This is Part Two of our fertility journey. See Part One HERE.
OCTOBER 2020 — THE INITIAL CONSULT WITH OUR FERTILITY DOCTOR
In October 2020, we went in for our initial meeting with our fertility doctor, Dr. McCarthy at IVFMD in their Jupiter office. By the time the appointment came, I was actually looking forward to doing it and just getting some answers.
The main question was: Is there an “issue” or is it just a matter of us giving it more time?
By now, it had been 10 months of trying with one chemical pregnancy back in March (read more about that in Part One).
Ryan and I sat with Dr. McCarthy as she went through the thick manilla folder that I had brought with all of our previous testing. She flipped through, asked us a bunch of questions, and then said,
“I’m actually surprised you guys aren’t pregnant yet. Let’s go do a quick exam and see if we’re missing something.”
She took us into an exam room and proceeded to do a transvaginal ultrasound which I had done a few of before. I figured she would have the same findings, that everything was normal.
She looked around and everything looked fine but then she did something different that nobody had done before…
She counted my follicles. Also known as your “Antral Follicular Count”.
I didn’t even know what this was at the time!
After counting my follicles on each ovary, right and left, she shut the machine off and looked at me very seriously.
She told me that I had a little more than half the amount of follicles she would expect for someone my age. She explained that every month, when you go to ovulate, each of your follicles brings up a potential egg. The eggs all compete with each other like “the hunger games” to see which is the best egg, and the best egg gets picked to ovulate. If you have less follicles to begin with, that means less potential eggs are competing, and the one that gets picked is less likely to be a star, healthy egg. And without a healthy egg, you can’t have a healthy pregnancy.
My heart sank when she told me this, mostly because I felt broken.
I felt old. I felt like my body was ageing from the inside faster than it should be. I felt the opposite of youthful and fruitful and fertile. I felt like there was something wrong with me.
We asked her what we could do to improve this, and she said she’s seen amazing results with acupuncture, and recommended the acupuncturist who I ended up going to.
She wanted me to do a couple more standard tests the following week, and then we would reconvene to figure out “a plan”.
We came home, and I lost it. I’ll never forget this moment, finding out the first thing was “wrong with me”.
I felt like I let Ryan down — that he had married an unfertile woman who was ageing on the inside inappropriately and who wouldn’t be able to give him children. I felt angry at my body. I felt ashamed. I felt hopeless that I would be able to achieve our vision of having a family. In that moment, I truly questioned if I would be able to have my own children.
Looking back, it was all very dramatic. But in the moment, when you’re told something is wrong with you and you have no idea what your options are or what to do, it’s scary and heartbreaking.
After having my initial breakdown, I started to wrap my head around things. Ryan and our families were more than reassuring that we were going to be okay. It’s not like I had NO follicles. I still had a decent amount. Plus, they can fluctuate each cycle. And… it only takes ONE egg to make a baby. ONE. Maybe I didn’t have a ton competing each cycle, but was still ovulating every cycle, I was healthy, and all it takes is one egg. I was trying to find hope again…
THE SALINE SONOGRAM (SIS)
The next standard test they have you do is called a Saline Sonogram where they insert a tiny catheter into your uterus and administer saline to examine your uterus.
Dr. McCarthy performed this on me the week after our initial consultation, and honestly, it was painless, quick and not a big deal in my experience.
As she inserts the saline into your uterus, it shows on the screen all the aspects of your uterus — they check the shape, contours, and they check for any polyps or abnormalities.
Everything on mine looked good except I did have a few polyps. They were small, but there were several. I thought it was interesting that these did NOT show up on the transvaginal ultrasounds I had previously had… which I think is important to note. They must have been so small that they didn’t show up there, but were only noticeable in the SIS.
Dr. McCarthy said “The polyps are likely preventing implantation. But, if this is the biggest of your issues, this is extremely easy to fix. Let’s hope this is it!”.
I left that meeting feeling fine — I know lots of people who have had polyps (it’s extremely common) and knew it was a very easy procedure to remove them.
Plus, if they were preventing implantation, that would explain why we weren’t getting pregnant! And it would be an easy fix.
One more test to go and then we’d come up with our plan…
THE HSG TEST (FALLOPIAN TUBE TEST)
The last standard test is called the HSG where they test if your tubes are open. This test gets a bad reputation for being painful, as they again put a catheter in you and push dye through your tubes to see if the dye openly flows through.
