A Journey through Treatment and Pregnancy

Thankfully I work for a large corporation that allows employees to choose from approximately six different types of insurance coverages. When I was first given this option of choosing, I chose the most expensive coverage in order to always have my options open to me. It was a good thing I did too, because the coverage I had chosen allowed me to receive fertility treatment, 6 IUI attempts and 3 IVF attempts as well.

At one point in early December, I received a call from someone in billing at the fertility clinic. Apparently, I had to call my insurance company to request fertility treatment. I had no idea I was supposed to do this, as all other types of treatments and doctor’s appointments did not require I call for “permission.” Well, no harm in just picking up the phone, right?

Upon calling the insurance company, I was transferred to a special department dedicated to fertility treatment and such. I explained to the nurse that I was ready to begin the process for IUI and needed clearance for the procedures. “No problem.” The nurse said. “I just need to ask you some questions.” “What is the name of your partner?” “Umm . . . I have no partner, I’m single and decided to opt for becoming a single parent.” <RED FLAG> Now the nurse stopped, and asked me why. I explained my condition and that I was now ready to try to have children. I also explained I had been going to the fertility clinic to evaluate and search for avenues of treatment for my condition (adenomyosis, for those of you new to my blog) since January of 2007, and that I have no time to look for Mr. Right while my chances of becoming a mother may be dwindling.

The nurse stated they would have to evaluate my request further in regards to my reasoning for wanting to go through this method in trying to get pregnant and also needed to speak with my doctor to find out the specifics of my condition and how it is related to fertility and treatment of such. I was practically crying on the phone. How is it fair that I may be denied using IUI or IVF because I’m single?

Once I hung up the phone, I was in tears.  The worst part of it was the fact I was at work, sitting at my desk in my not so private cubicle.  I didn’t want to get up to go to a more private location for fear of people seeing me in that state.  While in this state, a co-worker who sat diagonally across from me came by to ask me a work related question.  I refused to turn to look at her while we were speaking, but she heard the stress in my voice and asked me what happened.  I just broke down and told her what had happened.

I can’t remember if the insurance company called me the same day or the next, but either way they called me to inform me I was approved for coverage and I could move forward.

So I began moving forward with getting ready for IUI . . .

October was slowly coming into focus, and the thought of children started to creep up on me.  In late May, I had broken up with my longtime boyfriend and decided I was best on my own, and had made the decision that being a Single Mom by Choice was my best route to having children.  I didn’t want to look for a “daddy” or a “husband.”  I sincerely thought it wasn’t fair to subject someone to that.  “Oh hi, nice to meet you.  Would you like to be my baby daddy?”  That just seems so wrong to me.

In making this choice, I had to be aware of the laparoscopy that was looming over me.  You remember right?  The slight blockage in my fallopian tubes that could potentially cause problems with my getting pregnant?

Well I had never had surgery before and the thought of someone cutting into me scared the hell out of me.  After speaking to my doctor I had decided to hold off on going through with the procedure and instead opted to try getting pregnant without it.  My doctor wasn’t happy with my decision but he is enough of a forward thinker to realize there is a time and place for such an argument and this was not one of those times.  He understood my fears and just asked that I remain open minded.

So with opting out of the laparoscopy I also opted to stop my birth control as well, in order to purge the medication and prep my body for pregnancy . . .

With all of the questions on whether or not Birth Control Therapy for the treatment of Adenomyosis, I have to say that aside from this site, I was happy to be somewhat of a positive test case and urged my doctor to allow publication of my treatment if it would help other doctors make similar choices for their patients.

For several months I continued the birth control therapy.  It was great!  My periods were not heavy, but most importantly, they were not painful.  Of course I still carried the prescription naprosyn in the event the birth control failed me, but I didn’t have to make the change which made it all the more important for me.  I began to realize I would more than likely have to be on birth control therapy for the next 15 years or so, and to be honest, I didn’t mind.

I had finally given up on the notion of continuous birth control therapy. My body did not agree with it no matter what different medication my doctor attempted to prescribe.  Although the whole idea was to eliminate my period entirely in order to slow the growth of the adenomyosis, I felt my sanity was a little more important.  I took the new medication for only 10 days and stopped

Within 24 hours my cycle began, and within 2 days I thought I was hemorrhaging.  The only clear explanation I can give to strange little phenomena is the fact that I had last had my period 3 months earlier so my body was purging.  I was really scared, I was going through a super plus tampon in less than 30 minutes.  Then when I would remove the tampon it would nearly pour out of me.

I waited a little while longer to see if I felt weak, light headed or if it would slow down.  Luckily within about 30 - 40 mins it slowed down enough for me to leave a super plus in for several hours, and went back to normal by the following day.

I document every period I have, and had also been documenting all of the changes I had been going through since beginning the continuous birth control therapy, so I brought in a copy for Dr. Zimmerman’s records.
When I spoke with Dr. Zimmerman I explained what had been happening to me, and he agreed it was breakthrough bleeding. So he changed my prescription from Lutera 1/20 to Zovia 1/35. He felt that the possibility may exist that my dosage was just not strong enough.

I began my new medication within a day, and my breakthrough bleeding began to dissipate rapidly and finally stopped. However, with only a one day reprieve the brown spotting began all over again.
Now I must explain that usually when I have my period and have brown spotting it’s normally liquid. However, this breakthrough bleeding was anything but liquid. The only way I can describe it is by using the term “flecking” like small paint chips falling from a wall or ceiling. It was odd and quite disturbing, and as each day passed I felt less and less like a woman. I couldn’t feel sexy; how can a woman feel sexy wearing a pad 24 hours a day 7 days a week? I had begun developing something similar to a diaper rash because that portion of my body constantly had something against it and not allowing my skin to breath. It was devastating me. So I decided to just stop taking the medication continuously and just take it with the 7 day break . . .

