One of the biggest downfalls of “unexplained infertility” is that you don’t have answers. You don’t know what will work (if anything), and you don’t know how you got here. The upside is the possibility of a surprise, miracle pregnancy, especially after the first. It happens to so many women. A small part of me hoped it would happen to me for a baby number two, but a big part of me knew I had to accept a life as a family of three. A mom of one. No more babies. I knew I could not continue on or even possibly pursue another frozen embryo transfer without accepting it. But last week, I received some closure.
If you’ve been following me for awhile or know me well, you can skip this whole part. You already know all of this. (It feels weird to say that, but such is blog life, putting my vulnerable moments out there.)
In December of 2011, my appendix ruptured and I went into septic shock. I was 25, and lucky. It was a long recovery with two hospital stays and some complications. I remember, after yelling at me for not coming to the ER sooner, the surgeon told me I would probably have adhesions because the infection was everywhere. I was one of the worst cases he’d ever seen.
Tim and I got married in August 2013, and immediately jumped on the “TTC” wagon. I tested for ovulation and should have bought pregnancy tests in bulk. I questioned if my health issues would make it harder for me to get pregnant all along. It was always a question. After over a year of trying, my ob-gyn prescribed three months Clomid, which is the devil. My bloodwork showed a high AMH and I was told I “probably” have PCOS.
We went to a fertility clinic and pursued IUI. This doctor did not think I had PCOS. My official diagnosis was “unexplained infertility”, as an HSG showed my tubes were open. We did one cycle on Femara, and it was unsuccessful. We attempted another cycle and missed ovulation. We had a bad experience at this particular large and popular clinic, so we sought out a different practice.
When we had a consultation, and talked about my medical history, the doctor wanted to do a laparoscopy, thinking I likely had adhesions and possibly endometriosis. I objected, dramatically, because I was not ready for another surgery. This doctor did not think I had PCOS. We moved right into IVF, did an egg retrieval, did a failed fresh transfer, froze four embryos, did a frozen embryo transfer, and that is how Charlotte came to be.
During one of my ultrasounds throughout this process, another doctor in the practice said, “Has anyone ever told you you might have PCOS?” Ever since, I’ve assumed I might have PCOS, or I might not. Who knows.
What brought me here
I honestly am not sure when this started. I remember experiencing sciatic nerve pain and shrugging it off as some weird, postpartum hormone thing. My body was still figuring everything out. I’d had sciatica during pregnancy like many others, and it was no big deal.
I can recall three distinct times in 2018 I know I had back and leg pain at the same time as my cycle. I did yoga. I did all the stretches. I popped Advil like candy. I chugged water. I took CBD oil. I bought hemp lotion. I tried to strengthen my core and pelvic floor. What I did not do was seek medical attention, because it always got better, and it seemed to happen randomly.
It happened in December. And then March. In March, I could barely walk across the parking lot at Charlotte’s preschool. Then it happened in June. And I could not function. My leg throbbed and spasmed. I couldn’t sleep. I couldn’t get into a comfortable position. I couldn’t concentrate on anything, or stand for long. Advil didn’t work. By this point I knew. It was happening every 3 months by now, and it always started two days before my cycle started. It would get worse and worse, and it wouldn’t start to get better until my period ended. By now, it would take up to two weeks for me to feel better, and then I’d have a little bit of soreness, and lingering numbness for another week or two. This flare-up felt like a nightmare. And once it ended and only the tingling lingered in my leg, I was scared of my next period.
Knowing it was happening in sync with my cycle, I thought it was endometriosis. I made an appointment with my ob-gyn and did as much research as I could, also reaching out to women I knew had dealt with endometriosis to hear their experiences and see what they thought of mine. Most women I spoke to agreed it sounded like endometriosis. All I knew was I had to do something soon; it was getting worse each time, and I didn’t want permanent nerve damage.
I knew this appointment was going to bring me potentially to three options: a laparoscopy, birth control, or sending me to a different kind of specialist. My ob-gyn is someone I trust and I knew he’d hear me out. Endometriosis on the sciatic nerve is rare. But from what I read, I knew it didn’t have to be near the sciatic nerve to cause sciatic nerve pain. One of the common places to find endometriosis in the case of sciatic nerve pain was the colon (and oddly, my research also showed it was usually the left leg affected, as mine was). Sure enough, my doctor gave me two options: laparoscopy or birth control. We could try and see if something worked. I opted for a laparoscopy.
I really didn’t want surgery. I have so much trauma from my past connected to surgery, and the next two weeks I was so stressed out. Maybe others around me thought I was being dramatic, but (insert shrug emoji here). Despite my stress and worry, I was following my gut instinct.
There was no endometriosis. Immediately I felt defeated. I had no answers. What now? I was groggy while taking this information in, and went home to recover. My doctor called me the next day and gave me a short recap and instructions. There had been adhesions around my colon and ovaries. Could cutting those down possibly help? I hoped so.
I started birth control immediately, hoping if the surgery didn’t help, this would. It felt odd and wrong to take birth control. I’d spent the last year or so tracking my cycle and peeing on sticks again with a little bit of hope I’d get that surprise miracle baby number two without doing an FET. But I knew I could not parent the child I already had with the kind of pain I’d been experiencing.
I went to my post-op appointment two weeks after the surgery. I honestly didn’t expect there to be much else to say. I figured he’d check my incisions and send me on my way.
Instead, he sat down and showed me images of the adhesions he’d taken down. Both of my ovaries had been stuck to my colon. He cut those adhesions carefully. I’m hopeful this was the cause of my pain and cutting those adhesions brings relief. I’m really hopeful. Only time will tell.
My tubes were very scarred. He said he thought this was the cause of my infertility; that no eggs could get through there. I nodded, and we moved on. It wasn’t until I was in the car that this hit me. My ruptured appendix was the reason I couldn’t get pregnant. And my infertility was no longer “unexplained”.
This is huge. It means that doing more IUIs wouldn’t have worked, doing this surgery four years ago wouldn’t have changed anything, doing a weird diet wouldn’t have worked, and changing all the products in my home to “natural” ones wouldn’t have worked; nothing except IVF would have worked. I feel a sense of immense relief. I can let go of those tiny feelings of guilt that creep in, worrying I didn’t do everything I could have.
On top of that, I can stop wondering if a miracle baby number two could happen. I know I may mourn this later, but for now it feels like a weight off of my shoulders. I can continue to take the birth control without wondering what could happen if I stop it, without feeling guilty. I can rest easy knowing that if we decide to grow our family, it will be with one of the frozen embryos we already have.
I don’t know if the pain will come back, and I’m not totally sure what my course of action will be if it does. But for now, I feel like I made the right decisions. And those decisions brought me to some closure I’ve needed for the last three years.