miscarriage

 Meet Adriana! She’s a dear college friend who was also my sorority sister! After losing touch and finding each other again on FB, I found out she was struggling with infertility. She had a long, difficult journey but now, she is expecting a little boy in May! Read on for her truly inspiring story!

1. How long did you struggle through infertility?
Almost 2 and a half years. We started trying when I had just turned 29.

2. What did you go through (as far as treatments, different doctors, adoptions agencies, etc.)?

We tried naturally on our own for about 10 months. We saw all of our friends getting pregnant much easier and faster-usually around a 3 month period-so at 10 months we sought the assistance of my OB who sent us to a Urologist to have a sperm test done. The sperm test came back with low motility and we were referred to a Reproductive Endocrinologist. With the RE we went through 2 IUI cycles which were both negative before he suggested we move onto IVF. Surprisingly, my husband’s sperm samples with the RE were all really good so the RE didn’t think that was really the problem, but he said we would know a lot more through IVF.

Before we did the IVF, I had to have a hysteroscopy to remove a polyp. Our first IVF I produced 8 eggs, 5 of them were fertilized but only 3 were viable embryos. We decided to transfer 2 because the 3rd wasn’t really great quality and we were being overly cautious about the risk of multiples. We did get pregnant with our first IVF but miscarried at 8 weeks-we went in one day for an u/s and there was no longer a heartbeat. It was so incredibly devastating as there was no indication there was anything wrong up to that point and we were blown out of the water. I had a D & C and asked the tissue to be tested but either the Dr or the hospital messed up and it was never done. My RE said it didn’t matter-that he would proceed the same way regardless (little did I know how important this would be to our future knowledge). He told me that he suspected that I had low ovarian reserve because I did not stimulate on the medicine the way he expected me to. I found this very difficult to stomach at 29 years of age.

Before our 2nd IVF we learned that my D & C had basically been botched and there was still tissue from the first baby in there so I had to go through a second D & C plus another hysteroscopy to remove another polyp. We finally got to the 2nd IVF-I produced 6 eggs and only 2 fertilized and became viable embryos so we put them both back in. That IVF resulted in a chemical pregnancy. The RE once again blamed this on low ovarian reserve which he said can affect your egg quality. He suggested I take a prescribed supplement of DHEA for 3 months before another IVF attempt in hopes it would help me create more eggs and better quality ones. Around this time I got also some advice from a friend of mine who is a fertility nurse elsewhere and she suggested I start getting some additional bloodwork done-for things like clotting disorders. The RE did not think it necessary and it kinda got put on the back burner because within 1 month of being on DHEA I was pregnant from a natural cycle. That pregnancy only lasted 6 weeks-we knew from the first u/s at 5 weeks that something wasn’t right because the sac was an abnormal shape. Following that last loss I insisted we have additional testing done. To me, the issue was no longer just getting pregnant, but keeping the pregnancy. The RE said he would run the tests because I was asking for them, but that he anticipated that nothing would come of them.

The test results came back that I had high levels of anticardiolipins, phospolipids, something called the PAI-1 gene, and a mutation of MTHFR. The RE didn’t seem to know what do with this information and “put me on hold” from further fertility treatments until I met with a rheumatologist and a hematologist. At about this time, we also started seeking out other opinions from REs-3 of them to be exact. Most of the REs we spoke with agreed with the hematologist that I should be put onto the blood thinner Lovenox the next time we attempted IVF or became pregnant and that we needed to be more aggressive with the fertility meds. We really didn’t gain any useful information from the rheumatologist. Unfortunately during this time period I had restarted the DHEA and had allergic reactions to it which landed me in the ER one night. I immediately stopped everything going into my body (from supplements to prenatal vitamins to herbs from the acupuncturist) until we could figure out what was causing the reaction-hives, heart racing, sunburned face, etc. It took several weeks and investigations with an allergist but finally everyone, with the exception of the RE, agreed it was the DHEA and I should not be on it.

