Honestly, Getting Pregnant With PCOS Was Emotionally Exhausting
I was never someone who dreamed of having babies. Hell, I didn’t even realize I even wanted to get married until late in the game. But then all of a sudden, I did. I wanted to get pregnant. And I wanted to get pregnant right now. I was 29 and had been on birth control since my teens, so my husband and I decided to toss the pills and throw caution to the wind. All those years of absolute paranoia about pregnancy were over, and we expected nothing less than quick success in the pursuit of having a baby. Little did I know what was to come or how getting pregnant with PCOS would change my life forever.
Because I’d been on birth control for so many years, I had no way of knowing I had PCOS. In retrospect, I probably should have suspected it. My sister has severe PCOS and my mother had her own set of reproductive issues. But, I didn’t (and still don’t) have the telltale signs of PCOS (excess hair growth, irregular periods, insulin resistance, and excess male hormone being some of the most common markers, according to the Mayo Clinic) because my ovaries had essentially been asleep for 14 years. It wasn’t until I realized I had very few (and eventually non-existent) periods that the red flags started to go up. I got more serious about monitoring my fertility signs after reading the bible of all fertility books, Taking Charge of Your Fertility. I began to record daily basal body temperatures, and eventually graduated to ovulation predictor tests, and realized I was very infrequently ovulating. There was one strike of lightning when I did have a spontaneous pregnancy, but it ended in a very early, and extremely prolonged, miscarriage.
After my miscarriage, I got more serious about medical care and figuring out what was going on with my body. After seeing an OB-GYN, I felt more confused than empowered because she refused to give me any testing to confirm my PCOS. I was given very few options to move forward. In the end, my OB advised me to lose weight (although I had lost 50 lbs. the year before) and to “be patient.” Because the word “patient” is not in my vocabulary, I obsessively scoured fertility websites, joined message boards, and basically exhausted myself with information overload. You name the supplement, tea, food, Eastern-medicine practice, or complementary therapy — I tried it. And I didn’t see one iota of change in my body. I was consumed with so many feelings, and even questioned my own femininity. Am I a woman if I can’t ovulate? Why are my reproductive organs failing me? All these doubts led me to start a blog about my experiences and from there, I built an online community of women experiencing also infertility and loss. Even now, I remain close friends with some of these women, even meeting some in real life. After several months of said research and waiting for a period that never arrived (and having a lot of unprotected sex), my husband and I decided to bring out the big guns. We headed to a reproductive endocrinologist (RE), also known as an infertility specialist, to help us get answers.
Every time we tried to do something to help me get pregnant, it felt like we only hit more and more roadblocks. I can't even tell you what it was like to have our hopes raised with each new intervention only to have them dashed days later. My husband and I felt like no matter what we did, we were stuck standing still.
Although my previous OB-GYN had denied me the opportunity to get testing for PCOS, my new doctor immediately ordered all the testing needed. After a battery of blood work, ultrasounds, and a hysteroscopy (which OBs use to diagnose problems in the uterus, according to The American College of Obstetricians and Gynecologists), my diagnosis was finally confirmed: PCOS. Technically, I have a “subtle variant” of PCOS, because my symptoms are mild on the spectrum of how women manifest this disorder. Even though I didn’t have insulin-resistant PCOS, my doctors hoped putting me on Metformin, which is a common treatment for PCOS, would help bring on ovulation. They gave it to me on a sort of trial-and-error basis, hoping it might work. But, no such luck. Instead, we got more months of rising hopes and disappointment. We moved onto other low-level fertility interventions: first came clomiphene (Clomid), the most common (and least expensive) oral fertility treatment option, which is supposed to induce ovulation.
Although it was supposed to induce ovulation, Clomid gave me huge f*cking ovarian cysts. To make matters worse — I didn’t ovulate. Oh, and did I mention the extreme mood swings yet? Because every dazzling high was met with an even starker, dangerous low. What was even more fun, however, was that after each failed Clomid cycle, I’d have to go on birth control for at least one more cycle in order to shrink the cysts — the cysts made by the medication that was supposed to help me. My emotions during this time were all over the place. Every time we tried to do something to help me get pregnant, it felt like we only hit more and more roadblocks. I can't even tell you what it was like to have our hopes raised with each new intervention only to have them dashed days later. My husband and I felt like no matter what we did, we were stuck standing still.
When the delivery from the fertility pharmacy arrived on day one of my cycle, I spread all of my vials, syringes, patches, bottles, and sharps containers out on my dining room table, took a picture of them, and cried. It hit me like a ton of bricks: I was about to put a whole lot more science into my body.
