infertility journey

Anorexia Nervosa can inhibit a woman's fertility. When a woman's body weight becomes too low and thus goes into "starvation mode" menstruation will cease because the body can no longer produce the hormones necessary to ovulate. Even when a woman has returned to a normal weight the stress endured from the eating disorder can leave the body infertile. Doctors report that while some women's fertility is forever damaged, this is not the case for every woman. Every woman, body, and bodily reaction is different. Below is my infertility journey. 
  • May 2010 - Decided we were ready to get off birth control and not ready to officially "try" to become pregnant but just"see what happens"
  • May - August 2010 - four months go by and I never have a cycle
  • August 2010 - several blood & hormone level tests done 
  • August - September 2010 - test results in -  I have hypothalamic amenorrhea.  My gynecologist recommended that if we were not ready to get pregnant I need to go back on birth control in order to have a regular cycle (as there are other negative side effects of not having one). If we were ready to get pregnant then we need to begin working immediately with a fertility doctor, as my body does not have the proper hormone levels needed to conceive. We talk, pray, and decide that since who knows how long this road will be, we will start now. For further details specifically on ED and infertility click here and read for more info.
  • September - October 2010 - Started working with fertility doctor who confirmed that Clomid is not strong enough for me. I must go straight to trying Follistim Injections. Before injections I must have a Hysteroscopy. Hysteroscopy revealed I have a large uterine septum (basically lots of scar tissue) running up and down the middle of my uterus (this has nothing to do with ED, had this my entire life apparently).  Doctor cleans out the scar tissue and goes back in, a few weeks later, to make sure it has healed. All looks good and I am clear to start injections but first I need to have a period. 
  • November 2010 - Doctor prescribed Provera to trigger my period. It worked! (a good sign for someone with a history of anorexia). Started 1st round of Follistim injections and Dr said that my body responded beautifully as I had 3-4 good size follicles/eggs. I was given the ok to give the Ovidrel injection (shot that triggers ovulation). Did not conceive. Dr said to call on 1st day of my next cycle to set up base line blood work and ultrasound. 
  • December 2010 – Cycle begins! Went in for base line tests and Dr saw that I had two large ovarian cysts, a common side effect from the injectable medications. Put me on birth control for a month in order to help cysts dissolve on their own and told me to call him on 1st day of my next period to start again. 
  • January 2011 – Cycle begins again and went in for base line tests. Cysts were gone, so I was able to start 2nd round of Follistim injections. They kept me on a dose of about 112 IU each injection. In the end I had to cancel the cycle (or was given option to convert to IVF) b/c I had 10+ follicles that were average size 18. Of course we did not want to risk high order multiples, and not ready to pursue IVF, so we agreed to cancel the cycle. Dr warned us to be "very careful" as I would ovulate these eggs and also warned that my period would be much heavier than normal. Told me to call him on 1st day of my next period (are you seeing a pattern here?).
  • January 2011 - February 2011 – Never got that period Dr warned me about. Waited a while and went back to doctor. They did an ultrasound & blood work and did not see any cysts or hormonal reasons why I would not get a period. They proscribed Provera again to trigger a period. Provera pills did not work this time (not good). I asked why and all they could say is that it is all hormone related and they did not know. I found out later it was b/c my Estrogen was too low and when that happens your body will not recognize the Provera. 
  • March 2011 – Went back to doctor b/c still nothing. They did another ultrasound/blood work and reported that everything looked fine and they are still unsure why my cycle never began. Dr. said that since everything looked ok, I was fine to start injections again that evening.
  • March 2011 – Started 3rd round of Follistim injections. At my baseline appt I had 25-30 follicles (not a typo) that were all microscopic in size. (Follicles need to mature to size 18-20 to be viable). At the very beginning of this cycle the nurses kept saying I was a perfect candidate for IVF and asking if I would consider converting to IVF. We said no, so Dr. kept dose low (sometimes 75 IU & sometimes skipping a dose all together), in order to prevent all follicles from increasing too large in size. Went through a week or more of injectables and then doctor canceled the cycle. To make the follicles grow larger the doctor would need to increase my dose which in turn would make too many follicles grow too large (to prevent high order multiples). My estrogen level had also dropped, so converting to IVF this cycle was not even possible. 
  • March 2011 - Met w/ Dr. for consultation. He recommends IVF based on the way my body responds to the injectable medications. Says it is common for people with my history to respond this way and really IVF is the only way to control not becoming octo-mom. He says some people do IVF for anatomy reasons and others for safety reasons. I am a safety reason. He says we can continue doing the same thing but why when we are wasting nothing but time, energy, finances, etc... We talk, pray and decide ok, we will go for IVF next cycle. IVF is a two month process. Go on birth control for a month so they can regulate cycle to a T, and then start injections the next month. So I go back on birth control. (For someone trying to conceive via fertility treatments, it is amazing how ofter birth control is prescribed.)
  • April  - May 2011 - Start my period and go in for baseline ultrasound and blood work. I have more follicles than the nurse can count on the screen (because of course I am the one to set this record). Confirmation that IVF is the way to go. Start Round #4 of Follistim injections. Dr keeps my dose high (150 IU) in order to grow all eggs as big as possible. Eight - Nine days of monitoring goes by and all is looking great. Eggs are growing and I am a little (ok... a lot) bloated. All ok until my ultrasound and blood work results were in, about four days before tentative egg retrieval. Dr calls me from his cell phone (not normal). Estrogen has skyrocketed (above 7,000... Dr cannot even calculate how high it actually is) and ovaries are so inflamed they are touching. Dr says that I can go no more than two days with no injections in hopes that my Estrogen will decline. Estrogen will need to go down to the 3,000 range in order to proceed. The risk in continuing with the cycle if my Estrogen does not drop is ovarian hyperstimulation syndrome. Go in two days in a row for monitoring and day two reveals that my Estrogen is down to 4,000 range. Praise God! Dr says to  proceed with Ovidrel trigger shot that night and then come in for egg retrieval as scheduled. Dr calls me on his cell phone at 6PM. He has been reviewing my labs again w/ his team of Dr's, and they feel it best to cancel the cycle. Dr's are not comfortable with my ultrasound after all. I have fluid building up around my abdomen and ovaries are so inflamed it is likely I am starting to experience ovarian hyperstimulation syndrome. If I trigger ovulation I could end up in the hospital. This confirms why it hurts to sit, walk etc and why I look like I have a beach ball under my shirt. So cycle is canceled. Dr says to call on 1st day of next cycle so we can try again, and to expect a very heavy period on the horizon. I start reading The Fertility Cure by Randine Lewis, Ph.D. which leads me to this website which leads me to do more research on Eastern Medicine and acupuncture
