Receta The Four-Year Wait: Our Battle with Infertility
I knew that this day would come, the day when I would be writing about our very rocky journey to parenthood. Years ago when I found out that something was wrong, I was already thinking of sharing it to the world. But I changed my mind. I initially thought that it was just pride and probably shame that hindered me from doing so. Maybe it was partially true, but deep in my heart, I know that I kept it a secret because I wanted to wait for the day when my husband and I have finally overcome the battle before we share it with everybody. And with my recent pregnancy announcement, I knew that now is the perfect time to let you know how we struggled with infertility for almost four years. I just have to warn you, though. This will be long since this story is worth four years of our lives. I will try to compress everything as much as I can, but if you can’t hang any longer, then I wouldn’t take it against you. Feel free to read my other posts. But if you decide to stick around, then getting a bucket of popcorn might be a good idea! Hahaha! If you personally know us and you have witnessed how difficult things had been for us, then I suggest you get a box of tissue paper. Nyaha! Writing it today may be less painful, but I could still feel a little sting as I look back at our hardships. I was initially thinking of not writing this post, but I figured that there may be other women out there who are also facing the same battle and the only thing that could keep them from giving up is knowing that they are not alone. And besides, I need to do this so I can remind the Little Kolokoy of how hard it was to bring him/her to the world in case he/she turns out to be a brat in the future! Isasampal ko sa kanya ‘tong post na ‘to kapag sinagot sagot niya ako in the future! Charot! =))
My menstrual cycle has always been irregular. I first saw an OB/GYN before I turned 16 years old. My first doctor told me that it’s just typical for women under 18 years old. When I turned 18, things didn’t get better. I had my first pelvic ultrasound, but my then doctor could not see anything wrong with me. When I turned 21, I switched to a new OB/GYN from Manila Doctors Hospital. She did the same tests and came with the conclusion that I was having irregular period because I was underweight.
Even before I got married to Boyet, I already told him that something was wrong with me. I even told him that I had always felt that it would be extremely difficult for me to conceive a child because of my erratic cycle. I even teased him that he still got time to run away from me, and that I wouldn’t take it against him. But the guy is tough! He never left!
We got married in June 2011. We were both 27 years old. We both agreed to wait for 1-2 years before having a baby. Our savings got drained from paying for our wedding, and we were already planning to buy our own house. But because I knew that something was wrong, I went back to my OB/GYN on January 2012. For the first time, she asked me to have a transvaginal ultrasound. I vividly remember that she refused to let me have it when I was still single when she found out that I still didn’t have sexual intercourse at that time. Anyway, aside from the ultrasound, I was also asked to have my blood checked.
The results came, and the diagnosis was that I have Polycystic Ovarian Syndrome (PCOS). For those who are not aware, this is a condition where the follicles that release the egg cells don’t develop. In an ultrasound image, you’ll see that a Polycystic ovary has a lot of immature follicles that look like tiny cysts. Women with this condition do not ovulate regularly which explains the irregular cycle. In my case, I don’t ovulate at all. And if you were paying close attention to your Biology teacher, then you probably know that conceiving a baby becomes more difficult with irregular ovulation patterns. Aside from that, my blood tests showed that my estrogen level was too low, too low that my OB/GYN was speechless for almost a minute. According to her, I was experiencing early menopause. I remember crying so hard after that initial appointment. I looked to my husband and apologized for failing to give him the family that we had been dreaming of. But my husband always knows what to say. He reminded me that PCOS is a very common condition, and that we know a lot of women who successfully got pregnant despite having it.
