Dear Diary,
I'm finally going to write about my journey with secondary infertility, and the mysterious underlying conditions that may or may not be the cause. We have two beautiful children that I love so much it hurts. Two beautiful, rambunctious, silly, wonderful little girls. Our oldest came as a lovely surprise when I got off of my birth control so we could start trying a few months later. At the time I was convinced we would have a hard time getting pregnant since my cycles had always been slightly irregular, even when on birth control. Always between 30-36 days-ish. I never really knew why.
After our beautiful baby girl, Isabelle, was born, I did not go on birth control. We knew we would probably want another sometime down the line, but we were comfortable just leaving it in God's hands about when it would happen. Or so we thought. When Isabelle turned one I decided to stop breastfeeding her as I had not gotten my period back and hoped that if I stopped nursing it would help it start back up. It took another six months to start again. That is eighteen months from when I had my baby. At first my periods were normal, but after a few months they started to get a little wonky. And then a lot wonky. Pregnancy test after negative pregnancy test I finally realized my new normal cycle length was anywhere between 47-60 days. This was unheard of for me.
We officially began trying again when Isabelle turned two. I soon realized this wasn't going to happen without fixing my crazy cycle. I went to the Doctor. I was told I needed to lose weight. No blood tests, no exams, just told I was too fat. At the time I was only ten pounds more than when I got pregnant the first time. I joined a cross fit gym with my husband the following week. I started slow and worked my way up. It was hard. It was really hard. After four months I had lost a whopping two pounds. I had not lost a dress size, I had not lost any inches, and I still looked pretty much the same. My cycle was still crazy, and so I went back. The Doctor told me I probably wasn't trying hard enough. I should watch what I eat. Go on a diet as well. I told him I was working out five to six days a week. Sometimes even twice a day! Still, go on a diet. Ok, I decided to try paleo. I had some more success on that. Two months later I had lost ten pounds, yay! My cycle was still incredibly crazy though, almost worse than before. I went back to the Doctor. I told him that I currently weighed less than when I got pregnant before. I was on a diet, I was working out, and nothing was changing in my cycle. I was finally given a referral to an infertility specialist. I went home and cried the rest of the day.
Why would I cry about something I wanted so badly? This was going to fix me, right? I cried because I had finally come to accept it. I finally accepted that I couldn't do by myself what so many women do by accident. I cried because I was broken and didn't know why. I didn't know what I had done to cause this. I cried because I tried so hard to fix it by myself and couldn't. And it had finally become official.
I went to the infertility specialist. He was a funny one. I found out I even had several acquaintances and friends who went there. I felt out of place with my two year old in tow though. I felt guilty because I should have been happy with this one perfect, beautiful gift God had already given me in my arms. But I longed for another. Just one more I told myself, just one more to fill my heart to its brim.
My first appointment included an ultrasound and bloodwork. The ultrasound showed that I was not ovulating. Everything looked "lovely" in there though, so what was the problem? They took some blood, quite a bit of blood, and tested the crap out of it. They gave me progesterone to make me have my period, and scheduled a follow up the next week.
Well, the next week my labs all came back "lovely." He really liked that word. One hormone, Prolactin, was slightly high, but no big deal. I was given Clomid to make me ovulate, and told we would do another blood test at the beginning of my next cycle. I had to schedule another appointment later on to test the pH of my lady parts. I had to come in and have a swab taken after having "copulated" within 8 hours. I was told I would not be able to get pregnant without using Intra Uterine Insemination (IUI). My lady parts pH was too high or low and was killing all the swimmers in there, which were supposedly all dead. I went home and cried again. We were going to try without it anyways. Turns out I didn't have to worry about it after all.
Surprise, Surprise! My first round of Clomid worked! We were pregnant! How on earth people can get pregnant on that is beyond me. I cried. A lot. I got mad. A lot. I cried because I didn't know why I was so mad. A whole lot. I was hot. I was cold. I was in the mood. Then I was mad. Then I cried. It was crazy. Props to my poor husband who had to deal with me during all that.
My first appoint at the specialists after I found out I was pregnant involved an ultrasound. Yay! Wow. My husband couldn't be there, so I go to tell him on the phone. They thought it was TWINS!!! Holy Moly! He half cried and laughed at the same time, and then he cried more than he laughed because we would have to get a van and we had just paid off the car. That whole week I had to adjust my thinking. Not just one more baby, but two. Not two children for me, but three beautiful babies in our family. The following weeks ultrasound showed only one baby though, and they weren't sure if the other had been a baby or just some implantation bleeding. For one whole week I was convinced we were having twins. I cried at home, and my husband was sad but happy we didn't have to buy a van afterall.
