The Miscarriage

I thought it was the worst period pain in my life. 

I didn't expect a miscarriage. 

Heck, I didn't even know I was pregnant, especially since we'd struggled through our journey with fertility, up to five failed cycles with hormones and IUI before we decided to give it a break for the year. 

That particular day started out with some period pain, but I had errands to run, so I took a strong painkiller and left the house. 

That's when the pain started; cramping abdominal pain that I convinced myself were some particularly strong period cramps, tried to convince myself that I was stronger than the pain and I couldn't possibly go to emergency - even when I was doubled over in the car doing breathing exercises to try and deal. It just got worse, and despite my trying to convince myself otherwise, after 20 minutes of the intense pain, I gave up, and asked my driver to bring me to a clinic nearby home. 

"I'm in a lot of pain, and I need a painkiller stat." 

I could barely stand at this point, and probably really looked awful, cause the nurse jumped up and brought me to the treatment room. 

Suddenly, it felt like a gush of fluid; like something being expelled from my body with a lot of force. 

And magically the pain stopped. 

So did my heart for a second. 

In all that time, the possibility of a miscarriage only flitted across my mind once, only to shrug it off as very improbable due to my infertility. And yet, I ended up in the clinic toilet, looking down at a bloody toilet bowl and what definitely looked like a chunk of flesh, half the size of my palm. 

It's funny what goes through your head when you're in that situation. 

I was more concerned about leaving a bloody toilet bowl than anything else at that point of time, because it was a stranger's workplace, and I didn't know what else to do. 

So I flushed. 

I admit I cried a little, for all of 2 minutes, more from shock of processing what had actually happened than anything else, then spent another 5 minutes reassuring the doctor that I was actually okay and just in a bit of shock. 

How can I explain the emotions that happened? The sudden pain, and the sudden relief, the process of denial, grief and acceptance all within the span of minutes? The rational thought that kicked in, and wondering what the next step would be - did I have to go to a hospital, or see O&G? Should I have scooped out my POC to bring it somewhere? Would I need a procedure? 

Being a doctor has it's pros and cons - but in those moments of panic I honestly felt like being overly rational didn't actually help (obviously even though the pain was 9/10 I wasn't rational enough to think it wasn't normal pain pfft). I did end up in emergency for a scan in the end. I did end up with some ongoing bleeding, but luckily the latest scan has been clear and I can be back to my normal life soon! 

Thank you for the thoughts and the prayers and the flowers and visits; I've had so much love from everyone that I'm so touched. Everything happens for a reason, and it wasn't our time to become parents. 

Perhaps we will one day, but perhaps we won't - I have faith that He knows what it best for us, and I leave it in His hands.

Starting on Clomid

So after my first fertility clinic consult, Behr and I decided we would be starting on Clomid for a few cycles and see how that worked out. 

I had to come in for the dreaded transvaginal scan on the second day of my period, and gosh, I have to say it’s rather awkward getting a probe inserted into your vagina when you’re having your period. In addition to hoping that blood isn’t gushing out, there’s the additional possibility of cramping just with the probe insertion. 

This was a baseline check to see my follicles during the first day of my cycle, and it would serve as a baseline to see how the follicles would grow over the course of the treatment.

I was started on a low dose of Clomid (50mg) to be taken over 5 days, and I’m relatively thankful that I didn’t get much emotional lability, which I’ve heard is a common enough side effect; although I did get a major case of the munchies (the type you get before your period, where you just crave certain foods and just want to each all the time). I have to say I ate quite a bit, but I also increased my exercise regime daily so I would make up for the increased binging (try not to have too many sweet things in the house, I really struggled when I had those cravings)! 

At Day 6, I came in for a scan and was told that my follicles were growing as scheduled, and booked in for another scan. 

The next scan was at D8, and the follicle size at the time was about 15mm (apparently the optimum size for the follicles before ovulation should be 18-25mm), but they estimated that it would grow to 18mm in another two days. I was advised to take the beta-HCG jab on Day 10, and have timed intercourse about 48 hours after the jab. 

I had a bad reaction to the HCG, and ended up being very lightheaded and having my blood pressure drop as a reaction to the injection. I suppose it could have been worse, but since it was the first time I’ve ever felt that way, it wasn’t something I was entirely looking forward to. 

I’ve got a couple of weeks to figure out whether we’re successful this cycle, but in the meantime, it was interesting to have scheduled intercourse with the possibility that we were actually actively trying to have children. 

I suppose it was something that never seemed very real to me, but now we’ve started on this journey, it’s only starting to seep into the edges of my consciousness, almost as if my mental state was separated from the automated cognitive processes that we had undergone to kickstart the pregnancy journey. 

In the meantime, please keep us in your prayers and wish us luck!

