Microblog Mondays: Waiting Again

Back to waiting. There's something obnoxious about the fact that I was bleeding at 12dpo when I certainly did not want to be, and now there's no sign of bleeding at 20 dpo. I'm actually considering starting a pool: when will the bleeding/miscarriage start?

My first two chemicals, I've always started CD1 by the time my hcg was ~8, which was usually at 14 or 15 dpo. Last chemical, I stopped Endometrin on a Monday after home tests were negative, started bleeding Thursday, and still had detectable hcg on Friday. I'm picking Thursday in the pool. I stopped Endometrin on Saturday, but I was definitely still turning home tests then. BBT's still slightly elevated now. We'll see.

Regroup is scheduled for 3/19. I need to ask about:
- Menopur vs. Gonal. My successful cycles were Gonal only.
- Doxycycline. Do I need to take it again next time?
- Immune protocol, especially prednisolone/prednisone
- Baby aspirin, considering my issues with NSAIDs?
- Other options for lining (viagra?)
- Any concerns with acupuncture?
- WTF is up with mistakes from the office?

I might word the last one a bit differently when I actually talk to her. I might not.

Is there anything else I should be asking about now? I've gotten all my paperwork together to send to Dr. Kwak-Kim, one of the leading reproductive immunologists, but I'm really on the fence about that. I don't think we'd actually do any of the more controversial treatments (itralipids, ivig). I would sign up for uterine gcsf (Neupogen) wash in a heartbeat if anyone here did it, but I don't think Kwak-Kim does, nor does CCRM to my knowledge. So, on the fence about the utility of Kwak Kim.

Diet is officially on anti-inflammatory mode. Breakfast: chia seed pudding made with coconut milk, almond butter, and dried fruit. Lunch: Tofu, bell pepper, snap pea, and pineapple curry or lentil and soy chorizo omelette. Dinner: Beet and black bean burgers and asparagus. Snacks: carrots and hummus and whole-milk greek yogurt. I know the perspective on dairy and inflammation is mixed, but I think getting the live bacterial culture is the better part of valor. Given my estrogen issues, I'll probably eliminate the soy and tofu from future weeks and switch over to shrimp or some other fish.

Trying to take things one day at a time and remain hopeful. It's really hard right now.

Filed Under the Category Of:

Really good news: The stent is out! For at least a few weeks, I have my body back to some state resembling normalcy.

Helpful news: My perinatologist was able to find an in-network OB to do a FemVue, so I won't have to pay my RE entirely out of pocket to check tubal patency. That's a huge relief.

Upcoming news: I have the infectious disease appointment on the 2nd and the FemVue on the 4. Depending on what ID says, I'll probably also have another biopsy on the 3rd. Oh boy!

Emotional news: I know, logically, that grief isn't linear. That said, it's still really rough when I'm doing ok for a few days and then suddenly have a day where I'm not doing ok. I'm grateful that I'm now having more good days than bad ones, but I still have moments where missing the girls just takes my breath away. I'm still sleeping with Quinn's blanket on our bed. We had hoped that it would soothe her some day, but instead holding it is the one thing that helps me relax when I wake up in the middle of the night and can't stop thinking about them. I guess 37 isn't too old for a "blankey"?

Rainbow-spotted Unicorns

In my utter dismay last week over the need for another operative hysteroscopy and stent, I overlooked something really important that happened. Something that makes me breathe a sigh of relief for the first time in months.

What could that be, you ask? Winning lotto tickets? Calorie-free chocolate? A more functional uterus? The ability to write a post without at least one egregious typo? Alas, none of those. Rather, the MFM called me back. She left me a voicemail and told me she'd try me at home that night if I wasn't able to reach her during the day.

When I got in touch with her, she told me she'd gone back and done a lit search on chronic endometritis (CE). She wanted to find the most up to date info. She noted it was mostly associated with early losses (like my first miscarriages), but that it was also associated with losses up to 20 weeks. She said that she'd recommend we add a few other things to the biopsy being done, and noted that the literature reflects the use of hysteroscopy for CE diagnosis. She wasn't sure it was worthwhile to do the hysteroscopy, but wanted to discuss that option with me.

