Timeline

2005: I move across the country for the second time in 18 months and start a new job where I meet someone who will in time become my friend and eventually Life Partner (LP).

2008: I change jobs. New job is very stressful and workplace beguiling at first but extremely toxic beneath that veneer. I stick it out.

2009: The LP and I get engaged. We also talk about maybe having a child. I get a heap of tests done to confirm my fertility and immunization status. My doctor is very supportive and encouraging.

2010: We get hitched. We actively try to conceive. It doesn’t work. My cycles are bananas until I start acupuncture and Traditional Chinese Medicine (TCM).

November 2010: First-ever positive pregnancy test. We are thrilled. My doctor says really cruel crap and forecasts a miscarriage before saying he does no prenatal care so I am on my own. I fire him and wait for my first-ever OB appointment.

December 31, 2010: Trip to ER. Blood tests and physical exam suggest all is well with the pregnancy but an ultrasound is ordered just-in-case.

January 1, 2011: Ultrasound shows no heartbeat or fetal growth consistent with time passed since first ultrasound. Miscarriage #1 diagnosed. Misoprostol (Cytotec) prescribed.

January 13, 2011: hCG levels plateau (do not drop as they should). Ultrasound reveals part of fetal and/or placental tissue (“retained products of conception”) are still attached in my uterus and has blood flowing through it.

January 17, 2011: D and C (dilation and curretage) #1 is performed.

Late January 2011: We tearfully attend OB appointment but a locum is there. She says wait to try to conceive. We ignore her advice and hope the real OB (who is on vacation at the time) is a better fit. And that we have occasion to meet him one day. Under happier circumstances.

February 2011: Another gloriously positive pregnancy test!

March 2011: Loss #2.

June 2011: Surprise! While awaiting IVF appointment, we find ourselves unexpectedly pregnant. Third time was the charm – Yay!

February 2012: Miracle Baby arrives early after I develop severe cholestasis and am called in for emergency induction. My OB is on vacation again since I wasn’t due at this time. The same locum delivers Miracle Baby. I have decided I kind of like her despite her brusque manner and her having told me “things don’t usually go so well when we get these” as I handed her my birth plan before the delivery. In an uncharacteristically zen- like moment I laugh and smile sweetly. That was when I thought she wouldn’t be at my baby’s birth anyway so who cares? Funny how life works. Miracle Baby is healthy and we are all cleared to go home about 18 hours after my first ever vaginal birth – Yay! The LP and I are over the moon. The dog is thrilled (she used to love babies). Until the Miracle Baby cries. Barking ensues. She eventually gets over it. She still loves babies for a while.

Fall 2012: New job! (I decided not to return to work at the home of corporate emotional dysfunction.)

February 2013: Body resumes menstruation and we promptly begin actively trying to conceive again.

March 2013: Pregnancy #4!

April 2013: Miscarriage #3.

May 2013: Pregnancy #5!

June 2013: Miscarriage #4.

July 2013: IVF consult. Plan is made to start IVF cycle in September. RE suggests we try one more time on our own and wishes us luck. I begin weaning Miracle Baby with much heartache.

July 2013: Pregnancy #6!

September 2013: After seeing baby’s heartbeat, baby #6 dies. Miscarriage #5. We are crushed. The third time (v.2) was not the charm. Another part of me has died with this baby. Again my body is not on board with reality so I undergo D and C #2.

October-November 2013: The hell that is waiting for hCG to drop so we can start IVF. I am frequently distraught, prescribed sleeping pills (which don’t work) and offered anti-depressants (which I decline). I somehow muddle through and we tell ourselves that IVF may be our chance to end the cycle of miscarriages.

November-December 2013: Oral contraceptives to prep for IVF. My body hates this drug. I hate this drug.

December-January 2013/14: IVF #1, microdose Lupron (flare) protocol with max dose of pure FSH stims for 9 days. AFC 6 at baseline, 6 follies grew, 5 mature eggs retrieved, 2 fertilized, 1 abnormal. One transferred on day 3 (10-cell, “some” fragmentation).

