Wednesday 31 July 2013

Post miscarriage - things I am thankful for

In the world of infertility and loss that I find myself, I hear stories of other women and how they are coping or not coping. So I want to write a list of thanks.

I am thankful that I have had a healthy pregnancy and have the joys and love of my son. I am well too aware of those that have no children in their arms, just in heaven.

I am thankful I have got pregnant twice through IUI - and in short timeframes.

I am thankful I have a body that has a uterus capable of holding a pregnancy, and that I can try again.

I am thankful my depression has not overtaken me with the loss of this child.

I am thankful for an amazing and supportive husband, and the smiles he brings to my life.

I am thankful for the smiles I get from my son - who reminds me no child wants to see a parent sad - not even those in heaven.

I am thankful, that although life can be hard, it can also be amazingly good.

I am thankful for my friends - the ones that know - the ones that support.

I am thankful to my family, for caring as much about the loss of this child as I have.

Some days you just need to remind yourself and be thankful.

Tuesday 30 July 2013

Weird things happen when I am pregnant!

Before my husband (DH) and I got married, we broke up for a short while. In that time I had to do a lot of soul healing - and for me that was in the form of meditation. Seeing my white light and healing from there. If you have never done it, do try it. It can be as simple as starting by visualising a burning candle, and then visualising your own energy. It takes time but it was a beautiful healing time - so much that my DH noticed the difference in me when we finally met again - the rest is history.

So why am I telling you this. Well when I started trying for my son, I was very stressed. As I mentioned in my previous IUI post,  the process is very hard mentally. I was a bit of a train wreck and so went back to my visualisation and meditation. When I got pregnant with my son - I knew it had work because I suddenly saw another little energy. The only way I can explain it - it was the purest white light and it was a lovely globe shape. I always cried when I saw that energy - it was just so pure. I freaked myself out when I said to my friend she was pregnant with twins. Two weeks later she confirmed she was pregnant, and two weeks after that she as pregnant with twins. It still shocks me that I could see this - but it seems I only see it when I am pregnant.

So the same thing happened when I got pregnant with my little angel. I saw the energy - but even then it looked wrong to me. Instead of a globe, it looked like it had been strangled in the middle two globes joined in the middle - I thought at the time that maybe it was an identical twin - and didn't think much more about it. The energy of my angel wasn't as strong as my sons, and I just thought to myself I was fooling myself with this idea I could see my childs energy - and I tended to not look for it, as it just felt wrong.

I wonder now - did I see there was something wrong? Did my baby tell me - and I just had no idea? How the do I even see it? I am a scientist, I am rationale, and I shouldn't believe in the estoric world - but sometimes I need to just believe and hope and pray - it is the only way to get through this time.

I hope when I eventually can have a rainbow baby, I will get a sign again, and faith all will be okay. I have no idea how to cope with the stress another pregnancy may bring about, but I know I need to manage it to be able to have another child. Ultrasounds can happen - but I miscarried after 12 weeks, I now feel no time is safe. I got through my sons pregnancy by looking for his energy before I felt him move. I hope I can get back to meditating and using that to calm me down... I just hope I get to experience it all again, even the stress. It is still better than no pregnancy or baby.

What is the strangest thing that has happened to you while pregnant?

Monday 29 July 2013

I want my nights back

Night has always been a save haven for me. Sleep a comfort and dreams an escape when I needed it. Since the miscarriage a number of things have happened.

I wake up at 4am EVERY MORNING. I don't know why. Did my baby die then, and I am waking then. Is it because the 3/4am time is suppose to be more in tune with other wordly thing. Is it just my hormones causing me to wake every E%%#$ morning?

I dream... last night my dream really got to me. I dreamt I had my baby, and struggled to get my baby to breath or live. I tried it all. I tried to work out if it was a girl or a boy, but my baby was just wrong. My dreams hurt.

And I wake up longing for the lost child.

I hope it gets easier. I am so tired!

PCOS - how I overcame PCOS and won my battle!

I have opened up comments to everyone now! So please feel free to leave a comment. 

My story

When I was 17 (just under 20 years ago) - I was complaining to my doctors how AF (period) was never normal. I was yet to be regular and the answer I kept getting was - "you will grow into it". My Mum mentioned it to her gynaecologist who suspected that I may have a condition that was just starting to be discussed. I was sent off for blood tests and an ultrasound. I still remember that fateful day when the sonographer turned around and told me I had cysts on my ovary and would never have a child.

