Unexplained Infertility – 8 Things I’ve Learned

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Those who know me may not know I was diagnosed with Unexplained Secondary Infertility about 4 years ago.  This means, my husband & I were able to have a baby once but unable to conceive again…and no one can figure out why. Not even people with lots of letters following their name, who wear white coats and who are called experts. No one knows why we find ourselves in this situation.  While I’m not a medical expert, I’ve learned a lot these past 4 years, which most of the time felt like we were wandering around in the dark with blindfolds on.  This post is to make sense of our experiences and perhaps offer some ideas to those walking through this situation.

A bit about us: When our daughter was 2.5 years old we decided to try for Baby #2. Up until that point, I had been gluten free for over a year due to postpartum blood sugar & digestive issues that surfaced but not knowing what a gluten free diet would mean for attempting pregnancy or growing baby in utero, I decided to slowly (and deliciously!) add gluten back to my diet the summer our eyes were set on Baby #2.  Other than a slight bit of weight gain (welcome back, pizza!), I never noticed anything different about my body – regular periods, consistently negative home pregnancy tests and a bit of exhaustion which I chalked up to a busy life with a toddler. Nevertheless, I ended-up in the hospital with a ruptured tubal (ectopic) pregnancy, not ever knowing beforehand that I was pregnant – 6 weeks pregnant to be exact. I hemorrhaged for nearly 3 hours in the ER before being wheeled in for surgery. During those long hours, my blood pressure crashed and panic’d ER teams prepped me with cardiac arrest tabs with an unforgettable fear in their eyes. I prayed God would let me survive the ordeal. Of course, I did. I received 3 blood transfusions the next day before being released back into the world less than 24 hours after walking in those hospital doors. I was happily alive & more thankful than my heart could contain, though one fallopian tube down and a lot of questions in its stead. Everyone –and I mean EVERYONE- from doctors to nurses to friends shared encouraging stories of someone they know who experienced the same ordeal, who were able to get pregnant again and reassured me to not worry. So, with positivity and confidence, we waited the obligatory 3 month healing process (due to the transfusions) and resumed our efforts for another baby. During that time, I cleaned my slate of anything that was adding unnecessary stress to our lives or pulled at my ability to be a fully present wife & Mom (after all, I’d been given a second chance!).  However eager to put that ordeal behind us, after 5 months of resuming our effort, still no positive pregnancy test. So, given my age & history, my OBGYN referred us to a fertility clinic. Stat. That’s where things got confusing. Fast forward 4 years and reflecting in the rearview, here are some things we have learned:

 

  1. It’s a thing & it happens

Maybe it’s because our culture doesn’t want to scare moms, maybe because of the delicate nature no one really wants to share or maybe I blissfully skipped over that section of the What to Expect book during my first pregnancy – either way, I was unaware such a thing as secondary infertility exists and even more unaware that it could exist without explanation…and that I would be part of that 12% of American women labeled with this confusing diagnosis.

  1. …and it’s more common than you may realize

According to RESOLVE national infertility awareness organization, at the time of this writing, infertility affects 1 in 8 women & unexplained infertility affects 1 in 5 women.  Next time you’re in a meeting at work, at the mall or at church, look around you – chances are 1 in 8 (or 1 in 5) women you see will be struggling privately. I’ve looked back at the single-child families I have known throughout my life and wonder if they too were private warriors, just like me, bravely smiling through their pain.

  1.  It sucks & you need to process it

It took me over a year to realize that I needed to talk about this. Thankfully, my friends are a hopeful bunch – so very supportive, sensitive & optimistic for our efforts (some women aren’t that lucky!). My husband is also one of the most understanding men alive and for that I am also grateful. But I felt the need to specifically talk about the nitty gritty of this with other women who are also on this unique journey. You see, not only is there a grieving in figuring out why the body just won’t cooperate but with secondary infertility, there is a uniqueness in the sadness – grieving the (possible) loss of a dream for more babies and what you envisioned your life to be and the never knowing ‘why’. It may sound greedy to be sad about not having a second baby when so many women are trying to get pregnant the first time. People will try offer the silver lining “at least you have one baby!” and while that’s true, it’s also OK (and necessary) to be honest about the sadness in grieving the reality of what this diagnosis could mean.

  1. Finding Your Safe Space

I bolstered my tribe with two peer-led support groups sponsored by RESOLVE. One group was for women in all stages of infertility where I learned from other women about the different fertility clinics in our area & their different treatment approaches, the benefits of supplementing fertility efforts with things like acupuncture and tricks to help the treatments “stick”.

