Infertility and unplanned pregnancies

Approximately half of all pregnancies in the U.S. are unplanned. That can seem unbelievable to an infertile couple—how can it be so easy for everyone else and so hard for us??  Of course many of those pregnancies are because of youth—i.e., a super fertile and irresponsible (no BC) couple of kids.  Many infertile couples have great life experience, maturity, etc., but crusty old eggs and sperm. Ah, youth (and youthful eggs/sperm) is wasted on the young!

But unplanned pregnancies can even happen to people who have suffered with infertility.  A friend of mine had two planned pregnancies after years of infertility—her son, after IUI, and her daughter, after IVF.  And then a few years later, BAM! pregnant with her miracle baby.  Pretty much everyone I know has a friend (or a friend of a friend) with a story like this—the one that keeps the dream alive.  The one that justifies that tiny, the quiet voice in the back of the mind of those of us trying and failing to have a child: maybe it will happen naturally.

Obviously that can’t happen to me.  

Occasionally a well-meaning friend/family member will say something like, “maybe it will still happen.”  “No,” I firmly but kindly tell them, “not for us.”  Understanding it comes from a nice place, I don’t react the way I think many people (including myself, from time to time) might be tempted to respond: IT’S NEVER GOING TO HAPPEN AND IT’S LIKE A KNIFE IN MY HEART THAT YOU EVEN SUGGEST IT.

About a month ago I was catching up with a friend I hadn’t seen in many, many years.  After sharing our adult life stories (my middle name should be TMI), she ended up writing me an email asking, “Are you still allowing yourself the chance to get pregnant naturally?” I responded (and this is less than 3 weeks ago, mind you):

“On the getting pregnant naturally front….  I mean, it’s not like we’re doing anything to stop it, but I’m pretty confident there’s no chance.  After my 1 (and likely 2) ectopic pregnancies, one of my tubes is so scarred the doc told me if I ever got pregnant naturally there’s a 50% chance it would be ectopic.  And it looks like my body naturally releases eggs really late, making a natural pregnancy highly unlikely.  And our last 2 pregnancies (from chromosomally normal embryos via IVF) both had catastrophic birth defects.  So if I found myself pregnant naturally, I would be terrified, not excited or happy.   :/  But I suppose anything is possible.”

After another couple emails, I told her:

“If I thought we had a good chance of getting pregnant naturally, I think I would probably make the decision to medically do something to make it impossible, because I am pretty nervous about what would happen.  Infertility is the lazy person’s birth control!”

So, that pretty much sums up my thinking on getting pregnant naturally.

And we are really in a good place now.  I feel like myself again.  I have taken back my body!  I’m currently training for the Chicago marathon.  This summer, I did a number of road races and a couple triathlons.  (And I even PLACED in some of them!!)  We have no intention of having another child.  We sold our crib and gave away all of our baby stuff/baby clothes/maternity clothes.  Our little guy just started KINDERGARDEN.  We redecorated our living room and got really nice furniture because we don’t have a destructive little kid anymore.  We planned some awesome vacations—including in tropical locations where Zika is running wild.  We are DONE.  Sure, we wanted a second child, but it didn’t work out.  We’d moved on.  We were happy.

And then…. You want to make God laugh?  Tell him your plans.

Last weekend I went out for my longest marathon training run of the season—21 miles.  I had an amazing 17 mile run, but then I just hit a wall.  I couldn’t run anymore.  I had to walk.  It was bizarre.  And I was so exhausted for the next few days, I skipped two more runs.  I might occasionally miss a run here and there, but never two, and certainly not in my top training week.  I chalked it up to overtraining, rested a few days, and did a couple shorter runs to get back into my training plan. And then my boobs really started to hurt.  I didn’t think anything of it, because that’s been happening lately right before I get my period.  So I assumed that meant any day I’d be getting auntie flow.  But I didn’t.  And I’d been waiting for my period because I was hoping it wouldn’t be right in the middle of my marathon—which is now less than a month away.  So then I started wondering, when was the last time I had my period?  It seemed somewhat recent, but overdue.  (One bad thing about not being on birth control—periods sneak up on you.)  THEN I had another long run this Sunday.  Before my run, I weighed myself.  I always weigh myself before and after a long run because I’m trying to dial in my race nutrition, and I want to figure out how dehydrated I get.  And from the many times I’ve weighed myself before my long runs, I know that I have been basically the exact same weight for months.  BUT that day I was randomly three pounds heavier.  Bizarre.  So I started my 18 mile run, and I just my mind just kept going over all of the weird things that had been happening over the last week—tiredness, sore boobs, weight gain, missing period….  And suddenly, I had to pee like I’d never had to pee before.  I stopped to pee three times during my run.  I was like, “no…. it’s not possible.”  I couldn’t shake the feeling that I was pregnant.  I cut my run short, went home, and told my husband.  He was like, “nah, I think you had your period right around a month ago.”  I’m like, “yea, you’re right. I didn’t randomly gain 3lbs in a week from being pregnant.  It’s water retention right before my period.  And my boobs are always sore before my period.  And I had to pee so much because I’m psyching myself out.” 