The weeks wore on and he deployed. I recorded my ultrasounds and emailed them to him. My twenty week ultrasound came and I didn't want to know the gender. My husband did though, so they put it in an envelope and I gave it to a friend so I wouldn't peek. I finally caved in to the pressure from my husband and our friend told us while I skyped with my husband so we could find out at the same time. A girl. Another beautiful baby girl. My husband said soon after (a few days? That same conversation? I forget) that we could try for one more, hopefully a boy. What?! Lets have this baby first before we start talking about any more.
This baby finally came. All my worry over how I could love another baby as much as I loved Isabelle disappeared when I held her. Oh that sweet little angel! We had a bit of a rough time at first, but oh how I loved her! My sweet girls. I loved them both. And I thought then that maybe two were enough. But then my baby Margot got bigger, and bigger. And then she turned one. I started to get the baby bug again watching all my friends get pregnant.
I never went back on birth control after Margot was born either. I figured it would be like last time. Well, I stopped nursing her at thirteen months old. I figured my period would show up a few months later like last time. Six months at the most, right? Six months came and went with no period. I went to my new Doctor since we had moved. He gave me a referral right away for a Gynecologist off base who was also supposed to be an infertility specialist.
"When was your last menstrual cycle?"
"Two and half years ago, before I got pregnant with my baby."
"Excuse me? Why haven't you had your cycle since then?"
Um, gee, maybe that’s why I'm here? Blood tests. More progesterone. No cycle this time though. All levels normal except one that’s just a little bit high. You guessed it-prolactin. This is the hormone your body makes to help you produce milk. I had stopped nursing eight months previously though. Blood tests again. A little higher! Time for an MRI of my pituitary gland, where prolactin is made. All normal. Tests for Thyroid function. All normal (but not really, one thyroid hormone turned out to be low. Apparently they say it isn't something to worry about, but then why test for it?). Test. Test. Test. All normal. More progesterone. No cycle. They finally decided to put me back on birth control. I cried again.
In all the testing and retesting, I finally realized that I didn't just kind of want another baby, but that I desperately wanted another baby. A sweet, snuggly, chubby little baby to make our family complete. My five year old had been asking me for over a year now if we could have another baby, preferably twin boy mermaids (mermaids? Yes you read that right), but a girl would be okay too she said, and the baby didn't have to be a mermaid after all. My husband was on board too. He would love a little boy (which of course means we will have another little girl if it ever happens, but that’s ok with me). Somewhere in the mess of these appointments, I realized this wasn't just about getting my period back and my cycle regulated. It was hoping to have one more baby. On our own this time. Trying to fix whatever was wrong with me, and THEN trying for another baby. Not just going on clomid again, only to have the same problem after a baby came. And so I cried when I went back on birth control because that meant even longer to reach my goal. It was the exact opposite of what I wanted at the time. So I went on birth control anyways. I had a light period the next two months. Hardly anything, but at least it was something. After the third month I stopped taking it as it had caused me to gain a whopping twenty pounds. Awesome… My Gynecologist had said three months should be enough to kick-start my cycle again.
No period the next month. Test after negative pregnancy test proved a baby on the way was not the reason. Back to the Gynecologist I went. More progesterone. Still no cycle. I had to have an ultrasound. All clear and normal, although they didn't use the word lovely like my last doctor. A higher dose of progesterone was prescribed for three months, only during ten days of the month on the same days each month. I also got a referral to endocrinology because I didn’t want to go back on the birth control, and I also didn't want to just go on clomid. Her diagnosis was PCOS (Poly-cystic ovarian syndrome). Let me give you an overview of the criteria you need to have in order to be diagnosed with this. 1. Irregular or anovulatory cycles. Check! 2. Many small cysts on the ovaries, often appearing as a string of pearls. Nope, my ovaries were fine and I had had three separate ultrasounds to prove it. 3. High levels of testosterone and insulin resistance. Nope. This same gynecologist had bloodwork done to test me for this at the beginning. SO…. Could I have PCOS? No. Not without at least two of the three criteria. When you look it up on wikipedia or other websites it says this. And it also says that there are several other issues that can present with similar symptoms including, drumroll please…. Hyperprolactinemia (high prolactin).
