Infertility sucks. I’ve shared the highs and lows of my personal struggles to get pregnant before, but as a quick recap: my husband and I purposely waited about 6 years after we got married to have children. And sadly, it didn’t happen right away.
We tried for about nine months with no success. I read all the advice, used all the tracking apps, and did what I thought was all the things. And here my body was, betraying me and not working like it’s supposed to.
Navigating infertility in the doctor’s office includes a lot of logistics, and sometimes, it’s intimidating and scary because it’s not exactly clear what to expect.
Today, I’m sharing the basics of what to expect navigating infertility; because the more you know, the more empowered you can feel going into that first appointment.
It took me about 18 months to get pregnant with my first child, and about the same amount of time for baby #2, who is due this month!
Read on for my personal recap of the practical, tangible process of it all.
One more note: I would be remiss to not mention that no fertility journey is the same. Every woman’s body/reproductive system is, looks and acts very different. My experience is no by means comprehensive and I am so very much not a medical professional who has any authority to give out medical advice. (I was a lawyer before I had my son, can you tell?)
Step 1: Identify a Problem
The first step is obviously failing to get pregnant when actively trying. I originally downloaded a period tracker app on my phone to track my cycle and identify ovulation days, which is typically around day 14-16 of your cycle.
My husband and I would try to have sex a few times during the week we thought was correct. After 9ish months of that, I finally brought up our struggles to my OBGYN at my annual well visit.
Step 2: Dig deeper to pinpoint the cause
I told my doctor that my periods were pretty regular, usually occurring on almost the same day every month. From that information, he surmised that I likely was regularly ovulating (this was later proven incorrect).
It was suggested we try Natural Family Planning (“NFP”) which is similar to cycle tracking. However, NFP also teaches you how to observe your cervical mucus (the regular flow of vaginal discharge a woman has every month).
Apparently, the consistency changes through your cycle and when you observe runny, egg-white like mucus, that is when you are ovulating. Have sex on those days and you should be able to conceive.
Step 3: Try to correct the pinpointed cause
I tracked my cervical mucus for six or seven months (which is truly as fun as it sounds).
Still not pregnant, I brought it up to my doctor again and asked if there was another way. He then suggested I track my basal body temperature at the same time every morning. I liked this because it is more objective than the subjective assessment of my cervical mucus.
Theoretically, your body temperature rises during ovulation.
As I tracked, I only noticed an extremely slight raise in temperature (maybe 0.1˚), which was extremely frustrating. We would attempt to conceive at all random times during the month because I just couldn’t tell what constituted an actual temperature raise.
Back to Step 2
After two months of temperature tracking and still no pregnancy, my OBGYN then ran some blood work and ultimately diagnosed me with Poly-Cystic Ovarian Syndrome (“PCOS”), which essentially presents all kind of complications with fertility.
Back to Step 3
To treat the PCOS, I was prescribed Metformin which is a diabetes medication. (FunFact: the endocrine and reproductive systems are very closely linked.) I took the medicine for one month before I found out I was pregnant.
You’d think the second time would be easier?
Two years later when we started trying for Baby #2, I began taking the Metformin again believing that it was the magic potion for us. We went back to NFP as well, but 12 months passed with no pregnancy.
Finding a fertility specialist
This time, I decided to seek the help of a fertility specialist, not just my OBGYN.
After the initial consultation, bloodwork has to be taken at specific times in your menstrual cycle to check different hormone levels.
I also underwent several internal ultrasounds at specific times in my cycle to check my ovaries, uterus, and fallopian tubes to rule out endometriosis, blocked tubes, or any other major issue.
The bloodwork showed that my hormone levels were significantly decreased which indicates that I was, in fact, not ovulating.
This was surprising to the fertility specialist because of the extreme regularity of my periods. This is also probably why my OBGYN didn’t investigate further and suggested NFP. I’m kinda salty about that, but we press on.
Testing for both of us
Bloodwork also showed some irregularities with my thyroid. I was prescribed some medicine for that, as well, because again the endocrine system effects fertility. #themoreyouknow
My husband’s sperm was also tested, and it showed to be (and he wanted me to be very specific here) “above average.” #blesshim
Turkey basting sperm
Since ovulation was the problem, it was decided that I would take medication to stimulate ovulation and we would do an Inter-Uterine Insemination (“IUI”).
That means artificial insemination with my husband’s sperm and my egg. Think turkey baster.
To prepare for an IUI, you have an internal ultrasound on Day 3 of your cycle (like, while you’re on your period; absolutely no fun for anyone involved!) to ensure everything is in working order. Then you take the stimulation medicine (an oral pill) for 5 days.
A few days later, you have to give yourself a shot in your stomach to stimulate your follicles. This shot is really not that painful, but I did have my husband do it because I don’t do needles.
A few days after that, you take “the trigger shot” which is the actual ovulation stimulator that prompts your ovaries to release an egg. Again, it’s not that bad and I didn’t experience any side effects. You have to take the shot 36 hours before your scheduled IUI. So, my first IUI was at 11am which meant we had to take it at 11pm two days before.
Then, your husband goes in 90 minutes before the scheduled IUI to deposit his sperm. #talkdirtytome. Then, you go in and his sperm is injected into your cervix to hopefully fertilize that egg (or eggs…ovulation stimulation increases the chances of multiples by 20%)
For the next 2 weeks, you are to take progesterone supplements to help support pregnancy and prevent miscarriage. These supplements are taken via vaginal suppository. (Yes, you read that correctly)
And then 2 weeks later you take a pregnancy test.
And that’s my experience so far. Lots of waiting, lots of appointments, lots of blood work, lots of observing your body. But also, lots of hope.
My heart and prayers go out to you, mama, if you have waiting arms and are in the thick of it, too. But the more we all share our experiences, the less lonely this feels and the more supported we become.
My dear friend also compiled five tips for supporting a friend struggling with infertility here, if you’re reading this and know someone in your life going through this.