My doctor discussed two options. She asked me if we were already trying to conceive. If not, she’d give me contraceptive pills. I didn’t think twice because my test results already told me that I needed to act as soon as possible. We went for the second option. She then prescribed me with Humamet. It’s a brand of Metformin. Metformin is the primary drug being prescribed to PCOS patients. It’s also the same drug given to diabetics because both conditions have something to do with being insulin-resistant. I started with 500mg a day. Metformin is an evil drug! Believe me!!! It causes LBM, nausea, headaches and mood swings! Aside from Metformin, my OB/GYN also prescribed Duphaston. It’s a form of hormone that works two ways. If you happen to be pregnant, it serves as a pampakapit. But if you’re not, it can induce menstruation. I started with 10 tablets a month, and then 20. But the problem was that, I was bleeding too much! I even bleed twice a month. And worse of all, I wasn’t getting pregnant! By November 2012, the doctor asked me to undergo biopsy. I even had to go through all the physical exams to clear me for biopsy. And then it got me thinking, why is there a need for biopsy? Is she looking for cancer?! But I still went ahead with all the tests. My ultrasound results showed that my endometrium was too thin. My doctor then told me that a biopsy wouldn’t be necessary. By this time, I got to talk to someone who has PCOS and was undergoing fertility treatments. I was very surprised when I found out that she was taking different kinds of meds. I told my husband that the doctor’s approach was definitely not working. It also didn’t help at all that she has too many patients. We would sometimes wait for almost 6 hours, and then she would just talk to us in 2 minutes! I don’t even know if she knew what my name is! After almost a year, I was then convinced that we needed to seek a second opinion.
I was already working in BGC by January 2013 so I considered looking for a doctor in St. Luke’s Global. Two of my managers from my previous company recommended two different OB/GYN. I went with my friend Nanet’s recommendation. Dra. Australia Luz was also her OB/GYN, and she has nothing but good praises for her. She also told me that Dra. Luz is also a sonologist so that convinced me even more.
My first meeting with Dra. Luz was like love at first sight! Her secretary is more systematic so I don’t get to wait for 6 grueling hours. And Dra. Luz takes her time to explain everything to us. I showed her a clearbook containing all my previous test results. She also asked me to narrate everything from the start. She told me, “I don’t personally know your OB/GYN, but I don’t understand why she did that approach.” According to her, my estrogen levels are expected to be very low because that is consistent with PCOS patients. And more importantly, the meds that were given to me were not helping me to ovulate at all! She asked me how old I was when I was diagnosed with PCOS and when I started to notice my irregular period. I told her that I was just diagnosed the previous year, but my cycle has always been irregular. According to her, my previous doctor should have ordered at least a transrectal ultrasound because it is very difficult to diagnose PCOS with pelvic ultrasound. Her guess is that I have always had PCOS, but it was diagnosed late. But then she said that we couldn’t do anything about the past, and that we needed to start with the real fertility workup! The first thing she did was to switch me from Humamet to a cheaper version of Metformin – Ritemed. She said that the effects are just the same. From 500mg a day, she increased it to 500mg twice a day. So did you remember what I said about LBM, nausea, headaches and mood swings? Make that LBM, nausea, headaches and mood swings multiplied by two! Hahaha! One tablet made me a bitch, two turned me into a monstrous bitch!
Now here’s to give you an idea of what usually happens in a cycle of fertility workup. To start (or end) the cycle, I am asked to take Duphaston. This will induce menstruation in case I don’t get pregnant. I would then take different kinds of pills. During the first few cycles of our workup, I took Ovamit to induce ovulation. I started with the lowest dosage of one tablet a day for five days. After this, I would switch to Premarin, which is conjugated estrogen, for the next five days. As early as day 14, follicle monitoring starts. This is done through transvaginal ultrasound to check if there are any mature follicles that are ready to release an egg. I didn’t ovulate in the first cycle so my doctor increased my Ovamit dosage to two tablets a day. It still didn’t work so I had to take 4 tablets. I finally ovulated, but I didn’t get pregnant. After three cycles, we were asked to take a break for at least a month so as to give my body ample rest from all the pills and the very strenuous process.