My world kind of crashed around me that day. I loved kids, wanted to be a mother and generally at the age of 17 - could not deal with it. I cried. And cried. And cried some more. I finally had the appointment with the gynaecologist who explained that I did have a fertility problem - but I was not infertile! It would just be harder for me, and I was at risk of a multiple pregnancy due to my condition releasing more eggs at the same time. I had what they called Poly-cystic Ovarian Syndrome. I had too much male hormones and little cysts on my ovary - which caused the lack of AF. She could help me by putting me on the pill and seeing how I went. Well Yee-Har! I finally starting to get periods and less facial hair! Six months after starting the pill, I decided to get off it. I ended up with more facial hair and a lack of periods. When I went back to her, she prescribed the pill and another drug. An anti-androgen drug they used to treat men with testicular cancer with (women with PCOS have high androgen hormones - a male hormone). My mum did not want me to go on this drug - and when we said we were not happy things got nasty. I was told I would end up with cervical cancer if I did not take the drug - and she wrote a letter saying it as well. Well what do you do with that? Get a second opinion. There was a great IVF doctor (remember this was the 90s, and fertility medicine was still being pioneered) that a family member had used. I went and saw him, and lo and behold he had just started to work in the field of PCOS (things happen!). He was shocked by the letter and that I had been told I would get cancer and that I had been prescribed the anti-androgen medication. He explained that I was only at risk of cancer, if I let me lining build up by not having a regular period. As long as I was on some sort of birth control, this would not be a problem, and the BC I was on had some anti-androgen properties that would help as well. He told me to come back when I wanted to get pregnant, and he would help me.

The next 13 years, I just accepted my PCOS. With comments from lose some weight and it will fix the problem (down to 58kg and still no AF mister!), I really did not look much more into it. The internet was now very active, and I decided to do a bit of detective work. I read a paper on PCOS that caught my eye - (please read it) - it changed my life!. It discussed the latest finding of PCOS - and what caught my eye was the first page with a title of "Common misconceptions about the polycystic ovary syndrome". Under this heading was  a comment on "You will get cancer". I stopped, read it again, and went - that was me. I finally looked at the author, did a few calls and discovered that it was indeed my saviour doctor - who was now a leading expert in the field. I made an appointment and started on my battle against PCOS.

PCOS - what we now know :
So back when I was first diagnosed they knew it was a syndrome - made up of a whole lot of different things - but they didn't know why. They also saw these cysts on the ovary. Well we know a lot more now.\

1. Most women who have PCOS is due to a hormone imbalance. This is caused by an underlying insulin resistance issue. Insulin is a hormone - and all hormones in your body are on a feedback loop. What that means is if one goes out of balance, the whole system is out of whack. Our cells are not receptive to insulin, so we have too much of that hormone in our blood, which puts us out of whack - and increases our male hormones, which leads to all the problems we find (loss of hair, hair growth, weight gain, fertility issues etc).

2. We don't have "cysts" on our ovary. What we have are unreleased follicles. A follicle is formed when we make eggs, but with PCOS we don't release the egg and we are left with a follicle. I have about 150 across both my ovaries. These cysts also make our ovaries larger - so yes I have big ovaries!

3. Size does not always matter. Women who are thin can have PCOS - but all women with PCOS are likely to put on weight. I have found as I have got older and my IR has got worse, my weight has been more difficult to control.

4. It is an evolutionary thing. Supposedly this evolved from evolution, when we were starved of food, so our body put in a mechanism to store energy for longer. Thanks evolution!

5. Signs you are insulin resistant are - skin tags (those loose flappy bits of  skin - I have them under my arm), and skin darkening (Acanthosis Nigricans) (again I have them under my arm, I could never understand why I always looked like I had a shadow under my arm - it was due to this)

6. You can get pregnant!

7. There are a few other causes - but the majority of women this is the major factor.

8. That depression you get? That is real and caused by our horrid hormones!

9. PCOS is a redundant name.

10. You are at a higher risk of heart disease, diabetes and a variety of other fun stuff. But if you get your IR under control you reduce your risk. You are also at a higher risk of gestational diabetes.