I told her I was getting the biopsy done later that day, and unless I got really lucky, there was a good chance we'd see adhesions and need a hysteroscopy anyway. Further, even if we didn't see adhesions, my RE encouraged a diagnostic hysteroscopy before a COH cycle, so I was likely to proceed with one. Dr. N told me she'd call my OB right away and let her know what other tests needed to be done on the biopsy sample, and that she'd provide her with information/images on what to look for during the hystreroscopy, to detect CE.

I ended that call with such a feeling of relief. What I have hoped for, what I have felt I needed since the beginning, was a doctor who would take me seriously. A doctor who would be willing to look into the newest research on relevant topics, rather than dismissing me based on previous knowledge or assumptions. A doctor who might normally practice "when you hear hoof beats, think horses," but who would acknowledge that give my history, thinking rainbow-spotted unicorns might be necessary. I will always wonder if things might have been different for Quinn had I found a rainbow-spotted unicorn doctor before getting pregnant with her, or during those first 12 weeks when I asked about cervical monitoring, but at least I'll know that any future pregnancy has the best shot possible.

Is Hope Enough?

During the three weeks I spent in antenatal at the hospital, there was a weekly 'group' session for inpatient moms, facilitated by one of the social workers. I was fortunate enough to meet some great ladies, one of whom I'm still in contact with, and to whom I wish a very long, very boring stay.

The social worker asked us during one group session how things were going, that is, how were we feeling emotionally. How could we describe our stay? In my case, the answer was: terror, punctuated by hope. Honestly, every single time I had to get up to use the restroom there was fear. With my cervix open, I knew I could have a complete rupture at any time, and straining at all to use the toilet was likely to cause that. I also had several bleeding episodes when up to use the toilet, and those brought on sheer terror. Yet every time I felt Quinn move, every time her heartbeat was still perfect and my temperature was still normal, there was hope. Every morning that we woke up and got to add another day to the whiteboard with her gestational age, there was hope.

When we knew I was going to deliver, I tried to tell myself that at least I wouldn't have to live with the terror any more. That's the bright side of the worst happening, right: at least you don't have to be scared that the worst might happen anymore. For the record, that is an awfully shitty bright side.

To be fair, looking back at my entire pregnancy with Quinn, there was a lot of fear. The two weeks leading up to our first ultrasound were so rough that I started seeing a therapist who specializes in perinatal loss and infertility. The fear leading up to the NIPT results was bad as well. There was also a lot of joy. Feeling her move was so amazing. Looking forward to our lives with her was joyous. Loving her brought joy.

As I think about the future, and try to decide if this is the end of the road for us, this weighs on me. Can I survive the emotional roller coaster that is fertility treatments? Can I survive (hopefully) 9 months of fear? If we get pregnant again, I will have a cerclage of some type. If things went wrong again, could I live in the hospital with the kind of fear I had hanging over me, knowing the cerlage could rip out (TVC) or my uterus could rupture (TAC) and I could lose the baby? Basically, it comes down to a decision: is the hope worth everything that accompanies it: fear, potential heartbreak, potential loss, and all the surgeries, fertility treatments and costs associated to even have a chance at hope?  I don't know yet, the heartbreak and the fear are still too fresh.

Should be Easier

There are a lot of things in life that shouldn’t be as hard as they are. Understanding tax laws. Picking paint colors. Dealing with CVS Caremark. Finding time to be healthy. All of those could and should be easier, but aren’t. Adding another one to the list: finding a support group for recurrent miscarriage or perinatal loss. Or a pregnant again after loss group. Despite the fact that I’m an introvert and generally don’t like groups, I’ve really felt the need for some contact, in person, with others who have been through this. It’s an especially strong feeling right now, as I’m early in another pregnancy and trying to deal with fear of likely outcomes and anxiety about the unknown.

