INFERTILITY AND RECURRENT MISCARRIAGES, HOW IT ALL STARTED
In my 20’ and early 30s I didn’t actually want any children. The sudden loss of my father when I was 11 had made me somewhat fatalistic and I was simply too scared that history would repeat itself. I did not want any child of mine grow up with that level of grief and sadness. I also had a successful career and was not ready to give it up or make compromises at that point.
The first wake up call came when aged 33 I was diagnosed with very severe endometriosis after almost losing a kidney because of it. After multiple surgeries to excise the endometrial tissue I was advised by my consultant that if I wanted a family it would be wise to try sooner rather than later. The endometrial tissue would otherwise grow back and may cause issues with fertility. At the time I was still not ready to have children and brushed the warnings aside. I went on to have further surgery 2 years later. By the time I was 37 my pain had become constant and excruciating and I was no longer able to survive without swallowing daily painkillers to make it through my long working days.
THE FIRST MISCARRIAGE
I was referred to a pain management specialist who told me in no uncertain terms that if I did not reduce my stress levels at work, he would probably not be able to help me. At that point I decided to resign from work altogether and focus on getting better. This was a turning point in my life, the point at which I realised that maybe I did want to have children after all. Something had ‘clicked’ in my brain. We started on our journey of ‘trying’ to have a child. We did not know what to expect given my age, medical history and the multiple warnings we had had about the consequences of endometriosis on fertility. Despite all this I fell pregnant almost straight away. I still remember that very first pregnancy and how ‘easy’ it all felt.
We had planned a wedding anniversary trip to Venice and went on our way a few weeks into the pregnancy. Two days after our arrival in Venice I had my first miscarriage. We were numb and confused. It is a trauma that so many women go through and yet so few speak about. I felt guilty for having travelled, guilty for having thought it was going to be easy, guilty about everything. I trawled the internet for answers. It appeared to be a common phenomenon amongst women past the age of 35, so we persevered and hoped the 2nd time would be the lucky one.
INFERTLITY AND RECURRENT MISCARRIAGES, WHEN IT ALL WENT WRONG
Again we got pregnant quite quickly, this time a bit more cautious but by 11 weeks we felt a little better. We went for a scan and were told then that the baby probably wouldn’t make it because it’s heart beat was too weak. What did that even mean? I did not want to believe it. I still remember walking out of that room and looking at all the other pregnant women with happy faces while my tears were streaming down my face. I clung on to that little heartbeat and hoped the doctors were wrong and that the little fighter would survive. After 3 long weeks of hopes and fears, the heart stopped and I had to have my first D&C to remove the ‘products of conception’ from my womb. I remember looking forward to the general anaesthetic just so that I would not have to think for a while. The analysis of the tissue revealed that the embryo suffered from trisomy 18, a genetic abnormality that is often not survived.
INFERTLITY AND RECURRENT MISCARRIAGE, WHEN THE REALITY HIT
Still we carried on. This time we had to wait 3 months and tried again. We got pregnant but my hormones were following an unusual pattern. Up and down and up again. I was in pain. It turned out to be an ectopic pregnancy. I had to have an injection of Methotrexate to eliminate the pregnancy. By then I wondering what I had done to deserve this. Why me? I started to find it difficult to speak to pregnant friends of mine, or any friends. I became very withdrawn. I felt lonely and misunderstood. I knew many who had experienced one miscarriage but none who had experienced that many. It was hard to comprehend for me, let alone anyone else. I was referred to a psychologist to help me overcome my emotions. It didn’t work all that well and I ended up just getting myself out of my ‘trance’.
We also got referred to an IVF specialist to look at whether we could attempt ‘embryo’ testing for abnormalities (it was then very cutting edge and now much more frequent). We embarked on our first round of IVF. The first one resulted in insufficient follicles. It turned out that the vast amount of surgery I had had on my ovaries due to the endometriosis had basically resulted in early shut down. At least that’s what the hormonal tests seemed to indicate. My FSH and egg reserve (AMH) results were terrible. Yet we tried again, driven by some sort of denial of reality and refusal to accept that we had simply waited too long. My guilt grew with every attempt.
