Switching horse mid-race

After a number of failed cycles, many women (smartly) switch fertility clinics.  If we had nothing but failures at my clinic, it would be a no-brainer.  We would have switched for our last fresh cycle.  BUT my clinic has gotten me pregnant in all of our cycles but one (5/6) and has actually gotten us pregnant with “viable” pregnancies twice (2/6).  So I would not say I have no confidence in them.

Still, I did cheat and get a second opinion with CCRM.  I was impressed, but I wanted to see what my doctor had to say after our most recent failure.  It was interesting and reassuring.

First, he reiterated the fertility doctor mantra—for recurrent pregnancy loss, the biggest reason (70%?) is due to genetic causes.  Those losses tend to be earlier in pregnancy (first trimester).  The second biggest reason for recurrent pregnancy loss is due to uterine abnormalities (ie polyps, fibroids, scar tissue, etc.).  Those losses tend to be later in the first trimester.  The third biggest reason relates to “systemic” causes—basically, are you sickly (ie diabetes, thyroid conditions, infections, autoimmune disorders like lupus or rheumatoid arthritis)?  These losses also tend be later (10-12 weeks).  In this bucket he also placed immune issues.  He basically said what the docs at CCRM said—nobody knows if immune issues play a part in recurrent loss, there’s debate but nothing has been proven.  The theory is, much like the way the body can reject a transplanted organ, the body can reject a pregnancy as invasive.  He said some doctors will treat patients with steroids (such as prednisone) or blood thinners (heparin, aspirin.  

With respect to the “systemic” causes—I have none of the known things that would cause concern.  Also, all of my losses have been very early, so they are likely not systemic.  With respect to the uterine abnormalities—they have been repeatedly ruled out after the doctor has done saline sonograms.  (I just had another one that confirmed—my uterus has no issues.)  Plus, they also tend to be later losses, not earlier losses.

Which leaves us with genetic issues.  This one is confusing, too, as we have now failed with chromosomally normal embryos (ie. the right number of chromosomes).  But it might be our genes (ie. the question of whether the chromosomally normal embryo develops normally) that are the issue.

I had three pregnancy losses before I even saw a fertility doctor.  One was definitely ectopic, and at least one of the other two was also likely ectopic (we saw further scarring of my tube).  SO, we have to put those in a different bucket because they may have been caused by my tubal issue.  (Which itself may have been caused by hernia surgery I had as a baby.  My whole life my mom worried I would be infertile because the doctor told her, just after operating on a month old baby, that my ovaries were “swollen” and I might have trouble conceiving children.  Fast forward 30 odd years later, and it turns out that abdominal surgeries are thought to potentially increase the likelihood of tubal pregnancies.)  Anyway, we can’t really say for sure, but we won’t “count” those in the recurrent pregnancy loss bucket we’re trying to solve for now because they may have been related to a tubal issue that IVF all but solves.

Okay, my second “bucket” of losses are the two failed pregnancies I had with chromosomally untested embryos after my second IVF cycle.  One was a blighted ovum, so it was likely a genetic issue.  The other one was a chemical pregnancy, and those are also generally due to genetic issues. 

My third “bucket” of losses was with chromosomally normal embryos after my third IVF cycle.  As it related to the anencephaly pregnancy, that embryo turned out to be chromosomally normal.  (We did not know that when we put it in, but we had it tested at 12 weeks.)  While the “chromosomes” were normal, there was a genetic issue, as anencephaly is, as we have previously discussed, some mixture of genetic and environmental.  So there was a genetic issue.  My FET after that was with a chromosomally normal embryo, but that also ended in a chemical pregnancy.  It too was likely related to genetic issue, even though the chromosomes were normal.

In other words, our genes might be a problem.

And how do you solve for a “genes” issue when all you can do is test the embryos for chromosomes?  Well, you just keep putting chromosomally normal embryos back in and hope that one of them is genetically normal as well.

FUN.