Things reached a point this week that I decided to reach out to my company’s EAP program. We actually have two on-site EAP therapists/counselors. They’re both licensed psychologists who see employees to address a variety of issues. They were able to get me in for an appointment the day I called, and it was helpful to talk one on one with someone. The therapist I spoke with said she’d look for a support group that might fit my needs, and she called me back after the appointment with a recommendation on a local one. It sounded perfect: great location for me and on weekends when I’d be able to go without worrying about my work schedule.

I checked the provider’s website, and it looked like the session was just for those post-loss, not yet pregnant, so I called to confirm what my options were, and what the cost might be. What did I discover? There are no longer any in-person support groups. Due to low demand, they’ve all been canceled. When I tried to join a support group last year, right after losing the girls, the one closest to me held its last in-person meeting the week before I could attend, then switched to on-line only.

For now, I can see one of the therapists from this group one on one, but that’s my only option. I may still do that, because there are several who specialize in recurrent miscarriage, late term loss, and infertility, and if this pregnancy continues, I may need that support. But I can also continue to see the great EAP therapist, who works one floor up from me and for whom appointments are both free and super convenient. I am grateful that at least THAT is easy, but man, I wish a support group was easier to find, too.

Nueroticism, Thy Name is Symptom Spotting

I've gone a bit neurotic. There, I said it. Admitting is half the battle, no?

What am I neurotic about? Symptoms, of course. Now, let's set the stage here: this is my fifth pregnancy and I have zero living children. The odds of this pregnancy not being successful are probably higher than the odds of bringing home a healthy baby. So I think it's accurate to say I come by my neuroticism fairly. It still makes me laugh at myself and question my sanity, though!

Case in point - nausea this week. I've had off and on nausea most days this week. At times when I was feeling nauseous, my mind kept thinking, "It's too early. I shouldn't be nauseous at only 4 weeks x days. I didn't have symptoms until 5-something last time and I didn't get nauseous until 6.4 or so. It's all in my mind or something is wrong!"  At times when I'm not feeling nauseous, I find myself thinking, "Why don't I feel any symptoms? Why am I not burping? Why am I not sick? The baby must have stopped growing. Something is wrong, it's going to be another MMC!"

None of this is helpful in the slightest. At 5 weeks 1 day, symptoms come and go and mean nothing. I know that. I know it's ludicrous to worry about both having and not having the same symptoms. I own my neuroticism.

Still, why aren't I feeling nauseous or gassy right now, I just ate breakfast?!? ;)

Baby #6, Beta #1

I got the phone call last night. Actually I got two - two nurses both rushed to be the first to call me, which was either genuinely sweet, or an indication of how bad my clinic's internal communications are.  (Side note: Let's just say that the people at the clinic are all absolutely sweet and compassionate, but no fewer than three people asked me if I was getting blood work done because I'd had a positive home test, despite me calling and saying "Hi, this is Me. I'm 15 days past trigger and got a positive home pregnancy test, so I'm calling to schedule blood work." Their internal communications are the pits.)

Anyhow, at 13 dpo, my hcg is 67. Pregnant. A bit less than the median hcg of 86 reported on betabase. Drastically lower than the 249 at this same dpo with the girls. Still undeniably pregnant.

So I return on Saturday to retest and we see if my hcg rises as it should. Doubling time should be approximately 48 hours, so we're hoping for a 140 or so. I'm not holding my breath, given my history and how this cycle has gone.

I am feeling so many emotions right now. None of them are good. Here's the thing: starting out TTC in October 2015, I was adamant about only wanting one child. I wasn't interested in the challenges, the costs, the physical demands, or the stress of two. I just wasn't. I am an only child, I liked that lifestyle, and I wanted that for DH and I. I truly, truly did not want two children.

Despite that, when I saw the girls' heartbeats for the first time, nothing has ever felt so right to me in my life. And when we found out both were healthy girls, I could not have been more overjoyed. I don't have words to explain how utterly perfect everything about that situation seemed. It was as if something I didn't even know I had dreamed of had come true. Despite the constant retching, I was so happy because my family felt "right" to me.