For me, it wasn’t that painful, just uncomfortable. But it’s pretty quick, and you get to see everything on the screen which is cool!
My doctor wasn’t available on the date I wanted to do this test, so I booked it with the other doctor in the practice.
I knew that the chances of my tubes being blocked was extremely rare given I had no risk factors, plus after finding something “wrong with me” at the other appointments, I figured at least one appointment would go well. I wasn’t really nervous about this one and assumed I was fine…
I laid on a table as she got everything hooked up and then we watched the dye start to flow through my tubes.
The right side cleared.
The left side appeared stuck.
She pushed the dye a bit harder, adding pressure. Still stuck. Pushed a bit more, still stuck.
After a few minutes, she turned it all off and said “your left tube appears to be blocked”.
I asked a rush of questions, but because she wasn’t my doctor, she was pretty vague, and told me that Dr. McCarthy would follow up with more information.
I left, feeling so defeated. Crying.
3 out of 3 appointments all showed something was wrong. It was one thing after the next after the next. I felt like I couldn’t catch a break.
I came home and once again tried to process what this all meant.
My natural process is typically → go to the worst case scenario → feel how shitty it all is → and then after I’ve fully gone into it, I naturally start to align more with hope → I start to find the silver lining → I start to align more with possibility
After a long dark day, I remember saying to my Dad that night, “I’m going to be a woman who gets pregnant with one fallopian tube!”
While digesting all of this news was so so hard, I somehow believed that all of these things were happening for a reason, and there was still a place within me that believed in my own fertility and ability to become a mom, somehow and some way.
THE CANCER SCARE
But, I wasn’t done yet…
A couple of days after getting the HSG test, I woke up with a fever. They do put you on antibiotics when you get the SIS and HSG, just in case of infection, and I was on my last day of antibiotics when I got the fever.
Over the weekend, it got worse and spiked to 103 on a Sunday. I had been in touch with our fertility doctor, because we weren’t sure if it was related to the HSG test, and when they heard my fever was 103 they asked me to go to the ER (because it was a Sunday).
I felt SO SICK, and going to the ER was the absolute last thing I wanted to do, but we went. After a couple hours there, they didn’t find anything to be seriously wrong, so just said to watch my fever for the next couple of days.
The next day, I went in to see Dr. McCarthy who did a pelvic exam to make sure it wasn’t a pelvic infection, and didn’t find anything either.
After a few more days, things finally started to clear up and to this day, we aren’t sure why I got so sick. My theory is that I did have some sort of reaction to the HSG, potentially from the dye, but who knows.
The last part of the fertility check-up was to do a full blood panel.
Since I was sick, we put this off a week until I felt better, but then did the blood panel.
A few days later, it was 5pm on a Monday and I had just had my first GREAT day in a while — I was feeling better and way more like myself.
My doctor called, and it was actually Dr. McCarthy, not a nurse.
Immediately, I knew this wasn’t good.
She told me that they just got my blood panel back and there were a few markers that alarmed her — my immature white blood cell count and my liver enzymes.
She said that these heightened numbers could indicate leukemia or lymphoma.
Ummm, whhhhat? I couldn’t believe what I was hearing.
Do you actually think that I could have leukemia?
She said, “it’s definitely one of the things I’m concerned about.”
What happened after that is such a whirlwind. She told me she had already spoken to an oncology hematologist who wanted me to get a more advanced blood test done the next day to specifically test for leukemia and lymphoma, and was then going to see me as soon as those results came back, in about a week.
She said, “I don’t want you to be thrown off guard — the place you’re going to is going to say ‘Cancer Center’ on it, but we are not saying you have cancer, we just need to figure out what this is about.”
When I got off the phone, I went in to tell my mom and she was shocked.
But, the worst part of it all was telling Ryan when he got home.
There is one thing to digest the news on your own, and another to have to tell the person you love more than anything this kind of news. I will never forget Ryan’s face as I told him. It absolutely broke my heart to see the shock and fear come over him.
Those next few days, I’ve never felt closer to Ryan or more in love with him. When faced with the possibility of something really bad happening, all of the bullshit instantly drops away and the love you have for each other feels overwhelming.
Our families were so scared as we navigated the next week — the appointments, contacting different doctors for different opinions, the tests, etc.
It was one of the hardest weeks of my entire life to get through.