January 2014: A couple of positive home pregnancy tests (pregnancy #7) then some negative ones. Diagnosis: Biochemical pregnancy. IVF did not end our cycle of miscarriages. We feel lost.

February 2014: Our first BFN in a year – after trying naturally first cycle after IVF (which was admittedly a bit wonky). Follow-up consult with the RE. He insists we stick with the same protocol and gives us a 10% chance of pregnancy (not live birth) if we agree to a re-do. We decline but sign up to do IUI using Puregon and trigger only, same maximum dose of Puregon as with IVF#1, when my next natural cycle begins (Feb. 20/14).

February/March 2014: Puregon 300 units for 5 days, hCG trigger (10,000 units of Pregnyl), TCM herbs and other supplements. One 22 mm follicle (Right) and one 15 mm follicle (Left) immediately before trigger on 18.02.2014. Single IUI with 13.8 million washed, motile sperm (69% speedy boys); original sample 98 million motile boys but only 5% fast motility pre-wash/spin. Pregnancy #8… ends quickly. Chemical pregnancy #2 in 2014. Gutted and questioning the point of it all.

April 2014: We freeze 3 high-quality embryos a generous stork brought us (for a small charge).

May 2014: I undergo a “natural” frozen embryo transfer of one 5-day blastocyst graded 4AA. Only meds are Ovidrel (hCG to trigger ovulation to be sure of timing for my transfer and so I could go home between monitoring and transfer). Praying for this chapter to be the first of many leading us to the end of this novel in about 9 months’ time.

Late May – Early June 2014:  Pregnancy #9. Biochemical pregnancy #3 in 2014 (miscarriage #8 in total), this time with DE IVF.  First beta-hCG was 14 at 7dp5dt.  Second beta-hCG was 15 at 9dp5dt.  Natural miscarriage ensued. We are now counting 8 losses for my 9 pregnancies in the past 4 years. I want to curl up and die inside.  Again.

June – July 2014: Break. During which, all of this stuff happens:
* More autoimmune testing done, showing sky-high immunoglobulin E (IgE) levels and elevated TSH (3.17 up from 1.55 in June 2013). All other results normal.
* Aggressive course of corticosteroids (prednisone) prescribed for a 22-day period (7 days at 60 mg, 3 days each at 50 mg, 40 mg, 30 mg, 20 mg and 10 mg) and Synthroid 50 mcg prescribed.
* Immune symptoms subside nicely with the drugs, the test (literally) will be what has happened to the IgE and TSH levels as well as my T3 and T4 levels (which were not tested pre-Synthroid treatment). We debate consulting a Reproductive Immunologist, which is 100% out of pocket for us as our insurance will not cover it and there are none “back home”.
* I can’t see a regular immunologist because the waiting period after referral is 1-2 years. Not months. Years. This is one of the big cons to a public health care system. We cannot even jump the queue.
* RE recommends another natural FET in August to take advantage of “immune quiescence” period following steroids provided IgE levels have come down to normal and TSH is under 2 at time of cycle.
* I remain discombobulated and steadfastly refuse to make any decisions. We are on a break, remember?

July – August 2014:  We consult by telephone and in person with Reproductive Immunologist Dr. Jeffrey Braverman in Long Island, New York.  We had comprehensive immune testing completed and find out that I have a host of immune issues that are systemic to me and that the LP and I lack HLA-C mismatches, which means my body does not recognize antigens on the surface of the LP’s sperm cells or embryos containing the LP’s genes as sufficiently  different from me to trigger the normal tolerance immune response required for deep implantation and continued pregnancy.  Our one successful pregnancy and the 6 failed ones since then have  likely made my immune system’s aggressive response even stronger.  It is very unlikely I could ever sustain a pregnancy without a cocktail of medications (neupogen, prednisone, lovenox and intralipids or IVIg). It is very likely each unmedicated pregnancy will also make me sicker as the ones earlier this and last year did. On top of that (why stop there?), it is quite likely I have endometriosis which would have affected egg quality.  On the whole, incredibly depressing news but at least we have a chance if we accept the aggressive protocol.