The First Fertility Clinic Consult

So today was the first appointment I had at the fertility clinic, and Behr and I were there bright and early to make sure we got a parking spot.

So prior to seeing the specialist, I had to do another transvaginal scan (noooo I hate those things, but what can one do). The clinic has a dedicated sonographer that screens patients, most likely because their scans are more accurate I assume. Somehow trying to consciously relax your vaginal muscles when the probe is inserted is much more difficult to do that it sounds. 😑

We then met the specialist, Dr M, who talked really fast and walked us through the investigations that we had done.

So we were lucky that most of our scans were normal - ovaries were fine, tubes weren’t blocked, sperm analysis was better than normal (Behr was super happy lol), and all the hormonal assays were normal except for progesterone, which was below the normal range (that’s the culprit right there)!

Dr M basically told me I was anovulatory - that my ovaries were not releasing the ovums (why ovaries, why?). If we all remember our basic biology, the ovum is basically the egg that the sperm has to inseminate to make an embryo, and basically mine were just staying in my ovaries. 😑😑😑

So we had a few options, and he went through them super fast, so my head was spinning a little bit from the information overload.

The first option would be to try a medicine called Clomid, which would basically encourage ovulation. That would just involve taking pills, but I would still have to come in for a scan on the second day of my period to make sure that my ovaries would be ready.

Failing that, the next option would be for artificial insemination (intrauterine insemination or IUI), but apparently the success rate was pretty low.

The next step was in vitro fertilization (IVF), which costs a bomb, would need quite a few hormone injections, egg collection (under sedation) and the whole process of putting the embryo back in. That would most likely be the best option for us.

It would be fine to try a couple of cycles for the hormone treatment, but essentially the concern was that the longer we waited the lower the success rate would be (basically he told me my ovaries were old, even though I don’t feel old at all). 😪 Dang biology.

Sigh. So here we go, down the rabbit hole.

So I might be massively putting on weight, or I might be eating more than usual or having more mood swings (as Behr puts it, being more ‘woman’ than usual) on this treatment, so I’m mentally prepping myself for more gym runs and to eat healthier in the event that this might all happen (please hormones be kind).

In the meantime, anyone has thoughts or feedback about IUI or IVF? Any recommendations for centers, good doctors, experiences - I would appreciate any feedback!

Starting Our Infertility Journey

Recently, Behr and I started on our infertility journey. After a year of trying for a child, we realized that we were probably going to be one of those couples that would have some difficulty conceiving.

I went for the first appointment and they organized for some blood tests, a semen analysis and a hysterosalpingogram, which were all done at different times.

Behr did his semen analysis first and it was a hilarious few days, making sure we didn’t have intercourse for three days prior (classic case of the more someone tells you no, the harder it is to abstain), and waking up bright and early to get the sample over to the lab. I asked if they had magazines to inspire him, and I remember us laughing over it.

This week I did my hysterosalpingogram, an imaging test that basically checks if your Fallopian tubes are okay. It involves inserting a catheter up your cervix and injecting a contrast dye in that tracks upwards.

I had to lie down, be prepped so I was sterile and they inserted a speculum in (uncomfortable!). There were a first year and a third year radiology masters student, but the first year female doctor proceeded to attempt to put in the catheter.

I was prepared for it to be painful, but I had taken a painkiller, so the pain was tolerable. The first doctor couldn’t insert the catheter though (I could hear the words difficult, if I force it it would be traumatic etc), and at that point they would call a registrar. As they opened the door a crack and the registrar poked his head in, I realized it was Jimmy, my ex-medical officer back when I was a houseman. FML.

Eventually they called in a female registrar and they finally proceeded. As they injected the dye, I got these massive abdominal cramps - I must have been making a face because they then put in a brannula to give some IV medications.

Apparently the procedure usually takes 30 minutes, mine ended up taking over an hour. 😅 I was good immediately after, but later that day, I had the worst cramping pains I’ve ever experienced - I couldn’t walk, didn’t have any painkillers on hand, and basically stayed curled up in bed until Behr came back with a hot pack and medicine. I was still in pain for two days after!

The things women have to go through. 😑

I wanted to share our story because I’ve had so many people telling me they went through a similar situation, and I don’t think it’s something to hide behind.

Infertility is more common than you think, and I don’t feel it’s something to be ashamed of. It’s a shared problem - and if you have been trying for children for a year without success, both partners should be tested.

Children, like everything else, are blessings from Allah. Behr and I have decided we’re not going to be super fussed either way. We’re just at the beginning of a journey, and we have no idea where it will lead us. We’re lucky in so many ways, and whatever comes up in the process, we’ll just take it as it comes. I’m lucky to have Behr, who’s been supportive throughout, and in this journey with me.

And for everyone else going through the same journey, we’re all in this together. 😘