Infertility Pt. III

As Mr. Schroeder and I were gearing up to do rounds of infertility treatments, we began to become more and more open about it to those around us. Naturally, there were countless individuals who had no idea what these treatments entailed. I've said it a million times before and I'll say it again - people mean well. I don't know why people would be knowledgeable on the topic if they didn't have to go through it.

I remember when Mr. Schroeder and I first got married, the thought of In Vitro Fertilization (IVF) intrigued me. It was super interesting to me. That was probably God's way of being like, "Hey, look into this - It's cool, and will be your reality someday.

I have met with a handful of Reproductive Endocrinologists (aka Fertility Specialist) at a couple of different clinics. Each clinic seemed to have a similar approach in regards to the process & what is tried first, at least for couples who struggle with 'unexplained infertility.' I attended a discussion with my doctor who helped us get pregnant with Lyric just a couple of weeks ago & she confirmed this process. I was actually really surprised at her statistic. She practices at Utah Fertility Center and she said, "We are able to help about 80% of our patients successfully get (and stay) pregnant prior to resorting to IVF." This was a big surprise to me! But, really great numbers if you're struggling.

For me and Trevor, we did treatments for almost four years. I wanted to put a little post together outlining the process we took, along with why. I have a few friends who have, or are currently, struggling with infertility and I hope this post helps someone out there. If not, hopefully it will serve as an educational guide :)

When Mr. Schroeder and I were first married, I was on a form of estrogen that made my cycles go complete wack. I didn't worry about it for a few years (1st mistake) because if I wasn't trying to get pregnant, not having a period was kind of nice. When it was time to start trying for a baby, I visited my OB about 6 months into it to hopefully get some help with ovulating.

Clomid is one of the most common drugs to help assist women in ovulating. It's a good first step because it's fairly inexpensive and works out well for many women.

Mr. Schroeder and I tried this for a couple of months and I'd go get ultrasounds throughout the week to ensure I had a follicle (which houses an egg). After a few months of that, we moved onto the next step.

Femara is the next drug we tried. A tiny bit more expensive than Clomid, but not much. Femara is actually used for women with breast cancer, but is a little bit more of a rigorous approach to get women to ovulate.

The fun part where the husband gets involved and gets a miniscule taste of what we go through 

After 6 months or so on these types of drugs, we decided to go visit a specialist. They recommended Trevor get a semen analysis to ensure nothing was wrong with him. For men, it's fairly easy to identify a problem. Women? Not so much. We're complex creatures. Ha!

This process was actually really really hard for Trevor.  The room was full of drawers of pornography (in which he doesn't participate in), a TV, a couch, and a sink shaped like a sperm. Of course, I laughed my head off when he told me this. Poor Trev. Some clinics allow you to go home and do a collection, but our clinic was very protective over those little swimmers -- so, in the clinic it was!

Gonadotropins & Timed Intercourse
While my OB was pretty on top of ultrasounds, the infertility clinic was much more detailed. Our doctor recommended we do a couple rounds of gonadotropins + timed intercourse. Gonadotropins are hormone medications that are much stronger than Clomid / Femara. Each day, I'd go into the clinic and they would look at my ovaries to see if they were producing follicles, housing lil eggs. Once those follicles grew to be a perfect size, I would take what is called a "Trigger shot." Exactly 36 hours after taking this shot, the follicle would burst, release the egg, and we'd, well...get it on.

Let me just tell you that infertility takes the fun out of sex. Like, completely. When you absolutely HAVE to do it at 3:32 PM and your already feeling like a crazy person, it makes it really hard.
*Side Story, because it's really funny*  
One time, Mr. Schroeder and I were on our way to Idaho to visit his parents. We had to do it at a specific time and the vehicle we were driving in was packed full of stuff, so we couldn't do it in the car. I called my mom, explained the "situation" to her, and she told me to come over real quick because she just made the guest bed. She's so sweet. She was like, "I'm home! But I'll just go in my room, turn on some music, and pretend you're not here. Have fun!" Seriously the most awkward moment of my life -- yet that's what the infertility world brings. A whoooole lot of uncomfortable moments. TMI is no longer a thing, folks. 