After two of those failed cycles, we “graduated” to injectable medication and an intrauterine insemination (IUI), or as I lovingly call it, the “turkey-baster method.” Now, I am someone who hates needles. Like, when two friends were once discussing an IV while we were getting drinks, I started to black out at the bar. But somehow, after watching my doctor’s kind and patient nurse draw circles on my abdomen and practicing on an orange, I became a pro. So much so that not only was I injecting myself on a daily basis with medication, but I was also doing a kind of extreme form of Chinese acupuncture known as “electroacupuncture.” I paid someone to stick me with needles, and attach electrodes to them, sending current into my cyst-laden ovaries every week at $80 a pop. Sometimes I even did it twice a week. Unfortunately, although the injectable medication and electric volts did finally help me to pop an egg (for the first time in about a year), the two IUIs we did were not successful.
Oh, and every time we did an IUI, I ended up being benched for more cycles each time thanks to the return of those wonderful, huge cysts. Luckily, my insurance let me bypass a third IUI and approved me for IVF not long after. We took our first vacation in years and tried to mentally prepare for IVF the best we could.
Now here’s where sh*t got real: IVF is not for the faint of heart. When the delivery from the fertility pharmacy arrived on day one of my cycle, I spread all of my vials, syringes, patches, bottles, and sharps containers out on my dining room table, took a picture of them, and cried. It hit me like a ton of bricks: I was about to put a whole lot more science into my body.
The incredible amount of ultrasounds and blood work needed in order to monitor my progress meant that my life now literally revolved around getting pregnant.
A few days later, the other shoe dropped when I realized that this was now my part-time job. The incredible amount of ultrasounds and blood work needed in order to monitor my progress meant that my life now literally revolved around getting pregnant. This meant, at some points in my cycle, getting blood drawn and going for ultrasounds every other day in order to monitor my estrogen levels and prevent Ovarian hyperstimulation syndrome (OHSS), a potentially fatal complication of IVF that’s more common with women with PCOS. I had to do all of that until “Retrieval Day,” which is where you get really good drugs and your RE takes all of my ripe little eggs out of your ovaries.
For once, I was actually grateful to have PCOS, because women with it make so many eggs. However, it was all for naught. My doctor retrieved 23 eggs (19 of which were mature) during my first IVF cycle, with all normal sperm, but none fertilized to make embryos. Zero. Zip. Nada. And taking the phone call about this at work was probably one of the worst moments of my life. The crushing depression and sense of failure was overwhelming. Laying in bed and sobbing for several days was the only thing I could do.
Once my pregnancy was over and my son arrived, I blocked out so many of the details, the pain, and the heartache we endured to have him. I actually had to go back to my own blog to fill in details in order to write this piece because I wanted so badly to put it all behind me. For a long time, I even refused to consider having another child because of how difficult the journey was.
But after taking some time to emotionally recover from our first IVF and to give my body a break from the fertility medications, we reconvened with my RE and made a new plan. We were given no good explanation for why our first cycle was a dismal failure, but we agreed to add even more science to the next one. This time, in addition to all the other pieces in place, we added intracytoplasmic sperm injection (ICSI) to the mix. This time, my eggs and my husband’s sperm were going to be forced together, like at a middle school dance. With this extra piece in place, we had magical results: 26 eggs retrieved, with 23 mature, and 20 fertilized with ICSI. I hoped the odds were in our favor.
I got a voicemail from the nurse in my reproductive endocrinologist's office telling me that my pee stick did not lie: I was pregnant.
Five days later, with (slightly less awesome) drugs, we transferred one textbook perfect blastocyst, which means "embryos are cultured in the laboratory incubator to the blastocyst stage before they are transferred to the womb," according to the Human Fertilization & Embryology Authority. And, drumroll please, we had six high-quality embryos to freeze. Several days later, after a blood test to confirm what my home test already told me, I got a voicemail from the nurse in my reproductive endocrinologist's office telling me that my pee stick did not lie: I was pregnant. That voicemail remained saved on my phone until only recently.
That lonely little embryo now sits in my back seat and begs to hear more Lady Gaga and complains when I give him the wrong breakfast cereal. What is funny, though, is that once my pregnancy was over and my son arrived, I blocked out so many of the details, the pain, and the heartache we endured to have him. I actually had to go back to my own blog to fill in details in order to write this piece because I wanted so badly to put it all behind me. For a long time, I even refused to consider having another child because of how difficult the journey was, as well as how tough of a job this whole parenting thing is. When I think about whether or not my PCOS will rear its ugly head again in the future if we try again, I’m not sure I’m ready to find out.