The following cycle, my OB/GYN tried to switch from Ovamit to Clomid. We had to undergo the same tedious process. I still didn’t ovulate on one tablet of Clomid, so I had to go up to 4 tablets a day! Now here’s the deal. Ovamit is just PHP100+ while Clomid costs PHP300+!!! And the side effects are just unbearable – nausea, dizziness, headache, mood swings. My husband already got used to my patayin-mo-na-lang-ako-kesa-mag-Clomid-ako kind of days! He could not even talk to me while I was on Clomid! Plus, the nausea was just unbearable! I kept on throwing up every single day. One time, we didn’t have any available plastic bag inside the car so I had no other choice but to throw up along one of the sidewalks of Makati! Puke and run! :p And there was also one time when I threw up in the middle of Ayala Avenue! And we had no other choice but to carry the bag full of my vomit until we found the first trash bag in BGC! Aside from the horrible side effects and what seemed to be was a never-ending financial stress that the workup was bringing to us, the whole process just changed our lives. All our major decisions had to be based on our fertility workup schedule. There were times when we had to go to St. Luke’s almost every day for my follicle monitoring. We cancelled travel plans. We missed a lot of opportunities at work. It was as if our lives were put to a halt. And the worst part was the emotional stress that it brought to us. I got really tired of people asking why we’re still childless. Do you remember my post about the things that you should not say to childless couples? I wrote that because I got really pissed off with insensitive people who managed to make my reproductive system as vital parts of their daily lives. I had to endure all of these despite the fact that the positive effects of the workup with me are inconsistent. There were times when I would successfully ovulate, but more often than not, my body would fail to respond to the medications.
A few months through our workup, I ovulated a few times, but we still failed to get pregnant. That was when my OB/GYN asked my husband to undergo sperm analysis. The count and quality of his sperm were both ok, but there was a minor issue which we later on found out was another factor why we kept on failing with the workup. He had a problem with his sperm liquefaction. As explained by our doctor, liquefaction is the time it takes for the semen to liquefy. The normal range is 20-30 minutes. During my husband’s first sperm analysis, the result was more than 1 hour. Because of this, the sperm is having a hard time to swim and go to where it is supposed to be. He was advised to rehydrate more and to lessen sugar intake.
After a while, we just gave up. There was one time when we were supposed to come back to treatment after a one-month break. We came back after almost half a year. We took a break, bought a house, and went on endless travels and staycations.
We thought that the break would be good for us. Yes, we had time to recharge, but the effects of the treatments were still the same. My doctor told me that a small percentage of women with PCOS are resistant to Clomid. E bakit ang malas ko at kasama ako sa small percentage na ‘yun?! Although my ovaries were “shrinking”, which is a good sign that my PCOS is slowly being treated, my ovulation patterns were still erratic.
Things were harder in 2014. I really wanted to give up, but a part of me kept on pushing me to go forward. I know that I am built to become a mother so I didn’t want to let those tiny cysts in my ovaries prevent me from fulfilling my mission in life. My husband had another sperm analysis. The liquefaction time was within an hour. It still wasn’t the normal range, but at least he was inching closer. On the other hand, my Metformin dosage was increased to the maximum – 850mg twice a day. And yeah, Clomid was still my best frenemy! We continued to spend money on fertility drugs and laboratory exams that were not even covered by my HMO. Our life was still on freeze mode because of the very demanding medical appointment schedules. And my heart was slowly breaking into tinier pieces out of frustration and what seemed like a bottomless pit of disappointments. It was a never-ending process. There were days when I was very hopeful, but there were some days when I would be beaten by pessimism. I know that some of my friends probably got used to all my whining and crying. I know that my husband could see the longing in my eyes each time I look at a child. I know that he saw how painful it was for me to see everybody else getting pregnant, even those who were not even planning for it. I have to admit, it somehow put a strain in our marriage. I remember countless of times when I would just cry in the middle of the night, and then I would tell him that I would not take it against him if he decides to leave me because I couldn’t give him a child. And in all those times, he would just hug me and tirelessly assure me that he’d rather spend the rest of his life with just the two of us. “Pinakasalan kita kasi mahal kita. Bonus na lang ang anak sa akin. Kung anak lang pala ang gusto ko, sana inanakan ko na lang ang kung sinu-sino dati.” And then he would end the conversation by saying, “You and I, we’re already a family. No one can argue with that that. A child will just make our current family bigger.”
During the latter part of 2014, we tried for the nth time. My husband went for another round of sperm analysis. His time was at 45 minutes. He was getting better. During the first round of 4 tablets of Clomid and maximum dosage of Metformin, I ovulated. But I still didn’t get pregnant. On the second round, I failed to ovulate. My doctor wanted to try for another round, but it was nearing the Christmas season. We told her that we wanted to enjoy the holiday break and promised to come back on January. She then suggested another route to increase my chances of ovulating. We took advantage of the long break to think about it.