Here are two decent overviews of causes of recurrent pregnancy loss: 

http://emedicine.medscape.com/article/260495-overview

http://www.glowm.com/section_view/heading/Genetic%20and%20Nongenetic%20Causes%20of%20Pregnancy%20Loss/item/318

And here’s one that says that for women with recurrent pregnancy loss, they are losing chromosomally normal pregnancies at a higher rate:

http://www.ncbi.nlm.nih.gov/pubmed/15298979

We talked about whether, with our history, we should just bite the bullet and put in two embryos in our next cycle. This process is just NOT FUN.  But our doctor (like the CCRM docs) is anti-twin.  As he said, even the best twin pregnancy has more risk than a singleton pregnancy.  Twin pregnancies are hard on moms (higher blood pressure, more likely to go on bed rest, more likely to get gestational diabetes, more likely to need a C-section) and hard on the babies too (more likely to be preemies, more likely to suffer from health issues).  He was like, if you want one healthy baby, but not twins, put one embryo in at a time. 

We also discussed whether it was ethically appropriate to use a B3 girl instead of a B2 boy.  He said their rating system (B1-B2-B3) was not strongly correlated with success (it’s as much art as science to rate those little suckers) and once they are tested to be chromosomally normal, the ratings of the embryos matter even less.  So he was like, go ahead and use your B3s if you’d like to have a daughter. 

I had a whole list of questions for him, so I’ll just run through them now.

First I asked, is it possible we have a translocation?  He said no, both my husband’s blood and my blood had been tested for translocations, and we were both normal (I was 46xx, hubby was 46xy).  He said that he did not do a “skit test” to look for DNA damage because we had good luck getting embryos to the blastocyst stage.  (If there is DNA damage, the hubby can go on folic acid in an attempt to improve sperm quality.)  So, it’s not a translocation.  We’ve ruled that out.

Second, I asked, is it possible it’s thrombophilia (clotting issue).  He said probably not, as those tend to cause late first trimester / early second trimester losses.  But, just to be sure, we had my blood tested to confirm.  (Factor 5 test, factor 2 test, protein C test, and protein S test.)  If that was an issue, I would go on baby aspirin / lovenox or heparin (blood thinners).  But the tests came back normal.  We’ve ruled that out.

Third, I asked if it was possible I had structure abnormalities.  He said unlikely—we’ve had saline sonograms that have said things are normal, and confirmed after each of our losses.  He assured me that if there was a structural abnormality, the saline sonogram would catch it.  We did another saline sonogram.  Normal.  We’ve ruled that out.

Fourth, we discussed the “immune response” issue.  He basically said nothing was proven and he has never treated a patient with steroids (such as prednisone) and / or antihistamines just for the hell of it.  (In other words, he poo-poo’s CCRM’s hail Mary approach.)  My husband was very uncomfortable with us doing any protocol that had no scientific support—especially with a drug as potentially dangerous as prednisone.  So, we decided that we were comfortable not using a “hail Mary” approach… for now.

(The theory behind the use of a steroid such as prednisone is that embryos might be exposed to bacteria or leukocyte infiltration if the protective coating of the zona pellucida is breached and that immunosuppression via steroids would help combat that. But a study by did not find any beneficial effect of adding low dose progesterone during the luteal phase:

http://www.ncbi.nlm.nih.gov/pubmed/12042275)

Fifth, I asked if we should use inter-muscular progesterone next time.  (Keep in mind I’m the one that’s been pushing NOT to use IM P4 in oil this whole time.)  He said, yes, let’s do it.  Again, there’s no scientific proof the shots are better than the suppositories, but he said they might be so let’s do it.  Big needles, here I come.

So, where does this leave us?  CCRM was very impressive, but our doctor said basically all the same things.  The big difference in protocol is the “hail Mary” approach that would include the use of prednisone.  My doc is against it, CCRM is for it.  At the end of the day, my husband is against anything that has not been shown to improve our chances of success, so he’s against the unproven “hail Mary.”  From what I’ve read, I’m comfortable with that approach… for now.

I was not convinced that transferring our embryos would be a good decision.  If we were considering doing another fresh cycle, I think we would switch.  But there did not appear to be much of a benefit to us to transfer the frozen embryos to a new lab.  Another consideration is the fact that (a) we would have to use our boy first and (b) CCRM might not even accept our girls.  Neither of those things make us want to switch.

Finally, I DO still have confidence in my doctor.  He gave us our son.  He got us pregnant a bunch of times, twice legitimately, and it’s probably true that those generally failed due to genetic causes or other causes outside of their control.  So let’s just blow through the rest of these embryos and see if we’re lucky enough to stumble onto a good one.

We’re staying with our current horse.

