Monday, January 7, 2013

Infertility: fact or fiction

Infertility (noun): not fertile; especially: incapable of or unsuccessful in achieving pregnancy over a considerable period of time (as a year) in spite of determined attempts by heterosexual intercourse without contraception.

Ok, infertility… hmm, that’s a lot to wrap my head around. I mean, Brandon and I have not been trying for a year.  I mean yes, I stopped taking birth control in December 2011 but at that point it was just a matter of, “let’s stop trying not to get pregnant” and we really didn’t start talking about trying until March and we didn’t really start using ovulation predictor kits until… You know what, it doesn’t matter, based on that definition, I am not infertile.  Yep – that’s what I can keep telling myself or I can own this, whatever this is, and take steps towards making more people, especially the people close to us, more comfortable with this (seemingly) taboo topic. Obviously, I am choosing the latter.  You weren't sure?  Did you not see my post about the HSG?  Seriously - you better read it.  I'll wait. 

The reality is that one in six couples will experience some degree of infertility.  In order to really understand what was going on with the whole elevated prolactin level thing, Brandon and I sat down with one of the physicians I work for at Shady Grove Fertility, Dr. Michael Levy.  Turns out, we’re totally not infertile because we were able to conceive.  Brandon and I experienced something that I hope no other couple ever has to go through.  In the spring of 2012, I was 10 days late, I had taken probably 10 pregnancy tests, all positive, I had planned out the perfect way to tell my wonderful husband that it was a good thing we bought that house because our little family was growing, and then it happened. I started cramping and I spiked a fever. I had some spotting and then (to keep it more G-rated) I got my period. (I know – that’s a little TMI, but not so bad about the HSG post, so deal with it).  I never got to tell my husband that I was pregnant.  How do you tell someone you miscarried when you didn’t even get the chance to tell them you were pregnant in the first place?  You don’t.  At least, I didn’t.  I bottled it up and I kept it in and I mourned it by myself.  It took me over a month to finally talk to my husband, my wonderful, caring, undeniably supportive husband, about what had happened.  He had noticed a change in me, but didn’t bring it up, just walked on egg-shells to avoid a fight and that's no way to live.  Opening up about my miscarriage is the best thing I have ever done.  It has made the experience easier to deal with.  I am extremely blessed to have the support system I have.

Now enough with the sad stories and the mushy gushy – I decided to educate, and that’s what I plan to do.  When I had originally approached Dr. Levy with my day three blood results, he told he that he didn’t want to piecemeal my treatment together.  He wanted to do a full prescreening work-up and do things the right way.  He wasn’t going to half-ass my care.  Gotta love him.  I explained the situation to Brandon and got him on board which was easier said than done.  Going to see a fertility specialist is a lot to take in.  I mean, we all know that fertility treatment isn't cheap and there are insurance plans that don't cover infertility treatment at all (thankfully, we don't have that kind of insurance). Before Brandon and I sat down with Dr. Levy, Brandon was convinced that Dr. Levy was going to immediately suggest the most expensive, most intense treatment options and that we were going to have to take out a second mortgage on the house in order to afford treatment and get a baby.  Honestly, I don’t think Brandon knew what to expect, but I think he found himself pleasantly surprised. 

Before we met with Dr. Levy I had done my day three blood work and I have great numbers (minus that whole prolactin drama), I had done the MRI of my brain (with and without contrast) and my brain looks great (we can't 100% rule out any prolactinomas, but we can say that I do not have worrisome prolactinomas), and I had done the HSG and Dr. O’Brien told me that I have a “beautiful uterus” – how’s that for a compliment you don’t hear every day!  Dr. Levy reviewed these results with us and said that he did not want to do invasive treatment.  He did not want to take drastic measures.  Dr. Levy is a "less is more" kind of guy.  He did say though, that he wanted to do an ultrasound the day after our visit with him to make sure things looked good and he wanted Brandon to do a semen analysis to make sure things looked good there too. So the plan was:  we get my prolactin levels under control and look at timed intercourse and, if needed, intrauterine insemination (IUI).  Don't worry, I'll explain IUI later; after all, I am a teacher these days...  

So let’s recap, shall we?  I work for the leading fertility center in the entire country and I work as the clinical assistant for one of the founding physicians of said fertility center and one of the most wonderful and talented female physicians of that practice.  I mean, I am literally working for the best of the best in the field.  I can totally own this (whatever this is) and know that I am in the most capable hands in the country.  

Dang, this whole infertility/non-infertility/elevated prolactin drama thing was easier to digest than I had thought it would be.