When we came back on January this year, we told our doctor that we’re ready to try out that route. Instead of Clomid, I would be injected with Puregon. It contains hormones similar to FSH or Follicle Stimulating Hormone. According to her, my chances of ovulating are bigger with it compared with Clomid. Plus, there are no side effects! The only downside is its price. Each 50iu shot costs around PHP2,000+, and I would be needing at least ten shots for ten consecutive days. Do the Math! The first struggle for us was finding it. No single Mercury Drug stocks up 10 shots of Puregon. My husband and my mother went to three different cities just to get those ten shots while I stayed at home talking to different agents of Mercury Drug to reserve.
When we were finally ready to take the plunge, my OB/GYN suddenly needed to leave the country for an unplanned convention. She asked us if we were willing to take under the wing of a reliever or if we prefer to wait for her to come back. We took the second option. Our doctor also took this opportunity to make sure that my husband’s issues will be completely addressed. He took some supplements and was advised to increase his water intake. Deep in my heart, I was also hoping that I would get pregnant simultaneously without the aid of fertility drugs during this time. But of course, that didn’t happen so we went back on February. Before we started with the cycle, I told my husband one thing. I wanted it to be the last. I told him that I wanted to stop if it still didn’t work out. “Kung magkakaanak tayo, magkakaanak tayo.” I told him that we should probably focus on building our house. He agreed with me. People were actually telling us that we could take the baby-making seriously when we move in to our own nest. Boyet would tease me, “Oo, sa bawat sulok pa! Kahit sa countertop! Hindi ako titigil hanggang hindi kita nabubuntis!!!” And you probably know by now that all his plans will not be materializing anytime soon! :p
I started going to St. Luke’s for my shots. True enough, I didn’t experience horrible side effects except for the cramps on my arms after every shot. By day 14, the transvaginal ultrasound result shows that I have growing follicles. My OB/GYN told me, “Hay naku naman etong ovaries mo! Ang sosyal! Gusto ng mamahaling gamot!!!” To make things even better, Boyet’s liquefaction time was at 30 minutes! We were both ready to rumble! :p
I know that married couples who are actively trying to conceive will agree with me that the most difficult part is the two-week wait. For those who are not aware, you need to wait for two weeks after ovulation to confirm pregnancy. Don’t worry because I will spare you of all the other (sexy) details before the two-week wait. Let me just assure you that there was no “action” on the countertop because our house was still under construction during that time. Haha! Anyway, I took Duphaston for ten days to aid implantation or to induce menstruation. After the last tablet, I would either get my period or not. If there is one thing that I am most thankful for is the fact that my body knows Duphaston very well. My doctor said that women usually bleed 3-5 days after taking the last tablet of Duphaston. I usually get my period the following day after the last tablet. I remember taking the last one on a Sunday. Though I was very hopeful, I still prepared for the worst. I even stocked up on sanitary pads! I didn’t get my period on a Monday. I got a text message from my OB/GYN on a Tuesday night asking me how I was. I told her that I was having horrible cramps. I really felt like my period was due anytime. Sobrang sakit ng puson ko! She told me that it’s actually a good sign and that I should take a pregnancy test if I still don’t get my period on Friday.
