Doctor appointment and green light to start again

This last Wednesday I had a doctor appointment with my Fertility OB, Dr. Hijano. We were nervous as to what would happen… Would everything be OK? Would he send us for a whole new round of tests? Would he want to pause treatment? Would our new circumstances affect the process?

My DH got offered a new position (same company) in London, so we are moving to London at the end of February which is exciting and also scary do to all the implications this new situation has and will have. More on this soon…

Doctor reviewed all paperwork I had from my hospital discharge, D&C, blood tests and biopsy and said there was nothing that we could have done to prevent it. He explained all about miscarriage in first trimester and this being my first miscarriage there was no reason to do an in-depth study of the case as it was not considered a medical issue yet. He said that if it was to happen again or I was having repeated miscarriages (at least two) then they would start more in-depth studies as to find the cause.

Doctor did an ultrasound to check everything was back to normal and everything was just fine. He told me that I ovulated and I should be having my period in the following week.

We asked the doctor how long should we wait to start trying again, he said we shouldn’t wait, we could start straight away. DH told him the hospital doctor said we should wait at least 3 month but  he completely dismissed this statement. Dr. Hijano said that was the previous consensus regarding D&C but nowadays fertility doctors  say it is not necessary to wait. He said we could start with the hormones for a next round of IUI with my first period. That was good news…

We also told the doctor we are in the mist of moving to London but that we would like to keep following the treatment with his team. After talking about procedure and logistics we decided to wait until we find a house in London and things settle a bit before going to another IUI round. That would be at least a 2 month pause.

When I mention my doctor that I would be writing this blog about my experience with the treatment and life in general he offered to help me out with it! So nice of him…  

We left the doctor’s office with a new perspective and with a whole load off our shoulders. It was a nice day.

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Family under construction: part 3 - trying again

Our first IUI failed. We decided to try again immediately so the third day from the start of my period we begun with the hormone shots again… had the trigger shot on November 3^rd and the AI procedure on November 4^th.

The second 2WW were worst that the first one. Every time I went to the bathroom I was expecting to see signs of spotting, signs that something was wrong.  Then I decided to do some research online about what to do to help implantation… and I follow the advices that sounded best to me… I stopped exercising, rested as much as possible, I ate pineapple cores the first 5 days after IUI, took my prenatal pills and started to eat and drink as if I was already pregnant (no alcohol, no raw meat, etc…).

http://www.imagesbuddy.com/images/129/2014/01/waiting-for-you-boy-and-girl-hands-graphic.jpg

On November 18^th I took my first pregnancy test and it came with a faint positive…. But positive nonetheless for the first time ever... I could believe my eyes… I took the test at 4am because I wasn't able to hold my pee no longer and when I woke DH to check he said that it looked as if it was positive… so I called my doctor first thing and they said to wait two more days and test again…. TWO MORE DAYS!

I was going crazy… so on November 20^th I took the second test at 7am…. And it came back positive again and darker this time…. I couldn't believe it yet… so I went straight to the pharmacy with the pregnancy test and asked the girl at the counter what she thought about it…. Funny thing, the pharmacy was full of grandma’s (it was early in the day, like 8 am) and they all said it was a positive as big as a house and all the grandmas came and greet me on the news… I was SO HAPPY! I've got my BFP! I was going to be a mum!

I called my doctor and he said to go for the first ultrasound to confirm the pregnancy in two weeks (another two dreadful weeks…) On December 2^nd we went for the ultrasound and Dr. Hijano said he could see the sack but couldn't see the baby… he said that implantation might have been late and to come back in 10 days for another ultrasound…

I was so nervous and scare… those 10 days were hell… On December 13^th we were back to his office and this time the ultrasound showed the baby and we heard the heartbeats! We were so relieved and so happy! We called our mothers and let them know… my mum cried and cheered and all you would expect from a future grandma… my brother was so happy and already planning to which concerts he will take his future godson or goddaughter… I asked them not to tell yet because people said that the first 13 weeks are very delicate and I wanted to be past that period to be telling all the world… but my wishes weren’t granted… more on that later.

Dr. Hijano asked us if we wanted him to do the follow up of the pregnancy but we weren't sure because we wanted to have the follow up in the Hospital Quirón which was closer to our house... biggest blunder... we later realised.