Today doesn't feel right. I have this awful feeling that if today's beta had come back strong, if I had the sense that this pregnancy was twins, I would feel so much better. Instead, I feel this sense of loss, knowing that this is, at best, a single baby. Knowing that at most there's one baby growing in me leaves me feeling like I've lost what my future was supposed to be - what the dream I didn't know I had until I had it was. I feel like I can't possibly love this one baby as much as I love the girls. And I feel so fucking guilty for feeling this way. It's unfair to that baby. It's horrific, when I interact with so many amazing ladies who would give anything to have a single baby. It's what my life would have been if my first, second, or third pregnancies had gone to term. It's what I wanted right up until that first ultrasound last August.  Why can't I be happy, that maybe we'll finally bring a child home with us, from the hospital? I don't know, but I'll hope that it resolves as time passes.

Full Circle

My journey to parenthood started December of 2015. That was when I got the first positive test. That was when I experienced the first rush of utter elation that I was pregnant and DH and I were going to be parents. January 15, 2016 was the end of the elation. I was 10 weeks, and there was no heartbeat on the ultrasound. I was scheduled for a d&c the following work day, January 18.

Two chemical pregnancies later, I had a saline sonogram done. It found scarring, caused by the d&c. I went through an operative hysteroscopy to remove the scar tissue, and then went on to conceive the girls with the help of a great RE.

After losing the girls, and knowing my history of scarring, I went in for a saline sonogram in late December. I wanted to be sure my uterus was clear to try again in March of '17. Alas, this SIS made the last saline sono look like the "good" version. This time around, there are adhesions all over. I suppose it's to be expected, in light of the infection and the fact that it took two rounds of emergency surgery to stop the bleeding after delivering Zoe. I've gotten an official diagnosis of Asherman's.

Thus, I've been scheduled for another operative hysteroscopy. On January 18. It has to happen then, because of the timing of my cycle and the fact that my OB only operates on Wednesdays. I won't lie, I'm hurting at the thought of being back in the same hospital on the same day one year later, with only heartbreak to show for the intervening year. I've come full circle, and yet instead of progress or joy, there's only pain and loss. I'm terrified at the thought of waking up in the same post op facility that I last woke up in the night I lost the girls. Those are memories I don't want to re-live.

I'm just hurting. I'm hurting because I miss my girls. I'm hurting because everything for the last year has been so damn hard. I'm hurting because I don't know if this will work, if we'll even be able to try again, or if our road will end here. I'm hurting because I know if it does work, and I do get pregnant again, I'll never be able to simply enjoy it - I'll worry until the moment I'm holding a living, breathing baby in my arms. I'll say it again, I'm hurting because I miss my girls.

Now I just hold out the hope that this surgery will work and the scarring will stay at bay long enough for us to conceive again. I hold out the hope that my ovaries can pull off one more pregnancy. I hold out the hope that this time, my uterus can keep my babies safe. None of this may come to pass, but I'll pray that January of 2018 sees my DH and I somewhere better than here.

On the Way Out?

Severe cramping yesterday. Awoke to brown spotting and more cramps. The end, I guess?

Then There Were None

I should be five weeks exactly today. It was right around now that my first pregnancy stopped developing, although I didn't know it for another five weeks. 

All my symptoms vanished yesterday. The bloat's gone. The indigestion is gone. My boobs are still sore, but not as bad. There is absolutely no mild nausea any longer. Even my racing heart rate has slowed down.

How utterly fucked up is it that I'm sitting here hoping for a serious case of morning sickness? I mean, really, who wants nausea and puking? Who wants to feel terrible? Women who've had losses and would do anything to know, on a daily basis, that their pregnancy is still progressing, that's who. And I fall into that group. 

Thus, I sit here, desperately hoping for the best, but expecting to see another loss when I go in for my first ultrasound on the 16th. Expecting to hear, again, that there's no heartbeat. Our tenth wedding anniversary is on the 13th. We're going away for a long weekend to celebrate. How do I celebrate now?

Vanity (un)Fair

I like to pretend that I'm not a terribly vain person. I care about my body's physical ability, and I engage in enough personal grooming to fit within corporate america, but I don't think of myself as fixated on my appearance. While I dress appropriately for work, I wear socks with sandals on the weekend, for god's sake! How vain could I be? And if my hair isn't perfect, and I'm wearing clothes that are out of style by a few years, I've always been belligerently ok with that, because I'm still clean and presentable, and I don't care what anyone thinks beyond that.

