Never had I questioned my ability or chances of carrying my own child. Until yesterday.
I arrived at Dr. E’s clinic early. Pulling into that parking lot and looking at the entrance to the building, I could not believe I was back there again after leaving her practice over two years ago. After failing one own egg transfers and two donor egg transfers at my current clinic, disappointing that I am back at her doorstep is an understatement.
Everything looked the same. The staff was the same. Arriving early, Dr. E was already waiting for me in her office early. She looked the same too. Although she was sitting behind the desk, I could see her scrubs wrapping snuggly around her belly area. I was quite sure she was expecting her fourth child. It was funny because Bob joked about her being pregnant when I go to see her, and he was right.
I told her what happened two weeks ago at my lining check, that the lining could not be visualized clearly and my U.CSF RE suggested removal of the big fibroid(s) that I had. I could see the familiar concerned look on her face. I know that look. I had seen it before whenever we had bad news. After listening to me, she said, “Let’s go do an ultrasound.”
Lying on the same table that I frequented two years ago, I somehow became a little emotional. Dr. E quickly checked my lining and measured the mass on my uterus. She was done in two minutes. Then she invited me back to her office to talk.
What we discussed about in the next hour made my head spin. From the ultrasound of my uterus, she thinks that I have a condition called adenomyosis. She had mentioned about it before. This is something that you can’t definitely diagnose until you do an MRI, a laparoscopic surgery or a hysterectomy. But there are signs that you can see. She showed me the ultrasound images. She compared them to photos of plain old fibroids. My images had these circular patterns that the other photos didn’t have. My uterus looked enlarged. Fibroids would have better defined round shapes but mine didn’t. All in all, from her experience, she thinks that I have severe adenomyosis. And with that, she is very very concerned about my ability to carry a baby to term. Severe adenomyosis is associated with higher rate of miscarriages, placenta detachment, placenta previa, or other complications. She thinks that cutting into the uterus with this condition could lead to a hysterectomy. She wanted to see the pelvic MRI report as well as the images to confirm her diagnosis. We can also check this protein called CA-125 as elevated level is associated with adenomyosis. If I have just fibroids and no adenomyosis, then she would definitely recommend surgery to remove them.
For any of the fibroids or this possible adenomyosis, I have had zero symptoms.
We discussed my options if I indeed have adenomyosis rather than fibroids. We could use lu.pron depot for two to three months to try to shrink the mass then transfer one embryo right away. If I don’t get pregnant, then maybe we will need to consider surrogacy.
All sorts of emotions came over me. In this extra long journey, I have given up my dreams of conceiving my baby naturally or conceiving with my own eggs via IVF. I have gotten over all of that to get to this point. Now there is a possibility that I can’t even try to carry a baby on my own?
Tears came down. All I want to do is to experience what every other woman in this world experiences effortlessly. I want to experience a little life growing inside of me. I want to feel the kicks, find the heart beat, and look at a little baby waving at us on an ultrasound screen. I couldn’t believe that we were talking about the potential of all of this being taken away from me.
I really thought that finally it was my time. This news was definitely a big blow. But amazingly, although I was crying, I was able to keep my composure and went onto talk about all the possibilities with her.
Like she said, we could try to shrink the mass with that nasty lu.pron depot and see if we would get pregnant.
She was pleased to know that we booked the donor that she recommended, as according to her, this is a fantastic donor. Again, our donor won’t be available to work with us until about August, so we have a few months to sort things out. She said that she probably wouldn’t even do a mock cycle to test my lining because she didn’t want the estrogen to feed the adenomyosis again to make it flare up. She would just use the protocol that had worked for me at U.CSF to grow my lining. Since our donor has a great record of making great embryos, she thinks that we can forego PGS testing if we are not selecting the gender of the baby.
If we don’t get pregnant, she would recommend surrogacy. She asked me to tell her my religion again. She knew that we were christians. So when I told her that, she said that there is a wonderful out-of-state gestational carrier agency that would only take intended parents who are born again christians. She said that she couldn’t refer many people there because her patients are mostly not born again christians. Surrogacy is expensive, but doing it in California is even more expensive. This particular out-of-state agency is strict about no termination of pregnancy due to chromosomal problems.
We discussed about donated embryos. I told her about the offer from a friend’s friend. Dr. E actually could hook us up with this couple who has 4 tested and 2 untested embryos. They are from the Filipino husband’s sperm and Caucasian donor eggs. Dr. E showed me images of the children born into that family from the same batch of embryos. They really could look like the children of Bob and me. They are darker with Asian features. Dr. E thought that this would be a good match if we would ever want to go that route. She also has Caucasian/Caucasian embryos but she doesn’t think it’s a good match for us. She doesn’t want people to constantly ask if I am my child’s nanny. Out of her three children, one of her sons is blonde with blue eyes. She has been asked many times if she, someone who has dark eyes and dark hair, was her son’s nanny. People even asked if she used donor eggs.
