And Another Failure

It's official. Pregnancy attempt #3 on Clomid is a failure.

Another Try...

After four months of recurring ovarian cysts, near-constant pain, and constant stress, I finally had a clean ultrasound in July. Unfortunately, it was too late in the cycle to start Clomid, so I had to wait for a new cycle to begin in August. By that time (of course!) a new cyst had formed, but measured only 1.5 cm at baseline ultrasound, so Clomid was still a go.

This is treatment cycle #3 for us, with each cycle being exponentially more stressful than the last. I don't know how much more hubby and I can take. This cycle has been absolutely brutal, for reasons I won't go into here. Because this is our third try, we won't be allowed to try many more times if this is unsuccessful. We're definitely feeling the pressure, because it's now (or very soon) or never. We simply can't justify going further down the fertility treatment road. The next stop would be injectables, which seriously increase the possibility of twins or higher order multiples. While we would welcome two or more babies, the fact is that any pregnancy we manage to conceive is already very high-risk. If we got pregnant with twins and even one had the umbilical cord problem, they would almost certainly both die because the dead one would poison the environment and kill the other one before it reached viability. If, as we expect, the odds of survival for a singleton are 50/50, then the odds of having twins survive is only 25%. We don't want to go there.

Likewise, it doesn't make sense to risk IVF not only because it's astronomically expensive and could result in twins, but also because it just seems to be going too far if my odds of carrying to viability are only 50/50. Since I did get pregnant very briefly on Clomid try #1 and we still have insurance coverage, it makes sense to exhaust the Clomid option and then reassess the situation if it doesn't work.

So this cycle there were 3 mature-sized follicles as well as 3 small ones at follow-up ultrasound. This is promising news. That evening I did the Ovidrel shot (even though I know it does't hurt, I still hesitate with that needle) which set off two days of painful bloating and hopefully ovulation. The IUI was done 42 hours later and it was absolute misery. It was also too late I think. This is really NOT promising. Now we're in the midst of the nerve-wracking two-week wait for the pregnancy test.

A Brief History

Updated November 2015:

Surgery #1 (October 2001): Just six weeks before my wedding, a large mass was discovered.  Laparoscopy to remove a 10" paratubal cyst (benign serous cystadenoma).  Nothing's been the same since!

Pregnancy #1: David born April 2003 at 39 weeks

• First noticed slightly lagging growth at 20 week ultrasound; more serious by 30 weeks
• IUGR (5 pounds even at term) APGAR scores 2 / 7
• Meconium and Nuchal cord x1
• We were told he had a "thin cord" and "small placenta", but it was not sent to the lab
• 5 days in NICU
• Has heart murmur, which we're told is "innocent" (not problematic)

Pregnancy #2: Tania born March 2005 at 39 weeks

• 6 pounds 3 oz. APGAR scores 9 / 9
• We were told the placenta appeared to have "two sacs", but it was not sent to the lab
• Diagnosed with hole in heart (atria) @ 3 weeks; resolved on its own by 3 years

Pregnancy #3: Jeremiah lost January 2007 at 21 weeks

• Normal chromosomes (except a pericentric inversion of chromosome 9 [inv(9)(p12q13)] inherited from mom - we're told this is insignificant
• Pathology report notes the cord was hypercoiled
• All labs on mom normal, except "moderate positive" result on anticardiolipin antibody IgG, which we're told is not significant; after six weeks this was retested and the level was "inconclusive"

Pregnancy #4: Miles lost July 2007 at 19 weeks

• Normal chromosomes
• I took baby aspirin from 6 weeks onward
• All labs normal, including anticardiolipin
• There had been a fetal-maternal bleed (2.5 cc) and the amniotic fluid was brown with old blood
• Cord showed stricture in mid-umbilical cord; we noticed after he was delivered that there were also a couple of less dramatic areas of narrowing
• Additional testing on me showed I am heterozygous for MTHFT mutation C677T, which we're told is "not clinically significant"

Surgery #2 (January 2008): Exploratory laparoscopy. I lost my right tube (had been badly damaged by previous 10" cyst) and right ovary, though I think it should have been saved as it only had a small endometrioma. I ended up in the emergency room six days post-surgery for a hematoma.  I'll spare you the gross picture.  You're welcome. After recovering from surgery, we started trying to conceive again only to find that I'm now infertile.


Pregnancy #5: Miscarried February 2009 at 5 weeks
This time conceived on first cycle of Clomid and IUI (We had no trouble getting pregnant the first four times)

April 2009 - Cycle 2 with Clomid/IUI = Negative
May through July - on the Pill because of large painful cyst!
August 2009 - Cycle 3 with Clomid/IUI = Negative
September 2009 - Cycle 4 with Clomid/IUI = Negative
October through December - on the Pill because of large painful cyst!
January 2010 - Cycle 1 with Follistim/IUI = Negative
February 2010 - Cycle 2 with Follistim/IUI = Negative
March 2010 - Cycle 3 with Follistim/IUI = Negative
April to July 2010 - on the Pill because of a small stubborn cyst and planning IVF
July/August 2010 - IVF #1: 12 eggs retrieved, 6 mature, 4 fertilized, 2 transferred on Day 3 (8 cell and 5 cell), none to freeze - Negative
September to November 2010 - on The Pill because at least one endometrioma has developed ; IVF #2 delayed
November 2010 - IVF #2: 11 eggs retrieved, 4 mature, 3 fertilized, 2 transferred on Day 5 (1 blastocyst, 1 morula), none to freeze - Positive!

Pregnancy #6:  Anastasia born August 2011 at 40 weeks!!
        Cord and placenta look normal; Apgars 9/9; she's perfect!


Epilogue!

Pregnancy #7:  In March 2015, I was shocked and terrified to find that I've gotten pregnant naturally.  After reliving the terror that is high-risk pregnancy, I had a healthy girl at term.  We found out only after she was born that she had cord stricture as well.

2015-present: We are DONE with this whole business!  Q got a vasectomy.  The kids are all healthy and growing well.  Since getting pregnant in 2010, I've been 95% free of the endometriosis pain I'd endured for a decade ... a wonderful and unexpected bonus!