Our (In)Fertility Journey - Part Three

Read Part One here.
Read Part Two here.

After the appointment, I felt defeated. Removing my Fallopian tubes was such a permanent decision, but it was our only option if we wanted to have children. A few weeks after the appointment, I had a CF clinic appointment and brought all of this up to my CF doctor. Surprisingly, she was not on board. She did not want me to go through surgery because she wanted me to get a second opinion. She thought the surgery was too drastic of a measure and that we could do IVF without having to remove my tubes. She was seeing the CF side of things and my fertility doctor was seeing the "getting me pregnant" side of things.
I was stuck between a rock and a hard place. I deeply respect my CF doctor and everything she has to say, and I've never gone against her advice before, but I just knew I had to go through with the surgery. It was very hard for me for a couple weeks, deciding if I was going to go through with it, but I finally called my CF doctor and told her it was something I had to do. She supported me and apologized for sounding so against it, and she understood why I wanted to go through with it.

On a Thursday in late February, Tim and I headed out to the hospital to have my tubes removed. Here's what I wrote about the surgery the day after:
"Overall, things went well. We arrived at the hospital at 12:30pm expecting the surgery to start around 2:30. Well of course it didn't go according to plan – I was taken in the operating room around 3:45 and the surgery began around 4:30. All I remember is going into the operating room, switching myself onto the operating bed and the anesthesiologist telling me not to be nervous and that I'll be in good hands. Next thing I remember is waking up in the recovery room around 7-7:15pm with a mask on my face giving me some albuterol. They let me go as soon as I was able to get up and walk to the bathroom. I had to prove that I could urinate (to make sure nothing got messed up down there) and then they let me get dressed and leave. We didn't get home until almost 11pm because the roads were terrible due to the snow and ice storm we got while we were at the hospital.

My fertility doctor was the one who performed the surgery and talked to my husband, Tim, after the surgery was over. He told Tim that I only had one tube removed! Apparently both of my tubes were surrounded by a significant amount of scar tissue (I'm assuming from my meconium surgery at birth). They removed the scar tissue on my right side and my right tube because it was so dilated and bad. They removed the scar tissue from my left side and around the tube and realized that my left tube is perfectly fine – no mucus or fluid in it! Yay! Due to the amount of scar tissue, I had to have 4 incisions, but they're pretty small.

The doctor also told my husband that we aren't going to go straight to IVF. My husband said he wants to put me on "drugs" and let us try to get pregnant naturally! I was VERY surprised and excited to hear this!!! Going into the surgery, I thought when I came out there was no chance of us getting pregnant naturally anymore! I don't know if this means Clomid or IUI, but our post-op appointment is next week, Thursday morning, so we'll be able to discuss everything then – I'm really looking forward to that.
Finally, my lungs are doing pretty well. I haven't tried my Vest yet, but I did do an albuterol treatment this morning to help open and loosen things up. I am able to cough and spit, but it's a little painful, mostly for the incision right at my belly button. I've also only been taking ibuprofen for the pain. They wrote me a prescription for Zofran (or something), but I haven't had it filled yet – I don't think it's necessary. 
Long story short, no IVF right away! I still have one Fallopian tube! And now I'm recovering at home and I'm not as uncomfortable as I thought I would be. Overall, I'd say it was a successful surgery!"

The next week, I had a follow-up appointment with the fertility doctor to check my incisions and discuss the next steps. It worked out perfectly that right after the surgery, I got my period, so I was at the beginning of a brand new cycle to start treatment. We decided to try six months of Fermara (which is just like Clomid, but since I didn't respond to it before, he wanted to try something different) with timed intercourse. Then if it didn't work within six months, we'd go to Fermara with IUI.

