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.
- 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.
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.