And a week later, we got the call… everything was fine. My numbers were likely elevated because I had just been sick, but I did not have leukemia or lymphoma. They wanted me to go back in and retest those levels a couple more times, but they were very reassuring that everything seemed to be okay.
THE GREATEST LESSON I LEARNED FROM THE CANCER SCARE
The week from hell that I was waiting on these results, I kept asking life — why is this happening?
And within the gripping fear and anxiety of the week, there was one really shiny gem:
It gave me so much perspective on my life. When thinking that there was a possibility that I might be too sick to even consider having a child, or that I could even die, it suddenly felt like a PRIVILEGE to be able to try to have a child, no matter how I got there. No matter what I needed to do.
I no longer cared if I had to do IVF. If I had to go through years of trying to have a child. At least I would be healthy enough to be ABLE to try, and that was a gift.
The week we found out that I was okay, was also Thanksgiving. Never have I felt so grateful in my life.
CONFIRMING OUR ‘PLAN’ TO MOVE FORWARD
After Thanksgiving, after coming down from the shit show that was the last few months, we met with Dr. McCarthy to finally go over our plan. Now that we had all the information, it was time to figure out how to move forward.
Essentially, Dr. McCarthy explained that the biggest thing we needed to do was remove my blocked fallopian tube, as keeping an “infected” tube inside of you was no good and could cause a whole host of fertility issues.
AND, when you remove a tube, there is a 10% chance that it will negatively impact your ovarian reserve.
Because my ovarian reserve was “borderline” given my follicle count was on the lower side and my AMH (neither of them terribly low, but on the lower end), she was concerned about removing my tube without banking any embryos first.
She said, “if you were trying to have one kid, I’d say let’s just remove the tube and the polyps, and then you can try naturally and I’m sure you’ll be fine. But since you want at least two kids, I would encourage you to try to bank some embryos BEFORE we remove the tube, in case removing the tube lowers your ovarian reserve.”
I said to her, “do you really think we can have two or three kids if we go this route (meaning IVF)?”
And she said yes.
For us, the idea that our dream of having two to three kids could really happen for us restored so much hope in us. It was as if I had started to convince myself that my dream was no longer possible and that I had to let go of it, and now it was being restored. It was the best feeling, feeling hopeful again.
After a lot of conversation about our options, we decided that in the new year, we’d move forward with IVF, going into our first retrieval round.
Months prior, if you had asked me how I’d feel about doing IVF, I would have told you I dreaded hearing from a doctor that we should go that route. I dreaded hearing the letters “IVF”. But at this point, after everything we went through, and after letting it all settle, I actually felt so much peace with it. It felt right to do this — it would ultimately give us security to have embryos in the bank and to know we were working toward the family we wanted. And after having such a rough few months, I knew I could handle anything. I felt stronger than ever and ready to take some steps forward.
Some lessons + advice from this phase:
- As you go through the various tests, and find things out about your body, remember to take every number and every result with a grain of salt. As you’ll see in the next part of our story, these numbers and test results only told part of the story, and ultimately didn’t hold us back the way we thought they would. It’s easy to get caught up in the science of it all, but remember that your body is always changing, and that fertility and making babies has way more magic to it than just science and numbers.
- Thankfully, we live in a time when there is so much that can be done to help us get pregnant if we present with various “issues”. Remember that there are always steps that can be taken no matter what you may find out about your own fertility.
- This phase was by far the most emotional for me. It triggered a lot of fears I had around my body and my own fertility, and was a lot to work through internally. If it feels similar for you, know that you are not alone. This is deeply personal. It can feel scary. It can feel incredibly overwhelming. It can be extremely sensitive, as a woman, to find certain things out about your fertility. Give yourself grace, love, and a lot of deep breaths. Hold yourself in your fears and your grief and your pain. Talk to someone to help you process everything. Know that you are not alone. I love you.
- Don’t do your bloodwork anywhere close to when you were just sick 🙂 Spare yourself what I went through, lol!
In Part Three I’ll cover our actual fertility treatments — from our retrieval round to our transfer, to getting pregnant. Stay tuned!
P.S. On December 1st, I am running a FREE Fertility Community Call with 3 of my friends who have all been through their own fertility journeys. This is going to be an intimate virtual gathering for women to come together who are on this path. We’d love to have you join us if you’d like! You can read more details + sign up here.