! I’m so incredibly glad we switched to a clinic that desperately wanted to find answers and do whatever they could to get me pregnant! The first clinic we went to pushed IVF and was discouraging us from trying other methods first. This new clinic seems hopeful that we won’t ever require IVF.
Be sure to check out part three, coming next Monday, for the details of our testing and treatments!