I called the hospital and got an appointment with an OB (not my usual one because she was fully booked until the end of January) on December 23^rd. According to the IUI procedure the baby should has been 9 weeks by that time but when we had the appointment the Dr. said that the baby measured 8 weeks 2 days and we were able to hear the heartbeat again. That was so nice… 

But I wasn't sure about the doctor. She didn't say much, she didn't explained much, and she only said that I had a myoma of 2-3 cm but not to worry because that was “normal. She sends us for the test for the first trimester and gave us our next appointment for January 23^rd, one month after.

My DH said he liked the doctor that she seemed nice… I didn't quite like her because she wasn't informative enough and she seemed distracted all the time… she even wrote her name instead of mine in the test order!

So Christmas came and with it a lot of stress due to family “situations”. Family were scattered during the holidays. We are used to have big family parties for the holidays but this year we ended up being only 4 at Christmas and my mother-in-law didn't even wanted to spend New Year’s Eve with us… which added to the stress of the holidays.

On January 3^rd we went for the blood work and tests. All seemed good.

But...

Part 4

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Family under construction: part 2 - TTC

In December 2011 we began trying for a baby. Oh my, did we try! After trying not to get pregnant for so long, we thought that it would be easy, we did get a lot of practice in the making department after all… 6 month with no luck we went back to the doctor and she told us that it is normal after a surgery like mine not to get results immediately but she ordered some tests for the both of us to check that everything was fine, so up we went for blood work, hormonal charts, seminal tests and hysterosalpingography. 

Every single test came back normal. There was nothing wrong with any of us. 

Great. Now, why we couldn't get pregnant? My doctor, who was pregnant at this time, said to try monitoring ovulation for a couple of month, timing sex to most fertile days and if nothing happened she will set a clomiphene treatment for us.

About a month later my doctor had her baby and was off duty, by the time I went for my appointment a new doctor was replacing her. This new doctor was very condescending and it seemed she was in a hurry. She didn't want to prescribe the clomiphene and said that if I was worry for my fertility I should go to a fertility specialist. I asked her to contact my doctor that she was the one that suggested the clomiphene and she basically refused. After a lot of talking she said she would contact my doctor and that I should come back in two weeks to check. She also suggested I quit my work because I had a hectic schedule and was stressed out so that could be the reason of our failure to get pregnant and gave me a prescription for something called Ovusitol.  

I went back for my next appointment and of course she didn’t talked to my doctor and basically just wasted my time. Add to this the fact that she used that condescending tone that doctors that really don’t care use and again stressed out the thing about “relaxing” in order to get pregnant. Arrrrggggg!

I was so angry I didn’t know what to do, so I called the hospital´s fertility clinic and told them what this doctor said and all test that I have been through recently. They said that they only look at the test they ordered and not to tests ordered by other doctors, even though the tests were performed in the same hospital! Meaning we have to go through the entire set of tests again and pay for them. I refused point blank. This was October 2012.

In the mean the company I was working for got absorbed by a bigger company and we were working overdrive to complete the process and get everything ready. I got offered a new position at the new company which would involve more hours, more travelling and more stress so considering what the doctors have said, my DH and I decided I should just turn the offer down and so I became a housewife. This was December 2012.

 Back in Paraguay I used to work as a pharmaceutical representative and some of my best friends are doctors, so I contacted my previous Gynaecologist and really good friend, Dr. Carlos, and sent him all my results. He said that my doctor was right and clomiphene should be the first step so he prescribed me the treatment, explained everything and off I went with it. He also said that if after 6 month of treatment I didn’t get pregnant, then other tests should be performed.

I follow the clomiphene treatment for 6 month, from January to June 2013. During this treatment I developed ovarian hyperstimulation syndrome (OHSS) on month 6 of the treatment and also gain a lot of weight (8kg) during the process.


For those of you who are not familiar with clomiphene,  helps you produce more of the hormones that trigger ovulation (follicle-stimulating hormones (FSH)), prompting your ovaries to produce one or more mature eggs, depending on how often you normally ovulate.

During this time my DH was transferred to London for a business development project and we were travelling back and forth every week which added to the stress of the situation.

In August 2013 I decided it was time to go to a fertility specialist, so after consulting with our insurance company we were referred to the Centro Malagueño de Reproducción Asistida. Through my insurance company I got a discount on the price of the treatment and the first consultation free of charge, so we went.

We were greeted by Dr. Hijano, which was very accommodating, listened to all we had to say and answered our questions. He said that unexplained infertility is very common and that he wanted to make and additional test and blood work to start with.

"Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older).  Women who can get pregnant but are unable to stay pregnant may also be infertile."

Infertility is different for everyone, and can be caused by a multitude of things from screwed up hormones, blocked Fallopian tubes, fibroids, tilted uterus, age, diet, weight, drug use, alcohol abuse etc.  And it isn't just a woman’s issue; 1/3 of infertility issues are due to issues with the male. 

