Pieces of the puzzle...

Two recent "Thoughtful Thursday" questions made me think and gave me reason for not just commenting on the posts but writing a bit more here on my own blog.

The first one is related to the TT from May 21, 2010 - which made me wonder if my infertility is a stand-alone thing or if there is a genetic link somewhere. There are two instances of known infertility in my family - my aunt didn't have any children because her husband had a fertility problem (and their marriage wasn't strong enough to endure the treatments) - but there is no blood connection between him and me, so that doesn't count. Then my maternal uncle and his wife were never able to conceive, but they never went to the doctor to find out why, so I don't know where the problem was for them. My dad and his siblings are all five years apart, which could be an indication of fertility problems, but I've never asked my paternal grandmother and don't think I will (as it's pretty impossible to talk about anything except the weather with her).

I know that I have some similarities in the woman's department with my maternal grandmother: we both experience(d) very painful menstruation cramps and carry our babies (well, I've only had one, so no idea if it would be the same for a second one) well past term, almost to 10 months. However, she had four children in a row (between 14 and 28 months apart), so she didn't seem to have any fertility problems. My parents' first child was stillborn and my mom had a miscarriage after that (probably because she got pregnant too soon after the first one - the only thing the stupid OBGYN had said to her was "I hope you'll get pregnant again very soon". So she did, and when she miscarried he scolded her for getting pregnant so soon...). My sister was TTCing for about two years before getting pregnant, which ended in a missed miscarriage. She then got pregnant about six months later and now has two beautiful children.

So... no definite clues for infertility problems, but there is a history of problems later in life with the reproductive organs on my mom's side of the family. Both her sisters had their uterus removed around the time of menopause (I don't know the exact reasons, but I think it was a bit of a 'better safe than sorry approach'). I think my grandma had something similar. My mom had polyps removed about 10 years ago and oh, I wish they had removed her uterus as well back then, because she has recently been diagnosed with endometrial cancer, which has spread to the cervix and the surrounding lymph nodes. She is currently recovering from surgery where they removed everything and will have radiation therapy in a couple of weeks. We don't know what the future will bring.

When I consulted Dr Google just after her diagnosis, I found a list of 'possible causes' for this cancer. One of them is infertility... Which leads me to the other TT from April 29, 2010 that deals with possible future problems related to infertility (treatment). This made me wonder if every women on my mom's side of our family has to deal with some problems related to our reproductive organs at one point in life, and mine happens to be infertility, or if I should expect to be a future endometrial cancer candidate because of my infertility history. Of course I don't have the answer to this question, but it seems like some pieces of the puzzle are coming together, no idea what the final shape will be though. Time will probably tell.

Hindsight

Now that I've reached the second trimester of my first IVF-pregnancy safely, I've been thinking why it had to take more than five years since we first started TTC, to get to this point. Even though it is what it is, were there moments where we maybe waited too long, or made a wrong decision?

The first big wait of 1.5 years before getting tested. Why did we wait so long? I was using BBT charts and ovulation kits, so I knew there was no problem there. I'd read that you should give it time, at least a year, before seeking help, so we did.

When we finally decided we should find out what was wrong, it took me some more time to decide where to go. Immediately to an RE, a regular OBGYN,... finally a friend told me I should go see her doc (OBGYN) and I did.

Test for hubby, tests and exams for me. All normal. Still I was put on Clomid for 'super ovulation'. BFN and I wasn't very happy about it, so I talked to the nurse, who immediately suggested IUI, for which I wasn't ready at all yet in my head.

That was all about six months before moving to France. The last year in the US wasn't a very happy one for both of us (mainly work-related), so I thought that might have something to do with our TTTC and had the naive though that once in France, all the stress would be gone.

Of course this was not the case, especially the first six months after the move were very stressful, so of course no BFPs either. Then finally took up the courage to find a doctor - first a general practitioner whom I asked for recommendations. She gave me a name of an apparently very good gynecologist, whom I called and could see three months later. The first visit was fine and she ordered a few more test. However, when we had done those and I tried to make a follow-up appointment, I was told I should call back in November (it was late August when I called) to make an appointment for January. Appalled, I vowed to find another doctor.

Luckily I met someone who was going through her 3rd or 4th IVF cycle and recommended me her RE clinic. I called and could make an appointment for a few weeks later. After the first consultation a fertiloscopy was scheduled, again only a few weeks later.

The result of the fertiloscopy was that everything looked fine, but that they had found some endometriosis in my ovaries, which was removed. The RE told us this could have been a reason for our infertility. So we went away happy that the problem was solved and thought it would work the natural way, but it didn't...

I think we were too happy that there finally seemed to have been a reason for our infertility and didn't hear in what the RE really said, that this could be a reason, but it might also have nothing to do with it. I wonder if I would have been in Holland or the US, I would have heard that when he told us, and it was the language that prevented us from 'reading between the lines'. In any case, we waited eight months before making another appointment...

I think our biggest problem was our diagnosis: unexplained infertility. After every test, every exam, we were told that everything was normal. So we initially blamed it on untimely business trips, not enough vacation, bad overall timing, stress, and think it should just work one day.

But, when you're planning a vacation with the goal to TTC, there will be added stress - and when you try to plan two weeks away without trying to think about your cycle, you bet, you've planned it around your period and not around ovulation.

So we started IUI, full of hope. After three months in a row of BFNs we took a long vacation to Australia. It was great. It was very relaxing. We didn't think or talk much about IF. And when we were on the plane on the way back home, I so not wanted to continue treatment, I was so fed up with all the false hope, the injections, the clinic visits and the ultimate BFNs.

A few weeks later we had another consult with our RE where we had to decide if we wanted to continue with three more IUIs (the maximum number allowed by the insurance) or go to IVF immediately. At that point I had resigned myself to going to do IF treatment again, but I wasn't ready yet for the tougher IVF cycle. So we chose to try three more times with the 'simple' solution, IUI. After #4 was again a BFN, I started to wonder if I'd made the right decision, but with a 'you never know' spirit, we went for #5 (BFN) and #6 (why stop now? Also BFN) as well.

After that, I really felt like we'd wasted three precious months. We decided to go for IVF after the summer break. And got a BFP. And I wondered what took us so long. But that's life I guess...