April 8th I had experienced my first bout of breakthrough bleeding. It lasted less than a day, so I thought nothing more of it and continued taking my daily dose of birth control.

April 14th I had realized I had forgotten to take my regimen of birth control the night before, and nearly 12 hours later I took my medication.

April 15th I began feeling uncomfortable mild cramping and spotting began. Not red, but brown. I thought I was experiencing breakthrough bleeding again, and thought it would stop, but I was wrong.

April 16th my period began even though I was continuing to take my daily regimen of birth control. Although it had began, I still continued to take my daily pill

April 23rd it had slowed down to only brown spotting, but by May 20th I had been spotting non-stop so I thought it was possible I had just needed a cleaning in my vaginal cavity, so I figured it would be alright to douche, but I was wrong. Within 30 minutes I began feeling uncomfortable cramping, and the bleeding began again in earnest.

June 3rd it had finally slowed to brown spotting once more, and then stopped but I had become tired of this back and forth. So I made an appointment with Dr. Zimmerman, in the hopes of some answers

Breakthrough Bleeding as described by the great Wiki:

Breakthrough bleeding is bleeding while taking the active pills of combined oral contraceptives, or other hormonal contraceptives. The bleeding is usually light, often referred to as “spotting,” though a few women may experience heavier bleeding. Breakthrough bleeding is most common when a woman first begins taking oral contraceptives, or changes from one particular oral contraceptive to another, though it is possible for breakthrough bleeding to happen at any time. Smokers are especially prone to breakthrough bleeding while taking oral contraceptives; though many users experience breakthrough bleeding in the first three cycles of taking the Pill, non-smokers tend to see the bleeding dissipate more quickly than smokers.

Many women find that the breakthrough bleeding ceases after one or two cycles. Breakthrough bleeding that does not resolve on its own is a common reason for women to switch to different Pill formulations, or to switch to a non-hormonal method of birth control.

Breakthrough bleeding is most commonly caused by an excessively thick endometrium (uterine lining). This is not a dangerous condition, though the unpredictable and often lengthy periods of bleeding are unpleasant for the woman. Breakthrough bleeding may also be caused by hormonal effects of ovulation. If the Pill is not suppressing ovulation, the woman is at high risk of pregnancy. Breakthrough bleeding may also itself be a symptom of pregnancy (contraceptive failure).

After spending a few days researching continuous birth control therapy, and finding some interesting information, I finally came to the realization that this form of treatment, although still experimental, was worth at least trying. The trick was to stop my period entirely until I was ready to have a child. So I gave it a shot.

A few weeks before my well deserved vacation I had gotten my period on March 12th, and began my therapy. The entire time up until this point I was still under threat of suffering from the knife like pain I had experienced the October before, so of course I was still taking my double strength Naprosyn.

While on my vacation, I began taking my second box of birth control without the break on April 2nd. All was fine until the day after we returned from our cruise. On April 8th I experienced what is called breakthrough bleeding, which was what my GYN had warned me would be a possibility. I just didn’t expect it to begin so soon.

In growing up, a girl is always told that having her period means she is moving onto being a woman. I know when I finally got my first period when I was 12 years old, in August, 1986 I totally freaked out. I didn’t want to be a woman, I just wanted to be a girl. I remember crying that day, not because I was in pain but because I was no longer a child. I truly believe that for a girl, this is truly her first step towards responsibility, especially personal responsibility.

Growing up, girls can be told a few things about missing their period; 1) you’re pregnant, or 2) something is wrong. However, no one tells girls that having their period nearly 500 times their entire life may not be such a good thing. Probably because it’s not so widely understood that there are studies that are starting to find that women in modern societies seem to be more susceptible to breast and reproductive cancers because of the amount of times they menstruate their entire life. I’ve included the following link for everyone to read, and it really opened my eyes:

News in Science: Skipping Periods May Cut Cancer Risk

Going to the 2nd appointment with the fertility GYN had me just a bit nervous. I had gotten the results of the endocrine test over the phone (my ovaries are releasing properly), but I couldn’t get the results of the hysterosalpingogram over the phone.

By the time I made it to the 2nd appointment I was pretty nervous and somewhat afraid.
1) The doc told me that his colleague viewed the MRI results, and that the results were accurate (it’s nice to have a 2nd opinion).
2) The results from the hysterosalpingogram showed some scar tissue in my fallopian tubes.

The fallopian tube test came back with some information that wasn’t too normal, but not terrible. The test showed that the fallopian tubes, at least one of them had blockage from scarring after an infection I had as a teenager. The doc basically said when I’m ready to start trying for children I should have a laparoscopy to help clear up the passageways. When I do become pregnant I would then have to be monitored to be sure I don’t suffer an ectopic pregnancy (this is when the fertilized egg implants itself outside of the uterus (normally the fallopian tube).

To try to slow the spreading of the adenomyosis, the doctor suggested Continuous Birth Control Therapy in order to “attempt” to make the uterus quiescent. Layman’s terms? The doc wants to treat it by putting me on the pill for at least 6 months, and then take another MRI image to see where my body stands. On this treatment, I would continuously take the pill and not take the customary 7 days off. Therefore no period. Sounds cool right? When the notion scared the crap out of me because there are so many issues with being on the pill . . . and not having my period sounded . . . well . . . unnatural.