But, seriously, the TWW-acne is killing me. On Friday, I stopped counting at 3 dozen whiteheads, just on my neck, chest and shoulders. Three dozen. They keep popping up, more and more. This happened last month, as soon as I started the crinone, and again this month with the prometrium. I don't think progesterone is supposed to cause acne, but this isn't without precedent for me. I was on Depo-Provera for many years when I was younger. From college through grad school, and then into my first several years of working. Depo is progesterone based birth control. For all the years I was on it, about once a quarter I'd get acne just like this. Dozens of little whiteheads. The last time this happened to me was while on Depo, and it never happened again during my 6 years with Mirena or my year on Nuvaring.

I am so uncomfortable and self-conscious. It's summer, and the hottest one we've had. The one part of my body I like are my arms/shoulders. The bike riding I do has made me feel good about them, and I have a ton of sleeveless summer clothes that I love. Thanks to the revenge of the progesterone, I hate wearing them. I hate the thought of anyone seeing how bad my skin is. My belligerent uncaring is gone by the wayside and I feel ashamed. It'll all be worth it for a lasting pregnancy, but it sure isn't easy now. As always, nothing about recurrent miscarriage or infertility is fair.

Out of My Hands and Into My . . . .

Here I sit in the dreaded 'two week wait' - the period between ovulation and when a pregnancy can be detected. I think the TWW is dreaded by most women because it's a time when nearly everything is out of your hands. The only thing you can do is wait and see what happens. (Actually, in my case that's not true. Everything may be out of my hands, but thanks to progesterone and estrogen supplementation, that's just because everything is in my vagina instead!)

My coping method for stress is to do something. Anything. So the TWW is the antithesis of how I productively deal with stress. Thus, I've used the time to do a bit of research on how this cycle has gone. And the result is that what I've found doesn't bode well for the success of my cycle.

Study after study, in the context of IVF, have found that having a progesterone level on hcg day that's over 1.5 ng/ml is correlated with extremely low clinical pregnancy rates. The hypothesis appears to be that the cause is an endometrial lining that is no longer conducive to implantation.

Hmmm. . .let's think back to my cycle. Lining, per ultrasound on injection day? Cystic patch. Progesterone level? 2.59. Well, crap.

I couldn't find any research on this topic specific to IUI/TI, so I'll hope it's less applicable here, but I know better than to expect a miracle. Time to prepare for the next cycle by asking my doctor how we manage this.

Diets, and Exercise, and Supplements, Oh My!

On the whole, I would describe myself as someone who likes to be in control. I want to have my own space, make my own decisions, and I’m ready to live with the consequences of those decisions. Studies have shown the probability of successful conception among women suffering fertility problems is higher with a “healthy” BMI and diet(Chavarro, et. al., 2012, Ferti Steril.). Other studies suggest that diet can play a role in fertility, especially caffeine and alcohol.

Thus, I find myself at a decision point: do I make changes that will be unpleasant in my daily life in order to improve the probability of getting the take home baby I want? And for me, the answer is that I have to at least try those changes. I may not succeed 100%, but I’ll feel I’ve let myself down if I don’t give it a shot. So, what am I doing, and why?

Exercise. A minimum of five days a week, 45 minutes a day of exercise. Most studies show a positive relationship between exercise and reduced miscarriage risk (e.g., Zhang, et. al., 2011; Latka, Kline, & Hatch, 1999; Clapp, 1998, AJOG). Further, exercising 3 or more times a week is associated with the most positive outcomes. I’ve seen one study that suggested that intense exercise can have a negative impact on fertility, via miscarriage, even in women with a “normal” BMI (Madsen, et. al., 2007, BJOG). As a result, I’ll drop the HIIT workouts I’d been doing, and focus on a goal to ride 2,000 miles on my bike this summer. That will mean daily exercise of at least 30 minutes, with longer sessions on the weekends, and it should correspond to a reduced probability of miscarriage.

