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Maternal Mental Health Week – preparing for IVF and motherhood

May 4, 2019

Earlier this week I tentatively reached out to fellow Instagrammer, Lauren, about the possibility of creating a piece about IVF and her path to motherhood for Maternal Mental Health Week.

While days and weeks dedicated to causes such as mental health can bring people together, they also carry the risk of excluding others. It’s not always possible to include everyone but it occurred to me that Maternal Mental Health Week also applies to those who are trying to start their families and yet I haven’t seen many conversations about it.

Lauren is openly sharing her fertility struggles and here, as part of #thebigselfcareshare, she talks about how she’s supporting herself with a whole heap of love and laughter.

Lauren - supporting your fertility

Tell us about yourself and your fertility experience.

I was born and bred in Surrey where I now live with my husband and 2 cats – Simon, Bruce & Maverick. The 3 loves of my life. Closely followed by wine. I used to always hear people saying “there’s never a good time to have a baby” but I have since learned that this is something only the super-fertile, super-fortunate say. My husband and I have felt SO READY to start our family for about 3 years and have been TTC since 2016.

Shortly after the first year of trying, we went to visit our GP who ran some tests and eventually gave us the news that there was a male factor issue making it pretty difficult for us to conceive naturally (in spite of all my efforts with ovulation sticks, thermometers, sperm-friendly-lube, bedtime handstands, pineapples for breakfast etc).

We were totally knocked sideways by the result but a lot of learnings came out of it.

We were referred for our first round of IVF in February which sadly ended without any embryos to transfer. We were totally knocked sideways by the result but a lot of learnings came out of it and we’re now looking ahead to our second fresh cycle which we hope will begin this summer.

What does self-care mean for you and how have you been looking after yourself on your fertility journey?

For me, self-care is about finding time for the things that make me feel like Lauren. Infertility – in all its forms – can be exhausting and miserable. Whenever I feel either of those things, I know I’ve been slacking on the old self-care. Being around my friends and family is my go-to remedy most of the time. Laughter heals me so I do everything I can to surround myself with people who make me LOL and LMAO and ROFL.

I’ve recently made a playlist of tunes that take me right back to that happy, exciting time in my life.

Music is another thing that really brings me out of a bad bubble. I spent years training as a dancer (my true passion although I have long since lost all technique) and I’ve recently made a playlist of tunes that take me right back to that happy, exciting time in my life. Some other fixes for me include sunshine, yoga and bubble baths – with wine and candles in emergency situations.

We first discovered each other through Instagram. How have you found the fertility community?

In short, incredible. It was September last year when I first “came out” about our struggle conceiving and discovered the online Insta-Sisterhood. Before that, I’d felt SO ALONE. Like I was the only one having a hard time getting pregnant. The people I’ve connected with on here make me feel stronger, more positive and more clued up about fertility. I love you all. I honestly don’t know how I’d be coping if I hadn’t found this wonderful tribe.

I believe our maternal mental health needs to be considered well before we have children. Is this something you’ve considered on your path to parenthood?

Absolutely.

As much as I don’t want to believe it, infertility has changed the way I think. It’s like my brain has sort of rewired itself to associate babies/pregnancy with a feeling of pain. I’ve had my low points but I’m determined to get myself into a stronger frame of mind ahead of our next IVF cycle.

We need to look after ourselves to make sure we don’t burn out the moment we cross the finish line. Because, in reality, it’s actually another start line.

Rumour has it that the pregnancy/motherhood malarkey is no walk in the park and, ideally, I’d like to enter that chapter of my life feeling ready for the challenge. For those of us dealing with infertility and IVF – that challenge starts a long time before conception. Making a baby this way takes BALLS (excuse the pun), unrelenting commitment and a whole heap of love. We need to look after ourselves to make sure we don’t burn out the moment we cross the finish line. Because, in reality, it’s actually another start line.

Lauren, thank you so much for creating space for those experiencing fertility struggles during Maternal Mental Health Week. At your rawest, you’re supporting others and I’m sure it’s a self-care piece that will touch hearts!