The second support group was specifically for those with secondary infertility. There, we could be brutally honest about the crappy-ness of our specific situation – how a simple Facebook pregnancy announcement can totally undo us emotionally as our friends pass us by in the pregnancy efforts (despite our happiness for them), talk through feelings of failure, how we handle the tricky questions “when ya gonna have another baby?” or how to cope when our child asks for a sibling. It was also here that I met a few women who were in the final stage of their journeys before calling off the baby efforts and going forward with one child.

Being a part of these groups and being able to freely share our situation took away the embarrassment I had initially felt for a body that wasn’t working correctly. I gained the strength to say “this is what the diagnosis is” and know that I wasn’t “less than”. I could also admit how I was feeling and know that I was understood by everyone in the room. I also learned from others farther along in the journey the normality of the ebbs & flows of emotionally processing all of this – how emotions can be raw one day and stable the next. This was a crucial reassurance for me trying to find my footing in this unchartered path. Now, being farther out from treading those deep waters, I can see those good/bad days get farther and farther apart – so far apart, in fact, it really surprises me when a tinge of emotion surfaces.

Ultimately, the groups allowed me to meet a whole new group of strong women pursuing their dreams of having another baby or ones having the graceful strength to say “I gave it my best shot, another baby is not for me, it’s time to move on.” These examples were crucial for me to learn how to navigate my own feelings, admit my fears (some I didn’t know I had, some I had but didn’t have words for), and find my own strength and peace in the process.

  1. The Deal with Fertility Clinics

The first fertility clinic I was referred to had wonderful doctors but the process seemed disorganized. I had communication problems with my assigned nurse and was told different things depending on which of their locations I went to (which mattered as sometimes appointment dates which fell on weekends required I venture far from my regular office location). All of this created a lot of extra stress for me (I am nothing if not process-oriented).  That clinic’s upside, though, was that they were flexible in protocol approaches. After our first treatment proved to be quite hard on my system, they allowed me to do another treatment with more monitoring and less medication.  I eventually decided to try out another fertility clinic to see if the grass was greener over there.

The second fertility clinic was much more organized and they operated like a well-oiled machine. Down the road, though, I discovered they weren’t interested at ALL in treating me as a patient for what I particularly needed – I had to fit their mold. They claimed they were supportive of incorporating holistic measures in my care but wouldn’t test for items outside of their standard tests that my Naturopath suggested I obtain. I eventually got the bloodwork done through my physician and it showed severe deficiencies in crucial-for-fertility things like Vitamin B & D and Zinc and some other hormonal imbalances. When I provided those results to this fertility group and raised my concerns, they were dismissive and encouraged me to forge ahead with treatment. This was a HUGE red flag for me – if I’m not absorbing nutrients for myself day-to-day, how would I be able to support a growing life? Maybe it was a misconception on my part – fertility doctors, I assumed, would look at all angles of someone’s particular fertility difficulties. But it seems that they were only interested in solving the “symptom” of not being pregnant, not fixing the reason or supporting my health as I attempted pregnancy. This, to me, felt like a sham, as if I’d put myself under the care of “Salesmen with Medical Degrees”, instead of doctors who heal.

One thing I learned later is that both these (and most) fertility doctors have in common is that neither properly test progesterone levels.  Months later, when I learned from cycle-charting that my progesterone was low, I contacted my fertility doctors to see what my levels had been like while I was under their care. Their response was “we don’t track progesterone” as they “don’t find it helpful”. When undergoing fertility testing, doctors pick 1 day in a patient’s cycle, with the assumption ovulation has occurred on/around CD #14, and test progesterone once. Progesterone, as we know, is a hormone that ramps up and surges the last half of the menstrual cycle – so, testing only once gives a random glimpse into a 2 week process. Sure progesterone supplements are part of fertility treatment protocols but if low progesterone was the only missing piece of our puzzle, why wasn’t that tested more thoroughly at the onset to avoid costly treatments? A prescription for progesterone supplements is a lot less expensive than a fertility treatment! (And not to mention: low progesterone isn’t just the problem – it’s a symptom of other things happening in the body)

  1. Calling-in for Back-Up

I’m a “get to the root of the issue” kind of girl and in my mind, I always wondered: how do we explain what happened? If we don’t fix the root cause of this, how can I get pregnant again, and if I do, would it be successful? When my fertility doctors couldn’t give me answers, I went on the hunt.