Diet. I’ve been gluten-free for about five years and pescatarian for nearly 20. No reason to change that, but I also eat way too much sugar and processed crap: Udi’s bread, YogurtLab Fro-Yo, protein bars, TJ’s greek coconut yogurt, chocolate – I’m looking at you! Inflammation may play a role in repeat pregnancy loss (Comba, et. al., 2015, Fertil, Stil.), although it’s not well understood. I have a history of juvenile rheumatoid arthritis, thyroid issues, gluten intolerance, and other allergies, all of which suggest my immune system isn’t my best buddy. Based on that I’m going to adopt a hard-core, Mediterranean-focused, anti-inflammatory diet. This is supported by research on luteal phase disorder (Andrews et. al., 2015, Hum. Reprod.), as well as research on inflammation in general.
Sadly for my taste buds, the processed food in my diet is going out. More veggies (kale, broccoli, asparagus, and their friends) and more fruit are coming in. I’ll still stick with my staples of lentils, quinoa, black beans, and chickpeas, but I’ll drop as much dairy as possible. This falls under the category of ‘things that are going to be really hard to do,’ given my love for chocolate, sugar, and processed-carb happy snacks. Still, I keep reminding myself that getting another “I’m sorry” phone call from my doctor won’t be easy, either, and I’d rather feel I’ve tried everything I can if I reach that point. . . see my earlier note on control.

Supplements/Medications. This one is controversial and I’ve spent more time pouring through journal articles than I care to admit. I’m proceeding on the hypothesis that I probably have egg quality issues, since all other likely causes have been ruled out. I also know I have a short luteal phase (10 days) and light periods, so pending further testing, I seem to have lining issues. Thus, I’ve focused on diet and supplements for egg quality and lining. What are some of the options out there, and why might you consider using them?

Melatonin, 3mg, at bedtime. Several studies have shown that melatonin positively impacts pregnancy outcomes. A very small study out of Japan showed improved serum progesterone concentration (>10 ng/mL during the mid-luteal phase) in nine of 14 women (64.3%) receiving melatonin supplementation, whereas only two of 11 women (18.1%) showed normal serum progesterone levels in the control group (Taketni, et. al., 2011). In addition, for IVF patients with PCOS, implantation rates in a melatonin-supplemented group were higher than those of the non-supplemented control group. Pregnancy rates were also higher, although not significantly. The findings suggest that the addition of melatonin to IVM media may improve clinical outcomes. (Kim, et. al., 2013). There is also research correlating melatonin and premature labor, although I haven’t delved into that space. There are few, if any, studies suggesting harm from melatonin.

DHA – A number of studies link Omega-3 consumption to positive outcomes for pregnancy. I think this one is pretty well accepted, so I won’t bore you with citations!

Myo-insolitol 2g dissolved in water, 2x/day. Several studies have shown that myo-inositol can regulate ovulation, improve egg quality, and enhance embryo development (Carlomango, Nordio, Chiu, Unfer, 2011, Eur J Obstet Gynecol Reprod Bio; Kamenovz, et. al., 2015, Gyecol Endicrinol). While it’s probably most effective for women with PCOS, I can find no studies showing harm, and quite a few showing benefit.

Ubiquinol – 100 mg, 3x/day. A relatively small study out of Egypt (N=100) of women with PCOS who took CoQ10 daily showed higher follicle counts, thicker lining (8.82 ± 0.27 mm versus 7.03 ± 0.74 mm), and more regular ovulation (54/82 cycles (65.9%) vs. and 11/71 cycles (15.5%)), and higher clinical pregnancy rates ((19/51, 37.3%) vs. (3/50, 6.0%)) in comparison to women in a control group who did not take CoQ10 (Refaeey, Selem, Badawy, 2014). Ubiquinol is the more bio-available form of CoQ10.