Cheating on my fertility doctor

If you’re reading this, it means you’re the kind of person (my kind of person!) who looks for answers to fertility issues online. And if that’s the case, you’ve likely run across the Colorado Center for Reproductive Medicine. They have really impressive statistics and are generally recognized as being a leader in the field of fertility treatments. So, after our FOURTH failed cycle from our clinic (I don’t count my cycle where we got pregnant but terminated after our anencephaly diagnosis a “failure” on my clinic), we did what many couples have done before us—we got a second opinion.

I have to admit, the doctors (two of them) I met with were VERY impressive. 

I’ve complained that we’ve never had an official diagnosis of what exactly our problem was. In other words, why am I infertile? We discussed my health history and the doctors suggested that a hernia surgery I had when I was a newborn might actually have had an impact on my fertility. They suggested that they have seen other examples of women coming in with tubal issues after having abdominal surgery, and that maybe my first three pregnancy complications / losses could have been related to that issue. (My first pregnancy was an ectopic, and there was further scarring of my tube after my second one, so it was also likely ectopic.)

They also suggested that my three failed IVF cycles last year—on genetically untested embryos—could have been because of genetic abnormalities. (That’s the unexplained failed IVF gut reaction.) Certainly the blighted ovum was likely a genetic issue.

And with our last failed cycle with a genetically normal embryo—well, that signals that there’s either a potentially serious issue or I’m just unlucky.

Anyway, CCRM suggested that with an extensive history of IVF failure—yes, that’s the bucket I’m in now—we should do a recurrent pregnancy loss workup.

There are three things they would like to rule out with that work-up:

(1)    A genetic translocation. They said it’s rare (1/500 people carries a balanced translocation), and in 3-5% of couples with recurrent miscarriage, one partner has a balanced translocation. These tend to be early first trimester losses. (Like ours.) They suggested that they could test our blood to see if we have it, and if we do the embryos can be tested to see if they carry it. (Our frozen ones would have to be thawed and re-biopsied. Apparently there is little risk to the embryo. Amazing!)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC558686/

(2)    Thrombophilia. They said the non-genetic form thrombophilia (acquired)—a clotting disorder, and more specifically a tendency to form blood clots—has been shown to cause early first trimester losses. They test for it with a blood test. If you have it they can treat you with Lovenox (a blood thinner) for the first 10 weeks of pregnancy. As the CCRM doctor said, there is a risk to the mom because if you’re in a really serious accident, well, you don’t want to be on a blood thinner. In other words, it’s not something to mess around with.

http://www.ncbi.nlm.nih.gov/pubmed/10823264

http://patientblog.clotconnect.org/2011/05/30/pregnancy-loss-and-clotting-disorders/

(3)    Structural abnormalities of the uterus (such as scar tissue). These tend to cause later first trimester losses, and are unlikely to be our problem considering we’ve been monitored for such things.

We also talked about our fresh IVF protocol (even though we’re very unlikely to do another fresh cycle). Every fresh cycle we’ve done, we have done a luteal Lupron protocol (also called “long Lupron” or agonist “down regulation”). I generally responded well to those cycles, and we got a number of fair quality embryos.

CCRM claims that that’s a “traditional” cycle. And they are “cutting edge.” CCRM says 95% of the time they do an antagonist protocol. (That works with normal menstruation, instead of putting patients on birth control. Instead of using Lupron on the front end they stim harder later.) CCRM claims an antagonist cycle allows for harder stimming and therefore more eggs without the risk for ovarian hyper stimulation syndrome. For a minority of their patients, they use a microdose flare (when patients have a diminished ovarian reserve and concerns about stimming too hard are not there).

Here’s a more detailed discussion of the different protocols:

http://www.advancedfertility.com/ivfstim.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759499/

I confirmed that at the end of the day, the egg QUALITY is the same no matter the cycle—that is, one protocol might get you more eggs, but none of them will get you better eggs.

For frozen cycles (the most relevant question for us), they first confirmed that they will take frozen embryos from other labs—with some caveats. (They also noted that the embryos have to be SHIPPED and there is a risk (small) that something could happen to them.) First, the lab that froze the embryo has to be good enough quality. (They want good quality vitrification [freezing procedures]. They also might have to actually specially order the medium.) I know our lab just updated its freezing methodology, so I am certain they would meet that criteria. Second, the embryo has to be good quality. Apparently CCRM does not freeze crap embryos, and will not accept low-quality embryos. Third, if an embryo is genetically tested, the testing lab has to have a low error rate. CCRM claims that its in-house testing lab has a very low error rate—less than 4%. So they would want an equally quality lab. Our embryos were tested by Natera, so I’m sure it’s fine. (Although I do not know what their error rate is. It’s scary that there is an error rate and that it’s so high!) Finally, and this was the most interesting, CCRM is VERY open about the fact that its success rates are highly important. (Indeed, the first, second, and third rules are directly related to success rates.) Anyway, CCRM does NOT tell patients the gender of the embryo (one of the options when testing is done in-house) and they do not allow gender selection. Again, that’s not about morally being against gender selection, but about picking the absolutely best embryo regardless of gender to maximize for the highest chance of success.