This used to be called "Artificial Insemination" but is now referred to as "Intrauterine Insemination." Now, the success rates of IUI aren't super high. My doctor once told me that the success rates are basically just about as high as a healthy, normal, fertile couple trying to get pregnant on their own. But, once again, the cost is significantly lower than IVF, and there are still successes out there! 

We consulted with our doctor and decided to try three of these treatments before looking at other options. After three failed attempts, the chances of conceiving this way decrease drastically. 
My house for two years. 
IUI works by putting sperm directly into your uterus when you are ovulating (so yes, Trevor must do another collection, and I continue to do ultrasounds to watch for follicles and take a trigger shot when it's time). The hope is that the sperm is being put "further up there" to get closer to the egg. That cuts down on the time and distance sperm has to travel, making it easier to fertilize your egg. 

For the last two of these cycles, I started taking injections to stimulate ovulation. These were much more intense than Clomid and Femara, as I'd inject them into my stomach area, encouraging my eggs to mature quickly and "get ready" for insemination. 

After three failed rounds of IUI's, it was time to have "the talk" about IVF with our doctor. It was pretty overwhelming and rather discouraging. Health insurance does not cover any part of IVF (yet it covers gender reassignment. #eyeroll. That's a conversation for another day).  So, we were looking at anywhere from $15K - $35K, depending on the plan you select. 


Woof. Where do I start with IVF? This was a really intense process. It challenged our marriage in so many ways. I was a monster because of all the drugs I was on, and Trevor was a massive trooper throughout it.

There are five steps in the In Vitro Fertilization Process. 

1. Fertility Medications

The majority of these medications are used to stimulate egg production. My doctor explained it in kind of a neat way. Each month you have 1 (sometimes 2) egg(s) that will drop With IVF, we are trying to get about two years worth of eggs to develop. Insane, right? Multiple eggs are desired because a lot of the eggs will not develop or fertilize once they are retrieved.

Throughout taking medications, ultrasounds happen all the dang time (to look at the eggs) and constant blood tests are taken to determine hormone levels.

Measuring all of the follicles

2. Egg Retrieval 
For me at least, this was the hardest part of IVF. They put me under and extracted my eggs. They used ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs.

The number of eggs retrieved varies greatly from patient to patient. We were able to retrieve  38 eggs. THIRTY. EIGHT. It was nuts. I was pretty much bedridden from a few days afterward from being so sore. I even looked pregnant because of how swollen I was.

3. Sperm Sample
The sperm collected is used to combine with the eggs retrieved.

4. Insemination
The coolest part, in my humble opinion. This is where an embryologist will mix the sperm and egg together in a petri dish to encourage fertilization. We chose 5 eggs to chill in a petri dish and "do their thing."

ICSI (intracytoplasmic sperm injection) is also an option that could be used. We took the rest of our eggs (33 eggs) and did this process. Through ICSI, a single sperm is injected directly into the egg in an attempt to achieve fertilization. These are monitored closely to confirm that fertilization is taking pace. It basically forces the two together.

I cried crocodile tears when our doctor called to let us know that all 5 eggs that they had "do their thing" in a petri dish took. ALL of them. This told us that his sperm and my eggs liked each other. There is a possibility of natural pregnancy in the future, and that was so comforting to me.

Once this process occurs, the fertilized eggs (that are still alive) are considered "embryos." Or, as I like to call them, "embabies."

5. Transfer
In some cases, the embryo will be transferred into the woman's uterus 3-5 days after fertilization. This is called a "fresh transfer." In my circumstance, we had to do a "frozen transfer" where the embryos were frozen and kept in a freezer for an additional month. This is because my ovaries worked their little butts off to produce all those eggs. My body was really tired, which created 'hyperstimulation.' I had to take a break. There's no increase or decrease in success by doing a fresh or frozen transfer.

