We finished fertility testing. If you don’t want to read the details about my reproductive system, feel free to stop reading here. 🙂 The results are both not hopeful and hopeful. They found three things about me that are “worthy of note” but only one of those things seems it could explain my recurrent miscarriages.
- I have a genetic mutation that makes me prone to clots. This clotting gene may have explained my subchorionic hemorrhage I had at 11 weeks gestation with Cami when I almost miscarried her. However, our fertility specialist said that there is no evidence that this gene increases the risk of miscarriages. In fact, apparently 70% of Mexicans have this gene but they don’t have higher incidence of miscarriage in their population. The potential treatment for this concern is to go on heparin shots while pregnant, but as the specialist pointed out, if I had started bleeding, I wouldn’t have stopped bleeding due to the heparin and probably would’ve miscarried Cami for sure. He says heparin shots are not indicated given that I am a “heterozygote carrier” of the gene and not a “homozygote carrier.”
- I have an underactive thyroid. My numbers fall within “normal” range but it’s not a range they want to see for someone trying to get pregnant. So they initiated me on thyroid medication and want to monitor my numbers and will give us the “green light” to try to get pregnant after my numbers are in a healthy range. So even though they want to make my thyroid more active, apparently hypothyroidism isn’t associated with miscarriages either. It’s just dangerous for the baby if I don’t have a good functioning thyroid. Although my internet searching does say there is a link between hypothyroidism and miscarriage…who to believe? The omniscient internet or our sub-specialist? Either way, treatment for my hypothyroidism is helpful and puts my mind more at ease about trying to get pregnant again, knowing my thyroid levels are in a better range.
- Now to the reason our specialist thinks I keep miscarrying: my egg quality. Doctors can’t directly measure egg quality. They can only measure egg quantity but they know that egg quantity is correlated with quality. As our doctor said, “When you get to the bottom of the barrel, the apples aren’t the greatest.” There are four categories of egg quality: excellent, good, fair, and reduced. I am in the “fair” category. Our doctor thinks that my miscarriages might be a result of “bad eggs” or as he puts it, “You might have flipped tails three times in a row.” He thinks it’s possible for us to get a good pregnancy from trying naturally, and sustain the pregnancy because maybe some of my eggs that are left are decent eggs. But he says, given my age (approaching “advanced maternal age”) and the quality of my eggs, we need to “be aggressive.” The doctor recommends that if we don’t get a sustainable pregnancy ourselves in three months, we need to start “moving up the ladder” of more aggressive interventions, ending potentially with at least one round of IVF.
How do I feel about all this? There needs to be a word that articulates: between hopeful and not hopeful. I feel both hopeful and not hopeful. I feel like we got some answers and that there is reason to hope, but I also feel that we didn’t get a complete picture of what is going on. For example, does my egg quality explain why I miscarry at exactly six weeks gestation? (I didn’t tell our doctor that I actually had a fourth chemical pregnancy that miscarried at 6 weeks at the end of April…so is it possible to flip tails four times in a row?). And these results don’t explain the autoimmune response I have when I get pregnant (swelling fingers that resembles rheumatoid arthritis). I asked our doctor about that and he said that in pregnancy the immune system if extremely suppressed, so if I have an early stage autoimmune disorder, symptoms could be manifest at that time because the immune system isn’t up to speed to hold the symptoms at bay. That does make sense to me and while it seems to me that a weird autoimmune response is related to my miscarriages, the doctor doesn’t necessarily think so. It’s hard when I’ve been tested for a couple autoimmune disorders and they all come back as negative. I’m not complaining, I don’t want a diagnosis of an autoimmune disorder. But I would like to know what is going on with my body in that regard and know if there is something that can be done. The biggest suspect for an autoimmune disorder that I could have is Hashimoto’s disease. When they were looking at my thyroid nodule, my ENT said that my thyroid looks like it has Hashimotos but the test came back negative. My swelling fingers and “lower register” voice, as well as fatigue and low thyroid numbers all fit that profile. Ugh, I’m getting bugged writing about all these medical concerns, let alone imagining how your eyes must be glazing over to read all this! Anyway, it’s a mystery yet to be solved. Maybe one day we’ll figure it out. The fertility doctor said that Hashimotos complicates pregnancy in that the thyroid needs to be monitored more closely as thyroid levels can change more rapidly and inconsistently, but I still wouldn’t need to be monitored more than once a month.
So, who knows what the future holds for us? We are going to go ahead and keep trying. If I miscarry again, the doctor wants me to get a D&C so they can collect the tissue and see if there are chromosomal abnormalities present that explain the miscarriages. He doesn’t think that’s likely though, since we’ve had three healthy babies.
What a guessing game this all is! Who knew that at 34 (I still feel young), I’d be looking at the edge of my fertility? I never thought I’d be in this place, considering significant medical interventions to help us have another baby, while also not knowing if those interventions will even help! As our doctor said, “We’ve gotten good at getting people pregnant, we aren’t nearly as good at keeping people pregnant.”
Taking deep breaths and continuing into the journey…wherever it leads us!
