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!