Happy Thanksgiving: A new path to explore

I have been out of touch for a while. It has been well over a month since my last post and I admit I am feeling a bit rusty in the blogging department. Following my return from Denver, I suppose I allowed myself to succumb to self pity and despair. I traveled to Denver on a wing and a prayer. After careful research on success rates for the top fertility clinics in the country, I came to believe that my final shred of hope rested in the hands of the renowned Dr. Schoolcraft at CCRM. I prayed this doctor might deliver a miracle, but instead, he confirmed what I already knew. My FSH is high. My follicle count is low. I am over 40. I have fibroids in my uterus. And most likely, with all these factors taken into consideration, my chances for a biological baby are exceedingly low at best.

Dr. Schoolcraft was adamant that my fibroids must be removed in order for implantation and pregnancy to take place. In fact, he referred to the fibroids as a “natural IUD” standing in the way of conception, implantation and pregnancy.Following our return home, the results of our one day workup slowly trickled in. Glenn’s semen analysis revealed less than 2% normal morphology. At CCRM, they don’t like to see less than 4%. Fortunately this issue can be EASILY bypassed through a procedure known as ICSI, where the most optimal sperm are selected and then injected directly into the egg for fertilization to take place. So, on my husband’s end at least, there is no reason why Glenn cannot father a biological child. However, on my end, things are not looking as promising.

Although CCRM did not re-test my FSH level since we already know the deal with that, they did test my AMH and it came back at (.7) They don’t like to see a below a (1), so a level of (.7) is considered below normal, although not as horribly low as my previous level at Southeastern Fertility several months ago, where my AMH level came back so low it was nearly off the charts. I was not sure whether to celebrate this news or grieve it, since an AMH of .7 is still considered borderline low, indicating that my fertility has clearly fallen off a cliff. Each time I called CCRM to clarify this issue I was given a different answer. One nurse was mildly encouraging and told me at CCRM, they work with blood levels like mine “all the time” without much cause for concern.  She reassured me that a .7 is significantly better than my previous level at Southeastern, while a different nurse suggested the exact opposite and insisted that anything below a (1) is a definite cause for concern. Welcome to the world of advanced age infertility, where nothing makes sense and clear answers are impossible to find.

Immediately following our return from Denver, I scheduled an appointment with my OB-GYN for my annual exam and to inquire about a referral for a surgeon capable of removing my fibroids. Ironically, the surgeon who came highly recommended both by Dr. Schoolcraft in Denver and my OB-GYN here in Charleston is in fact affiliated with Southeastern Fertility- our local clinic here in Charleston- the same clinic that pulled the plug on my scheduled IVF cycle several months ago after my FSH level came back elevated. Rather coincidentally, Glenn and I consulted with this same doctor quite a few years ago back in November of 2004 shortly after we were engaged for the first time. Due to my fibroids, advanced maternal age (I was 36 at the time) and Glenn’s vasectomy, we figured it was time to consult with a fertility specialist. The consensus was for Glenn to reverse the vasectomy and for us to try naturally. However with our broken engagement shortly thereafter, the reversal never happened until several years later. Now here we are five years down the road, having traveled full circle from Charleston to New York to Denver and ultimately landing right back in Charleston at our home clinic.

At first I was extremely resistant to the idea of setting foot inside Southeastern Fertility after my last experience there, which was no less than devastating. However this is no time for being emotional, so I put my past feelings aside and scheduled the consultation with the potential surgeon. In addition to putting the surgery behind me, I was eager to begin the Clomid Challenge Test as soon as possible with my very next cycle. This particular blood test is (supposedly) intended to act as the final piece of information in the diagnostic holding pattern that seems to prevent us from ever moving forward with any real form of fertility intervention. With the Clomid Challenge Test, ideally, Dr. Schoolcraft would like to see my FSH level decrease following 5 days of Clomid. If my FSH does not decrease in response to the Clomid, it is unlikely that the stimulation medications typically used in a cycle of IVF will stimulate my ovaries to produce enough mature follicles for a successful egg retrieval and implantation to take place. In essence, the Clomid Challenge Test (CCT) is used as a sneak preview to determine how a person might respond to a cycle of IVF.

