Meet Ms.Nasty

I finally managed to get a picture of my ultrasound, starring my big fat adenomyosis-slash-fibroid growth, whom I named Ms.Nasty.

During my last period, she measured in at a whopping 4.8cm ~ about the size of a plum. Dr.NeverGiveUp thinks it is a mixture of blood vessels and muscle tissue. He doesn't recommend surgery because it is not possible to do it without cutting away and damaging the uterine wall. I think he might be right because another patient who has the same growth as me in the same spot had all her other fibroids surgically removed except this one. And even if I did have surgery, it does not address the other adeno spots around my ute which cannot be removed. The only known "cure" for adeno today is a hysterectomy. So it looks like I have to live with Ms.Nasty. Ugh!

Here she is seen from the front. She sits in the centre at the bottom of my ute, bulging into the uterine cavity like a movie star desperate for attention.

Here is a side view of her resting against the back wall of my uterus towards the rectum (right of the image) in a spot commonly known as the Pouch of Douglas or Douglas Cul-De-Sac.  (I'm almost expecting to see a few houses there!) Now I am sure my Ass-Throb days are caused by Ms.Nasty throwing a tantrum every now and then!  

I asked Dr.NeverGiveUp if she could be nasty enough to stop hub's sperm from getting through (I'm thinking road block here). But he thinks it won't be an issue because sperm is very small  and they can get past Ms.Nasty fine. Well, I'm still concerned because hub's sperm aren't exactly olympian swimmers and you'd think they'd be so pooped after swimming over that gigantic mountain that they'd be too exhausted to swim any further, let alone find the right tube where eggy is before the time is up! Well, the only hope is that the chinese meds he's giving my husband will actually help them become super sperm!

As for pregnancy, the biggest issue for me is where implantation happens. If the fertilized egg implants on the upper region of the uterine cavity, as far away as possible from Ms.Nasty, then I have a shot! Unfortunately, not even IVF can help with this. IVF cannot determine where implantation occurs. I always thought I could do IVF as a last resort. But no. IVF cannot help my cause. 

Sadly, western medicine offers me little or nothing at all in my quest to have a baby. Neither surgery nor IVF is going to help. Traditional Chinese Medicine is the only way for me. I have no choice. 

Maybe it's why I've always believed in my heart that I will have a baby au natural. If and when I have my baby, it's going to be nothing less than a Miracle Baby!

Hope

I've had the worst diagnosis I've heard in years about my infertility at my new clinic. And the news keeps getting worse. 

I have an enlarged and deformed uterus. WTF? During my last ultrasound scan, Dr.NeverGiveUp and his wife, Dr.DontWorry were poring over my u/s image and speaking busily amongst themselves. They were paying close attention to it and making notes in a way that I've never seen them do. I couldn't understand them as they were speaking in chinese but I knew from their body language that they were really concerned. After wiping myself down, I sat down and probed them about what they saw. 


Here's the bad news:

They said that my uterus is large and inflated like a round ball. A normal uterus is about 7.5 x 5 x 2.5 cm (length x width x thickness) . Mine is 9 x 8.5 x 7.5 cm! The endo and adeno has grown so extensively that my ute has swelled up like a ball. Is that why I look perpetually pregnant? Oh the irony! It is so distorted that the cervix has shifted to the left. The fibroid-looking mass is at the base growing from the back wall and extends into the cavity of the uterus, possibly exerting pressure on my rectum too. That probably explains my "ass-throb" days! He thinks it might not be a fibroid but more like an adenomyoma with tissue and blood inside, but he said I could call it a fbroid (?). I'm guessing he can't make a conclusive report from an ultrasound because the only definitive diagnosis for adeno is a microscopic biopsy after hysterectomy, which, hell yeah I'm gonna have!  He says surgery is not an option for me as that meant cutting into the uterus extensively. I don't think much of my uterus would be left behind after that. A patient of his, by some strange coincidence, has a uterus almost identical to mine, with the same size, shape, distortion, fibroid mass in the same location, and shifted cervix. Her doctor told her she could never have children...