That raised a really interesting issue for us. We did not do genetic testing with our first five transfers, so the gender was as much a mystery to us as it would be for anyone. But with our last transfer, we had two equally rated B2s. (Who knows if an embryologist could have said one was slightly better than the other.) One was a boy and one was a girl. Because we have a son we said, heck, put the girl in. That cycle did not work. NOW we have a B2 boy and two B3 girls—that is, the boy is a better looking embryo. Would we want to pick the girls over the boy, even though they would be less likely to work? Well, if we did transfer our embryos to CCRM, they would not give us that option—we would have to go with the boy. And it’s not clear from their rules that they would even accept our “crappy” girl embryos.

When I told my husband that they might reject our embryos if we wanted to transfer them, he was completely turned off. And, of course, I would NEVER transfer my B2 if they would not accept the others—what if I went through a whole cycle and then my B2 did not thaw? The idea that I would not have my back-ups to use… well, no way.

But I’m getting ahead of myself. Is there even a benefit to transferring my embryos if we’re just going to do frozen cycles? Unclear.

First we talked about FET protocol. They said for patients with recurrent IVF failure (again, my bucket), they have a “hail Mary” protocol. Most of it is the same as what we have done on our other cycles, but with some new stuff.

CCRM’s hail Mary FET protocol:

(1)    3x a day progesterone suppository (what we always do) PLUS every other day IM progesterone. (No more avoiding shots for me.) When I confessed that I have avoided shots in every cycle, the CCRM doctors acknowledged that there was no data suggesting shots are better than suppositories, but with their hail Mary they just do it.

(2)    Vivel patches. (I’ve done vivel patches in the past, but have been using estrace more recently.) Again, they indicated that there was no study that suggested one was better than the other, although the patches are easier on the liver. (I completely forgot how hard this is on the woman’s body!)

(3)    Prednisone (steroid) and antihistamine for 10 weeks. This is the “hail” part of it. They acknowledged that there was a controversial idea that there was an immune system response, and although there was nothing concrete for their “hail Mary” patients they go for it. (Again, anyone googling infertility extensively has probably run across Dr. Sher’s office. http://haveababy.com/fertility-information/ivf-authority/recurrent-pregnancy-loss-immune-therapy When I mentioned his name they were like, “oh, we don’t go that far!” I should also note that he does not actually offer any suggested treatment regiments online, at least that I could easily find. http://haveababy.com/fertility-information/ivf-authority/recurrent-unexplained-ivf-failure-with-good-quality-embryos)

That’s it. The hail Mary. But I can do all of those things at my lab. So I pushed, is there any benefit in transferring my embryos to your clinic as it relates to the actual transfer? It seems like not much. They two things they suggested were: (1) Good quality control, including the fact that the embryo is literally in an incubator in the room, so it spends almost no time out of the incubator / mom. (2) They use “embryo glue” in the transfer (acid) (literally—it’s called embryo glue http://www.vitrolife.com/en/Products/G-SeriesTM-media/EmbryoGlue/).

Those are benefits, but I’m not sure it’s worth the risk that the embryos might get destroyed in the move. I asked, “would you move your embryos if you were me?” They did not answer yes or no as it relates to me, although one of the two docs suggested she had done IVF and she HAD transferred her own frozen embryos to CCRM. 

We also discussed my prior pregnancy with anencephaly. I was worried that my remaining embryos were all created during that time and thus all might be bad. They were reassuring—the folic acid is most important during the time the embryo is developing, not when the egg is developing, so it’s not certain that all of my remaining forties are doomed.

I have an appointment with my doctor next week. I think we’re going to have some hard questions for him.

To pee (on a HPT) or not to pee, that is the question

For my first pregnancy, I did not take a home pregnancy test (HPT). I waited for the blood test to be taken at the end of the two-week wait, and was legitimately surprised (although I suspected) when I got the call from the doctor’s office that it worked.