The test he requested is called hysteroscopy and consisted in a small camera inserted in the utero to check its surface. The blood work and hysteroscopy came all fine so at the end of August we visited the doctor again and he recommended starting an AI treatment. When we asked for IVF he said that there was no reason for us to go through IVF because there was no apparent cause for infertility and my eggs and DH sperm were just fine. So we scheduled the first procedure for October 2013.

The most expensive part of the IUI procedure is the medication; we bought the hormone injections and begin the protocol.

10 days of injections and a trigger shot later we had the first IUI procedure on October 11^th. It was quicker and less painful than expected. All in all it lasted about  20 minutes. The doctor said to take it easy that day but to resume normal activities the day after and no special care but the prenatal pills and progesterone . He recommended Natalben Prenatal, which I must say is pretty good. So we began the 2WW (2 week wait, not the Second World War!) which were the most nerve racking 2 weeks a woman can experience.

I was supposed to take a pregnancy test on October 26^th but I started spotting on October 25^th… and the first IUI procedure failed.

Part 3

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Family under construction: part 1

I thought long and hard about opening up and writing this post.  It took me a while to put the words together, and figure out exactly what I wanted to say and how I wanted to say it.  

Before anyone asks why I didn't tell you or come to you etc., this isn't about you. It’s about me and what I felt and who I felt I could really talk to and be vulnerable with, and who would be able to empathise or who could relate to what I'm currently going through. That being said… let’s begin.

Dear Husband (DH) and I met in a Halloween party in 2005Christmas. There was a gap in years between the two of us but despite that by Christmas that year we started dating. By May 2006 we were living together and by Halloween 2007 we got married. We’ve have so much fun together and we’ve grown up so much together during all these years that I can honestly say we are better together that we are apart. We have a lot in common and we also complement each other and we are best friends. What more could I ask for?

We have a great life together… we've had wins and setbacks and fun and we've been stressed and sometimes even despair… but being together and being best friends have helped a lot. 

In 2011 we thought we wanted to start a family, to procreate... it was about time we have a mini-me or mini-him in the house ... we thought it would be easy-peasy but life proved us wrong. 

  April that year I was diagnose with a myoma and it was growing alarmingly fast so surgery was required. I went to my doctor and she said that even though the myoma was growing fast I should try to get pregnant because if I went through surgery I might lose my uterus, which literally freaked me out. I’m not one to settle for just one opinion so I seek out another doctor which said to me that pregnancy was practically impossible if I have the myoma growing (and that my struggle to lose weight was also due to the myoma) but he also said that due to the location of the myoma I might lose my uterus. Not what I wanted to hear… now I had one doctor saying I need to get pregnant right away and another one saying that pregnancy was almost impossible.

So I tried a third doctor… and the third time was the charm. I called the Hospital Quirón for a quick appointment with a Gyno-surgeon and they said I was lucky as they just signed up a doctor and he had a day available that same week. This doctor turned out to be one of the most famous Gyno-surgeons in Andalucía… I couldn’t believe my eyes, really.

Went to the appointment with my DH (dear husband) and Dr. Perez-Bryan Hafner received us. He check all the paperwork I brought with me listened to the story and said he needed to see for himself… so up we went for an ultrasound… and he said that the two previous doctors were “alarmists” but this type of cases were his day to day so no problem at all. He said that in his hands the chance of complications that would result in losing the uterus were minimal if not almost non-existent and he scheduled us for surgery in 10 days!

Just a few months before my dear father-in-law Alan was diagnose with stage 4 lung cancer. In May Alan passed away, which was a very difficult moment in our lives. He was the most caring and wonderful person you can imagine and a little bit of light died the day he left us. We miss him a lot…

We had my surgery schedule by May 13^th, but we held the funeral that day so had to postpone the surgery. A week after the funeral we had the surgery and everything went just fine as Dr. Perez Bryan said it would go and he managed to remove the myoma without even touching the inside of the uterus which was a great advantage… we were so relieved!

Recovery was pretty quick, I was out of the hospital in 3 days and after 10 days I was almost completely recovered. The only thing I had from the surgery is a C-section like scar.

In the next appointment Dr. Perez Bryan said we could try for babies in 6 months and that because he didn't touch the inside of the uterus we could have a normal delivery. Then he transferred me to another doctor for the follow up.

6 month later (December 2011) and after all test came back OK doctor said we could start trying for a baby.

To be continued…

Part 2

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