In my eagerness to begin an IVF cycle with my own eggs before my final window of opportunity passes me by, I decided to apply a bit of pressure and inquire whether CCRM would be willing to allow me to cycle PRIOR TO MY SURGERY, have my eggs retrieved and fertilized, and then use the 6-8 week window following egg retrieval when specialized genetic testing is performed on the frozen embryos, to undergo the surgery and allow my body to heal in time for implantation.I was ecstatic after placing a call to CCRM and learning that it would indeed be possible for me to cycle BEFORE my surgery. I further learned that if all goes well with the CCT, I could in fact begin my stim drugs with my December cycle and be ready for egg retrieval right at the start of the New Year! The CCT requires an ultrasound on day 2, 3, or 4 of a given cycle, to make sure there are no cysts on the ovaries. It is very dangerous to begin the Clomid if the ovaries have cysts over a certain size, as the Clomid is known to produce extra cysts anyway, and there is a risk of causing long term damage to one or both ovaries. If any cysts are found, it is necessary to wait out that cycle and try again the next month. The CCT also requires a blood drawing on day 2, 3, or 4 of the cycle to measure the FSH level.  Then, Clomid is prescribed on days 5-10 of the cycle and a repeat blood drawing is preformed on day 10 to re-test the FSH level. The hope is that after 5 days of taking Clomid, the ovaries will begin to respond and the FSH will decrease.

Because CCRM only trusts their own lab, I was required to purchase a blood shipping kit for $100 and arrange for the blood to be drawn at Southeastern and shipped to Denver for analysis.With the start of my November cycle I called Southeastern and went in for my day 3 blood drawing and ultrasound. My day 3 fell on a Sunday and it was unseasonably warm and beautiful that day.  After I left the clinic, I decided on a leisurely lunch at an outdoor cafe near my house. I placed my order and turned my face towards the sun, feeling the first glimmer of hope that I might finally be on my way to moving forward soon with an IVF cycle. After what felt like a lifetime of obstacles and delays and heart breaking letdowns and so many stops and starts, I could almost see a glimmer of hope at the end of the dark tunnel. Just as I was beginning to relax and enjoy a beautiful sunny autumn afternoon, my cell phone rang and it was CCRM.The IVF nurse on duty dealt me the next blow. I had a residual cyst on one of my ovaries, most likely a result of my most recent ovulation, therefore I would have to wait for the cyst to dissolve before proceeding with the CCT. This could happen with the next cycle, or it could take months.

I felt time stand still and a wave of despair descended upon me as my first glimmer of renewed hope rapidly melted away. It was a feeling reminiscent of that fateful day back in August when the IVF coordinator at Southeastern Fertility called to inform me my FSH had risen to a shocking 17, and therefore I was no longer a candidate for IVF.The nurse explained that the cyst was no more than a simple case of “bad luck.” After a tearful follow-up phone call I convinced the nurse to approve a repeat ultrasound on day 5 of my cycle two days later. - This was the day I would need to start the Clomid and my hope was that the cyst would dissolve in the meantime. No such luck. The cyst remained, and I knew I would have to spend the holiday season still stuck in a diagnostic holding pattern, with no hope of starting a round of IVF until sometime after the New Year. This time I felt numb and indifferent when the news was delivered, as I had expected this outcome. With my upcoming surgery, the holidays and my recovery period, it will now be a minimum of 3 months before any form of fertility intervention can begin.

The following week Glenn and I went in for a surgery consult with Dr. Schnorr at Southeastern Fertility. He performed yet another ultrasound (I am getting to be an old pro at these) and further confirmed Dr. Schoolcraft’s recommendation. He diagnosed me with uterine polyps and fibroids that explained that due to their location, they pose a present a threat to implantation and pregnancy. In line with Dr. Schoolcraft, he recommended that I undergo an abdominal myomectomy- 3 hours of invasive surgery followed by one night in the hospital and a 30 day recovery period, before we get started with any form of fertility intervention. It would not be recommended to do the procedure laparoscopically due to the risk of scar tissue and damage to the lining of the uterus. Several days later, Dr. Shnorr’s office called with my surgery date. On December 15th, I am scheduled for an abdominal myomectomy. I would be lying if I were to say I am not really, really scared. I will recover through the holidays and by the first of January, I should be ready proceed with the CCT, again, pending that there are no residual cysts on either ovary. However I have learned to expect roadblocks and delays, therefore, I will not be surprised this time around.

