IUI #1 - cancelled

A few weeks ago (beginning of October) we were finally ready to start the process of our first (and I was hoping only) IUI -- after 2 months of healing post-surgery and another cycle where we were supposed to be traveling during the key dates.

I was so excited -- and really anxious at the same time. Seems so silly now, especially since we've been trying for so long! But in some ways I feel like I've gotten used to trying and coming up empty, so the thought of actually getting pregnant was scary. As was the needle that I would have to jab myself with to induce ovulation if all went according to plan. And, of course, I am such a spaz with the "what if" thinking far ahead into the future: what if I did get pregnant? What if I lose the pregnancy? What if I have to go on bed rest really early and can't work? What if I have the baby early and it's in the NICU, has problems, etc...

I know I am like this and it doesn't help anything, but I am who I am.

Anyway, all my stress last month was for nothing. I took the Clomid as directed (hello, hot flashes!) and went I went back for the follow-up ultrasound, my biggest follicle (22mm) -- all ready for ovulation and everything -- was on the unconnected side. So, no dice on the IUI. The good news? At least my right side was making follicles! There were two on that side (13 and 14 mm), but they just weren't big enough to move forward.

In some twisted ways I felt relief, but mostly I felt acute, stinging disappointment. And envy. Why is it so easy for people who do not even want to get pregnant to do so? Or even worse -- why do people I think would be worse parents than we would get pregnant so easily? They don't deserve it! Awful, judging, jealous thoughts. But they only lasted a few minutes, and then I moved on to the next round.

You're sticking what in there?! (aka: infertility testing)

Joe and I went to our first infertility consultation with Dr. B, armed with all of my ovulation charts for the past 8ish months, questions, and lots of nerves. Well, lots of nerves on my part anyway -- my practical husband said there's nothing to be nervous about! Let's just see what the doctor says. There's probably nothing wrong! My intuition told me otherwise, but I am trying to be better about listening to the practical.

So we sat down and met with him. He always puts me at ease, which is so nice. We explained how long we've been trying and showed him my charts (to which he said: beautiful!). He advised that we go through a cycle's worth of various infertility tests to see if anything was identifiable, then gave us a packet of information on testing and infertility as well as a "welcome to our practice" folder with all kinds of stuff in it. (The coolest thing, I think, is the peer support program, where you are matched up with someone who's gone through all of this before. I love social support.)

Leaving that appointment, the strangest thing for me was when I got up to the front desk to check out. I handed my folder to the check-out person, and she looked at someone else and said, "oh, she's an infertility patient now." It was like being punched in the stomach. I've gone to this practice for so long for regular gynecologic care, and I knew in the back of my mind that we were possibly dealing with infertility, but hearing it out loud was like a slap in the face. I was really surprised at my reaction to hearing it.

A timeline of infertility testing events:

• April, 2010: baseline bloodwork (estrogen, FSH, progesterone, etc.); semen analysis for Joe (probably his favorite event ever - ha! But that's not my story to tell); and an HSG. HSG performed by another doctor in the practice. Not as painful as I'd heard it could be, but certainly not my favorite test, I have to tell you -- but I can't imagine that it is anyone's favorite. The doctor that performed it was also not my favorite, but I had no choice if I wanted it done in April. He did the test, and said at the end "looks like you have a unicornuate uterus." Um, what? What the hell is that? Then proceeded, fairly nonchalantly, to tell me that the biggest problem was possible pre-term labor and that my doctor might want to do additional tests. Going into the test, I was afraid I'd had blocked fallopian tubes or something -- not a UU. Though, of course, how would I have been anxious about that? I didn't even know it existed.
  
• April, 2010, post-HSG: major freak-out. Called Joe on the way home and cried. Got home, immediately sat down, and googled unicornuate uterus. Reviewed some of the published stuff on it. MAJOR freak out. It was the worst possible thing I could do, but I am trained as a researcher (in public health, no less), and just couldn't not look into it. All of the outcomes were frightening, especially since maternal and child health fights constantly against so many of them, especially pre-term labor. Continued to be seriously stressed about it until our meeting with the doctor. Joe and I were able to find some humor in the situation, and started calling it my "banana uterus" (and laughed every time).
  
• May 21, 2010 (my 30th birthday!): second consultation with Dr. B. After some confusion with the HSG report, wherein I had to tell him that the other doctor saw a UU, he told us that everything else looks normal (yay!) and that I'd have to have additional testing to determine if I had a UU or something else. He was pretty convinced it was not a UU. What a way to spend my 30th birthday, right?
• June, 2010: had a saline infusion sonogram. Found a fibroid, couldn't definitively confirm the UU (doctor still not convinced it was there), and recommended lap/hyst surgery. Another freak-out on my part, of course -- I've never had surgery before! And what else could be wrong?
  
• July 6, 2010: surgery day! No complications. When I was in recovery, my poor husband came in looking so scared. When I asked him what the doctor found, he was so hesitant to tell me. I must have seriously scared him with the previous freak-outs. He eventually told me that the fibroid was successfully removed, but that I did have a UU. I think he was expecting fireworks, but at that point I think I knew what the deal was and I had prepared myself. The good news -- as I saw on the video of my surgery (!), I have both ovaries (though the left one doesn't connect to my uterus), and given the bloodwork results, at least one of them is working. I also learned later that I do have both kidneys. Woohoo!
  

I think through all of the testing and surgery, not knowing, and imagining all of the horrible outcomes, was the worst. It's hard enough to have difficulty getting pregnant, which is so incredibly frustrating in and of itself, but even worse to know that once I do get pregnant, the risk of something bad happening is a lot higher because of my banana uterus. Sometimes I just want to call the whole thing off and adopt or go the surrogacy route, just to avoid the heartbreak that possibly losing a baby would entail. But we haven't scratched the surface of treatment possibilities yet, so we're going that route! Fingers crossed for some good news in the near future.

The beginning: trying and trying

The process of trying to conceive, learning about my unicornuate uterus, and all the rest of it has been stressful and frustrating. I've gotten tremendous comfort and support through reading the experiences of and becoming online friends with other women who have this condition and are going through the same things -- some of whom have successfully had multiple children! This blog is to journal my own experiences and share them with others who might get that same kind of comfort from me.

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I guess the best thing I can do is start at the beginning -- of the baby-making process, at least. I went off birth control in February 2009, and we started trying to conceive in the spring of 2009. It started off relaxed enough -- not charting or monitoring anything. After a couple of months of that, with no luck, I started charting my cycles. Things looked good to me, and our timing seemed good -- but still no luck. After a month or two of that, I started using OPKs in conjunction with the charting to make sure I was actually ovulating. Again, nada.

In the midst of all of this, my dad was diagnosed with cancer in July and passed away in December, 2009. It was fast, somewhat unexpected, and incredibly, ridiculously stressful and emotional. I was very close to my dad and everything that he went through was very hard on our entire family. In addition to my normal levels of stress with being a doctoral candidate and trying to do my research, working, and teaching, I figured the added stress of my dad's illness and passing had something to do with our inability to conceive -- and, of course, trying took a backseat during that horrible time.

However, in April 2010, after continuing to try without any luck, we decided to undergo fertility testing to see if something was wrong. I just had a gut feeling that something was off, given my good charts, OPKs, and timing. Luckily, my regular gynecologist, who I've gone to for years, happens to be a reproductive endocrinologist with one of the best teams in Florida. This meant getting in to see him within a week of my phone call, which would not have happened otherwise.

Soon to be continued... :)