PCOS - how to help:

1. DIET - why is this so important? Well it is all to do with IR. In people with IR our insulin levels raise and stay high, while in normal people it will fall back to normal. Simple diet changes and exercise can get you approximating a nearly normal IR curve. The best diet? The low GI diet. The best book to help you understand it : The New Glucose Revolution.

2. METFORMIN - why is this drug so well used? It is a diabetic drug, used to treat diabetes before people inject themselves with insulin. Something in metformin helps reduce your IR. They don't know what part of the drug it is (it's like hitting a nail with a sledgehammer) but it works. Ask for the slow release (XR version) as it is much gentler on the tummy. You also want to be on it for when you are trying to conceive in the first trimester, as it helps regulate your hormones and prevent a miscarriage.

3. GOLF BALLING/OVARIAN DRILLING - this is something I had done, after the top two got my IR down to near normal levels (yay!) but I still had irregular AF and very painful periods. I was sure I had endo (but thankfully I don't!). This surgery came around as they use to first treat women with PCOS but slicing off the "cysts" of the ovary - it was called a wedge resection. Most of the time they actually killed the ovary - but in a small amount of women, this procedure got their ovary to heal and start working again. Ovarian Drilling was a modified version of this, where they drill holes into your ovary to try and get them to kick start. It is great if you are having problems conceiving, as you are very fertile after the procedure, but it only lasts about 3 years. There are risks - if your doctor doesn't know what they are doing they can kill your ovary. It was a hard choice for me to make but I went with it. He also did a D&C - and found out why I wasn't getting AF on my own. My lining was FULL of hormones which was interfering in my cycles. Within about 6 months of my surgery I was getting a semi-regular AF (at least one every 4-6 weeks!). This procedure is rarely done these days!

4. DETOX DIET - I swear by this. The best way I can explain our fertility is that our bodies are under so much pressure. When we feed it bad food, our digestive system is under stress, and our entire system is focussed on dealing with that. The system that gets the least attention is our reproductive system. PCOS bodies love good food and exercise. If you are having problems think about a detox to get rid of all those bad hormones and kick starting your reproductive system.

5. MISCARRIAGES - are real and happen at a much higher rate when you have PCOS. PCOS related miscarriages seem to be due to the hormonal imbalances at the end of your period. High hormones cause a spontaneous loss - but metformin stops this effectively. My loss was unlikely to be due to my PCOS due to it being much further in the pregnancy.

6. FERTILITY TREATMENTS - can be as simple as clomid, or as intense as IVF - but a lot of the time clomid and metformin get PCOS women pregnant and keep it that way.

7. IT IS NOT A LIFE SENTENCE!! I have met women who have cried their life is over due to PCOS. It isn't - it just may not be as easy :)
 

I have come such a long way from just treating it with the pill. I have not been on the pill since I was 30, I have regular AF, and two pregnancies! I never had gestational diabetes, and I am hoping to have more children born healthy. I have never been obese, though at times a little heavier than I like. I understand my moods - caused by my hormones, and I have chosen to try and treat the underlying cause (IR) rather than the symptoms (by using the pill).

Disclaimer - I am not a medical doctor, please consult your doctor for all concerns!


Sunday 28 July 2013

Things I have learnt about infertility, IUI and IVF - besides how rough it can be!

First off I have to mention I am not a medical doctor. If I was chances are I wouldn't be writing this post! I do however have a PhD in molecular biology, have studied developmental genetics and generally do a lot of research into things. So I decided to write this post to answer a lot of the questions I have had and that many people seem to have about the IUI process (and the difference with IVF). I also want people to know how hard this process is emotionally and physically. It takes a real toll on you mind and body.

So far I have had 5 IUI's and 2 pregnancies - so I have had a 40% success rate. Most IUI clinics have lower rates - on average they give you a 20% chance on every cycle. You need to do at least 3-4 cycles before throwing in the towel and moving onto IVF - because of these statistics. And you need to remember these statistics come from couples who are having problems conceiving, so they will be lower. My son was conceived after 3 IUI's, and my angel baby after 2. I am praying my next baby works after one - so I can have a 50% success rate. Now that would be awesome!

There are a variety of different ways you can do IUI.
1. Natural cycle - no medications taken, you wait until you have your surge (when your egg will be released) and go into the clinic and have your insemination.
2. Clomid cycle - you will be on a tablet - where they may or may not monitor you closely.  Again they will wait till you surge (or give you a shot to make you surge) and you will go in for an insemination.
3.  Injectable cycle (what I did) - you inject yourself daily with medications and will be monitored closely. They will give you a shot to make you surge/ovulate and you will go in for an insemination. I will be discussing this process below.

