journey to motherhood (part 2)

After a year of seeing a midwife on and off for basic labs and period support, I decided to take a little break from seeing providers for infertility. It starts to wear on you a little… or maybe a lot. Seeing providers and not really getting any answers or seeing much change in your health status. 

I started working with a wonderful health coach during this break from medical providers. Really just focusing on creating a life that feels very aligned for me and reducing stressors in my daily life. It ended up being very impactful for me- feeling like the progress I was making would ultimately better prepare me for motherhood, without feeling like I was focusing on my fertility directly.

After several months, I felt ready to consider a more medical-based approach. I researched several providers in the Portland and Seattle area to see which would work best for me. Turns out, there’s a decent wait time for many of the major providers. Summer of 2022 I ended up working with Pacific Northwest Fertility in Seattle, which felt like a good fit overall.

We had an initial video consultation to review the things I have done so far to support my overall fertility and planned out my first in person appointment. Appointments are scheduled by where you are at in your cycle… So it’s not something I could necessarily plan for ahead of time. I am grateful I had the flexibility with my job at the time to take the last minute time off for the appointments!

I think the first in person appointment was on day 4 or 5 of my cycle. They drew labs and did an intravaginal ultrasound to look for any abnormalities in my uterus, fallopian tubes, and ovaries, and count the number of follicles in my ovaries. The ultrasound results looked normal, which was a relief. 

My lab results also came back normal overall with the exception of my anti-mullerian hormone (AMH) levels being a little low for my age. Here’s the thing, AMH is very controversial in terms of accurately assessing a woman’s fertility. AMH is used as an indicator of egg count or ovarian reserve at the time of testing. This number can vary each cycle depending on a number of factors. I got a little hung up on this when they first shared my results with me, but looking at several research studies, it’s not the most reliable test for evaluating fertility and should not be used to determine overall fertility.

I experience a lot of anxiety at the thought of invasive procedures… let alone *having* invasive procedures.

Shortly after my ultrasound procedure (cycle day 10 maybe?) I went in for a hysterosalpingography (HSG) procedure. I was really anxious about this for a few reasons: my husband couldn’t be present for any part of the process, the radiation from x-rays doesn’t seem like a great thing to put right over my uterus (or anywhere on my body), and the potential pain during the procedure.

The procedure involved placing a catheter through the cervix and injecting contrast dye into the uterus. The X-ray then captures the flow of the fluid to determine if it freely flows through the fallopian tubes, or if there are blockages in the tubes.

A blockage would be problematic for fertility purposes, as this could prevent the egg or sperm from traveling through the fallopian tubes, or could lead to ectopic pregnancy.

The results of the procedure are immediate. The providers can tell you exactly what’s happening because they are capturing the images live. In my case, the fluid was able to flow freely, meaning there were no issues with blockages.

As for the pain during the procedure, I think each person will experience it differently. Having an object pass through your cervix is definitely not comfortable, and the fluid caused a little bloating after the procedure. That said, I was able to tune into my breath and focus my attention on breathing through the process.

I really debated heavily on if I wanted to have this procedure done based on my personal values and approach to health. I ultimately decided it was worth it so I could at least rule this out as an issue.

This HSG procedure concluded my testing with the fertility clinic in Seattle. The outcome was “we can’t really do anything for you” and “you’re still young, so just keep trying”. 

Ultimately, the outcomes of these tests were optimistic… but good/normal test outcomes can feel defeating and conflicting when you know your body isn’t functioning optimally. 

Over the next year, I decided to take another break to continue focusing on reducing stress in my life, create rhythms that better support my mind and body, and to continue to improve my endometriosis symptoms. 

Xo

Kayla