Infertility and Miscarriages – Loss and Grieving

Typically, miscarriages happen within the first 13 weeks of pregnancy (miscarriage is classified as loss within the first 20 weeks) and is a result of failure to implant or chromosomal abnormalities. This results in what most women would assume is a late period. At least 20% of all pregnancies end in miscarriage.

The chances of miscarrying is decreased the futher along in pregnancy you are, once the gestational sac develops there is a 15% chance and once the heartbeat is detected there is still 9.5% chance to miscarry. Age of the mother also impacts the chance of miscarriage, meaning moms that are 30 have an increased risk and it goes up to 78 percent at age 40.

Many factors can lead to a miscarriage, most importantly chromosomal issues with the fetus. As you know from my previous post, hormones are also a factor, smoking, drinking, excessive caffeine must also be taken into consideration. This is why there are recommendations when you are actively trying to conceive to limit the risks of miscarriage.

The symptoms of miscarriage can be found on the internet so I will not go into detail here because it can be a trigger for anyone who has had a miscarriage (for example me, even though I have two healthy boys it still makes me sad).

It is possible to have a missed miscarriage, this does not come with any common symptoms and is caused by the placenta continuing to release hormones and can be diagnosed by the lack of heartbeat during an ultrasound and/or lack of development.

Just like after a pregnancy, a miscarriage causes hormone changes and in addition to the loss of fetus your body has to adjust to hormone changes. If you have been trying to conceive and you miscarry I recommend talking with someone. Personally, I would recommend a therapist but it can be anyone that you can be open with. Since this subject is “taboo” and not discussed it’s important to find someone who will listen and help you to grieve.

Signs of depression after a miscarriage can be fatigue, trouble sleeping, loss of appetite, difficultly concentrating, crying, and self harm. The hormones during pregnancy and loss can make all of these feelings more intense. If you already have depression or anxiety this can increase your chances of depression after a miscarriage.

It is important to remember though, this loss is not just for the mother. If you have been trying to conceive and miscarry the father also feels the loss and it is important that both are able to grieve.

Resources

10 Unbelieveable Missed Miscarriage Statistics

https://datayze.com/miscarriage-chart.php

https://www.verywellfamily.com/making-sense-of-miscarriage-statistics-2371721

Key Facts To Understand And Cope With A Miscarriage

https://www.verywellfamily.com/when-miscarriage-grief-becomes-depression-2371329

After a Miscarriage: Surviving Emotionally

Infertility and Miscarriages – My Story

This is my second post on the taboo of infertility and miscarriages. I am a firm believer in sharing information to bring awareness to issues that many people face. I have already touched on my Multiple Sclerosis and Meniere’s Disease and now I will tell you a bit more personal story.

My story starts not long after my wedding, we decided to start trying to get pregnant in late August, early September. By October I was craving red meat that I had not eaten since I was 17 due to my heart issues and immediately took a pregnancy test. It was positive and we were elated. With the exception of being HUGE (everyone was convinced I was having twins) and having a hard time breathing due to the giant baby kicking my diaphragm in the third trimester it went textbook. An emergency c-section was required due to decreasing dilation (I didn’t know that was possible) and his head was in the 98th percentile, sent my husband off with the baby and that’s when the medication given to me wore off. I could feel every – single – stitch and begged for them to stop and give me more medication as I ensured them it was not pressure. I should have been prepared for that since Novocaine has to be administered multiple times during a filling.

You can imagine how confused I was when it took us longer the second time we tried to get pregnant. It took many more months for our second pregnancy and I was very excited when we got a positive test. I remember it was October again, because I miscarried the week of Thanksgiving. Most people wouldn’t even notice unless they had been trying I was told. Though we had seen a heartbeat on the ultrasound a week before. I was far enough along that I noticed it wasn’t like a normal menses so even if I hadn’t done the test I would have noticed the difference, I will not describe it because nobody needs that but I finally knew how traumatic a miscarriage could be. I was so emotional and upset that even though I watched Marley and Me quite some time after it came out when Jennifer Aniston’s character miscarried I bawled.

It took me a while to want to try again, I was terrified of another loss. After a while though, we started trying… a lot. It went on for months, I started buying ovulation tests and taking them. I was so confused, my ovulation tests were positive but I would start my period 2-3 days later. After a few months of that craziness I contacted my OB-GYN and they had me come in to check hormone levels in my blood after a positive ovulation test. Blood came back not ovulating so that meant time for a fertility specialist. At this point in my life I had NO health issues known to me (other than high cholesterol and resolved heart condition – or at least that’s what I had been told)  so this was pre-MS diagnosis and vertigo and hearing loss.

Before the fertility doctor met with me they pulled blood and ran about of different labs and did an ultrasound to check my ovaries and uterus. Walked into the office where the doctor was sitting and before he even said hello I was told there was a 98 percent chance I had Poly-cystic Ovarian Syndrome.  I was taken aback by the abruptness and not very friendly demeanor of the doctor. I sat down at his desk for more information, turns out my ovaries were over achievers in the amount of egg producing follicles but no longer in the ability to ovulate. I was told the “normal” amount is 5 follicles on each side; I had 32 on one side and 36 on the other, a whopping 68 opportunities for eggs and none of them worked.