You can find out more about Lauren by visiting:

www.instagram.com/laurenifen
www.thedinkyblog.com

Fertility treatment Our story

Our next steps

May 9, 2018

I can’t believe it’s been two months since my last post. Things have been incredibly busy for us on the fertility planning and testing front but, here we are, on the “other side” (of that part of the journey anyway) with a firm and final treatment plan.

It feels good to have some understanding of what might have happened over the last 22 months. The multiple losses we’ve experienced following an uncomplicated first pregnancy and birth is something even the professionals have struggled to make sense of. And having no real idea of how and why we were experiencing secondary infertility and recurrent miscarriage has put an incredible amount of pressure on us lately. Sadly, we’ll never know the exact cause of each of our losses. Even our last pregnancy, where we lost a son who tested positive for chromosomal problems, could have ended when it did due to underlying clotting issues. The unknown is something we’ve simply learned to live with, and it’s something I’ll have to learn to cope with in a future pregnancy should we be successful in conceiving again.

What we do have, which is positive, is a fairly good picture of our fertile health over the last 6-9 months. Clear improvements have been made, we’ve reversed some problems and I now have a firm and final treatment plan for pregnancy, which gives us hope that we’ll grow our family someday. I genuinely believe this is the best we could have hoped for after a series of complicated investigations.

Final diagnosis

So, these are my final results for which I’m having treatment (you may wish to read my initial diagnosis and my proposed treatment plan for a ‘little’ more background info):

  • Subclinical hypothyroidism
  • Endometritis – inflammation of the womb discovered during hysteroscopy, linked to hidden infection (see my initial diagnosis)
  • Scar tissue – discovered and removed during hysteroscopy
  • PAI-1 gene mutation – on its own this presents a clotting risk and when paired with my MTHFR (C677T – heterozygous) mutation the risk increases

I had also been diagnosed with immune issues (elevated NK cells and raised cytokine levels) last year, which I’ve since reversed, meaning I no longer need immunotherapy. This has come as a huge relief because I instinctively felt the treatment wasn’t right for me. I can appreciate that it’s helped some women conceive and carry babies to term but I had also read about others no longer needing it after making lifestyle changes or addressing other issues. I also have fewer PCOS symptoms, which I feel has been supported by Chinese medicine, something I was sceptical about, but which has helped me in many ways, and so I plan to write about my experience of it.

Six months ago sperm DNA fragmentation was also a factor and Jonathan’s results showed that there was 29% damage. The advice given to us at the time was that this ideally needed to be below 15%, though it’s possible to avoid ICSI IVF (previously recommended to us by two private clinics) if the damage is below 25%. This was a concern for us as finances aside, I had more or less decided that IVF wasn’t an option for me, not at this time anyway. It’s a completely new avenue, with its own emotional and physical demands, and I feel I’ve just about reached my limit with secondary infertility and recurrent loss while trying to conceive naturally.

The good news is that, with a protocol of antibiotics, as well as dietary and lifestyle changes, Jonathan reduced the damage to 8%. I’m still amazed and the challenge now is of course to maintain that result. Going forward, he’ll continue with his male prenatal and 200mg of ubiquinol each day. He recently stopped taking omega 3 supplements as we now get enough from our diet, but otherwise, it’s just a matter of keeping up with eating well and exercising regularly. And I think it’s really important to highlight here the benefits to us as a family of improving our health. We were never unhealthy, but we’ve made some significant lifestyle changes, which have become new habits. To me, those are things we need to hold onto, no matter what the future brings.

Treatment plan

To support my final diagnosis, this is my agreed treatment plan:

  • Continue with thyroxine before and during pregnancy and regularly monitor Thyroid Stimulating Hormone (TSH) levels
  • Take antibiotics to treat endometritis (10-day course completed following hysteroscopy)
  • Take serrapeptase for two months following hysteroscopy to help break down remaining scar tissue
  • Start antibiotics (15-day course) from positive pregnancy test to address potential inflammation issues, which can be caused by endometritis and hidden infection
  • Start prednisolone from positive pregnancy test to address potential inflammation and immune issues
  • Start aspirin from a positive pregnancy test to address clotting risk
  • Start heparin injections after 4/5 week scan to address clotting risk

Previously, it had been suggested that progesterone might be of benefit, however, I’m a big believer in getting proof of the need for any kind of treatment, so I had a progesterone test done last week. My levels are high and the length of my luteal phase has improved, as has my cycle in general, so this won’t form part of my plan.