According to Dr.NeverGiveUp, a uterus as bad as mine would have been in the making for many, many years. I am upset that within the last 2 years, two different gynaecologists who scanned me before and after my miscarriage failed to tell me that my uterus was abnormal. They only mentioned that it was retroverted and it was clear of cysts. Dr.NeverGiveUp explained that it was common for doctors not to say anything if the condition can't be helped or if it isn't life threatening. So what are your doctors NOT telling you? At least now I know that TCM doc's treatments over the past year did not do this to me. Considering the extent of my problem, any lack of progress from his treatments is totally understandable!

But here's the good news:

The patient with the identical abnormal ute is now pregnant (WOW!), 6 months after Dr.NeverGiveUp's treatments. I have hope! She is at 14 weeks and they are monitoring her closely. Dr.NeverGiveUp so kindly showed me her ultrasound and I could see her little baby in a sac sitting above and away from the fibroid. I am so rooting for her! He has said to me before that our bodies have an amazing ability to adapt. That there are many, many places and spots in the womb where an egg will find to implant itself. If it implants on a good spot, then it could survive. So even with his treatments, "It's all a game of chance right?" I asked. "Yes" he replied with a matter of fact. "And up to God". Hmmm, haven't I heard that somewhere before? Well, I do appreciate his honesty. There are risks and complications for these types of pregnancies but he believes that if the egg and sperm quality are good to begin with, the embryo has a good fighting chance for survival. And he firmly believes that my inability to conceive is largely because of my hormone imbalance-not the endo or the fibroid/adeno.

Thinking back, it is such a miracle that I managed to get pregnant last year with this busted uterus! And plausible that I couldn't sustain it because my hormonal levels were not right or that the egg/sperm quality were not good to begin with. Hmmm... All of Dr.NeverGiveUp's theories might just be right! But he says that I have a tough road ahead  (don't you just love his honesty?) and that I should expect to be treated for a year. He says there's no way to predict how long it would take for me to conceive. A woman with worse adeno than me conceived after 9 months. Some who couldn't conceive for 6 years conceived within 2 months after his treatments. The longest patient he had was treated for 2 years before she conceived at age 42. The bottom line is, I should not give up. He said that nobody should tell me that I can never have a baby. I love this guy! 

I was devastated when I learned how bad my condition was. I cried my heart out at the impossibility of having a baby with the challenges we have. But I've picked myself off the floor now and wiped away my tears.


I have hope.

And I have Dr.NeverGiveUp's help.


It might take me at least 9 months or more than a year to conceive. But I am going to make everyday count. Now I have time to work off the weight I always wanted to lose before a pregnancy. I have time to work up my fitness level so that I can be a fit mom. I have time to eat right and get healthy so that I will have a healthy pregnancy.
  
Yes, I'm going to make everyday that I am waiting count. 

My Third And Newest TCM Doctor

Having started treatments at a new fertility clinic recently, I'm officially in a new chapter of my TTC drama now. I've been to the clinic 3 times to date, and even though all they've given me were mainly bad news, they're NOT GIVING UP ON ME. I am so happy and grateful!

Meet my brand new TCM doc ~ Dr.NeverGiveUp!

• He speaks English. (Clouds in the heavens are parting...Aaaaa-lleluia! Alleluia! Alleluia!)
• He is trained in both western and chinese medicine and is the only doctor here that integrates both to treat infertility. (Just what I wanted! Woohoo!)
• He is an acupuncturist too. (Nice to know he got skillz)
• Has a Ph. D specializing in fertility. (He must know his stuff!)
• He also lectures and has been invited by a university to set up the first department to teach integrated medicine for infertility in the country. (He must really, really know his stuff)
• He's quite patient with my 1 million and 1 questions. (I like doctors who explain)
• He is honest. (He does not sugarcoat things and is realistic) 
• He told me to never give up because humans are meant to reproduce. (That's the spirit I need in my doc)
• He believes that our bodies have an amazing ability to rejuvenate itself and adapt (He gives me the hope I need)

I think he really is the answer to my prayer! I am shocked that god heard me. And answered. Infact he gave me two doctors.

Meet the wife and assistant of Dr.NeverGiveUp ~ Dr.Don'tWorry!

