This photo. For so long I have dreamed, hoped and prayed for this to happen. Our path to parenthood, like so many, was not straightforward. Read my full infertility journey in my latest blog post below.
September 2019 (Pre-COVID)
Uh oh, oh no, I hope she didn’t notice me. I shove my face harder into the magazine and hide as my patient walks by me. It’s 7 am, my hair is in a messy bun and I’m wearing sweatpants covered in cat hair. I’m sitting at my fertility clinic waiting for blood work and the last thing I feel like doing is talking to my PCOS patient about my own PCOS journey.
How did I even end up here in the first place?
It seemed like everyone around me got pregnant the first time they tried. It was just so easy, have sex and bang, instant two pink lines. And here I was trying as hard as I could to simply ovulate. I have lots of eggs, but none of them wanted to leave the comforts of my ovaries. Pretty hard to get pregnant if your body doesn’t release an egg.
My fundamental issue was that I did not ovulate due to my PCOS. The Simple Solution= Take drugs to ovulate. I, and my fertility team, figured my chances were pretty high. My husband has excellent sperm, I have plenty of eggs, and I was doing everything ‘right’. As my good friend said, “I know you Laura if you are going to do something, you are going to do it right”. I was never one to half-ass anything. I was a healthy body weight, I reduced my caffeine and stopped drinking red wine. I took the drugs, armfuls of supplements and did acupuncture and exercised regularly and meditated AND AND….it still didn’t work. No matter what, cycle after cycle it failed. Below is a quick month by month synopsis.
Letrozole, Letrozole and more Letrozole
July 2019- Started TTC naturally, stopped birth control and my period never came aka the story of my life
September- Started letrozole, 2.5 mg, complete radio silence in the ovaries. Told myself not to panic, we just need to up the dose, you can always up the dose…
October- Upped the dose to 5 mg. 1 follicle started growing! This is it, this is my month I told myself. After 7 consecutive early mornings of cycle monitoring, which meant 7 days of blood draws and transvaginal ultrasounds, I got the dreaded call from my fertility clinic. Turns out my body had likely created a non-viable cyst, but they were going to trigger me just in case. Trigger shots are painful injections in your abdomen, oh and they cost ~$100 per shot. Two weeks later, I got my period. Fucker.
November- Tried 5 mg again. Once again, my follicles started to grow and then fizzled out. Went on vacation to Hawaii and did a natural cycle. Nothing. Turns out the whole just relax strategy and go on vacation doesn’t magically make you fertile. Did I mention infertility is a reproductive medical condition and not something that is all in your head?
December- 5 mg again, estrogen started to rise and follicles started to grow, got to day 17 and everything died.
January – Upped the dose to 7.5 mg. My body started to produce 4 follicles. 4! One of them has to make it right? Nope. The higher dose just made my estrogen go up and down, up and down and eventually decline. This zig-zag pattern meant tons of side effects. Letrozole gave me a constant headache, nausea and made me feel extremely dizzy. I would often wake up soaked in sweat from hot flashes. It also caused insanely dry skin and massive amounts of hair loss. You know when you open a medication box and there is a long list of side effects? I’m that person who gets all of them. My hairdresser, who I see on the regular for hair therapy, recommended I stop highlighting my hair and allow it to re-grow and heal. So now I had no hair, terrible roots, dry skin, and I was still not even close to being pregnant.
February- Cried, a lot. All the time. Every day. Decided to take a break before IVF.
My Breaking Point
The medication costs, along with lower income due to time off work, was starting to add up. I could not schedule patients before 10 am because I had no idea how long I would be stuck at cycle monitoring appointments. For the first time in my life, I was spiralling downwards into a deep dark place of hopelessness, depression and despair. Even on vacation, I had to leave the beach at times because there were simply too many baby bumps and little kids running around.
For me, this was very hard because well, I was not used to dealing with failure. I had always worked very, very hard, and that hard work had always paid off. If I set my mind to something, I made sure it happened. But no matter how hard I worked at getting pregnant, it simply was not working. Morning after morning of negative pregnancy tests was draining.
Normally a pretty calm person, I started to develop debilitating anxiety. I would get incredibly uneasy, shaking nervously, every day around noon waiting for the nurse to call me with my results. Every time it was the same phone call, my ovaries were not responding to the medications and my follicles were not developing as expected. I started to feel bad for the nurse who had to call me.
Finally, after 7 months of trying, my husband and I were scheduled for an IVF consultation in January. As difficult as this appointment was, it also brought a great sense of relief. Our fertility specialist Dr. Tom Hannam was empathetic, thorough and listened to our concerns. Essentially, my PCOS was causing me to have anovulatory cycles, which was causing my infertility. He said that my body was very resistant to ovulation, and sometimes this can happen when someone has a very high ovarian reserve.
Ready, Set, Wait…
March- Prep for IVF. Feeling ready. Waiting in line to pick up my medications when the nurse tells me my cycle is cancelled due to COVID-19.
April- All non-essential services in Ontario, Canada are ordered to shut down. IVF is put on hold indefinitely.
To say April was a low point in my life would be an understatement. There were days I didn’t want to get out of bed or out of my pyjamas. Slowly but surely as the world opened up, the fog lifted. I kicked into full preconception mode and prioritized self-care above everything else. I am forever indebted to my fertility counsellor for helping me get through this difficult time. When I finally picked up my medication box in June, I still couldn’t believe that we were moving ahead with IVF.
On July 1st, 2020, a day we would normally spend with friends celebrating Canada Day, I spent the day in bed recovering from my egg retrieval. Despite careful monitoring and low doses, I still ended up with the dreaded ovarian hyperstimulation syndrome (OHSS). After several days of incredible discomfort and bloating, my fluid retention finally started to go down. Before we knew it, my transfer day was here. On Friday, August 28th, we transferred one perfect day 6 embryo. We crossed our fingers and hoped for the best.
My First Trimester
6 days after my transfer, I woke up feeling nauseous. It was unlike anything I had ever felt before. I broke the cardinal rule and did a home pregnancy test a few days before my first beta hCG blood test, it was positive. I obviously continued to test every morning (who doesn’t??) watching as the line got darker as my nausea and fatigue got stronger. My pulse became rapid and slippery, a pattern we notice in Traditional Chinese Medicine that relates to pregnancy. From the moment I woke up until the moment I went to bed, I felt like absolute crap. I couldn’t even look at vegetables in the fridge and my daily chocolate cravings had stopped. All I wanted to eat was crackers, cheese and bread. I was happy to be nauseous but worried about how I would survive the next few months Wearing a mask all day at work certainly did not help.
11 days after my transfer, my nurse called me to confirm my pregnancy. Despite unrelenting all day sickness and exhaustion, my first trimester was pretty uneventful. No bleeding, no spotting, and every test and ultrasound came back looking great. As difficult as this past year has been, I am forever grateful for what this journey has taught me. I know it will make me a better person, mother and clinician. To all my patients, do not give up hope.