Over the past several months I have struggled hard against the reality of my situation and found myself grieving the loss of so many dreams and opportunities. I will never be a young mother like my own mother was with me. In fact, I will be nearly 20 years older than my mother was when she gave birth to me! I will never have a large family with many children to love. I will never be able to relax and take my time getting pregnant, free of the constant pain of advanced age infertility. And worst of all, I might never give birth to a biological child. If I remain committed I can find a way to become a mother, but it may not be in the way I thought, and it will definitely not be in the way I always dreamed about, since the time I was a little girl.

Despite my grief and heartbreak, I also longed for a final shred of hope. I needed to find a glimmer of light amidst all this darkness and despair. I needed to believe in a miracle. As a practical person with a deep respect for science, I have NEVER been a person to follow alternative medicine practices or Eastern philosophies on health and well being. This is not due to a lack of belief or respect for these philosophies, in fact, these lines of thinking have always appealed to me and felt so right deep in my bones. I love to practice yoga, and I am always in awe of the healing power of the mind and the health benefits of natural light, relaxation and deep breathing. I have the deepest respect for therapeutic benefits of massage and a healing touch. So, I guess I am a perfect candidate for things like acupuncture and herbal supplements and non-western approaches to fertility, but at the same time, I tend to shy away from these peripheral out of mainstream approaches to health and wellness, most likely due to the lack of scientific data supporting their effectiveness by western standards.

On the fertility message boards and chat forums where I often go to seek comfort and solace and a sense of community, I kept hearing about a book called Inconceivable by Julia Indichova . Finally, when I felt the heaviness of grief pushing so hard against my chest that I could barely breathe, I purchased this book, ran a hot bubble bath, lit some candles and poured myself a glass of wine. A few nights later I sat in the tub once again, tears streaming down my face, as I placed the book down and allowed myself to believe in this woman’s story of hope and inspiration and the most unlikely of miracles. The author, like me, was diagnosed with a high FSH and told she could most likely NEVER have another biological child. Like me, she married late in life, as she was approaching 40, but unlike me, she was blessed with one healthy pregnancy- a natural conception- shortly after she married. With a young toddler at home she found herself fighting her way through the complicated maze of secondary infertility, and when every doctor refused to treat her due to her elevated FSH and advanced age, she turned instead towards acupuncture and herbal supplements and a healthy organic diet and a positive perspective and deep inner peace and relaxation. Within several years and much to the shock and disbelief of her doctors and her own self, she had somehow conceived on her own.

After reading this book I experience a radical internal shift. As I continued to pull away emotionally from my husband and family and the friends who share stories of healthy bouncing babies and homework and carpools and joyful pregnancies, I found myself shutting down and closing out the world around me. I wanted to hide from my pain and disconnect from the people closest to me, for so many different reasons. I feel ashamed of the mistakes I have made in my life- mistakes like so much wasted time, which caused me to land in the painful place where I find myself today. I feel guilty and ashamed for not producing grandchildren for my parents, especially given the fact that I am my mother’s only child. I feel grief and despair for abandoning my unborn biological children by failing to bring them into this world in my late 20′s and early 30′s. I feel anger and resentment towards my husband for his part in the reality of where we find ourselves today.

My decision to open my heart and my mind to alternative approaches to western medicine was perhaps my way of trying to fight my way back from the darkness. Somehow, I crossed over the rigid line of traditional ways of thinking and opened myself up to the life affirming belief systems of eastern medicine. As if guided by some external force much larger than myself, I made my way to Whole Foods and found myself paying top dollar for strange products I never dreamed I would purchase. As I filled my cart with “Female Toner” herbal tea, Wheat Grass powder, Royal Jelly in honey, organic fruits and vegetables, a bottle of produce wash and several books about alternative approaches to beating infertility, I soon felt lighter in my step and so much closer to my goal.

I called Southeastern Fertility and got the name of a female acupuncturist who has supposedly done a lot of work with fertility patients. We spoke on the phone and I immediately felt a positive connection. By the following weekend I found myself lying on my back on a table in a spare bedroom of this woman’s home, completely vulnerable and uncharacteristically trusting, surrounded by bottles of herbal supplements and statues of Buddha and sticks of incense.  At first I resisted the sensation of tiny needles poking through the tender flesh of my abdomen and earlobes and hands and feet and chest, but within several minutes I felt myself floating on a fluffy cloud, in a state of deep, delicious, mind numbing relaxation. I felt as if I had been drugged, and I found myself looking forward to the following week when I would return for my second treatment.