• She speaks English too. (Alleluia chorus-Round 2! )
• She is a chinese medicine doctor and acupuncturist. (Nice to have a second opinion)
• She's sweet and kind. (When I came in with cramps and waited torturously for my turn, she told me that I could jump the queue next time and not have to endure the wait if I was in pain!)
• She keeps telling me not to worry and just be happy. (I'm sure it's hormone-related advice ie, less stress, better hormones)

Having been with a very traditional doctor in TCM the last year and half (with "TCM doc"), I am not used to the ways of this clinic yet.

- I am required to submit my BBT which has to be taken precisely at a time I choose between 5-8 a.m. with at least 5 hours sleep prior. I must use the digital thermometer supplied and record, (in Celsius-I'm used to Farenheit), the temps in a notebook which they will check and draw a graph from. Wow! I am not used to having someone scrutinize my BBTs like that! 

- They will occasionally take my blood to test my hormones. It was never this scientific with my previous TCM doc. I like seeing proof. And Dr.NeverGiveUp is a pro at taking blood! My veins are notoriously hard to find-I've been probed and jabbed all over my arms and even the back of my hands with needles just to find blood. He found a vein on his first try! He's my hero!

- They will give me an ultrasound scan every time I go in for my weekly appointment to monitor my uterus and follicles. For this, I am required to drink 1.5 L (6.5 cups) of water and hold it before I visit the clinic. And they won't scan me till I'm bursting to go to the toilet! Wooo-peee! They charge me $50 for each scan but I only have to pay for 7 scans. After that it will all be free, even if I remain there for years or if I come back for treatments for a second or third child! I think that's awesome! 

- They will tell us when to have sex. No kidding. We are scheduled to have sex on the 12th of May! He wrote that on my BBT notebook! Precision timed sex seems to be a big part of his "treatment".

- I am required to take lots of herbal pills. Did I say pills? Yes!!! I did! Pills! No more gluggy, black, nasty, evil tasting herbal potions to brew and drink! It's so convenient and it frees up so much of my time. It's amazing how much more relaxing it is with this pill regiment! I don't have to constantly check on boiling herbs, or worry about burning my pot and setting off the fire alarm anymore! 

- I won't be having acupuncture. Dr.NeverGiveUp told me that he rarely prescribes acupuncture these days. He says that in his experience, acupuncture isn't very effective for infertility. That herbal medicine does the job better. I'm not sure I agree with him, but... What? No more being pricked all over like a voodoo doll? Shocking!

This method of treatment is indeed new to me but I hope this journey will be a fruitful one for me. I am not discounting my previous treatment with TCM doc nor discrediting his work. Infact I believe that I have less pain now because of him. My periods are shorter and I don't lose crazy amounts of blood anymore. The last time AF came, there was less pain, hardly any clots, and lasted only 7 days. And I did get pregnant for the first time in my life while under his care. But I am still not well. I am far from it. I think he's taken me as far as he could. And now I need someone else to take me further along towards my goal of having a baby. 

 Is Dr.NeverGiveUp my next stepping stone towards that goal? 

I hope and pray he is.

"Bloody" Bad News

My hormonal bloodwork came back. It's bad news as I had expected.

My hormone levels are crap.

And one thing that freaked me out was when my results for CA-125 (Cancer Antigen 125) indicated cancer in the ovaries! Fuck right? Then I found out that it wasn't a reliable way to screen for cancer and that elevated levels are also present in women who have endometriosis, pelvic inflammatory disorders, fibroids or women who are menstruating or are pregnant. Stress kills fertility. Yup! Mine just about died there and then when I saw my CA-125 results! 