September 2014:  Investigating and considering options to move forward.

September – October 2014: Estrogen protocol FET cycle using Neupogen, Intralipid, Lovenox, Prednisone, 81 mg Aspirin, Claritin and supplements for endometriosis recommended by Dr. Jeffrey Braverman. Transfer on 10.14.14. Heartbeat first seen and heard at 6w1d (measuring 6w2d) on 11.07.14. Fingers crossed!

21 thoughts on “Timeline

  1. The irony here is how ridiculously fertile you are. I am stunned at how frequently you became pregnant within one cycle. If Dr’s are attributing your miscarriages to AMA, that doesn’t make a ton of sense since I’d wager that most 30 year olds can’t get pregnant as quickly as you do. I can totally see why you went IVF if that allows you to select the strongest egg. Your body is so eager to have this baby, it’s amazing. There has to be a way.

    • Yes, it took quite a while to get our first BFP but after our one success we got pregnant *every cycle we actively tried*. Granted I’m type A and an expert at timing and how to overcome our MFI on natural cycles but it is wild. Our RE said I don’t have typical infertility issues but one wonders if they are missing something or just writing me off as AMA because they can?

  2. I take my comment back. You get pregnant more quickly than most 23 year old’s…. And with MFI, it’s kind of unbelievable. If you were at a research hospital they would probably study you. I can see why you would be wary of Clomid after IVF — only time it sounds like you had implantation issues. At 43, I’m willing to accept that at least half the times I ovulate, my egg might not be viable. But there has to be one healthy egg out of 8 or 10 cycles. You’re in such a fertile window right now that I would make the most of it — after 4 losses in 10 months, from my perspective, the odds are with you at this point, not against. You’re due to hit that healthy egg. I’m cheering you on but you don’t seem to need it. Your body (much less your cognitive self) is so geared up to be pregnant, it’s trying to turn every cycle you have into the one.

    • Hmn. Perhaps your body is more selective than mine or more alert to the fact a given egg is not viable. If money weren’t an object or we had insurance for the procedures I might do a few banking cycles of IVF then do CPD on any blasts that survived then transfer if any were chromosomally normal. But I’ve seen women do that and fail too so it all makes me wary. Maybe I just accept that I may have 10 or more miscarriages before we get lucky again. That’s a hard contract to sign though – hard on the heart and body. And time is not on our side as you know.

      As for being due – As I understand how statistics and games of chance work, the odds are the same every time you roll the dice. And up to 8 of every 10 eggs at my age are not viable says Western Medicine. I’m trying to ignore my knowledge of these things, accept that I am not in control and see what happens. At least that’s what I aspire to do.

  3. I hear you about the odds repeating anew for every cycle but I still feel like if I’m willing to endure multiple miscarriages that I’m giving myself more opportunities to hit it right. I’ve read on-line about women having 12 or more miscarriages which is so hard to fathom (one came up with her own successful protocol with help of her OB father although she had all CPs which sounds different from your situation). One of the challenges for me will be not seeing a positive pregnancy test as a “BFP,” but another stage in a longer process. We’ll see if I have the strength to endure that. Thinking of you and thanks again for sharing your journey – it really does help me prepare for what may be ahead.

  4. That is some timeline. One miscarriage sent me into a tailspin so I have no idea how you endured multiple miscarriages. You and LP must have amazing psychological infrastructures.

    • I don’t know about that. Medication helps. 🙂 (No, seriously.).

      Several people have asked why I don’t just quit and accept with gratitude that we have a child – as if the two are synonymous, which they are not – but our living child and the ways in which he has opened my heart, mind, spirit are key reasons behind my desire to have another and my willingness to persevere. That and I have spoken to our spirit baby and until recently I was dead certain I was meant to parent and raise another child. My faith and hope have taken heavy blows of late and perhaps the end is now finally near.