So off to the endocrinologist I went. I was so happy to get that sweet, sweet referral. Finally, someone who could fix me! My appointment came. I told the nurse my history. I had my previous labwork with me for them to peruse. She made copies for the doctor. I told her I had low T3 (that "unimportant" thyroid home). I showed her the lab. I told her I had high prolactin, and showed her the lab. I told her about all my strange symptoms which strangely enough seem to be the same symptoms as a thyroid condition called hypothyroidism. Its quite common. The doctor finally came in, my labs in hand. I tried to tell him my symptoms, and tried to ask if it had anything to do with my T3 and my thyroid. Did I have hypothyroidism after all? He told me to forget about it, my thyroid levels were fine. That test didn't even show the right kind of T3 anyways. I asked about my high prolactin levels. He said it wasn't that either, my levels were only slightly above the normal range and not at any level where it could be wreaking such havoc in my body. He said I have PCOS.
Oh no. Not this again. I tried to tell him I had already been tested for this twice now. Once just recently by the Gynecologist, and once a few years before at the infertility specialist. My ultrasounds were fine, no cysts. My testosterone and insulin were fine, not elevated. He didn't believe me. He told me I needed to lose weight. I felt a part of me going numb inside as he continued to talk. He would have blood work ordered… take all the tests to be sure… 1,200 calories a day… I stopped listening. He prescribed medicine to help for insulin resistance often given to PCOS patients, and also to diabetic patients. He told me to take more Vitamin D as it was a little low. I asked again about the prolactin. He said that if it was still high and everything else was fine he would give me medicine to lower it. I cried the whole way home. He was my last resort. I felt like he had failed me and there wasn't anything else I could do. No one else to go to.
Low and behold, all my blood tests were normal except my prolactin, which was just a little high. What did this mean then? Did the Doctor still think I had PCOS? If my testosterone and insulin were normal it meant I couldn't have it, right? Just like I said? The nurse couldn't elaborate much on the phone. Apparently he still thought it could be a possibility as he didn't have my ultrasound results. Really?! I asked her to mail me the labs for my records. After my "normal" T3 reading at the Gynecologist I didn't trust not being able to see them for myself. She said they put the prescription in for the prolactin lowering medication and I could pick it up. At least I had gotten that much. I knew it wasn't PCOS, but he apparently didn't care what I said. I got my labs in the mail a couple days later. Guess what the Doctor did not test for? T3. Not the "right kind" or the "wrong kind" as he had described. I called the nurse right away and left a message about it. I didn't get an answer back, even after I called a second time. I called my regular Doctor and he said if I brought in all my labs for him to look at he might be able to get some more blood work ordered about it. I love that Doctor. He's been the only Doctor I've ever had who listens to me, who seems to care about helping me get better. He's awesome.
So now we are all caught up to the here and now. I'm on the prolactin lowering medication which I started last week. It has some awful side effects. I have to wait six more weeks to go back and have my prolactin tested again. I still have a long way to go it seems. My cycles still haven't resumed. Still no hope in sight of having a baby in the near future. Sometimes I wonder if this is God's way of trying to tell me that two babies is enough? Maybe I'm not praying hard enough? Maybe I'm not thankful enough for the two wonderful gifts he's already given me? Maybe I should give up on fixing myself first and just try the clomid like the Gynecologist suggested? But how can that even work if I'm not having a period to begin with?
Right now I will try and hold out hope that the medicine I'm on will help. In the meantime I am also trying out essential oils specific for infertility. One in particular I am really hoping will help, Progressence Plus. I don't have to be taking the high levels of progesterone that the Gynecologist prescribed, which is great since they make me so nauseous all day long. I snuggle my two year old as often as I can, and kiss her still chubby cheeks. I wonder how long she will let me call her a baby, and carry her around. She's getting so big so fast. I hold her close and wonder if she is my last, and close my eyes to keep from crying when I see the beautiful swell of a blossoming pregnant belly walk by.
Honestly, Mommy
*About Amanda*
My name is Amanda Diamond. My husband and I have been married nine years now, have had an amazing wonderful life so far. Thanks to the Air Force we have been able to travel all over the world. We have two beautiful little girls, Isabelle who is five, and Margot who just turned two. I am currently a stay at home mom, which has been an emotionally rewarding, yet incredibly taxing and difficult, job. Especially without the support of family close by.
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