Sometime after that, I heard / read that you can take HPTs days before the blood test at the doctor’s office and get an accurate result. So for every cycle since then, I have taken a home pregnancy test two days before the blood test. And they have always been right. 

Recently, I read that some pregnancy tests can give results FIVE days before a missed period (or five days before the clinic blood test at my doctor’s office). So I bought the (allegedly) most sensitive ones and started testing way earlier than normal for this cycle.

The allegedly most accurate drugstore ones are Clearblue Easy Earliest Result Pregnancy Test (25 mIU/ml) and First Response Early Result Pregnancy Test (25 mIU/ml):

http://www.parentingweekly.com/preconception/preconception_information/home_pregnancy_test_accuracy.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119102/#!po=0.384615

https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0034-1368589?device=mobile&innerWidth=980&offsetWidth=980

https://www.thieme-connect.de/media/gebfra/201407/lookinside/10.1055-s-0034-1368589-1.jpg

Bad idea. Either it’s positive, but you know there’s a risk that things could go south any way, or it’s negative and you’re devastated but hopeful anyway. Either way it sucks. The blood test at the doc’s office is best because it tells you both if you’re pregnant and how healthy the pregnancy is.

All three of my HPTs this time were negative. At least I knew what result to expect at the doc’s office—negative.  The blood test confirmed it—HCG level of 2 which means implanted but going nowhere, or “not pregnant.”  Fuck.

Losing your soul to IVF

We’re doing this. Again. This is our SIXTH IVF cycle. I never, ever, ever would have believed I would be in this position. Not because I’m in denial that we’re infertile, but because I would have thought we would have thrown in the towel long ago. But because of a variety of reasons, here we are.

First cycle was easy. I was young (32!) and infertile, but one fresh cycle of IVF later (with a single embryo transfer) we had our beautiful little boy. I was a perfect patient. It was a perfect outcome.

Cycles 2-4 were a little messier. I was older (35). Our lab accidentally ruined the two frozen embryos from our first cycle (long story short, they were changing equipment; we can discuss later why I didn’t decide to go with a different clinic). But my clinic offered a free cycle so we went with it. And, again, we chose all single embryo transfers. First cycle we got pregnant but had a miscarriage before heartbeat. (Blighted ovum.) Second cycle was a bust. The third cycle we got pregnant again but it was a chemical pregnancy.

We went back to the doctor wondering, is there any chance or are we just done? Our doctor suggested maybe that was a bad batch and we could try one more time with chromosomal testing of the embryos. We thought that made sense. Given our history, we assumed we just had genetically abnormal embryos, and there was a good chance that we’d do a retrieval cycle and not get much or the ones we’d get would all be abnormal. So imagine our amazement when (now at 36) we ended up with FIVE chromosomally normal embryos. So off we went again, and I ended up pregnant. We were so, so happy. And then devastated when we learned our baby girl was not coming home with us due to a rare and fatal birth defect.

So where did this leave us? Now I’m 37. Emotionally, I want to be done. If we did not have any embryos in storage I would happily walk away from this whole process and just try to forget it ever happened.

But we did have embryos in storage—FOUR genetically normal ones. Quitting felt like running a marathon and then stopping ten feet before the finish.

So we tried again. 

And that’s how I’m in the position where I have now done SIX rounds of IVF. I have been pregnant seven times total, four times from IVF. Each of these experiences / losses has felt like they have taken a piece of my soul. And I feel like I almost (?) have nothing left.

One of the worst parts about reaching this point is that I could really use a friend to cry about it with. But I’ve been through this so many times I just can’t. I mean, my friends would listen and they would care and they would be sympathetic, but criminy! How many times can I ask for comfort/sympathy for choices I’m making? 

After my ectopic pregnancy all of my friends were so worried about me. After my post-ectopic miscarriage (which might also have been ectopic) they brought me pastries and chai tea while I cried in bed. After my blighted ovum they took me to lunch (we ordered wine!). After my most recent loss, they sent me flowers, dropped off food, gave me (expensive!) champagne (because I love it and could finally drink again), etc. etc. etc.

But I can’t keep demanding support. I’m sure people are thinking, girl, it’s time to be done. How much energy (physical and emotional) and money are you going to throw at this? You tried. A lot. A whole lot. Time to stop. (That’s what I would be thinking.)

The isolation I feel is crushing.