What happens before the process:
Each clinic is different. But most will do something along these lines. Please check with your clinic on how they will treat you. They will do blood tests on you and your partner to check you have no infections or underlying problems. They will also do a sperm analysis to see if your partners sperm is high enough and motile enough to get pregnant without IVF. They will also do some sort of internal check - normally a day procedure - to check for scarring, blocked tubes and endometriosis (and maybe some other things never mentioned to me!). They will then let you know if you are suitable for IUI. You then wait for AF (Aunt Flo - your period) and call the clinic when it arrives.

Day 3 of your cycle:
You will go in and they will check that you are not pregnant and that you have no cysts on your ovary. If you have cysts they will cancel your cycle - and may put you on birth control pills. If all is okay they will tell you how much medication to inject yourself. This is a hormone which helps ripen up those eggs! The first cycle you do is always hit or miss. Due to them not knowing how your body will respond to the medications, they need to monitor you and see how you go. They may up your meds if you don't respond, or cancel your cycle if you over respond (more on that later).

Day 3-14 of your cycle:
At some point you will go back in and they will check you to see how many and how big your follicles are. You may then be asked to come back in, or be told to give yourself your hcg/ovidrel shot (pregnancy hormone which will make you surge and release your egg (ovulate)). They will then do your insemination.

Day of IUI:
Your partner will need to give a sample that morning (unless they have a frozen sample), which they will clean and prepare. You will go in a few hours later where hey will insert a catheter into your uterus and inject you partners sperm into you. You may find you bleed and cramp a little after. That is normal!

About 3 days post IUI :
They will test your progesterone levels. This tells them if you ovulated. It tells nothing more. I have great progesterone levels, but still need progesterone support as my hormone levels drop off too early for my to sustain a pregnancy. I also have had sky high levels without being pregnant. Lesson : Don't read into it!!

About 14-16 days after IUI:
If AF has not arrived you can go in for a blood test to find out if you are pregnant (if you haven't tested already).


So that is the nuts and bolts of it.

The fine print :
The whole process is torturous. The first part of your cycle you are constantly worried if you will be over stimulated. What does that mean? Well it means you produce too many follicles. They will cancel a cycle if you have over 3 follicles where I live - and I highly recommend you don't go ahead. I have just read a story of a woman - desperate for twins - who had 10 follicles, and went ahead and now has a suspected quintuplet (yes 5) pregnancy. She is at high risk of losing all the babies, needing a reduction or losing her own life. As much as we want a pregnancy, be aware that lots of follicles can result in a high multiple pregnancy. And that is ten times worse than a cancelled cycle. I don't envy this woman or the choices she will have to make.

The hormones make you Crazy! With a capital C! I cried, I screamed, I wanted to throw my husband out of the house. Just some of the fun of the party.

The two week wait is horrible. Dr. Google is NOT your friend. You will find out soon enough, just try and have faith!

Can I do a pregnancy test with a home kit? Yes you can - but be aware the trigger has pregnancy hormone. On average a 10,000 unit injection of ovidrel will take about 10 days to get out of your system (1,000U a day), but changes with different people due to your metabolism. So if you test too early you may have a false positive. I tended to test at home at 12/13dpiui (12/13 days post IUI).

What if it doesn't work? You can jump straight into another cycle as long as they are happy you have no cysts (or large cysts). I had a baby one when I went in for my third cycle and got my son :)

Find a support group. Some great support sites are around with women going through what you are going through - have a look for them.

IUI is great if you end up pregnant as you are so closely monitored! Lots of blood tests, scans and a hopefully supportive doctor to help you through your first trimester.

So what about IVF?

The big difference is you are on a lot more drugs on IVF. They want lots of eggs - so you are on much higher doses of the same drugs, as well as drugs to stop you from surging and releasing eggs early. You then go in for surgery where they will aspirate (collect) your eggs as they are starting to be released (once they are released they can't collect them). The eggs and sperm are mixed together, monitored and then some are put back into you. It is a much harder process than IUI physically, and the mental challenges are still there.