Because I’m naturally hard-headed and it’s very unusual for me to miss my period that long with Duphaston, I decided to take a home pregnancy test the following day. It was March 18. My husband was still sleeping, but I really needed to pee. I saw that I had three kits at home. Yeah, I had been stocking up on pregnancy kits, too! :p I got used to seeing that stupid single line that I even had a theory that those things don’t really work! Hahaha! And because I was not discounting the fact that our last cycle might fail, I bought the cheap kind of pregnancy kit. I got a buy-1-take-1 deal for only PHP40! Haha! I took a sample from my first urine and put three drops on the kit. I was like, “Yeah, right! I’m so used to this! Buy-1-take-1 ka so malamang japeyks ka!!!” True enough, I saw one line. I was about to throw my urine when I took a second glance at the kit. And then… Waiiiiitttttt! Is that a second line?! I literally scrubbed my eyes (while holding my urine with my other hand, hahaha!!!) to make sure. I went back to our room and turned on the light. My husband suddenly jerked from the bed, with his eyes still very red, when I called him, “Baby!!!” He absent-mindedly looked at me while I was holding the pregnancy kit. And yes, I was still holding on to my magical urine! Hahaha! I asked him if he was seeing a second line. He then knelt down and buried his face on our bed. (He later on told me that he was actually praying!) I told him that I would be repeating the test. I doubted the cheap pregnancy kit! Hahaha! And so I put three drops to the other pair of the buy-1-take-1 kit. I got two lines. The second line was not even faint! My husband’s face was still buried on our bed so I decided to use the remaining kit. I saved the expensive one for last! Hahaha! It yielded the same result. Boyet then stood up and examined all the kits. I left him with the company of the kits while I went back to the bathroom to throw away my urine! Bwahahahaha! I immediately sent an SMS to my OB/GYN. She was ecstatic! Her exact reply to me was, “Yahoo!!!” She asked me to skip work for the rest of the week and take Duphaston 3 times a day. I was also advised to visit her clinic to take a blood test after three days to check my HCG levels.
I initially thought that telling you this story would be easy. Yes, it was liberating, but I didn’t realize that it would bring back a lot of sad memories that I thought I had already repressed. Writing this is like reliving a nightmare. But then again, I think that writing our journey is a good decision for so many reasons I can think of.
1. If you are one of the many people who said insensitive things to me and my husband, odds are you probably didn’t have the slightest clue of the kind of battle that we had been through. “Ang hina niyo naman!” “PCOS lang ang sakit mo, hindi ka pa magkaanak.” “Naunahan pa kayo ni __” “I got pregnant without even trying.” Even if you said these things in a form of a joke, I just want you to know that your words somehow scarred me. I may have not taken it against you, but you probably said it during a time when I was at my lowest, and that the last thing I wanted to hear was some nasty and uncalled for comments. (O ngayong alam niyo na ang kwento ng reproductive system ko, ikinaunlad ba ‘yan ng buhay niyo?! :p) I may have not held any grudges towards you, but I just want you to know that people who battle infertility are very sensitive even if they try so hard to convince themselves to just let such comments go. I’m telling you that it’s not an easy battle. If you are one of these people, please remember that I am not the only woman you’ll encounter with the same condition. You’ll probably meet a lot of childless couples in this lifetime. And I’m hoping that by reading my story, you’ll realize that you need to be extra careful with your words around these people.
2. People will finally understand that every person has his/her own struggles in life. We may have made you laugh through our Kolokoy Household posts, but you probably didn’t have an idea that we were dealing with our own demons. I know a lot of bloggers who divulge everything in their blogs. I’m not that type. But I want you to know that I wasn’t wearing a mask. I was and still am that jolly and optimistic blogger that you chose to stick around with. But it was a personal decision to keep this battle personal for years because I wanted to share it with you as soon as we have already understood what God’s plans are for us. And now is the perfect time. I also want to remind everybody to be kinder to other people because you have no idea what they’re going through. Some may strike as happy, but you probably don’t know that they are breaking inside.
3. Years from now when I’ll feel that I'm at my lowest and my weakest, I want to look back at this story to remind myself how strong I was. One of my best friends once told me, “Ang liit liit mo, pero hindi ko alam saan nanggagaling ang tapang mo,” when I told her about our battle with infertility. When she said that to me, I didn’t know the answer. She’s right. With someone as small as I am, where does my strength come from? But as I look back, I think my strength comes from my husband, my family, my best friends, and that BIG GUY UP THERE who kept on reminding me that He is a faithful God who knows the deepest desires of my heart. I know that years from now, I will stumble again and think of giving up. But I will hold on to this experience to remind me how God transformed my life to make me the kind of person that I am supposed to be.
Whew! That was long! But if you’re thinking that this was already the worst part of our journey, wait ‘till you hear my story about my very scary first trimester. For now, this preggy Nanay needs to rest. Ang haba ng sinulat ko, napagod ako e! Hahaha!