I told my husband, I’m losing my soul to this. (Maybe I’ll end up like Voldemort—immortal.)

Losing the baby weight when there's no baby

Before I go any further on this post, I have to start by acknowledging that I lost my pregnancy at 17 weeks. I am not comparing myself to women who go longer or, God forbid, lose babies after they are born. But I did gain baby weight (about 10lbs) and it was fucking impossible to lose. 

When I was reading about what I might experience after our termination, one (unlikely, given I was not that far along) possibility was that my milk would come in. I was convinced that would be devastating, so I did what little I could do to make sure that didn't happen. (No nipple stimulation at all.) My milk did not come in. (Although a couple times in the shower some milky fluid come did out of my nipples.) But, of course, milk production helps post-partum women lose weight and helps their uterus contract to help them get their figure back. My milk did not come in (thank goodness) but that means I had to lose the weight all on my own (no help from my hormones!).

For the first few weeks after the termination, I was supposed to take it easy—no exercising. So I did what anyone in my situation would do—I sat on the couch and cried and ate carbs and sugar and drank booze. So no surprise I did not lose weight. But once I was cleared to exercise I started up, mostly doing light/medium cardio (jogging, swimming, biking, etc.). After a month of that, I lost exactly ZERO pounds. ZERO. I was stunned. I was watching what I was eating and I was working out just about every day. And I had not lost AN OUNCE. (Of course, I hadn’t gotten my period yet, so my body still thought I was pregnant. I doubt that helped.)

So about 6 weeks after my termination (right after I finally got my period) I decided to get serious. I started doing significantly more strenuous exercise. Among other things, I bought Insanity. (60-day exercise video series: http://www.teambeachbody.com/workout-routines/insanity-workout.) I worked out for around an hour EVERY DAY at least once a day, sometimes twice a day. I dieted. (I’ve never dieted before in my entire life.) After a month I’d lost seven pounds. I had hoped I would lose more, but it was a start. I eased up on my dieting (which is to say, I was eating normally/healthy, but not calorie restricting), and my weight lost stagnated…. even though I was still working out over an hour every day HARD. It was really, really frustrating that I had to go to so much trouble just to get back to the weight that I should have been, and it was 10x more frustrating when results were very slow.

I only lost two pounds in the second month. So I was not quite back to my old weight, but I was close. And, because I did it with serious hard exercise, I have to admit I look good. (That is, I’m heavier than I want to be, but more muscular than I’ve been since I had my little guy.)

The three months after my termination were some of the hardest, emotionally, in my whole life. Throwing in the fact that I continued to LOOK pregnant and couldn’t fit into my clothes for several months just made it that much worse, but I think having a goal and a specific plan was a good way to take my mind off of things…. A bit. 

Ironically, the timing worked out in such a way that my last Insanity exercise the day of my next transfer.

Yes, we’re on this fucking ride again.

Scar tissue after D&E

Of fucking course I had scar tissue after my D&E. Scar tissue is a risk of any surgical procedure on the uterus. Any while it's not common to have scar tissue after a D&E, it's not unheard of either. (The more severe the scarring, the rarer it is. I don't know exact percentages of risks. Searching information about abortions online is scary because you can find yourself on pro-life sites. So scarring is rare, but it happens.)

The scar tissue was caught during an HSG at my fertility doctor's office to prepare for my frozen cycle. (Which I have very mixed emotions about--but that's a post for another day.) I had to have a SECOND surgery to remove it (a D&C this time) immediately to avoid delaying my cycle, because scar tissue can affect fertility. (It can hinder implantation of the embryo.) It was stressful and awful and unpleasant but it's over. Fortunately the scarring was minor and the doctor thinks that it was completely removed with the D&C. 

Being back at the hospital and having my poor veins hacked away at and being scraped again and all of the attendant stuff was really traumatic and set me back emotionally a fair bit. As I told my husband, knowing what I know now, I would not have tried to have a second child. But we're doing our best to move forward with the most positive attitude/outlook possible. 

A love letter to Planned Parenthood

Let’s talk about Planned Parenthood.  Planned Parenthood is the largest U.S. provider of reproductive health services, with 97% of its services focused on breast and cervical cancer screening, HIV screening and counseling, and contraception. Only 3% of its services relate to abortion.  And no federally funded money is used to fund abortion services.