With a frozen transfer, you have to start taking shots again to get your body ready. It's almost like you're tricking your body into already being pregnant.

During the transfer (which is a SUPER cool process, by the way), a catheter or small tube is inserted into the uterus. It's pretty painless. If the procedure is successful, BAM! You're pregnant!

The white line in the center of the ultrasound are the embryos that were transferred 

After the egg retrieval and sperm collection, the embryologist would call us every day to give us a report with how many embryos were still healthy. This gave me SO. MUCH. ANXIETY. We lost a lot of embryos at first, making me think we might not have many left toward the end. We ended with 11 embryos, which is awesome! 

We had 1 "excellent" egg, which we transferred. 10 days after the transfer, we get a blood test to see if we're pregnant. It didn't take. And yes, this nearly killed me. Or so I thought. The pain was unreal.

A few months later, we got ready to do another frozen embryo transfer, and transferred 2 eggs that were graded as "good." 1 Took.

And we got our miracle babe, Lyric. 

Other Fun Stuff
If you have stayed with me this long, Congratulations. You are amazing. There were so many parts to our infertility journey that aren't even covered here. I don't know how to cover it all! But hopefully this gives you a gist of what those who are struggling with infertility go through. It's a lot. Mentally. Physically. Emotionally. And it's draining. There are a few other steps we took to get to the point of IVF. 

HSG (Hysterosalpingogram): 
A HSG is an x-ray examination of the fallopian tubes & uterus. During the procedure, a thin catheter is inserted through the cervix and into the uterus. Dye is then injected. The dye allows the shape of the uterus & fallopian tubes to be seen. The progress of the dye is watched through the x-ray to see how it moves through the reproductive system, and whether or not there is a tube blockage.

Lucky lucky me, there appeared to be a blockage on my left tube. This procedure isn't too painful for most, but for me, it was probably the most pain I have ever been in my entire life. My mama was there with me to hold my hand and cry with me, but because of the blockage, the dye had nowhere to go. I turned white and was pretty darn miserable.

Because of the blockage, this led to an exploratory laparoscopic surgery. Blocked tubes could lead to removal of one (or both) tubes so I was pretty nervous. I was very fortunate because they were able to fix some tissue around my tubes and also laser off some endometriosis they found. The recovery for this was a few days.

Water Ultrasound (Sonohysterography)
A small amount of saline is inserted through a catheter into the uterine cavity. During this procedure, any abnormalities (fibroids, polyps, scar tissue, etc) can be identified.

This, too, shouldn't be painful for most. But for me, I again turned white and threw up. It was really painful.

The picture I sent Trevor after the procedure. Haha! 

The reason for the pain was because I had about 30 (benign) polyps. So, yay! Surgery again. This surgery was called a Hysteroscopy. This is where endometrial polyps are removed by "scraping" the uterus. Recovery was similar to by laparoscopic surgery and I was good to go after a couple days.

After both the HSG & Water Ultrasound showed some abnormalities, my doctor encouraged me to get an endometrial biopsy to learn if I had something called "endometritis" (not to be confused with endometriosis). This is basically an infection that causes inflammation of the uterus and can be the reason for infertility. Luckily (drumroll, please), everything in my biopsy came back clear.

This post was so much longer than I intended it to be. It's really difficult to put our infertility journey into words. There was a lot we went through. But I would do it all over again if I had to to get this perfect angel. We are so happy and oddly enough, I'm really thankful to God for putting us through this. I never thought I would say that.

But Lyric is 8 months now, and I haven't had 1 week where I haven't cried while putting her to bed as she's snuggling me, because this. life. is. so. good. And I wouldn't have had our journey any other way.

If you're going through infertility struggles and want to talk, please feel free to email me. I am so happy to share more of my experiences with you or even just be a listening ear. If I had any words of advice, it would be to not give up. Because we almost threw in the towel multiple times - and are  so so grateful that we didn't.

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