During the break while we were speaking with all of these other Drs-we once again got pregnant naturally, but it resulted in another chemical pregnancy. This was now our 4th consecutive loss and I wanted a good game plan. Our current RE was not willing to change our protocol to be more aggressive and he was still pushing the DHEA despite my reaction to it, so we decided to leave there and try something new. By now we were feeling very bogged down and financially strapped. We explored the idea of PGD/CGH but it was so expensive and there were a minimum # of embryos you needed to produce in order to even test them and given my track record of low stimulation, this didn’t seem like a good option. One of the REs we were consulting with told us that they believed we only had a 20% chance of another IVF being successful with our own eggs. Since we had limited $ to build our family with, we made the difficult decision to proceed with the donor egg process instead. We were about 2 weeks away from putting down a deposit on a donor when we went to have some advance sperm tests done-figuring if we were going to be spending so much money on the donor egg process, let’s be 100% sure we are working with good sperm (we also did the mail-away S.C.S.A. sperm test which looks at sperm DNA). Since the day of that test was 1 day before my missed period and b/c I was trying to keep a close eye on whether I was experiencing more chemical pregnancies or not, I asked them to run a beta-lo and behold it came back that I was pregnant for a 5th time …but this time my HCG levels were very high. 48 hours later they had tripled and 48 hours after that had more than tripled again. I immediately started progesterone inserts, Lovenox injections, Citracal-max and continued with a regimen of baby aspirin, pre-natal vitamin, and Folbee (prescription folic acid). We were monitored for 9 weeks at both Yale & at The Sher Institute in Manhattan (yes-somehow insurance covered u/s at both places which was great-we had 2 u/s a week which made us feel reassured) where I had immediately started receiving monthly IV infusions of Intralipid Therapy. Sher had run a Natural Killer Cells bloodtest on me which indicated I did have elevated levels. Their research shows that Intralipid Therapy (which is basically soybean oil & egg phospholipid) often helps women who have had recurrent pregnancy loss-it confuses natural killer cells from attacking the baby. Finally, both REs released us to an OB who has been treating me along with a perinatologist who specializes in high-risk pregnancies and the hematologist. It appears that somehow we have lucked out-or found the magic concoction of meds with the Lovenox and/or Intralipid-because as I write this we are celebrating that today we are 27 weeks! We are expecting a little boy around May 15th!

3. How did you handle disappointments through your cycles (natural and otherwise) or months of waiting?
The two and a half years that we struggled with infertility was the worst, most difficult time of my life. The waiting was the worst-from the 2 week wait, to the waiting for my levels to drop again after a loss, to waiting to get back into another cycle. It seemed like a constant uphill battle which was just made worse by the fact that everyone else I knew were popping up pregnant with their first or second babies. There were times I was quite bitter and it got to the point where my husband and I had to isolate ourselves a little bit from some of our friends. It wasn’t that we weren’t happy for them but that it was just too hurtful for us to be around their growing families. There were many times I wanted to give up and just run away to a tropical island, but thank goodness for my husband who was constantly trying to keep us moving forward.

4. What were the ‘stress-free’ techniques that you tried that helped you get through the cycle or time (yoga, meditation, acupuncture, support through family, friends & on-line, etc.)?
After our first miscarriage I was fortunate enough to get introduced (through a co-worker of my mother’s who had also struggled with infertility due to PCOS) to my acupuncturist who specialized in women’s fertility. Her knowledge of fertility medications (and how they affect our bodies) and the IVF process in addition to her knowledge of chinese medicine was so helpful. When I spoke with her, I didn’t have to explain anything, she knew what I was talking about and she “got it”. She was, and continues to be, a major source of strength for me. She was one person who always told me, “You can do this-there’s nothing wrong with you-it will happen”. I found acupuncture very relaxing once the needles were in and I truly think that it has had an effect on my fertility and general well-being in the last year I have been going there. I highly recommend acupuncture to someone-whether IVF cycling or not.

I also took Fertile Yoga which was offered free of charge to the community through my first RE office. There I met an amazing Yoga instructor who had dealt with infertility herself for 10 years and since then made it her life’s work to support others going through it. She created a very safe and relaxing environment where I met other women going through the same struggles.
While not always “stress-free” I also got to the point where I opened up to people about what we were going through and as a result found some relief through the support I received in places I didn’t originally expect-in a high school friend of my husband’s, in a college friend of mine who became a fertility nurse who I hadn’t spoken to in years, and in a sorority sister who I was happy to get back in touch with (thank you Krissi!). I also joined an IVF support page on Ivillage as well as the Recurrent Pregnancy Loss group-there. I found more people who knew just what I was going through and I didn’t feel so different or alone.

5. If you could give advice for couples going through infertility now, what would it be?
Learn as much as you can-don’t just go with what the Drs tell you-they don’t know everything!! Talk to different Drs-make sure you are in the right place! You have to learn to be your own advocate! You have to keep having hope! If you are determined-somehow, someway you will have the family you desire-it just may not be in the way or in the time-frame you thought it would be in.
If there is any way I can assist anyone reading this, ask Krissi to connect us- I’d be happy to further share my experiences.

Thanks so much for sharing Adriana! I am so happy for you and can’t wait to meet your little boy!