The other side

I've worked with couples with infertility or repetitive miscarriages for several years now.  I probably told every engaged couple I met during their CrMS introductory session, "I hope you never need NaPro, but just in case, it's reassuring to know that it's there."  I've even taught engaged couples who started TTC on their wedding night and went on to need NaPro.  It was heartbreaking to watch cycle after cycle pass without a pregnancy...and to see their excitement and hope turn into disappointment and (sometimes) despair.  My heart broke for them...but I never imagined I would one day be in their shoes.

My CrMS chart wasn't textbook perfect, but it didn't have the "major" signs pointing to increased risk of infertility that we're taught to look for on charts.  My mucus was great...really great.  (Seriously, if there was a contest of whose mucus stretched the most, I would win.)  My post-peak phase was well within the normal range.  I averaged very close to the "typical" 28-day cycle.  I didn't have painful cramps during my periods.  I even had a client with an almost identical-looking chart to mine who was super-fertile.  I had pretty much convinced myself we had good fertility.  I really wanted that to be true.  But in the back of my mind, I knew I had too much bleeding.  My periods seemed to go on forever and would be followed a few days later by more spotting.  I tried to rationalize that the mid-cycle spotting was probably just estrogen-breakthrough bleeding, so nothing to worry about.  But I could not explain away the long periods.  Regardless, I still clung to the (naive) hope that we had normal fertility.

While I was in Omaha for practitioner training (before I was married), I showed my chart to Dr. H, the founder of NaPro.  He studied it briefly, handed it back to me, and said, "You need a hysteroscopy."  I was not expecting that, but I figured with 30 years of experience, he knew what he was talking about.  :)  There wasn't a NaPro ob/gyn anywhere near where I lived, so I had to find someone else.  I found a local ob/gyn covered by my insurance who specialized in hysteroscopy and was also pro-life—a nice bonus.  Unfortunately, he did not agree I needed a hysteroscopy.  He ordered an ultrasound and said that the results explained my unusual bleeding but needed no further intervention.  "Come back to see me when you're pregnant," he said.  I was relieved not to need hysteroscopy and didn't pursue it further.

We started TTC last summer.  Six cycles came and went without pregnancy.  (Note:  When charting with CrMS, if you begin TTC and have not conceived after 6 cycles of fertility-focused intercourse, you can be referred to a medical consultant—you don't have to wait the full 12 months like most non-NaPro doctors require.)  It was a little strange to refer myself to the local NaPro doctor (Dr. A), but I wrote the referral letter just like all the rest I had written for clients.  The only difference was the number of charted cycles I sent to him.  Normally if a couple learns CrMS after they have experienced infertility, they only need two cycles charted to send to the medical consultant.  I sent Dr. A more than 40 cycles.  Overachiever, I know.  :)  (I charted long before we were married.)   Dr. A ordered the standard targeted hormone profile, a series of blood tests to measure different hormones throughout the cycle.  He also had me go back to my non-NaPro ob/gyn to see if he would do a hysteroscopy now.  The ob/gyn still didn't want to do it, but he did order a pelvic MRI to check out the anatomy of my uterus.  The MRI showed the same thing as the ultrasound so still no hysteroscopy.

The hormone profile ended up being 11 blood draws over 3 weeks—I felt like a human pincushion.  I really don't like needles, so DH came with me to all but one of the draws.  (I was so proud that I did one by myself!)   The phlebotomists at the lab started to recognize me after I kept showing up and said, "We love our regulars."  The good news is that I think I'm over my fear of needles.  :)  Everything came back normal except for low progesterone at the end of the cycle—a late luteal phase defect.  The treatment was post-peak HCG injections on certain days of the cycle.  Dr. A said the HCG should give us a pretty good chance of pregnancy, but if it didn't work after three cycles, we'd try something else.  So far we've tried two cycles with HCG without success.  We are disappointed, of course, but I think more than usual because Dr. A was rather optimistic about the HGC working.  This cycle he wants some blood tests done post-peak to see how my progesterone is doing.  The next step will probably be antibiotics.  After that, I refer myself to another medical consultant who does surgery...maybe I'll finally get that hysteroscopy.  Is it unreasonable to ask God to let me get pregnant before I would need surgery?  Surgery was not in my original plan.  ;)