Final disclaimer: 
Each clinic has it's own protocol. I have written about my experience and what I have learnt. Please contact your clinic if you feel something is wrong, or you have more questions. This can be an expensive process, depending on where you live - and you need to feel comfortable in what you are being offered.

This is not medical advice or guidance. Contact your clinic for more advice.

Any other hints or tips out there on how it went for you?

A tough weekend

This weekend seemed to be really tough. It started with some bleeding and cramping and a rush to the doctor. I was given a referral for an ultrasound - which I was dreading. To see an empty uterus - I wasn't ready for that. Things subsided and so far I haven't gone for my ultrasound. I just feel like my body is reminding me of what has happened. I can try and move on - but I'm not sure my body will let me. 

I also worked today. A job I did when I had just fallen pregnant. It made me think I had fallen pregnant as I couldn't do the job properly. Today I got to be in the same place knowing I should be sitting and  showing off a belly. Instead I saw little babies, pregnant women and photos of newborns. I rushed around carrying stuff thinking I shouldn't be doing any of this. I should have my baby in my belly and I should be taking it easy. I cried on the way home. I feel so flat now. I really miss my baby. I want to move forward but I can't sleep properly. I feel sick all the time and cry at the drop of a hat. it gets easier doesn't it?

Thursday 25 July 2013

A first post - a post of loss (warning - miscarriage mentioned)

About two weeks ago I was quite excited to have finally got to my 12 week scan. I was 13 weeks along, and couldn't wait to share my news, as the next day was my birthday! And what a birthday gift I thought I had! This baby like my first was an IUI baby. It is a process in which I inject myself with hormones to help produce eggs as well as release them, and then my husbands sperm is inseminated into me. The cycle seemed perfect (my second cycle after the first failed), and I had already had a 6 and 7 week scan showing a perfect bub. It wouldn't be till 12 weeks till my next scan, but some spotting at 10 weeks had me rushing to an ultrasound where I saw my little baby moving and wriggling and waving it's little arms around. A wonderful heartbeat and perfect growth.

I remembered later that I did wake up the morning of the scan, with a feeling something went wrong. I went to the bathroom to check bleeding (there was none) and reminded myself the chance of miscarriage at 13 weeks after having a perfect scan at 10 weeks was less than 5% (and I have even read 1%). I completely put it out of my mind for when I finally got up. When we entered the room (my husband and son), the ultrasound technician asked how I was feeling (she did my 10 week scan) and I wanted to say I had some strange feelings below - but I didn't. I thought I was just over reacting. The scan started and she said the baby was asleep and was facing my back. It was in a bad position and I did wonder why I couldn't see the heart beating. I asked if it measured right - as it looked small to me, but she said the measurements were perfect. She then did an internal as the baby would not move position. And then an external. And then those words (or to this effect). "I have to be honest, I am having problems with this scan, I can't find a heartbeat and your baby won't move. I was stumped as it did measure correctly, but I am sorry this pregnancy is no longer viable". She gave us a moment. In a daze I got up, cleaned myself up, grabbed my son and walked out with my husband. I asked when did it die? And she said in the last few days, if that. We then went home and I just sat there.

I prayed my body would allow me to miscarry. So I would know for sure. I wanted to see my baby, hold it and let it know it was loved. But I never got that chance. I was booked in for a suction curette a week later - and by that time I knew. My uterus felt smaller, I could lie on my stomach, and generally I knew it was over. I would have been 14 weeks. I walked into the surgery trying to be brave but as they injected into me the anaesthetic all I could hope for was to go to sleep. I remember waking, and within a few moments crying again. My baby was really gone. And I had nothing left to remember it by. Just some early ultrasounds and my love in my heart for my little one.

I still am in shock that the supposed "12 week" mark is not as safe as it seems. I am so glad our scan was at 13 and not 12 weeks. I don't know what would have happened had I had a perfect scan to lose the baby suddenly. At least I had time to prepare. Time to say goodbye.

It now just over a week and I am trying to heal. Trying to move forward. Trying to be strong for the family that is here. But it is hard. I feel this longing and missing of this child. A child I was convinced was a girl - a much longed for daughter. But I cry at the thought of another son - a little brother to my amazing boy. I am trying to forgive myself, for reasons I will explain in future blogs.


I will post a lot more about my infertility issues caused by PCOS. And post a past blog about how I got pregnant with my son - and that journey, as it may help others. But right now I need to share my story of loss.