Anyway, for those of you who love, love, love numbers, here are some of my bloodwork stats based on mid-luteal phase parameters:

- My progesterone level is low @ 8.13 (should be 7.96-23.37)

- My estradiol is ok according to the doctor even though it looks high to me @245 (should be 90-220) 

- My testosterone levels are a bit high @ 0.86 (should be 0.14-0.76)

- My FSH is at 2.7

- My CA-125 is @63.8 (should be <35)

I have a tonne of questions about my blood test for my doctor because I wasn't quite lucid when I got the results. My brain had shut down due to the period cramps I was having then. As I had expected, all my icy cold coke indulgence the weeks before came back to haunt me. (Docs told me to avoid icy drinks for my condition) Well, it was really fun while it lasted.  So, it was CD1 and my cramps were increasing in intensity as I waited for my turn in the clinic. My torture was exacerbated by the 1.5 L (about 50 fl oz or 6.5 cups) of water I had to drink and hold in my very full bladder, required for the ultrasound scan. Oh yeah-more bad news: my fibroid looks to be about 4.8cm (almost 2") now as opposed to 3cm last week. The doctor also said my tests indicate poor egg quality.

Sigh! When will this bad-news-avalanche ever come to a stop? 

So what are the chances of a couple with
-endometriosis
-adenomyosis
-fibroids
-imbalanced hormones
-infrequent ovulation
-poor quality eggs
-low sperm count
-low sperm morphology
-low sperm motility
-mature age factor


have for getting pregnant? That's a freakin' long list of problems!

Our chances sound pretty damn awful don't it?

According to what I've read, here are more stats for those who, again, love, love, love numbers:

- fibroids that distort the shape of the uterus decrease fertility by 70%

- endometriosis decreases fertility by up to 36% 

- by age 40, fertility rates drop by 95%

I don't even have stats on the impact of adenomyosis, or hormonal imbalance or sperm issues on fertility (I'm assuming it's not 0%) but let's tally up the numbers I already have:

100% fertility-70%-36%-95% = -101%

I'm no math genius, but that is a MINUS fertility rate. MINUS 101%! My chances are freakin' awful. I am sure there is at least one doctor out there who will tell me that I have absolutely no chance of getting pregnant...  Thankfully, my new fertility doctors have not said that to me (I have 2-it's a husband and wife team). They told me not to give up hope, but it was going to be tough for me. 

It's going to be really tough.

---------

On a side note: It's CD4 today. I went to the gym today. This is unheard of as I am usually still in agony locked in my room from endo/period pain on Day 4. I did have cramps on CD1 and 2, but the intensity and duration is half of what it normally is. I have not stained my panties or bed with overflow (not once!) this time which means my flow is normal and manageable now. The clinic did give me some herbal medicine for my cramps. It's the first time any herbal formula has worked for my pain, which to me is remarkable! When I took them, my pain was greatly reduced to just an annoying ache within 2 hours. Amazing-this is all plant stuff! The doctor was not kidding when she said the pills were "really, really good for cramps". If this is any indication of how good these TCM docs and their herbal medicine are, then, a spark of hope has finally been rekindled in my heart...

Broken

This week is Infertility Awareness Week (USA).

And what an apt time it is for me to find out that I am even more infertile than I thought I was.

Yes, I have heartbreaking news about my latest diagnosis. An ultrasound at my new fertility clinic revealed that I not only have endometriosis (endometrial growth outside the uterus that causes adhesions, inflamation and scarring) which I already knew I had. But now I also have adenomyosis (endometriosis that occurs inside the uterus) and a 3cm fibroid in my uterus.

In simple English, my uterus is really fucked up! It is full of abnormal growths which are distorting its shape and decreases my fertility by 70%. My uterus is retroverted. The growths also make it difficult for an embryo to find a suitable spot to implant. The fibroid could also be blocking the passage of DH's sperm to my egg. This may not be the end of my bad news, as I am still waiting for my hormonal bloodwork to come back.

I am devastated. I've been depressed the whole week. My eyes are the size of tennis balls from all that crying. We have such an uphill struggle.


My body is broken.



My heart, is broken.

Divine Intervention or Dr.Google?

Do you think god sometimes answers your prayers...just a little?

Well, he didn't answer my prayers about ovulating--maybe because I didn't specifically say to him,

"God, please, please, please make my ovary lay me an egg..."

