It's Been a Long Road

"Happy 28th Birthday! I want to...when you want to. I love you, D. 12/21/04"

That was the message Drew wrote inside the Taking Charge of Your Fertility book he gave me (as requested) for my 28th birthday. That was the beginning of what turned out to be a very long road.

This is going to be an extremely long post. It's also one that I can't imagine will be of much interest to anyone reading (except me) so don't say I didn't warn you. But as I've said, I'm doing this blog for selfish reasons. I want to remember everything we went through to have this baby. And this was how it began.

January 1, 2005 we started actively trying to get pregnant. After about 4 months it was pretty clear things were not normal and I went to my OB/GYN. I spent the entire second half of 2005 and the first few months of 2006 doing the standard OB/GYN treatments for "irregular" women. I went in for progesterone shots to induce cycles, I took blood tests to watch hormone levels, I had my thyroid tested, I tried Clomid, I tried Letrozole. None of it worked. Through it all I was charting my temperatures...and found absolutely no patterns. Finally, my OB/GYN gave up and referred me to a Reproductive Endocrinologist at the Midwest Reproductive Center in Olathe, KS, Dr. Dan Gehlbach.

I believe it was the middle of 2006 when I saw Dr. Gehlbach for the first time. He confirmed what I already knew, I have Polycystic Ovarian Syndrome or PCOS. Essentially, my hormone levels are completely out of whack. Rather than having a normal monthly cycle where ovulation occurs, I start the process but then don't have enough hormones to finish it. The result is many partially developed eggs that shrink back down and remain in my ovaries as a bunch of little cysts (hence the name, polycystic ovarian syndrome). For the most part, harmless. But when trying to conceive, a big problem. He presented us with several options. Some not so bad, some middle of the road, others terrifying. We elected to go the "slow" route (also the cheap route) and try a couple more combinations of oral medications before moving on to the more radical stuff. After all, we weren't quite in panic mode - we felt we had plenty of time.

That was when I was introduced to Metformin (which I am still taking to this day and will continue until the start of my 2nd trimester). Studies have found that often women with PCOS also have an insulin resistance problem. Apparently, the body builds up immunities to insulin; therefore, requiring a much higher production than is typical. As a result, your hormones are so busy processing the insulin they don't have time to focus on other hormonal efforts; therefore, throwing your whole body out of whack. Even though I didn't respond to Clomid on it's own, many women had success when taking Metformin (to get the insulin issue under control) in combination with Clomid (to induce ovulation). Sounded great! I took Metformin for a few months to let my body adjust and then we added in Clomid to the mix. I believe it was at the end of 2006 and the first month of treatment using both drugs worked - I had a feasible egg! We went home that night with our "assignment" and hoped for the best. No luck...I didn't get pregnant. We tried again the next month and this time I didn't respond at all. No eggs. So the "slow" and "cheap" route wasn't going to be an option after all.

This was a pretty big let down for us. It meant I was going to have to pursue ovulation induction with gonadotropins - in other words, daily injections of hormones. The injections (while a bit inconvenient) didn't deter me in the least. It was the cost. We were now past "exploratory" medicine and were into plain old "infertility". Meaning no more insurance. Just one cycle of injections is in the $3,000 ballpark. Ouch. We waited a few months after coming to this realization before moving on. I think we needed a break and we needed to save up some money.

Somewhere in here Drew was tested for any issues he may be having as well - just in case. Before we invested some serious money into this we needed to know exactly what we were up against. He checked out fine. I'd also like to mention that I started doing yoga. Not only is it a lifesaver for people like me with anxiety issues, but it also changed my body. I lost over 25 pounds, 2-3 sizes in clothes and was in my best shape physically (and mentally) since college. I don't think that's a coincidence in all of this.