Except, I wasn’t so sure.  

I couldn’t get it out of my head, and I was having an impossible time concentrating at work today, so after lunch I popped over to a pharmacy and bought a cheap-o home pregnancy test, which I took in my work bathroom.  (The exact same work bathroom I took a HPT in almost 10 years ago when I discovered my first pregnancy—ectopic.)  I felt like it would be quick negative, I’d get my period tomorrow, and it would just be a silly thing I’d laugh about later.  (“Remember the time I thought I was pregnant?  Ha!”)

But the test didn’t give me a quick negative.  I was so confused I couldn’t read the test.  (I should’ve gotten one of the digital ones that just say “pregnant” or “not pregnant”.)  I’m looking at it, thinking, “I see a dark horizontal line, and a light vertical line, and another light horizontal line. Is that a plus sign, or just the outline of what I would see if I were pregnant?”  My hands were shaking so hard, but I managed to sneak the test to my office, take a picture of it, send it to my husband, and call him.  He answered and immediately asked, “are you alright?”  I could barely talk.  I wasn’t laughing or crying.  I wasn’t happy or sad.  I was confused.  VERY confused.  He looked at the picture and then he was confused too.  We boththought it was a plus, but we were not sure.  So I called my OB’s office and demanded/begged/cajoled my way into a blood test.

And then I spent the rest of the day freaking out.  This was not the plan.  This was officially NOT the plan.  We’d made the decision to stop trying because we are super scared that even if we were lucky enough to carry a pregnancy to term, our histories make it super likely we’d have a child with potentially profound medical issues.  And, of course, I could totally die from an ectopic pregnancy.  I literally kept having phantom feelings of discharge, like this was the sticky beginning of me bleeding to death in my office.  Fortunately, I survived the afternoon.

I got my result tonight.  HCG 4119.  Pregnant.  Holy shit.  I cannot believe this.  I cannot believe that after trying, and failing, to get pregnant for almost a decade I find myself here. 

Of course, I have absolutely no idea when I ovulated, or even when I last had my period, so don’t know if this is a good result or not.  My husband and I think I started my last period on August 3.  So that would make me… 39 days post-LMP?  A rule of thumb is ovulation 14-16 days after your LMP, so I’m probably around 23-25dpo?  If that’s right, this measurement is significantly lower than my other 3 pregnancies to make it out of the gate (my son was 7519 at 5 weeks and 1 day pregnant, my anencephaly pregnancy was 4167 at 21dpo, and my omphalocele pregnancy was 10693 at 24dpo.  My blighted ovum, which was diagnosed at 6 weeks, was 453 at 18dpo, so we’re past that….).  I will say this—it’s already much higher than any natural pregnancy I’ve ever had.  I have gotten pregnant naturally exactly three times.  The first with my ectopic pregnancy, diagnosed at about 6 weeks.  My highest HCG measured then was 682.  The second time I got pregnant I had a very early miscarriage, probably also ectopic due to additional scarring in my fallopian tube.  My HCG never got above 64 that time.  The third was never even confirmed, I just knew.  But before I could even take a HPT I got my period.  That was the last time I even arguably had a natural pregnancy.  That was over seven years ago.  So, at THIRTY NINE years old, I have my highest HCG measurement from a natural pregnancy.  And my lowest HCG of any pregnancy that made it beyond 5 weeks.

Oh, and I keep forgetting I might die!  My doctor’s note said, “we should schedule you for an ultrasound promptly to determine the location of this pregnancy.”  She gets it—I could totally die right now!!!  Although that HCG measurement is pretty high—even high HCG levels can be ectopic.  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247706/)  It’s high enough that the doctor should be able to see a sac on the ultrasound, so if she can’t, we’ll know it’s ectopic.  I’m going to get an appointment tomorrow, asap, and confirm this is not growing in my tube/about to kill me.

And what if it’s not ectopic?  Let’s not even get started on my “baby health.”  Am I on a prenatal vitamin?  No, unless you’re counting margaritas as prenatal vitamins. Was I on any kind of rest?  No, unless you count cutting off a 21-mile run off at 20 miles.  Have I been avoiding things like gardening, lifting heavy objects, sex, and anything else fun?  Why no, I have not.  HOW IS THIS POSSIBLE??  My husband and I couldn’t find a healthy egg and sperm to rub together when I was 29.  What are the changes we got it right now that I’m 39?  

I haven’t given myself the luxury of thinking, “how do I feel about this, assuming it’s not ectopic.  Do I even hope that it works out?”  I mean, I honestly can’t believe how it could, considering our history.  But it’s already a miracle I’m pregnant at all.  Is it too much to hope for another miracle—a healthy baby?

I was wrong, my initials shouldn’t be TMI.  They should be WTF.