  5. Before fertility the word just used to be neutral. Now I loathe it. Just adopt. Just quit. Just accept that it’s not meant to be. Just trust God. It’s on the shelf right next to “at least you know you can get pregnant.” Another one that induces teeth grinding.

    I hope the end isn’t near if your desire is still there.

    • Agreed – “just” deserves a burial. My desire will never go away I expect. But at some point the psychological, emotional, spiritual and financial hits may become too heavy. Reading your blog last night reminded me how much wine I’ve been drinking since getting our diagnosis and my need to be mindful about it and how I’m “coping”. On that note – your timing was divine and I am so grateful you stopped by.

  6. Wow what a journey you have had. My heart broke more for you every time I read the next pregnancy was also a miscarried. I am so sorry that you have had to go through this. I am glad you had a consultation with Dr. Braverman. I too had one on the phone with him, but since I am not one with RPL, and I was overwhelmed with all of his suggestions, I decided to hide myself in the sand and move onto the next round of IVF. I hope for a very clear direction for you. ❤

    • Thank you so much. I am very curious what suggsetons Dr. Braverman had for you when you don’t have a RPL history; he has a similar view of multiple failed IVF as he does to many RPL cases it seems so perhaps much of what he would have recommended for me by way of testing except I’d already paid for the testing to be done through him before I ever spoke to him (because I avoided calling him for months after thinking he charges a fortune – he does – and it was too far to go for me – it is). I appreciate your kind words and hope. I’ve been short on hope lately so I am very grateful for every outside donation of hope that comes my way! I look forward to following your journey and wish you better luck, too.

      • I wrote about it here: http://binkymoongee.wordpress.com/2014/07/08/tearful/
        Yeah he charges a fortune… and I just don’t have the stamina to do any of that and delay the process more. I am on the west coast… I guess… I just wanted to see what he would say. Plus a friend of a friend went to him and found success… Her story is very different from mine though. So in the end, I just decided that it was too much for me to handle.

        • Thank you for posting the link. I think we each need to decide what is right and enough for us in any moment. We must be at peace with our choices if we are to function. And feeling overwhelmed is no way to live. I truly hope you have success following the right choices for you.

  7. I came across your story and admire your strength through what you have had to deal with.. I have had many failed procedures including iui’s, ivf fresh with my own eggs and also using DE ivf. I recently had a failed cycle of our first FET. Our doctor now wants us to do immune testing.. Of course the cost is insane.. We unfortunately were only pregnant once that led to a miscarriage and from that point on I have had issues.Thank you for sharing your story.

    • Thank you for your kind words and for sharing your story. I sincerely hope you get some answers and assistance. The costs are high but our losses have cost us (and me in particular) immeasurably. If the immune protocol works it will all have been worth it. If it does not I know with time and a great many tears I will survive and carry on knowing I did everything within my power to pursue my dream. I wish you the very best on your journey.

  8. Just spent the last half hour (yes I’m meant to be working) reading your story. It is an understatement to say that you have been on one rollercoaster of a TTC journey. But what really inspires me is that you have stayed the course. I have had 3 miscarriages in the last 12 months and can feel the strain its putting on me. Your story is inspirational me and makes me feel like I’m not alone. Thanks for sharing x

  9. Hi! My wife and I have been reading for the last 6 months and we really admire how your sharing and tone makes this all a tad easier. If you ever have a sec, would you mind lending us your thoughts on our project to try and help out other couples also grappling with conundrum on how to find care and what to believe? The URL we built is FertilityIQ.com (our mobile site is not great to be honest). We now have gotten a ton of fertility caregiver assessments, from all 50 states, but we could clearly make this much better.

  10. Hey, you might remember me – I had 2 losses last year at 21 and 20 weeks. Can you tell me what prednisone dose you had and for how long? Taking info to my doctor. Thanks! ❤

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