  • May 2011 - Five days later (from day Dr canceled cycle) I start to bleed but it is not enough to be  a real flow, although more than just spotting. Call Dr who says that it is hard to say if this is a real period or not, yet regardless my ovaries have not had time to calm down (this is true, the beach ball is still there) and so we need to give it more time, and call again when I get my next period. 
  • June 2011 - Wait, wait and wait some more and no period. Start acupuncture. Call fertility Dr who says to come in for blood work and ultrasound to see what might be preventing my cycle. No cause is found.  I am given birth control for one month with the goal of trying IVF again in July. Both acupuncture practitioner and fertility Dr working as a treatment team to make the next IVF cycle the best it can be. Research shows that those who combine Eastern and Western medicine while doing IVF have the best outcomes in terms of bodily response to the injections (not as likely to hyper stimulate) and pregnancy success. 
  • July 2011 - Second try at IVF treatment cycle. I am also continuing with weekly acupuncture. Dr keeps me at 75 IU the entire cycle, this is the Round 5 of injections. Stimulation process goes well and I have over 30 follicles that are growing. After 13 days of injections I get the ok to trigger ovulation on Friday 7/15 and thus can move forward with egg retrieval on 7/17. Egg retrieval goes well and Dr is able to retrieve 20 eggs! I am sent home to rest and told to take it easy for a few days as I will experience some cramping, bloating, pain etc. The Monday and Tuesday after the retrieval I could hardly walk. It was actually worse than I expected. Also had major bloating. Fertilization results look great, 17 out of the 20 fertilized, and our embryo transfer is scheduled for Friday 7/22. Praise God! We arrive to the surgery center that Friday and then the unexpected happens. While this was a major let down in the moment, we have so much to be thankful for this cycle!!! We also learn that we have nine embryos that have matured to the blastocyst stage (these will be frozen until we can proceed). Dr says to expect a heavier than normal period. I am to call the office once this happens and we will move forward with a frozen embryo transfer (FET) cycle next month. 7/29 = got that heavier than normal period. 
  • August 2011 - Begin Estrace pills and patches on 8/2 in order to help my uterine lining thicken up for the FET. On 8/18 I was given the ok to start the (dreaded) Progesterone In Oil injections. These shots typically begin five days prior to a FET. On 8/23/11 I had my IVF FET transfer (transferred two embryos, remaining seven will stay frozen). Bed rest for the next three days, and Dr instructs me to continue my pills, patches, and PIO shots until my pregnancy test in September. 
  • September 2011 - POSITIVE TEST on 9/8! Praise God! Nurses say based on my incredibly high HCG level there is probably more than one bun in the oven. First ultrasound on 9/13 confirms two sacs and two babies! We are thrilled! Hear two heartbeats on 9/16. Amazing! Ultrasound on 9/20 shows that baby A has a very low heartbeat compared to baby B (83 bpm vs 150 ish bpm). Dr says this is not a good sign, and that they want me to come back Friday to check on baby A. Ultrasound on 9/23 reveals no change in baby A's heartbeat. They say at this point it will either increase (not likely) or stop beating all together. They will bring me back next week to check again. Ultrasound on 9/27 showed that baby A no longer had a heartbeat. We are sad and grieve the loss, although continue to praise God that baby B is growing strong and it's heartbeat/development is on target. Thankful that my body will absorb baby A on it's own, over time, and that I will most likely not experience any cramping or bleeding typically associated with miscarriage. 
  • October 2011 - Dr begins to wean me off of the pills, patches and injections. I am officially discharged from the fertility Dr on 10/10 and they wish me well. On 10/25 I have my first appointment with my regular OBGYN. Everything looks wonderful. The baby is growing on target & the heartbeat is strong! We go back in two weeks just to be extra cautious (just to make sure hormone levels stay in proper range) although at this point Dr reports no concerns. We are on target for a due date of May 10, 2012. Praise God for His good gift and hearing + answering our prayer. 
  • November - December 2011 - Continued appointments w/ my regular OB. All is well. We learn on 12/23, at our 20 week anatomy scan, that we are expecting a healthy BABY GIRL! Best Christmas present ever. She is a week ahead of schedule and our new due date is May 4, 2012! Praise God from whom all blessings flow . . . We name her Clara Anne. 
  • January 2012 - Have a follow up ultrasound on 1/24/12 (25 weeks, 4 days pregnant). Dr reports that Clara is growing well since the last ultrasound in December and she currently weighs 1 pound and 11 ounces. Her heartbeat measures 150 bpm. My placenta is reported to be high and towards the back. Dr reports no concerns via the ultrasound pictures/measurements and we are still on track for a 05/04/12 due date. I visit my regular OB for my fasting glucose blood test and results come back within the normal range. 
  • February - March 2012 - Continued appointments and as of 3/2012 I am now (once again) going to my OB every two weeks. Swelling in my ankles/feet is getting bad but my blood pressure and urine check normal consistently which means no current concerns of preeclampsia. On 3/8/12 Clara's heartbeat measures 140 bpm and the Dr reports that my tummy is measuring on track. 
  • April 2012 - Start seeing OB weekly. Swelling continues to be severe although my blood pressure and urine are completely normal. I am now seeing my acupuncturist weekly, to help aid in circulation and offset swelling. Have a follow up ultrasound on 4/10/12 and results reveal small concern with Clara's rate of growth. She weighs 5lbs 4oz (approximately) and is below average on most percentiles, especially in abdomen and stomach areas. Dr reports that she could just be a petite baby although we need to monitor the fluid and blood flow from the umbilical cord and placenta, via weekly ultrasounds, to make sure there is not a bigger issue as to why she is small for gestational age. Dr suggests eating more protein and sugar (blood work results show slight deficiency in both of these areas), drinking more water and getting as much rest as possible when not at work & in the evenings. Although my last day of work is set for Wednesday 4/25/12, Dr suggests an end date of Friday 4/20/12, just to ensure extra rest for Clara's optimal growth. Dr states that as long as fluid levels remain normal there should be no reason why I cannot make it to my due date of 5/4/12. Blood work also reports I'm positive for the Group Strep B bacteria and am told that I will get antibiotics once I go into labor to prevent passing this bacteria on to Clara (can cause meningitis in infants). 
  • April 2012 - Follow up ultrasound on 4/17/12 shows no concerns with fluid levels. They will wait another week to measure Clara again as a one week time lapse leaves too much room for margin of error. Was encouraged to continue resting and to keep up my eating. Saw my OB on 4/18 and he said all continues well. I am 70% effaced and 1 cm dilated. OB said if I do not go into labor by my due date (5/4) I will be induced on that day (no need to drag out the swelling). 
  • April 2012 - Ultrasound (the biophysical profile and non stress test) results great on 4/24. Fluid levels look good and no signs of an aging placenta. Clara passes the non stress test. Dr decided not to measure her but said it is safe to assume she is making progress since all results are positive and the placenta is thriving. At my regular OB appt on 4/25 my blood pressure is good, urine fine and I have gained two pounds since last week. Swelling at an extreme high. Only dilated to a 1cm so no real progress there. OB decides he wants to admit me Tuesday evening 5/1/12 at 9PM to be induced. He reports that since I will then be 39 weeks 4 days it is fine to induce, and it will provide some needed relief for my swollen feet/legs.
  • May 2012 - Our hearts are forever changed!