Naturopathy had been very helpful for me in dealing with my endometriosis, PCOS & other health needs throughout the years, so when western medicine had left me unassisted, I opted to incorporate this into our fertility efforts. My naturopath looked at my overall lifestyle (diet, exercise, stress, etc.) and began bolstering my self-care with measures like castor oil packs, detox baths, supplements, herbs, diet, etc. The Naturopath also helped me treat adrenal fatigue and leaky gut syndrome which I developed after my first fertility treatment and the negative effects from the gluten my fertility doctor had suggested I add back to my diet.

It wasn’t until I read this article that I realized what I thought were “new norms” in my cycles were actually not normal. I realized that I should probably start charting my cycle, something that I previously thought was needless since my cycles were always timely and predictable. What I once considered a tedious chore ended up being a really helpful tool that gave me the ability to put into visual terms what my body experiences to (1) take ownership of my body and (2) a visual aid to show my healthcare providers cycle patterns to help them put the puzzle pieces together.

There are a lot of different cycle charting tools out there – I chose NaProTechnology / Creighton Method because there are also medical doctors trained in this charting method who work to provide treatments in conjunction with your body. Whether or not one wants to get pregnant, the end goal is optimal health (cue my ‘get to the root’ affinity).  Within 3 weeks of charting, my charts revealed (and blood tests later confirmed) I have low progesterone and insufficient/irregular ovulation (despite having regular periods) – something my fertility specialists didn’t even look into.

Acupuncture was also invaluable as it also supported me as a whole person. My acupuncturist knew my goal was internal healing & normalized fertility functions and she kept that in mind during our weekly appointments, while also treating me with where I was that particular week: fighting a cold, stress management, lack of sleep, etc. My acupuncturist also offered a wealth of knowledge for other approaches to self-care, self-nurturing for my overall wellness & fertility efforts.  I felt so much more aligned once I added acupuncture, Chinese herbs and supplements to my healthcare. And anything that nurtured me while going through this process was valuable to my overall well-being.

  1. Dig, Baby, Dig!

This journey is not for the faint of heart.  Please be vigilant to also dig for & hold on tight to hope as you work to change what’s going on in your world. Use your strength to find the good in things around you – even on the sad frustrating days. Positive fun music, peaceful & self-empowering yoga classes, buying yourself flowers or treating yourself to something cute on Etsy are great pick me ups. I read books on Hope and kept “hope” themed quotes and Bible verses on hand. Someone may choose to define their hope by the arrival of another baby but I decided to work hard to keep my hope alive however life transpired – whether that meant another baby or not. The life my husband and I set out on when we said “I do” was for better or for worse and in sickness & in health. We had chosen each other on a beautiful May evening not knowing what the future was going to hold and those promises we made required I work to keep hopefulness alive for our life, however the journey unfolded.

Having other interests or hobbies are also great coping mechanisms that can help keep you moving along. Someone suggested that I make a list of things to look forward to each season – like a Hope Filled Bucket List. Simple things  like ice cream on a walk at the riverside in the summer, an autumn getaway with friends, summer concert date nights, coffee with a friend, painting wine nights, etc. If you need a baby fix, and being around babies isn’t an emotional trigger for you, offer to babysit for your friends or family.

  1. Protecting Your Heart

This is a very emotional journey, with new emotions at every twist and turn, and with constant monthly reminders. While working to keep your hope and health, it’s OK to establish boundaries to keep your peace. Your boundaries may look different, at different points along the way, too. Don’t feel guilty if you need space from emotional triggers like baby showers, being around babies, logging onto social media or needing to walk the long way around Target to avoid the baby section. Be encouraged that these raw feelings won’t last forever if you keep processing emotions along the way. It’s OK to protect your heart while you walk through this – it is, after all, another form of self-care.

 

Of course, everyone’s situation and health needs are different and everyone’s journey may have their own intricacies. If you are walking through this struggle, know you are not alone in all of the head-scratching, mind-consuming possibilities in this unexplained and/or secondary infertility world. I hope that you give yourself the time and space you need to process the emotions, a tribe to make it bearable, information to make the best decisions, and grace as you walk through this and find your peace, however you decide to conclude your journey.

~ jm

PS: In addition to the links included above, here are some other resources that have been helpful to me in restoring parts of my health in correlation to my fertility:

* None of the above links are benefiting from inclusion in this article

 

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