BY ESTHER HOLMES
Trigger Warning: This article mentions and discusses miscarriage.
I was first diagnosed as infertile in October 2017. My husband and I had been trying to conceive for almost 12 months by that point, and hadn't been successful.
I decided to buy some Ovulation Predictor Kits (OPK), and a Basal Body Thermometer (BBT), measure my cervical mucus and position to track if I was ovulating. This is known as the Fertility Awareness Method (FAM) which can be used for trying to fall pregnant, or avoiding pregnancy to determine your fertile window.
Despite what we were taught in sex education through our schooling years, it is not possible to fall pregnant at any time during the menstrual cycle. The average healthy woman will only ovulate once during her cycle, typically between Cycle Day (CD) 14-18 of a 28 day cycle.
From the moment the egg is released, it begins to die.
There is a small window, typically of 24-36 hours when the sperm can fertilise the egg, before the egg dies.
After 3 months of negative OPKs, no temperature shifts, low to no cervical mucus and irregular menstrual cycles that could last anywhere from 45-62 days, I made an appointment with my GP. I presented him with my data and explained that I didn’t think I was ovulating. He confirmed that it didn’t appear I was, but gave me several pathology referrals for CD 16, CD21 and CD28 blood tests to measure my hormones, as well as pelvic and transvaginal ultrasounds.
He also gave me a referral to a fertility specialist, but it would be February 2018 before I could be seen.
As I suspected, my blood tests confirmed Anovulation. Anovulation is the lack or absence of ovulation, and is the most common cause of infertility. Anovulation is often the result of an imbalance of hormones, and can be a result of thyroid conditions, polycystic ovarian syndrome (PCOS), autoimmune disease, as well as a variety of other factors.
The ultrasounds also found multiple cysts on both of my ovaries.
From there, it was a waiting game until I could see my fertility specialist.
February finally arrived, and as I had already had the preliminary tests done, my fertility specialist was able to formally diagnose me - Primary Female Factor Infertility (unexplained), as well as begin treatment. It’s difficult to describe what I felt when I heard those words. It was a small comfort to know I was “right”, but it then meant that my body had failed. I felt as though, being a woman, my body was incapable of doing the one thing it is ‘designed’ to do. I felt as though I had let my husband down, and my family down.
There is a process of being treated for female factor infertility. The first step is oral medication to try and induce ovulation. There are several drugs on the market available, and it will depend on your diagnosis and test results as to what is most appropriate for you.
My specialist decided that Letrozole was the most appropriate drug to start me on. I ovulated and fell pregnant on the first cycle!
Unfortunately, that pregnancy resulted in a miscarriage.
Losing that baby was beyond devastating. I was crushed. I kept trying to rationalise with myself that I hadn’t been “that far along” and that “it could have been worse”. But again, the feelings of failure, and letting my husband and family down crept back in.
Not only could I not fall pregnant naturally, I couldn't even sustain a pregnancy to term. I sunk into a deep depression, which took a lot of time and the help of a wonderful grief and trauma therapist to work my way through.
It would be another 6 months of fertility treatment before I would fall pregnant again. I spent the entire 9 months with extreme anxiety, terrfied of losing the baby again. I changed so much about myself, and my lifestyle, desperate to ensure this pregnancy made it to term.
And that pregnancy was not easy - I had Hyperemesis Gravidarum (the same thing Kate Middleton had through her first pregnancy). I was hospitalised several times to receive fluids, and to monitor the foetus.
When I was 35 weeks, I was diagnosed with preeclampsia and spent two weeks on bed rest in hospital.
At 37 weeks, in March of 2019, I was induced and gave birth to a healthy baby girl.
Shortly after our daughter's first birthday, my husband and I decided that we were ready to start trying for our second baby.
We made an appointment with our fertility specialist to begin the process again.
I had not had a period since conceiving my daughter in June 2018, so we began by attempting to induce a period using a drug known as Provera.
That drug did not work, so my specialist suggested just picking a date to begin taking the Letrozole again.
This time around, the letrozole did not work.
My husband and I made the decision to change fertility specialists to a clinic that had higher success rates.
Over the last 12 months, I have been prescribed Letrozole, Clomid and Tamoxifen, all oral medications used to induce ovulation.
Even on the highest doses, my body has not ovulated, and I have not had a period.
We are now at the stage of starting In Vitro Fertilisation (IVF).
The process is not widely known, discussed or shared, so I will be documenting my journey and sharing it with you all - the highs, the lows, the heartbreak and the joy.