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 . . .

For those of you not versed in dealing with techniques on becoming pregnant outside of the more natural method.  Let me take quick moment to explain the difference between IUI (intrauterine insemination) and IVF (in vitro fertilization).

IUI is the process in which donor sperm is washed (meaning separating the sperm from the semen) and injected inside of a woman’s uterine cavity at her point of ovulation.  This method involves a women utilizing an ovulation kit to monitor her LH surge which is the hormone that triggers ovulation, and going to the doctor the following morning for insemination.  Or going to the doctor’s every other day for monitoring and taking an injection that will induce ovulation when the egg(s) maturing have reached a certain size that indicates the body is close to natural ovulation

IVF is the process where eggs are removed from the woman’s body once ovulation is induced and placing it in a dish with unwashed sperm (meaning the sperm and semen are not separated).  The fertilized egg(s) are then placed into the uterine cavity.  This process can include using drugs in repressing, stimulating and then inducing ovulation (4.5 week schedule) or only stimulating and inducing ovulation (2 week schedule)

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 . . .

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.

The endocrine test was nothing; all I had to do was go in for a blood test. However, the hysterosalpingogram was a bit more invasive:

I’m not going to go into the whole procedure, just because I posted all of the information on a previous post. However, what I will say is that it’s not “terribly” painful, but what’s a little scary is that the doc prescribed a five day antibiotic for me to begin taking the day before the procedure, until I was done. When I went in they also had me sign this release about how I am aware that I can get an infection from the procedure and/or an allergic reaction from the dye used. Luckily, I didn’t have any of it (woohoo), but I have to say that I now know what a pregnant woman feels when her water breaks. When I stood up, this gush of dye came pouring out of me. If I hadn’t been in a doctor’s office, it would have been quite embarrassing.

In going to see this new GYN, I decided I wanted to go as prepared as possible. So I called the radiologists who performed the Intravaginal Ultrasound as well as the Pelvic MRI, and asked them for copies of the Pelvic MRI. I was willing to pay whatever money was necessary, but as it turned out, they only give the results to the doctor, and hold onto the imaged results. Needless to say I was able to obtain a free copy with no strings attached, and save myself a few bucks.

On January 9, I marched to the radiologist and picked up my images, and then we continued on to the fertility GYN. I was sooooooooooooooooooo nervous. I just didn’t want to be there, but I was determined to understand what had been going on.

After an extensive amount of paperwork, we were finally brought in to see Dr. Zimmermann. A very nice German doctor, who was extremely patient and diligent. He asked me all kinds of questions, including when I was planning to have children, and so on. I explained to him my concern with the condition of adenomyosis itself, and gave him the images and asked that he and/or a colleague take a look at them to confirm what the radiologist had already diagnosed. Dr. Zimmerman agreed to show the images to a colleague who is an expert in reviewing images of this type. Also, for good measure, Dr. Zimmerman also performed another Intravaginal Ultrasound, so he could see for himself what was going on.

After the procedure, Dr. Zimmermann explained to us that he wanted to help me with my condition and also to help catch and even stave off any other problems that I may have that are unknowns. He explained that he doesn’t want to treat the adenomyosis only to find out later that it’s not just my uterus, but my ovaries and/or fallopian tubes as well. So I was scheduled for two additional tests: An endocrine test to make sure my ovaries were functioning correctly, and a hysterosalpingogram (say that one 3x fast) that checks the pathways of the fallopian tubes.

The hitch? On the day of my first visit to Dr. Zimmermann, I was on the 5th day of my current cycle. Hence it was too late to perform the endocrine test because it has to be done on the 3rd day of a woman’s period. I also had to wait for the hysterosalpingogram because although it can only be performed 2 to 5 days after the woman’s period it was too late to book the appointment. So I had to wait . . .

The following week after speaking to my GYN about my diagnosis, I called my doctor’s contact at the fertility clinic. A lot of the information I’d like to give you on the amount of time it took them to call me back, and so on. However, it’s vague to me now, as time has passed and I’ve been under a lot of stress from all of this.

What I will tell you is that I finally spoke to either my doctor’s contact or a colleague of that person, and they kind of scared the crap out of me. I told them about my diagnosed condition, and one of the things they said was something like, “Well we only treat women who are looking to have children now.” NOW? NOW? In my head was swirling the question of, “Why do I need to seek treatment only if I’m looking to get knocked up now?”

I tried my best not to get anymore upset than I had been over the months that led up to that moment, but it was becoming difficult for me. I finally made the counselor understand that, no, I was not ready to start trying for children, but wanted to speak to a doctor about some sort of treatment before it was too late. I mean 70% diffused over the entire uterus is a lot of space. Being 32 at the time did not leave me a lot of time, as no one is sure if the adenomyosis began recently or had been creeping ever since I started getting my period when I was 12 years old.

I guess the counselor finally understood where I was coming from, and referred me directly to the receptionist who at first gave me a date in March, 2007 for a doctor. I begged her for a date that was as soon possible, and she found one. My appointment was set for January 9, 2007