L’agrinine – 1000 mg, 2x/day. This one’s controversial, so do your own research. A small study (N=34) out of Italy looked at poor responding women undergoing IVF. Half received L’arginine in addition to stims, the other half did not. The treatment group saw improved blood flow, improved number of eggs retrieved, higher numbers of embryos transferred, and 3 total pregnancies, compared to none in the control group (Battaglia, et., al., 1999. Hum Repro.).

Pycnogenol – While this supplement has been studied mostly in men, it’s also been shown to have positive impact on reducing endometriosis symptoms (Kohama, Herai, Inoue, 2007, J Reprod Med.). I am somewhat skeptical as the authors of most studies I can find are the same (vested financial interest, perhaps), and the one meta analysis I can locate showed only studies with small sample sizes (Schoonees, et. al., 2012).

Low dose aspirin – 81 mg 1/day. My OB suggested this as a ‘it can’t hurt’ measure. There’s also a bit of research to suggest it can reduce inflammatory processes and thereby help prevent RPL (Radin, et. al., 2015, J. Clin Invest).

There’s an interesting question around how long to sustain changes in diet and supplements to see results. I can’t find good answers in the literature, but for the changes I’m making, I’m going to aim for three months to start and see what happens. That will take me through all the rest of the medical testing I need, and will probably start me down some more invasive and expensive paths, given my age. Here’s to healthy eating and a healthy body!

Well, Hello There!

Hi there. My journey started in October ’15, when I had my IUD removed, just days after my 36th birthday. I remember my OB’s words: “Congratulations, you’re fertile!” Having been on birth control that prevented menstruation for nearly 15 years, I wasn’t sure what would happen next, but I knew my periods during high school and college were infrequent and light. I figured “fertile” might have been a bit of an overstatement, but we agreed that I’d wait 6 weeks for a period and call in for Provera if none arrived. I truly expected that the husband and I would spend 6 months trying to conceive through irregular cycles before starting fertility treatments in April 2016. I was the girl who’d gone 12 months without a period as a healthy 18 year old, so there was no expectation in my mind that 36 year old me could get pregnant, or probably even menstruate, without help.

To my utter shock, two weeks later I had a super light period, and 13 days after that, the opks I’d bought from Amazon showed an LH surge was approaching. Of course, life interrupted when my job was eliminated that day due to corporate restructuring. Nothing puts you in the mood to get pregnant quite as much as suddenly being unemployed, so that month our timing wasn’t great. Ten days after I ovulated, AF arrived, and by that time I had secured a new job and we were ready to try again.

Month two worked out better. Once again, the opks showed a surge starting on day 13 and peaking on day 15. Our timing was perfect. My online tracking software gave us a ‘high’ score, but hey, I’m 36, so I wasn’t expecting much. Still, day 10 post ovulation (DPO) came and no period arrived. Day 11 came, still no period. Since DH had to leave town for a week at 5 am on day 12, I decided to get a FRER and test that night. Within the 3 minutes, a second line showed up. Cue a straight-out-of-the-movies scene of DH picking me up and hugging me. We were ecstatic. The due date was our 10th wedding anniversary. It seemed like a sign and couldn’t have been more perfect.

Days passed and the lines got darker on the home pregnancy tests. I scheduled a first ultrasound, but due to DH’s travel schedule, it wasn’t until 9.5 weeks. I spent the time with mild nausea, the worst cramps of my life, and a few other nasty side effects, but otherwise all was well. Except that it wasn’t, because the ultrasound revealed a blighted ovum. Development had stopped weeks ago and my body hadn’t figured it out. I opted to have a d&c at 10 weeks in January. It was one of the roughest experiences, emotionally, I’ve ever had.

My doctor told me as long as we were emotionally ready, we were cleared to try again as soon as I’d had a period. It took a full 6 weeks for my hcg to hit zero and AF to start, but it did in late February. While March’s cycle had a longer follicular phase than normal, I got a strong positive on an opk roughly day 17, and our timing was once again good. Twelve days later, when my period still hadn’t arrived, I tested and got a faint line. The lines stayed faint, and when I went to the doctor for a beta around 17 DPO, it was 8. “Chemical pregnancy” they told me. I had therefore joined the 1%. That is, the 1% of women who experience repeat pregnancy loss.