PS Chad’s swimmers passed with flying colors!
Despite my efforts to continue to pretend she’s a baby, Cami has completely grown into a little girl. It’s bittersweet to see her grow up! I miss my little squishy baby, but I also delight in the little person she is today.
Developmentally we feel Cami is right on track. She isn’t potty trained yet, but that isn’t her fault. We have tried two separate times to potty train her and with some success. The problem has been that each time she has quickly developed a UTI in the process. This last potty training attempt was very scary for us because she got a fever of 104+ and doctors were beginning to wonder if she had a kidney infection. Our pediatrician sent us to get images of her kidneys with ultrasound. Overall her kidneys look fine. There is a tiny bit of fluid in one of her kidneys but it is so minimal that our doctor said the “fluid is not exciting” and he’s not worried about it. Her urine has “debris” in it, and we don’t know what that is about, but right now our doctor isn’t worried about that either. In a few weeks we will try potty training again. We feel some urgency about this as we hope to get Cami into preschool this year but most preschools require that kids be potty trained. The start of the school year is rapidly approaching! What is different with Cami than Hailee regarding potty training is that while Cami is developmentally and intellectually ready to be potty trained, she just doesn’t WANT to. I don’t blame her though because each time she starts using the toilet, her “bum is hurting” from a UTI. So, we’ll see how this goes. If it wasn’t for the approaching school year, I wouldn’t worry about it for awhile. Maybe we can find somewhere she can attend school and not be 100% potty trained. We’ll figure it out.
Cami still sleeps with us every night. That was a battle we gave up on this last year…but also no longer wanted to fight. We love snuggling her! Even if it means poorer sleep for all of us. We did solve the problem of her falling asleep in her own bed. She falls asleep in her own bed just fine. It’s just VERY predictable that every night between 10:30pm and 2:30am, she will wake up and wander into our room. We will pull her into bed with us for the rest of the night at that point…and we kind of love it. In fact, many nights we end up with both girls in bed with us as Hailee has been having nightmares lately. It gets a bit crowded when that happens but we are a snuggly family and we love it!
As I mentioned before, my personal theme for the year is “bravery.” This week, I made another brave move by quitting the job I’ve had for the last four years at BYU’s Counseling and Psychological Services. This is a decision I’d been ruminating about for over a year and was a very difficult one to make.
Over time however, my professional development slowed and there were frustrating circumstances about our workplace that were unresolvable. The main frustration was that for eight months of the year, I could only meet with my clients about once a month. This obviously wasn’t conducive to effective therapy or helping my clients overcome eating disorder and body image concerns! Given that it is my passion to be a competent therapist for treating eating disorders, it no longer felt like a good fit. Plus, I have recovered significantly in terms of my emotional reserves and feel ready to work more in depth with the eating disorder population again.
I absolutely must give a shout out to my partner in crime: the social media website, Pintrest. I am so glad I live in the age of Pintrest! I got 95% of the ideas for this party from this site!
Once they knew who the bad guy was, they had to find him and capture him! I then gave the kids “interrogation tools” to get him to reveal where he had hidden their goody bags. The kids loved dousing Chad in silly string and Chad was a great sport. After he told them where they could find the goody bags and the kids released the prisoner, we celebrated Hailee’s birthday with cake and presents.
While we waited for parents to pick up the guests, a lively water fight ensued with water guns the kids found in their goody bags. Hailee said the water fight was her favorite part! Oh the irony that her favorite part of the party was the impromptu, unplanned part! But oh well, I think the party was an absolute success!
I totally gave myself a pat on the back for this well-planned and executed party! It was stressful and barely controlled chaos, but everyone had a great time and it’s a party for the books! We had important help from our nanny, Zoe and her husband, Ryan. Zoe decorated Hailee’s cake in an awesome spy theme! And Zoe and Ryan helped set up and facilitate the different activities so that everything ran smoothly! That evening we were all happily exhausted! I’m not sure this party can be topped!
Last week I went to NYC for the annual American Group Psychotherapy Association conference. As I’ve shared on this blog before, this conference is a highlight of my year; every single year.
Beyond reconnecting with different parts of my identity and personality, I also really valued connecting with others. AGPA is “all about” connection, given it’s hundreds of group psychotherapists merging to commune with each other and learn from each other. The connections with both new faces as well as old friends, was incredibly valuable and rejuvenating for me. It was also through these connections that I had powerful experiences and gleaned new insights into myself.
I didn’t know, after I applied, that the interview process would be so intense! The interviews took place over three days. During that time I met with several faculty both in the psychology department as well as the clinical psychology department. I also met with grad students, taught a class that was observed by professors, and gave a case conference presentation. Beyond that I had interviews with the Dean of the psychology department, Dean of the College of Family Home and Social Sciences, Associate Vice President of the University, and a General Authority of the LDS Church!
That experience was a very important experience of feeling valued and wanted by my faith and community. That hasn’t always been the case and isn’t the case for many working LDS mothers. As Jared Warren said, I “won the lottery for a GA interview!”