In early 2007 we decided time was of the essence. We were 30 now. Way beyond where we thought we would be when we started a family. So we decided to screw the money and jumped in full force ahead. The next step was a procedure called a Hysterosalpingogram (HSG). It sounds scary but it wasn't as bad as I had feared. I was placed in radiology under an x-ray machine while a dye was inserted in my uterus. The doctor watched the screen as the dye flowed through my body to make sure there were no blockages in my fallopian tubes. It wouldn't make sense to spend thousands of dollars on injectable hormones if there were blockages we had to worry about anyway. As it turned out, my tubes were fine and we got the okay. I was so relieved.

I did my first round of injections with interuterine insemination (IUI) in September of 2007. Basically, I took a hormone shot every night and went to the doctor for an ultrasound every 3rd day. It's really important that you are monitored extremely closely. For one thing, over stimulation of your ovaries can be quite dangerous and we had no idea how I would respond to the hormones. For another, you want to have a precise idea when the egg is fully developed so you can time the insemination. Drew would then provide his piece of this puzzle and we would inseminate directly into my uterus - hoping to get the 2 players as close to each other for fertilization as possible. I actually responded very quickly to the injections and had an egg in no time at all. We did the insemination...and waited. When enough time had passed to do a blood pregnancy test I got a call from my nurse, Jane. "Sorry Heidi, the test was negative."

At this point we needed a break. It had now been almost 3 years. Even though we were completely aware of the statistics (most people don't have success until the 3rd or 4th cycle of these treatments), we were pretty emotionally (and financially) spent. We were coming upon the holidays and my busiest time of the year at work involving tons of travel (which makes ultrasound appointments every 3rd day pretty difficult). So we agreed to give ourselves a break until after my conference in February of 2008. Then we would start again...full force ahead.

We completed our 2nd cycle of injections with IUI in March of 2008. Same story...I responded well, we got a viable egg, we inseminated, Jane called, "Sorry Heidi, the test was negative."

We started round 3 immediately. This cycle was different from the start. I wasn't responding very quickly. I had to increase my injections to 3 times the levels I was taking with the previous cycles. It took twice as long to get a viable egg - although I got 2 this time. This cycle just felt different. The week we were due to inseminate, we got 2 phone calls from our parents. The first one was from my Mom. My Great Grandma Diers had passed away at age 102 in her sleep. The next morning Drew's Dad called. Drew's Gradfather had passed away in the nursing home of heart failure at age 97. Not only were we sad for our losses, but we couldn't attend either funeral...we both had to remain close by the doctor's office so we could perform the insemination that week. As a result, we had to tell our immediate families what we were in the process of doing. We had hesitated to share much information related to our procedures up to this point because we really didn't want the extra attention/pressure/questions that are bound to go along with it. But we didn't have a choice, and in the end I'm glad we did. Now, not only did we have 2 new angels in heaven on our side, we also had family members across the country praying for us. I know both of my Nanas were lighting candles in church for Drew & I and I'm certainly not going to question the power of a catholic woman and her candles! I was inseminated on Sunday, April 20. I was all too familiar with the drill...insemination, rest (on your back) in the procedure room for 20 minutes, free to go. This time, I took my iPod with me and I listened to music (always my refuge) and prayed. When I drove home I called my Mom (who was in Iowa for the funeral) and I also talked to my Nana Diers. After I hung up I was sure the gods were on our side. I cried the rest of the drive home.

The last thing I want to mention about this 3 1/2 year journey is how I felt through all of this. I don't think it's conceited to say that Drew & I really handled this like champs. No one imagines having to go through all of these steps to start a family together. Through it all, I was never one of those "why me" women. I didn't get weepy at the sight of babies and I didn't resent pregnant women. (It's a good thing because I can't count the number of friends and family that had pregnancies and babies in that 3 1/2 years!) I'm not trying to sound like some superwoman. We definitely had hard times. We definitely had tears. But I think we both believed deep down that we would have a child. I never gave up and I never felt like it wasn't meant to be. And I have the most supportive, amazing husband in the world.

I knew our time would come. Our road was just a little longer than most.