Clara Anne Blackburn
May 2, 2012
6 pounds 5 ounces, 20 inches long

  • June 2013 - We learn we are pregnant, again. 100% unplanned and 100% spontaneous. Zero fertility treatments. Knew something was up because I was beyond tired, all day long. Took 4 pregnancy tests (all positive) and then it was confirmed by my OB two days later that I was already 10 weeks along! What a fun surprise and not to mention, another amazing miracle. 
  • January 2014 - Our hearts are forever changed, once again. 

Camille Elaine Blackburn
January 14, 2014
7 pounds 15 ounces, 20 inches long

  • December 2014 - God blessed us, again, with another surprise pregnancy! We found out earlier this time, at only 5 weeks. Thank you God for this amazing gift. All praises and honor and glory to your name. It is all because of you. Baby B #3 is due early August 2015.  
  • April 2015 - At our 20 week anatomy scan on April 1, 2015, we learned that our sweet baby longer had a heartbeat. We delivered our son, Chance Michael, on April 4th, and buried him on April 7th. More posts related to our situation can be found under the "pregnancy loss" tab. 
  • Our hearts are forever changed, for a third time. 

I wait quietly before God, for my victory comes from him. He alone is my rock and my salvation, my fortress where I will never be shaken. Psalm 62:1-2
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