INFERTLITY AND RECURRENT MISCARRIAGE, DENIAL
We tried another round, it produced only 3 follicles and despite this we pushed ahead with the extraction of only 2 eggs. The last surviving egg was then tested and deemed ‘normal’. Fortunately the egg did fertilise and we proceeded with the implantation of the healthy embryo. This was the best chance at a normal pregnancy we had had so far and we really hoped it would work given my track record of getting pregnant reasonably easily. But we didn’t get pregnant. Our hopes were dashed yet again. We had always thought about infertility in terms of difficulty in getting pregnant and thought IVF would resolve all this. Little did we know that IVF does not work if your ovaries do no co-operate! We were suffering from another type of infertility: recurrent miscarriage.
We got pregnant 3 more times. I tried every trick under the sun, every trick I could find on the internet. Acupuncture, Chinese herbs, vitamin concoctions from Zita West and the Hale clinic, special diets and exercise such as Yoga and Pilates. But all pregnancies died between 8-12 weeks due to chromosomal abnormalities. Admittedly the getting pregnant bit worked well but clearly something else was wrong. I was wrong! I reached the end of my rope, felt like a complete failure. I felt I had let my husband down and dashed his hopes of a family. I did not want to speak to anyone anymore, I did not want to be in London anymore, I did not want to be in my house anymore. My husband decided to ask for job transfer and we moved to New York to start a new life, away from our grief. We had spent 3 years trying to get pregnant and had only encountered sorrow.
INFERTILITY AND RECURRENT MISCARRIAGE, THE NEW LIFE
We set off for our new life in Manhattan. It was exciting, we had found a new lease of life. We decide to give it another try. New country, new doctors were our thoughts. We went to see a specialist in premature ovarian aging who prescribed us with DHEA, a drug often used in the by bodybuilders since it increases testosterone (but should not been taken without medical advice). I also took prednisone (steroids). I was prepared to try anything. My periods reverted to normal and my blood tests improved. We embarked on another IVF round, hopeful that we had reversed the ‘ageing’ of my ovaries in some way. Sadly it failed, again I didn’t produce enough follicles. At that point the consultant advised that perhaps it was time to look at other options, such as egg donation. My ovaries had clearly been too damaged by surgery to produce healthy eggs. The consultant also believed that somehow my body may have be attacking the pregnancies due to some sort of immunity reaction. We did not know what to believe anymore. The theory about NK (Natural Killer cells) and their role in miscarriages is now quite widespread and there may well be some truth to it. We will never know for sure.
INFERTILITY AND RECURRENT MISCARRIAGE, ACCEPTANCE
It took several weeks of coming to terms with the idea that we had reached the end of the road in terms of trying for a child that would carry both our DNA. As an adopted child myself I was worried about the impact on the children. Finally in 2012, 4 years after we first started to try for a child, we embarked on an egg donation IVF round. We chose our donor online, this is quite an easy process in the USA. The round resulted in 3 grade A embryos of which 2 were implanted into me. We got pregnant with twins! At that stage we were so eager to keep the pregnancy that we also agreed to do the immune treatment (IVIg). 3 sets of ‘infusions’ with IVIg once a month until 12 weeks to avoid my body attacking itself.
INFERTLITY AND RECURRENT MISCARRIAGE, THE FEAR
At 11 weeks I started bleeding profusely, we thought that we were again going through a miscarriage. I was beside myself. We spent hours in the Emergency room waiting for an answer. It was my mum’s 70th birthday and we had only told her about my pregnancy the night before. Surely we were cursed! In the end, the twins were still there but I had suffered from a placental abruption and a blood clot had formed causing the bleeding (subchorionic hematoma). My obstetrician told me that it could indeed end up in miscarriage if the placenta completely detached itself. I went on bed rest. I didn’t dare move. Fortunately the placenta re-attached itself. But we lived in fear the entire pregnancy. Our fear of loss was completely incomprehensible to most people but anyone who has suffered recurrent miscarriage will know how it feels. It is a constant worry that it will simply happen again. We didn’t dare do a baby shower, we didn’t dare buy anything.
We had many scares throughout the pregnancy and it certainly was not easy. I had daily contractions from 26 weeks onwards, got gestational diabetes, carpel tunnel syndrome, sciatica and my feet were so swollen that I had to buy shoes two sizes larger. In the end I could barely walk. Our beautiful girls were born prematurely at 32 weeks after my water broke and came home after 5 long weeks in the NICU.
My girls are now 5 years old. Would I go through this arduous journey again? In a heartbeat. I am glad we did not give up, I am glad we tried everything even though it was heart breaking. I could not love them more if they were my own DNA, and knowing how hard it was to have them makes me appreciate every day with them even more.