What’s next for us?

While we’ve been encouraged to try again from a medical perspective, emotionally it’s just not the right time. We’ve had two very trying summers, experiencing losses and coping with due dates and anniversaries, so plan to stick to our plans for a guaranteed summer of fun. I really want us to connect again as a family and enjoy what we have.

We’ll continue working on our health and nutritional needs, and I’ll be keeping up with the Chinese medicine and reflexology to support my cycle, something I’ll touch on in a series of blog posts covering each part of my diagnosis. I feel I can confidently share the support I’ve been getting now that I have a clearer idea of where I’ve been, where I am and where I’m going.

Meanwhile, I’m enjoying finding time for me and a little self-care.

Love,
Sarah x

Fertility treatment Our story

My proposed treatment plan

March 15, 2018

In recovering from our losses and since my initial diagnosis, we’ve had a lot to juggle and consider.

Many women have undergone treatment for immune and clotting factors, and couples have addressed the various health issues my partner and I are tackling, but it still feels like we have a steep mountain to climb before we can consider another pregnancy.

And so the next step, after our visit to a private clinic in Athens (and assuming we get the all clear!) will be for me to follow my NHS treatment plan to treat subclinical hypothyroidism and clotting issues:

  • Continue with thyroxine before and during pregnancy and regularly monitor Thyroid Stimulating Hormone (TSH) levels
  • Take aspirin from positive pregnancy test (this will be a long way away with no plans to try again in the near future)
  • Start heparin injections after 4/5 week scan to detect the location of the pregnancy

My private treatment plan is more aggressive and involves addressing immune issues and support for the hidden infection that was found in my womb. It’s a plan I’m exploring in more detail before fully committing to it:

  • Intravenous immunoglobulin from ovulation
  • Progesterone from a positive pregnancy test
  • Steroids from a positive pregnancy test
  • Antibiotics during the first trimester

While I appreciate that many successful pregnancies have resulted from a protocol like this, I’m conscious that it’s a lot of medication. Together with my PCOS symptoms and thyroid issues, it’s been hard for me to get my head around.

I also have my daughter to consider. She is the centre of our world and although we want to grow our family she must come first. I have to be in the right frame of mind to embark on treatment while being the best mother I can be to Cora, and that means accepting that plans for a future pregnancy might need to be put on hold.

I have to be in the right frame of mind to embark on treatment while being the best mother I can be to Cora

We made the recent decision to give ourselves at least another 6 months to prepare and ensure we’re in the best health, both physically and mentally, and in that time we want to have a fantastic spring and summer with our girl. We have the opportunity to work abroad in August and holiday with family in September and we had initially disregarded the idea because “what if I’m pregnant?” But we can’t put our lives on hold and say no to new experiences and opportunities to create memories.

There’s a lot we can do in the meantime to continue on our fertility journey; April will be a busy month with travel and digesting more test results, May will no doubt be taken up with adjusting plans and supplements, and June, July and August will be hard for us with our son’s birthdays and other babies’ due dates. There will also be a lot of time dedicated to talk therapy and mentally preparing myself for the next steps.

June, July and August will be hard for us with our son’s birthdays and other babies’ due dates

While we work out the finer details, we’re going to keep being kind to ourselves, and put our trust in those who are helping us; our fantastic GP, friendly practice nurse, NHS fertility clinic and our private clinic. Not to mention the Chinese medicine fertility expert I’m working with over the coming months. Chinese medicine is something that’s very new to me and it’s exciting in some ways. So more on that later as I found my diagnosis interesting and would love to share it with you soon.

Hopefully, some of this has been helpful. And I’d welcome any comments or questions or suggestions for areas you’d like me to expand on.

Love,
Sarah x