My thinking was that, if I really need surrogacy, maybe using donated embryos would free up the money to compensate for the gestational carrier, because the whole thing does cost an arm and a leg. She said that this couple does ask for a few thousand dollars for those embryos. Some people ask for a symbolic amount of $500. Some people give them away for free. She said that just the day before an Indian/Indian couple asked her to discard their female embryos because they have already finished making a boy. When Dr. E asked if she could take the embryos to donate them out instead, the couple asked, “What do we get from that?” Dr. E really looks down on those to try to make a profit out of their remaining embryos.
I told her that sometimes I wonder if this is God’s way of telling me not to have babies. She said, “NO, maybe this is His way of telling you that this is the timing for you to have the most beautiful babies that you are meant to have.” She said that a year ago she wouldn’t have met our donor and she wouldn’t have that donor to recommend to us. Timing works out that way. Maybe the last two failed transfers are God’s way of protecting me from any catastrophe happening because of my uterine condition.
The list of questions that I prepared ahead of time seemed so irrelevant to the new development. We have new things to worry about.
I was able to maintain my calmness throughout the consultation. She is a wonderful doctor as she spent a whole hour with me answering any of my questions. When she walked me out of the office, I asked if she was expecting. She is currently seven months but I don’t think she is taking any maternity leave. For her last pregnancy, she returned to work to do a retrieval one week after she gave birth.
Walking out in the very hot sun, I was feeling okay. I was not devastated or overly upset. It was a strange feeling but I was really doing okay. Bob and I chatted on the phone for ten minutes. I quickly updated him on all the main points. It was by God’s mercy that both of us could remain calm. Once I got home and saw my dad (who is currently in town, by the way), I couldn’t hold my tears. I told him and my mom what happened. My mom of course told me not to cry. But I told her that I had to, because this is the way I deal with my emotions. My dad listened to me and held my hand. It was heartbreaking to see him tear up for me. I told him about the possibility of needing a surrogate and the whole cost. He told me that he is willing to pay half of the surrogacy cost. I was speechless at his generosity. Only parents are willing to sacrifice so much for their children. I also desire for that chance to do everything I can for my own children. In fact, Bob and I are doing everything we can do have our children even before they are born.
Bob came home smiling. He is an amazing partner who is extremely supportive. I knew that the news would sink in some and he would get angry at the situation. It is only natural to do that. He did finally get upset this morning but it was expected. I know he needs time to process and to release his emotions.
Last week my surgeon offered me two dates for surgery ahead of our surgery consultation but she would only hold a date for me only if I am absolutely sure that I want a surgery, as they want to minimize cancellations. One was in mid-May and the other one in early June. However, after yesterday’s consultation with Dr. E, I am not so sure if I wanted to schedule a surgery without knowing what my surgeon thinks. I wrote my surgeon about Dr. E’s findings. This is what she said:
“I have attached a copy of your MRI report below. You may also request the images from Medical Records to be given to you on a CD. The MRI gives a much clearer picture compared to ultrasound. I will be reviewing the images with you at your upcoming consultation visit. Your uterus most likely contains both fibroids and adenomyosis. Both fibroids and adenomyosis have been shown to reduce fertility and surgical removal has been shown to be beneficial for both. Once I remove the masses, I send them to Pathology for analysis, which is how the final diagnosis is determined. There are certainly other considerations in your case due to your age and your low chances for pregnancy, so we will need to discuss all of these factors at your surgery consultation. I hope this information helps! As always, please feel free to email me back if you have any other questions or concerns.”
I forwarded her response to Dr E, who said this:
“Thank you!!! This is very very helpful. Interesting that she agrees that you have adeno but the MRI report doesn’t say a single thing about adeno!! You probably do have fibroids but I think the larger masses described as fibroids pushing into your cavity is all adenomyosis. Let me know what she says. Talk to her about considering a CA-125 level. She may say no and that’s okay. Please keep in touch! She sounds like she has an excellent handle on the situation and is very wise and experienced. I just don’t want you to go through anything unnecessarily. I obviously want surgery to work and be beneficial for you.”
So this is where we are, trying to wrap our mind around this new development and trying to make sense of it. I feel fortunate that these two doctors seem to know what they are talking about. But Bob and I also feel cheated by our current clinic and Dr. NN as nobody ever mentioned anything to us about the risk of having this uterine condition on our last two transfers. Fortunately, we are in the financial position to save up money to pursue surrogacy if needed. Giving up my dreams of carrying my own baby is very tough, but if it means that is the only way to have a baby we can call our own, then we will find a way to do it. Because deep down, Bob and I still believe that we will be parents some day.