But he might have responded to my other "prayer": If you remember my mini meltdown a few days ago..., well, I decided to see my TCM doc the next day to get some answers about why my cycles were getting worse. He said he had no idea why because all my tcm vital signs told him I was doing rather well. Needless to say, I was frickin' disappointed and annoyed with his answer. My TCM doc's good (I did get pregnant within 3 months of being under his care) but he is not a fertility specialist. While I was laying on the clinic bed with a million needles stuck into my belly, I cried out in exasperation,


"God, Help Me!" (Not out loud, but in my head. The new needle-virgin patients waiting for their turn might appreciate that).

The next day, Saturday, I spent most of my time surfing the internet for answers. Most of my searches led me to fertility acupuncturists that were not even anywhere within a thousand miles from where I lived. Yet they were exactly what I wanted and needed. I was so desperate I fantasized about moving across oceans to be near them. After what seemed like an eternity drifting through cyberspace in desperation, I FOUND ONE! And he practically operates out of my own backyard. OK, I exaggerate, but his clinic is in my neck of the woods. The acupuncturist specializes in infertility and claims to use both Chinese and Western Medicine to diagnose infertility (they include hormonal bloodwork and ultrasound scans to monitor your follicles for ovulation) but use traditional chinese medicine to treat IF. This was exactly what I was looking for! I mean, yes, I still have delusions that at 39-going-on-40, I, endo girl with poor sperm DH, will get pregnant and have a baby without resorting to ART!

...
...
...

Okay, you can stop laughing now... Of course I still have a back-up plan--I will still talk to a fertility specialist about doing ART.

We plan to see this new fertility acupuncturist tomorrow. Maybe I just got lucky with Dr.Google. Or maybe God heard me and decided to give me a helping hand. So this is my new prayer to God:

"Oh God, please, please, please let him speak English.
May his english vocab extend beyond the words "Hello" and "We accept credit cards".
And please, please, please don't let his needles hurt.
May my acupuncture sessions with him be devoid of any screaming.
That's right God, please don't let him be a Dr.Yeeeoch v 2.0!

And please, please, please God, may I have a baby real soon!"

Mid-Cycle Meltdown

I have a severe case of Infertility Psychosis.

Yesterday, my heart dropped and a pang of jealousy shot through it when I learned that a critically endangered sumatran rhino, recently photographed in the wild, is believed to be pregnant. This is unbelievable! I am jealous over a pregnant rhinocerous!

Today wasn't any better. I had a mini meltdown over a negative OPK.

And a negative saliva ferning test.

And negative egg-white CM - As in it's so dry, my lady parts has tumbleweeds blowing by and desert dunes have crept in.

I am 25 days into my cycle and still have not ovulated. If my previous cycle and the present one are anything to go by, it means I am heading into longer cycles. My fertility is going from bad to worse. I am just so devastated by the way things are going inside my frickin' body.

Now I have two meltdowns during a cycle instead of one big one: Once when the red tsunami hits, and once in mid-cycle when my eggs are a no-show day after day. And so the tears flowed today. They flowed in the bedroom. They flowed in the kitchen, while I was preparing my frickin' fertility herbs. Then it flowed again in the bedroom. I cancelled my appointment to see TCM doc. I won't be able to face another session of empty promises from him.

And the irony is, my body has never felt better or stronger. I haven't had any issues with endo pain this month. My lower back/kidney yang pain is gone. My body feels warmer. My libido came back from the dead, albeit briefly. My egg-white CM did make a stellar appearance a few days ago, though it's vanished now. So why is my infertility getting worse?  Did my in-laws kill my fertility this cycle? Have I got a crap doctor? I am now a broken, mad, raging infertile looking for someone other than myself to blame!

But miraculous and fortunate things happen to infertile women every where. And we try to draw hope and strength from them. Hmph! The sad truth is that the world promises us good things but sometimes, all it does is just rain... and rain... and rain...

(This photo I made in Beijing, China, of a woman walking by a happy billboard in the rain pretty much sums it up)

Oh! I want a baby so badly! And just to think--somewhere in the world right now, some teenager, or a young wife, or a jilted lover or a super career woman is rejoicing and falling to the floor with relief, and thanking god and their lucky stars that their pregnancy test is superbly negative! 

Yes, someone in the world is shouting with a delirious smile on their face, "I AM NOT PREGNANT! YIPPEE!"