After leaving my very first acupuncture session, I had planned to stop at Starbucks for a dose of the much needed caffeine I was forced to forgo earlier that morning so the acupuncturist could get an accurate reading on the color of my tongue (apparently coffee turns the tongue brown, preventing an accurate reading). I felt so clean and pure and rejuvenated after my first acupuncture session, and somehow it felt all wrong to fill my body with caffeine at a time when I was striving for hormonal balance and healthy blood flow. Instead, I pulled up in front of a juice bar and ordered a double shot of wheat grass juice followed by a raw vegetable concoction made from blended beets and ginger and lemon and apples and carrots. My craving for these natural products and my enjoyment of the flavors was so intense I could hardly believe it was me ingesting these things. I maneuvered my car out of the parking lot of the shopping center on a beautiful sunny day, rolled down my window to welcome the fresh air and washed down my first dosage of herbal supplement capsules with a healthy swig of raw vegetable juice. 

The following week I switched from plastic water bottles to BPA free glass bottles and dragged my stiff, aching body to a yoga class. During my second acupuncture session I decided to incorporate some visualization into my experience to capitalize on the relaxation of my body and mind. I found myself back in St. Lucia where my husband and I spent 8 glorious days on our honeymoon last year, gazing at the awe inspiring Piton Mountains from the privacy of our own personal infinity edge plunge pool. When I left my acupuncture session that day, I took my memory all those beautiful images and sensations along with me. 

These days, I start my morning with two spoonfuls of Royal Jelly in honey and three herbal supplement capsules. The taste of the Royal Jelly makes my stomach revolt, so I mask the flavor with several spoonfuls of plain flavored Greek yogurt and wash it all down with cold filtered water. Then, allow myself some yummy coffee, but I limit myself to one small mug- just enough to take the edge off. Later in the day I drive to the juice bar for my double shot of wheat grass juice and a raw vegetable juice blend. They grow their own wheat grass on trays right there in the store and the flavor is much more tolerable for me than the powdered version I found at Whole Foods, so it is well worth the 15 minute drive each day. I try to consume 2-3 cups of Female Toner herbal tea each day and I never miss a prenatal vitamin.  Glenn is even taking his own supplements prescribed by the acupuncturist. Now that we are looking at a minimum of 3 months for any form of fertility intervention to begin, we have plenty of time to allow our bodies to reap the benefits of these alternative approaches.

My focus these days is on relaxation and preparing my body for surgery and healing, and this has given me a new sense of well being and positive purpose. Since starting the Royal Jelly and the wheatgrass over a month ago as well as cutting way down on my alcohol and caffeine intake and going to yoga and acupuncture, I have noticed several remarkable changes. My allergies which manifest in the form of chronic nasal congestion have almost completely vanished. For years, I have grown accustomed to keeping a box of tissues at my bedside and waking during the night with a stuffy nose and periodic sneezing bouts that last into the morning hours. I have learned to live with a constantly runny nose and eyes that feel itchy and dry at night, as if someone threw a handful of sand in my face. I am now practically free of these struggles, and my irritable bowel flare ups have calmed down considerably. For the first time in months, my menstrual cycle was almost perfect this month, with no abnormal spotting and cramping in the days between my periods and a healthy flow that lasted for almost three days.

The best way I can described these physical changes is an overall quieting down of my internal systems. There is less cramping, less spotting, less mucus, less sneezing and less aching. Who knows why these changes have occurred? Who knows if I am wasting my time and my energy and my resources on these costly alternative approaches to overcoming advanced age fertility? Perhaps I will never know, and that is fine with me.  What matters is that I am finally focusing on the things I can control, like diet and stress and overall lifestyle, while releasing the things I cannot change, like advanced age and high FSH levels and reduced follicle counts.

Through alternative approaches to modern medicine, I have found a path of hope and faith and reconnected with that very authentic part of myself- the part that believes in miracles and the power the mind to overcome physical and emotional blockages to health and well being. I believe that somewhere deep inside this little body of mine, there exists a golden egg that is destined to become a child. I believe that with healthy living and a positive perspective and a combination of east and west and perhaps a little luck as well, I will manage to become a mother before it is too late. One step at a time. One moment at a time. One day at a time. Somehow, someway, I will bring this baby home.