As a way to observe National Infertility Week, I have decided to share our story of infertility in hopes it may help at least one person. This story is extremely personal to me and has taken tremendous effort to live through and now write about. I understand firsthand how taboo the topic of infertility can be. Please keep in mind how vulnerable I am making myself when reading and commenting.
I shared the first part of our story, the birth of our daughter,here. She was conceived naturally without any issues. Today, I begin the part of our story when we decided to start trying for our second child.
Throughout Claire’s first year, I nursed and pumped. The doctor put me on a low dose birth control since I was overproducing and had developed mastitis. It was supposed to help decrease milk production. As a result of the nursing and birth control, I never got my cycle back. I pumped until Claire was 10 1/2 months old (October of 2013) and we had enough through her first birthday. But I didn’t get my cycle back until I went off birth control that following May. I have no idea if that contributed in any way to our infertility, but I certainly wonder at times. The doctors never seemed that concerned.
In June we decided to start trying to have another child. Of course you think about how you’d like them spaced out and hope that having them close in age means they will get along. Infertility can really knock those dreams out of the water. The first few months went by with nothing, but we weren’t too concerned. I ended up starting a job in a new school district so we took a few months off of trying until my short term disability kicked in that October of 2014. Months went by and still nothing. I tried ovulation kits, basal body temperature charting, anything I could think of. I mentioned it to my OB when I went in for my check up that February and he seemed unconcerned. He thought I was too stressed out about it and to make an appointment if we still weren’t pregnant by summer. Each month got harder and harder emotionally. So many people around me were announcing their pregnancies and I couldn’t understand why we couldn’t just all be pregnant. Why was I the one left out?
Finally that July, I made the call for another appointment with my OB. Admitting we couldn’t do it on our own was so difficult and incredibly humbling. People get pregnant on accident all the time. Why couldn’t we get pregnant on purpose? At the appointment, the doctor still didn’t seem concerned. He said everything looked fine, but we could do some blood tests to make sure I was ovulating. He could also order a hysterosalpingogram (HSG) to check if my tubes were open as well. An HSG is a contrast xray where they use a catheter to inject dye and see if it goes through the tubes. My husband could also be tested. Another option was to go on Clomid (a drug that makes you ovulate-not fun!).
We decided to go ahead with the blood tests first. I began my next cycle while on vacation and we made sure to get home in time to get to the lab on the day I needed. There was some confusion at the lab on which day of my cycle I should get my first blood test, Day 3 or 5 and since it was the weekend I had to go in twice just to make sure they had the correct day. Honestly that should have been my first clue that OB and office was not the right place for me. They took blood work two other times that cycle. Results came back totally fine. I was ovulating.
Onto the next step. Rather than do an HSG, my doctor said I could go on Clomid. Since I had already had a child naturally, he didn’t think my tubes were blocked and felt comfortable prescribing it to me. I think this was my first mistake. I should have asked about my options and looked into the success rates. Afterwards, I looked up studies and for women who ovulate regularly, Clomid only has a 5% success rate and a lot of side effects, physical and emotional. Insurance did not cover the cyst checks or the medication itself, so each month was about $400. Don’t get me wrong, the cost isn’t bad considering the amount we paid for other treatments, but for only 5% chance of success I wouldn’t have done it had I known. I was on it for 3 very emotional months with at least weekly migraines that would last up to 3 days. Obviously we didn’t have success.
In the meantime, my husband went in to get checked. Every time we called, his results seemed to change. We couldn’t get a straight answer about what was in the average range and what wasn’t. Another clue this was probably not the right place for us. In the end we found out there was a very slight morphology factor (but probably not enough to cause issues for a year and a half). I then inquired about getting an HSG to check my fallopian tubes. After all bloodwork, male testing, and then an HSG, we could move on to the next step: an Itrauterine Insemination (IUI). But I had so many issues with communication, trying to schedule an HSG, not having phone calls returned, and then how they would be billing my insurance that I gave up. To make a very long story short, in states that do not have infertility coverage, getting a diagnosis for your infertility can be tricky. Infertility can be viewed as a diagnosis or a symptom of a medical issue. Our insurance covered testing for infertility, but no infertility treatments. Well, if you get a test done (like an HSG), the doctor can bill it as a diagnosis of ‘testing for fertility’ or infertility. Same procedure, different ICD 10 diagnosis code. Insurance will cover the around $1000 procedure if the diagnosis code is ‘testing for fertility’ but not infertility. So stupid. But my doctor refused to use the ‘testing for fertility’ diagnosis code. He would only use ‘infertility’. I took a real issue with this because it IS a diagnostic test and it was not illegal in any way and it was sweat off his back to use a different code. After months of this and even trying a patient advocate (NO HELP AT ALL) I switched doctors. We had enough stress at that point and we didn’t need stupid doctors and bad communication making it worse. Don’t ever settle for a doctor and office that treats you that way. We deserve better as patients. We deserve consistent, timely, and quality communication. We deserve a doctor who will listen and consider our concerns and possibilities to help with insurance and billing. We deserve a doctor who will educate us on our options instead of leaving us to educate ourselves!
Thankfully, I found a new OB in a different office that I could have my yearly exam with in January 2015. After talking with her and being very upfront about it all, she agreed immediately to do an HSG in February and bill it with the diagnosis code of ‘fertility testing’.
In January I also began seeing a chiropractor and getting weekly acupuncture treatments. The Clomid had taken its toll and my migraines were awful. I was looking for anything that could help and studies showed they could, and they certainly wouldn’t hurt our chances.
The HSG test in Feburary went smoothly and my fallopian tubes were clear. The test cost $52 instead of the $1000 it would have cost us at the other office. Advocating for yourself can make a huge difference!After the results, she recommended we contact a Reproductive Endocrinologist (RE) for more specialized services. There wasn’t anything more she could do for us. At this point, she said our diagnosis was Secondary Infertility, unspecified. That basically means they have no idea why we weren’t pregnant. Awesome. It also means there wasn’t a clear path forward for treatment because they didn’t know what would work and what wouldn’t. I appreciated her listening to me and her advice. After a lot of internet research, we decided to contact Advanced Fertility Clinic in Gurnee, Illinois. It is a 50 minute drive, but the success rates really impressed us. Their website is extremely informative, too. I made a consultation appointment for early April knowing the next step would be an IUI.
I plan to continue our story later this week with the treatments we have tried, and other things we have been through. But I also eventually want to do a Q & A post on infertility. Many of my friends and family had no idea process of getting pregnant and how many ways it can go wrong, possible diagnoses, different treatments (it’s not just IVF), and what happens during it all. If you have any questions about anything related to infertility or what you can do if you know someone going through it, please comment or email me at laura.bambrick [at] gmail [dot] com. I’m happy to answer anything privately, too. Just make sure to tell me in the email.
