Rick and I were married in 2006. After 2 years of marriage we were ready to start the pregnancy process in December of 2008. We started trying for a baby in December and by my annual check up in May, we still weren't pregnant. After a conversation at the annual check up with my OBGYN I had a very frustrating conversation with her. I was 26 years old so, I thought, there was no reason we weren't getting pregnant. Just one month later, in June, I took a pregnancy test when I thought I might be pregnant, sure enough, I was. I couldn't be more excited. That's all Rick and I talked about, but I told him I didn't want to tell anyone yet. I wanted to wait until closer to the second trimester, to keep the secret just to us for the time being.
Almost 2 months later, before my first pre-natal appointment, I woke up with severe cramping. I went to the bathroom and found out I was bleeding pretty heavily. I called my OB and was told to come into their office for a check that morning. By the time I reached the office, I had passed the embryo. My OB confirmed this with an ultrasound. She told us miscarriages are more common than most people realize. 10-15% of pregnancies end in miscarriage and most times there's no reason. She saw no reason for me to miscarry and thought the next pregnancy would go smoothly. She suggested that we take 2 months physically to let my body recover. Emotionally, it was up to us, whenever we were ready.
The next couple weeks were difficult for me. It was all a blur and I was just coasting. I knew I wanted a baby badly and I didn't want to wait long. We started trying again in September and immediately found out we were pregnant again. This time, we made it 6 weeks before I miscarried again. Again, my doctor confirmed my body passed the embryo and a D&C wasn't necessary. Again she told us she didn't see any reason why the miscarriage happened, my uterus was in good shape, my age was perfect, etc. This time, though, she scheduled me for a procedure called a hysterosalpingogram (HSG) at the local hospital.
A HSG is an outpatient procedure that takes about 30 minutes. It's non-invasive and involves placing an iodine-based dye through the cervix and then taking x-rays to determine the shape of the uterus and determine if the fallopian tubes are open or blocked. The procedure was done while I was awake and talking with my doctor. There is no anesthesia, only a pain killer is used in order to help with the discomfort. Cramping can occur which feels just like your period but it's a pretty uncomfortable procedure. While she was injecting the cannula and dye into me, all I could think was this is really uncomfortable. I was so uncomfortable that I forgot that she would be giving me results which could change my life, in a matter of minutes.
She told me that everything looked fine and again chalked it up to something that just happens. By this point, Rick had become frustrated and so had I, though him more so. It's difficult to have no answer to digest. She told us again, to try whenever we were ready. In December 2009, I found out I was pregnant. Again, we kept everything quiet and again, I was nervous about it all. I didn't want to think about being pregnant for fear of what may be about to happen. In January 2010, I miscarried my third pregnancy. This time, it was determined to be an ectopic pregnancy and was potentially life threatening.
An ectopic pregnancy occurs outside of the uterus and the baby cannot survive. Typically, an ectopic pregnancy occurs when a pregnancy starts outside of the uterus, usually in within one of the fallopian tubes. They occur in 1 - 2.5% of all pregnancies and I didn't fit into any of the categories in which an ectopic pregnancy usually happens. As I mentioned, an ectopic pregnancy must be ended in order to save the mother's life. If the area of the pregnancy ruptures, the mother must be treated immediately in order to prevent death (which is rare). Luckily, I had not gotten to the point of concern for rupture, though my doctor informed me that I could not continue the pregnancy. In order to fully stop the pregnancy I was given methotrexate and monitored my quantitative HCG blood levels to ensure the methotrexate "took".
This was difficult for me, each time you miscarry your chart is noted with a spontaneous abortion tally. For someone who is very pro-life, to even see the word abortion on my file was tough to take in, but to see it 3 times made me very sad. At this point my OB knew there was absolutely something else taking place that needed to be solved. She referred me to a reproductive endocrinologist (RE), to determine why I was able to easily get pregnant but was unable to carry the pregnancies. I wasn't very optimistic by this point but knew I absolutely could not stop until I knew whether or not I would ever have children.
In March, I saw the RE and had a sonohysterogram (HSN) scheduled. A HSN is an outpatient ultrasound which can determine if there are abnormalities inside the uterus that could interfere with pregnancy. The procedure involves inserting saline into the uterus so the uterus is full and then the ultrasound is performed. The way this was described to me was your uterus is like a collapsed balloon, a normal ultrasound is often hard to see because of the "deflated balloon", whereas the HSN is a procedure where the "balloon" is inflated and all of the walls are easily viewable. Much like the HSG procedure, there was some cramping and discomfort but the procedure was pretty easy. Again, like the HSG, it was determined my uterus looked fabulous. Great news, right? Well yes, but still the question is why can't I carry a baby?
The RE had a full blood work done on Rick and I. I think I counted 25 viles of blood taken to be tested. Various test ran, which I can't even tell you because there were so many. The RE was confident these test would help solve our mystery. Several weeks later, we were called back into the office with our test results. Rick's came back clean. Mine, not so much. NOTE: This is about to get overwhelming to understand so stick with me.
It was determined I had several issue which could be the cause for recurrent miscarriages. I have heterozygous methylene tetrahydrofolate reductase gene abnormality (MTHFR) meaning one of my parents passed this on to me. I also have a heterozygous plasminogen activator inhibitor (PAI-1), again, one of my parents passed this onto me. Lastly, I have a protein S deficiency which was determine to be the primary cause for miscarriage. The interesting piece of all of this is these levels can increase or decrease over your life. With all the hormone changes while pregnant, these numbers can really spike or fall and would affect the pregnancy.
So if you've made it this far, your probably overwhelmed. I was too. I think Rick and I sat in that office with a dumbstruck look on our faces. All of this medical talk and we had no idea what it all meant. The doctor was able to break it down a bit for us. I am a thrombophiliac meaning I develop blood clots due to an abnormality (in my case abnormalities) in the system of coagulation (forming semisolid lumps in a liquid). So every time I was pregnant, my body would clot the embryo causing a miscarriage. Finally, we had our answer and a solution. The RE told us the way for me to carry to term was to offset my bodies natural reaction to clot during pregnancy by taking a blood thinner called Lovenox. The scary thing, I had to inject myself at the same time daily, in the stomach throughout my entire pregnancy
In April 2010, we began trying to get pregnant and found out in May I was pregnant. We began testing my HCG levels to ensure the levels were doubling over a period of time. When this was confirmed, I began my daily Lovenox injections. Again, I wanted to keep this all a secret. At this point, I was confident everything would be fine but I was still nervous I would miscarry again. I didn't want to talk about the pregnancy for fear I would get excited and would start planning the nursery, baby names, etc all for it to end badly again.
|12 week ultrasound|
In August 2010, I made it through the first trimester. I was ecstatic! I had graduated from my bi-weekly ultrasounds with the RE and was being passed back to my OB for continued care through my pregnancy. My RE explained that at the 36 week mark I would stop the Lovenox and be switched to Heparin injections twice a day (12 hours apart). Heparin has a shorter life span than Lovenox. In the event I went into labor, I would not be able to have an epidural until the blood thinner was completely out of my system. Heparin can also be reversed whereas Lovenox cannot. I've never been so happy to be back at my OB for continued treatment.
After my first visit with my OB, at 13 weeks pregnant, we told our family we were pregnant. I was finally able to be excited about the pregnancy and was able to enjoy the next 27 weeks. The remainder of my pregnancy went smoothly. My OB kept saying, you deserve a smooth pregnancy after everything you've been through to this point. I could not agree more.
We're 3 days away from our baby girls birthday. It's been 3 year since our journey began and I could not be happier for the result. Stay tuned tomorrow for the birth story.