So, I get asked all the time why we've had such a hard time getting pregnant (and staying pregnant). And to be honest, the short answer is, we just don't really know.
But the long answer is, well, a little different. Because, there may be several reasons.
Here are a few reasons why we suspect we've been having such a hard time conceiving. *Note: I will always say "hard time getting pregnant" and will never say "'can't' get pregnant" because I will always leave room in my heart for a miracle.
First of all, despite what our health class teachers taught, it's actually not that easy (for some of us) to get pregnant. A woman can only get pregnant during her "fertile window" of ovulation. But that "window" isn't very long (only about 24-hours) and is different for everyone because it depends on the length of your menstrual cycle. For me, I have fairly irregular periods, meaning, it's hard to detect my "fertile window," despite the use of ovulation tracking sticks.
But for the most part, I get my period every 24-26 days instead of the typical 28. This means, I have a slim and unpredictable "fertile window." If you miss the window, your chance of conceiving that month is gone. Because once that egg is no longer in the fallopian tube, it's pretty much impossible to get pregnant.
We've tried every single combination imaginable: sex everyday leading up to suspected ovulation, sex every other day leading up to expected ovulation, sex at exact ovulation, triggering ovulation via HcG shots and using intrauterine insemination at the exact moment of ovulation with our IVF doctor... and still no luck.
I mean, I wish my body could just have like a loud beeper or something that says, 'it's go-time lady.' But maybe, someday, someone will invent that. Can I put that on my wish list?
So, I say possible because it's never been officially confirmed. But I would not be surprised to be honest. And, this is total TMI, but I'm an open book. I've always had very painful and heavy periods. So heavy in fact that it's not uncommon for me to go through a 'super-plus' tampon AND a pad in less than 30 minutes on days 1-3 of my period. And cramping so bad that I have actually fainted in the shower due to the pain. Not an exaggeration. By day two, most of the time you can find me in the fetal position holding my crotch rocking back and forth while moaning. Day three usually lets up, and by day four, my period is 100% gone, only to be like SYKE, and return with light spotting on day 5. Like clock work. Good times. Our household sure loves when 'aunt flow' comes to visit each month (me particularly).
If you pair those symptoms with my infertility, you have a pretty good case for endometriosis.
But I have never been officially diagnosed with endometriosis and here's why: the easiest way to confirm endometriosis is via laparoscopic surgery. It's pretty hard to see via ultrasound unless you have a cyst (and even then, it's just a suspicion), and an MRI can't definitively say either, but only can detect the presence of cysts. And the presence of cysts could also be indicative of other things.
Is it worth getting the surgery? Probably not. Because the only way around it anyway is via fertility treatments, which, we're doing anyway.
But I will say, endometriosis is quite common in "infertile" women. In fact, it can be found in about half of women suffering from infertility.
When you have endometriosis, the tissue that normally lines the inside of your uterus - the endometrium - grows outside your uterus. This displaced endometrial tissue, continues to thicken, break down and bleed as it normally would with each menstrual cycle, but has no way to exit your body and becomes trapped, causing inflammation and cysts, eventually causing scar tissue. This can cause your fallopian tubes and ovaries to become blocked (preventing the sperm and egg from coming together). The inflammation also creates "unfriendly" molecules that basically paralyze the sperm and egg, also preventing the fertilization process.
Basically a recipe for infertility.
Low Egg Quality
The next reason we may be having such a hard time conceiving is that, through IVF, we have discovered that I have low egg quality. Specifically, a low maturity rate.
During my second egg retrieval, we really amped up the stimulation meds in order to maximize the amount of follicles and eggs produced (yippee for OHSS... not!). And, our doctor was able to retrieve TWENTY-ONE eggs! Holy moly! That's a lot! Like, that was a MAJOR WIN! We were over the freaking moon.
BUT, unfortunately, as they examined them closer, they discovered that only about half of them were mature (eleven). And of those eleven, only six turned into embryos. And of those six, only four made it to day 5 (freeze). And of those four, only one was "normal." So, we'd gone from twenty-one, to one. We were heartbroken, to say the least. What a disappointment.
But, to look on the bright side I suppose, this helped explain why we might be having such a hard time getting pregnant on our own. It makes for an even slimmer window of opportunity.
I have Polycystic Ovaries
This one provides probably the most definitive answers. My doctor recently confirmed that I unfortunately suffer from PCO (polycystic ovaries) evident by my history of cysts and polyps.
If you suffer from polycystic ovaries, it's hard to get pregnant. This is because there is inconsistent or no ovulation. And if there is no ovulation, there is no release of the egg. So even with the help of ovulation drugs (HcG), you can't get pregnant. This would explain why all four of our IUI's failed.
But, and this is just something I have to clarify because I feel like 'PCOS' is thrown around a lot: a lot of people commonly mistake polycystic ovaries (PCO) with PCOS (polycystic ovarian syndrome). If you have PCO, you don't necessarily have PCOS. PCOS is often accompanied with things like diabetes (insulin resistance), excess body weight, excess body hair, acne, hair loss etc. I don't fall into the latter, but my history of polyps and cysts certainly shed light on some things.
If you think this could be you, definitely talk to your doctor about it and through ultrasound monitoring, they will be able to detect the presence of cysts or polyps post-ovulation.
A History of Chromosome Abnormalities
And lastly, another reason we've likely not only had a hard time getting pregnant, but also staying pregnant, is because through IVF, we've discovered our embryos have a history of chromosomal abnormalities. Many miscarriages are caused by chromosomal abnormalities. When we had our second miscarriage, we performed a D&C to remove all pregnancy tissue in order to test the fetuses (twins) for any potential answers/issues. From this, we discovered that one of the twins was Trisomy 13.
Perhaps it was my body's way of recognizing a problem in the developing baby and thus ended the pregnancy. Or perhaps the babies ultimately reached a point where the chromosome abnormalities caused them both to both stop growing. Honestly, we will never know. My only comfort is that we can find a way around it in order to prevent this from happening again through testing all future embryos.
The older you are, the higher your chances are for a chromosomal abnormality, sadly. This is why screening our embryos through preimplantation genetic diagnosis (PGD) played such a huge role in allowing us to both get and stay pregnant with Luna.
hallelujah for science!
For the most part, our infertility has always carried the label, "unexplained." And there is nothing more frustrating than that. Because without a 'why,' it's hard to find the 'how' around it.
But regardless of the 'why,' infertility will break your heart. Nay, shatter your heart. But that doesn't mean you give up. Keep fighting. Keep searching for answers. Keep hope and keep heart. Because in the end, it will all be worth it. And someday, you WILL find a way around that 'why.'
And always remember, I am here for you all.