Now let’s talk about tissue donation.  Some Planned Parenthood locations may donate fetal tissue at the request of a patient; consistent with federal law, these samples are never sold (although shipping costs may be reimbursed).  Planned Parenthood in Minnesota, North Dakota, and South Dakota (as well as others) do not currently engage in any kind of tissue donation.

Now let’s talk about abortion.  It has been the law for over 40 years that a woman has a right to abortion until fetal viability.  Statistics suggest that somewhere around 3 in 10 women will have an abortion.  And women have a variety of reasons for choosing abortion.

I was in my early thirties when I had my first abortion.  My husband and I were very excited to start our family, and like many young-ish and naïve couples thought it would be a matter of weeks before we were pregnant.  Several disappointing months later I suffered from a variety of increasingly scary symptoms including severe pain and bleeding.  A visit to the emergency room confirmed that I was pregnant, but the pregnancy was not viable—it was an ectopic pregnancy (lodged in my tube).  Ectopic pregnancies are the leading cause of maternal mortality in the first trimester.  Devastated, we terminated the pregnancy.

I know what you’re thinking—that’s not a real abortion.  The pregnancy was not viable and you could have died!  Even the Catholic Church has suggested abortion might be acceptable in such a situation!  Well, it was a real abortion.  And if the most strict abortion laws were in place—no exceptions, even if the mother’s life is in danger—that pregnancy would have remained non-viable and yet I really could have died.  Fortunately I had a right to terminate the pregnancy, and I was later able to go on and have a much-loved child.

I was in my mid-thirties when I had my second abortion.  After multiple rounds of fertility treatments, we were beyond overjoyed to find ourselves pregnant.  It was one of the happiest times of my entire life.  And then it wasn’t.  We received an absolutely devastating diagnosis at 16 weeks—the fetus was suffering from a severe, fatal, and non-curable birth defect.  (It was the worst day of my entire life.)  Even if the fetus somehow managed to survive the entire (risky) pregnancy and delivery, it would die hours after birth, never conscious.  I made the extremely difficult and heartbreaking decision to terminate my much-wanted pregnancy. 

This brings me back to Planned Parenthood.  I was able to have my abortion performed by a doctor from my OB’s office, who had been trained to do abortions by doctors practicing at Planned Parenthood.  If I had been just a few days further along, my safest and best option would have been to terminate at Planned Parenthood.  (And the procedure I had is not even legal in all states… for now.  A number of states have passed highly restrictive—and dangerous and stupid—limitations on abortion.  Hopefully the legal challenges to these foolish and misguided attempts to bar access to abortion will succeed.)  Many other women in my exact situation are either a little further along when they get their diagnosis or in a state where the only real option is to go to Planned Parenthood (possibly being required to travel to another state).  I am so very thankful that Planned Parenthood exists and provides a much-needed service to women when they are in their darkest and most painful moments.

This also brings me back to tissue donation.  Because our fetus was suffering from an extremely rare and devastating birth defect, I sought out a medical study (evaluating what causes this and trying to find a cure) and enrolled in it.  One of my only sources of comfort at that time that was that maybe some small amount of good could come from my experience, and that some other family would not have to be devastated by this experience.  The study did not pay for the tissue sample necessary for the research, but would reimburse shipping costs.  Ironically, had I had my abortion at Planned Parenthood, instead of at a hospital, I would not have been able to donate my fetus’s tissue because Planned Parenthood in my location does not currently engage in tissue donation for research.  What an absolute shame.

Without access to a safe and legal abortion, I could have died.  Without access to a safe and legal abortion, my ability to have a second child—one who could live—would be virtually nonexistent.

There are a lot of really, really important things that are facing this country and world.  Trying to take away a woman’s right to have an abortion before the fetus is viable is not one of them.  Likewise, Planned Parenthood is a fantastic organization that provides a variety of important health services to women—including abortions.  Trying to de-fund Planned Parenthood—funding used for purposes other than abortions—should not be on anyone’s list of things to do.  Politicians who are focusing on taking down Planned Parenthood / abortion rights do not have women’s best interests in mind.  They certainly do not have my best interest in mind.

I’m not just pro-choice.  I’m pro-woman.  

I stand with Planned Parenthood.  Please consider donating to Planned Parenthood.  (https://secure.ppaction.org/site/Donation2?df_id=12913&12913.donation=form1)  And please vote for candidates who support Planned Parenthood and a women’s right to choose.  (Elizabeth Warren’s speech is right-on: http://time.com/3983266/elizabeth-warren-planned-parenthood-speech/)