The next step was a hysterosalpingogram, this imaging is laying on a x-ray table while a technician injects dye into your Fallopian tubes to make sure they are not blocked. Apparently BOTH of mine were, how so much could go wrong with a body in a couple of years from a normal pregnancy is insane to me. Luckily she seemed to unblock one tube with the injection of the dye but no luck on the other side. With all the blood work they were doing on me to check hormones they were able to determine the most likely cause of my miscarriage was the lack of progesterone in my body. The mother produces this for the first trimester until the baby/placenta takes over, low or no progesterone means it cannot grow.

The next step was discussing IUI, Intrauterine insemination, they would give me something to encourage ovulation and then basically turkey baste semen into the uterus when the eggs are ready to drop. The tricky part was not making too many eggs since the side the tube was not blocked could potentially make 36 eggs. If that happened they would not proceed, three or less eggs in order to do IUI. This also meant that Clomid, the standard drug for ovulation, could not be used. I tried something call Femara, this is a drug used for breast cancer but oddly has the side effect of ovulation. The nurse practitioner I was seeing at the fertility clinic advised me they typically get 3 good tries from this medication. 

Month one, I ovulated yay, nope it was on the wrong side, eggs can’t come out of a blocked Fallopian tube. OK, no problem, 2 more tries, it should work on the correct side the next month. Nope, Femara did not work the second time. What does that mean for our very wanted second child? My only other option I was told was IVF, and kudos to those women who can do that but I had one child and insurance wasn’t covering any of my tests or medications and I cannot put a needle into myself, so we decided we were done. The nurse did tell me that I may have a shot if somehow my periods became regular for a year or more, which wasn’t encouraging to me at all.

I got rid of all of our baby stuff and decided to focus on my weight because PCOS comes with insulin resistance which could lead to diabetes, which would have meant giving myself shots. I got a trainer and worked out early mornings to try and lose some body fat. By June/July I had lost 10 pounds and 5% body fat. I felt ok but I did miss food, counting calories and balancing fruit with protein has always been challenging to me.

Imagine my surprise when only two months of regular cycles I started craving bacon, which I never really liked previously. Panicked, I bought a pregnancy test and when it came back positive I immediately called the fertility clinic worried about my progesterone levels. Luckily, I was seen for blood work the same day. My levels were low so my husband got the job of giving me a shot in the ass every few days with progesterone for the entire first trimester. In between all of that there was more labs, hormone checks, ultrasounds and so many doctors.

This pregnancy was harder, but it was hard to get started, my thyroid levels were wonky so I had to take medications for that. I looked like I was carrying triplets but only gained 15 pounds. My muscles were getting weaker, I was having a lot of pain in my abdomen and what I assumed were braxton hicks but scared they were real. I joked that the baby was eating my muscles and had new managers at work who I kept assuring they’d be amazed at how smart I was once the “baby brain” cleared up. I ended up on bed rest for a while towards the end of my pregnancy but my work was amazing about it. In the end, we had a very healthy second baby boy. Things continued to not be quite right and medical things just kept happening. It would be 2 years before I finally got diagnosed with MS and the “baby brain” never went away because it was brain fog. After diagnosis I thought that was why the pregnancy was so hard, but most studies and people say their symptoms get better during pregnancy so just another weird thing about my body.

Believe it or not, that is actually long story short :/ next post will focus on miscarriages.

Infertility and Miscarriages – Removing Stigma

Lets discuss infertility and miscarriages this week, this post will be mostly informational and science of infertility; the next one will be my story and then I will touch on miscarriages last. For some reason people do not discuss these subjects openly, it’s considered taboo. For so long our society and focused on the woman and her role in creating a baby. You are considered “broken” if you cannot get or stay pregnant. That needs to change.

Women go around fighting these issues alone because they don’t feel able to discuss the matter with anyone other than their doctor and possibly spouse. We should change that, we need support to learn about these things and it is important for our mental health.

Technically speaking, infertility means the lack of ability to become and/or stay pregnant. Though, for hundreds of years it was thought that women were in control of everything from getting pregnant to the gender of the baby. Science is better than that and I believe the term is due for a change in definition.

6.1 Million women between the ages of 15 to 44 (why the CDC is determining fertility for children I have no clue) in the United States has difficulty getting or staying pregnant. Granted, most of the process starts and stays with the female, if you are having regular intercourse and have been trying to conceive for 12 or more months then there is a fertility issue. Since most of the process is with the female that is where all the testing starts.

Standard first tests is blood work, usually of both parties. Checking for STDs, hormone levels, iron, thyroid and others helps to know if there is an imbalance somewhere. Next is the ultrasound, “this gives information on what the ovaries and uterus look like. Your doctor will look at the growth of eggs, the thickness of the lining of the uterus (if thin, it can indicate hormonal problems), the presence of fibroids or polyps on the uterus, as well as signs of endometriosis or ovarian cysts.

While the ladies get the ultrasound (fyi, if you’ve never had one please be prepared because if they’re looking at your uterus and eggs it is an internal ultrasound and that can be a touch alarming) the guys get to give a semen sample to make sure they are shaped correctly, not running in circles or slow.

The thing with infertility is guys really only have one thing that can go wonky. Women have many different parts of function that can get a bit haywire and it’s mostly treated as different issues.

I would like to note at the end of today’s blog post that I know, I myself had fertility issues and have had a miscarriage. Unfortunately, it is not uncommon and gets more noticeable with age.

 

Resources Used

http://www.abc.net.au/health/library/stories/2007/05/30/1919840.htm

https://www.womenshealth.gov/a-z-topics/infertility

https://www.cdc.gov/nchs/fastats/infertility.htm