Of course I was super hopeful that the first round would work and was heartbroken when it didn't, but the doctor and nurse both told us it'll take a few rounds to get everything right. Since I was only doing each round with one working Fallopian tube on my left side, if my mature follicle was on the right that month, there was a very, very slim chance it would work at all because there was no way the follicle could get to the right spot without a tube to transport it. So each month I would take Fermara on days 5-9 of my cycle, then I'd go in for internal ultrasounds around day 12 and every few days after to make sure my follicles were growing and to see which side they were on. Once my follicle(s) were large/mature enough, I would give myself a shot of Ovadril to make myself ovulate. Then we'd do what we had to do and wait two weeks to see if it worked. We did this for four months, March - June, with no success. It was very emotionally tolling for me because each month I'd get my hopes up and each month I kept getting negative tests. There was even a month where I produced three mature follicles and nothing happened - that was frustrating! So after many discussions with Tim, we decided to try our July cycle with Fermara, Ovadril and an IUI.

Our (In)Fertility Journey - Part Two

To read "Part One" please click here.

After getting settled into our new rental house, setting up my classroom, and starting a brand new job teaching Kindergarten, you'd think the last thing on my mind would be getting pregnant - of course not! It's something I've always wanted and I knew it wasn't going to happen without help. I learned that one of my teacher partners was currently going through fertility treatments and decided to confide in her everything that we had gone through and asked where she was getting her fertility help from. She referred us to a wonderful clinic about 45 minutes from our new town. In late October 2012, I had my first consultation with the head nurse at the clinic.

The consultation went very well, in my opinion. I explained everything that we had been through with the genetic counselor, and the Clomid and she wanted to take a step back, dig deeper, and figure out why I wasn't getting pregnant before just putting me on some hormones. Good idea! I already liked this clinic better! And, when I asked if they had experience with CF and pregnancy, she told me she had a woman with CF in the previous day who was working towards her second pregnancy - awesome! :-) So over the next couple months I had several tests done including lots of blood work and a procedure called an HSG, and Tim had to get a semen analysis done - just to make sure he wasn't the problem. During my HSG, they inserted dye into my uterus and through my Fallopian tubes to make sure that they weren't blocked or obstructed in any way. They took x-rays the whole time to watch the dye to make sure it flowed through my tubes properly. The procedure itself wasn't too terrible, just some mild cramping during. After the procedure (which was done by an extremely pregnant doctor...of course), the doctor told me that she noticed some slight dilating in my tubes, but otherwise everything looked fine. She didn't go into detail about what that meant, so I was under the impression that this "dilating" wasn't going to be a problem...

At the end of December, a couple days before Christmas, we finally met with the fertility doctor who went over the results of all of the testing we had done over the past couple months. Tim's semen sample was pretty good, some of his sperm were not fully mature, but he said he had a big enough sample of ones that were, that he wasn't too concerned. He referred Tim to a male reproductive specialist who didn't give him too much information. Tim ended up researching online how to make his sample better, and started taking some vitamins. When he had a repeat test done a couple months later, his sample was completely normal. :) If only my issues were solved with a few extra vitamins...

The fertility doctor then explained that my hormone levels looked normal, but my tubes did not. He said that they were filled with an "embryo-toxic fluid" called hydrosalpinx which is harmful to my follicles and any embryo that tried to implant in my uterus. He said it would be best if we just "took them out". And I think that I was in such shock from trying to absorb all of this that I misunderstood what he said and thought he meant we had to take out my whole female reproductive system! I started crying while he was talking because I though "this is it, I'm never going to be able to have kids. They just have to rip everything out of me." That was not the case. He re-explained it to me, assuring me that we could still get pregnant even if I didn't have Fallopian tubes, we just couldn't do it naturally - it'd have to be through IVF.

The job of the Fallopian tubes is to bring the mature follicle to the uterus to wait for sperm to fertilize it. Without Fallopian tubes, there's no way the mature follicle could get to the uterus which meant there would be no way to naturally get pregnant. The IVF would help me produce mature follicles, then they would have to surgically be removed from my ovaries, Tim would give a semen sample, and our egg & sperm would be fertilized in a lab, and once it was mature enough, it would be inserted (through a catheter) back into my uterus to hopefully implant itself.

The plan was to have a laparoscopic surgery, which would be minimally invasive with two or three tiny incisions, to remove my Fallopian tubes. Once we decided to do the surgery though, there was obviously no going back - we would have to get pregnant through IVF. We left the appointment with a lot of information to digest and a surgery scheduled for the end of February to remove my tubes.