Canadian Infertility Awareness Week: Baby blues

I was 34 when my husband and I started trying to have a baby. I envisioned getting pregnant while vacationing in Bali, where he had proposed two years earlier. It would be the perfect, romantic story to tell our future child.

But life rarely goes according to plan. We traveled to Bali twice during our infertility journey, with no bulging belly to brag about. We never thought we would find ourselves enduring years of heartbreak, spending thousands of dollars and suffering several miscarriages before getting an answer—and a surprisingly simple solution—to our baby-making drama.

After our honeymoon in 2008, we returned to Tokyo, where my husband’s work had taken us in 2006, far from our home in Ottawa. My life was on pause—professionally and personally—as I struggled to find my identity as the trailing spouse of a diplomat. All around me were women with a sense of purpose, either as professionals or mothers. I was neither, with no job and no prospects to speak of. My contract at The American School in Japan had finished as well as my part-time position at Temple University teaching business writing, two jobs that provided me with both social and career connections. The language barrier made it close to impossible to pick up anything else other than ESL jobs, for which there was a surplus of candidates. With the lack of fulfillment, trying to get pregnant became an obsession. I was consumed with calculating my days of ovulation and prime times to “have relations”—the doctor’s words becoming an inside joke between my husband and me. The pressure soon began to take its toll. All the planning put a damper on the physicality of our relationship, taking the sexy right out of sex.

It was especially difficult on the days I got my period. I felt such shame at yet another monthly reminder of what my body was not able to do. My husband was supportive in the best way he knew how, but what I needed was a heart-to-heart with one of my girlfriends; Skype sessions were a poor substitute for a shoulder to cry on.

After six months of trying, I started to think maybe there was something amiss. I voiced my concern to my doctors. I had seen my general practitioner in Canada, and two OB/GYNs in Tokyo; all three were hesitant to diagnose anything other than stress. None seemed surprised that we had been trying for months without success. They assured me I was young and healthy, and that it might just take time.

Read more: The medical side of infertility >

But I didn’t feel healthy. In previous years I’d suffered through three parasites and several bouts of food poisoning, and I had been diagnosed with celiac disease at age 32, shortly before we moved overseas. My stomach had played host to some inhospitable inhabitants, and I wondered if there might be a connection between these health issues and my struggle to get pregnant. My menstrual cycles were long, and my periods had become excruciating once we started trying to get pregnant in Japan. Prior to this, my cycles had been short and light, with little to no cramping. And I wondered why, after cutting wheat and gluten out of my diet, I still felt rundown and exhausted.

But the doctors didn’t think the symptoms were a sign of anything more serious. And I was guilty of being a passive patient and not following my instincts. It wasn’t the first time I’d ignored that inner voice; I’d spent a good part of my 20s doing the same, staying in unhealthy relationships against my better judgment and seeking out menial jobs that left me feeling unfulfilled. But not listening to my gut as we struggled to conceive had the potential for grave consequences—nearly costing me my health and my marriage.

After a year of trying, my husband and I were each given a baseline fertility test. Both of our results came back normal. We were left back at square one with no answers. And that’s when—under the weight of all the stress and shame of our secret—our marriage started to crack. We started the blame game. Angry outbursts triggered a flood of tears, followed by days of cold silence. It was our darkest period as a couple, and we came close to divorce before celebrating our one-year wedding anniversary. We sought counselling, and after a few sessions, we realized that we weren’t yet ready to toss away our years together. Thankfully, our love for each other outweighed our personal pain and our relationship eventually emerged from this experience stronger.

Read more: How to take care of your relationship through infertility >

That summer we moved from Tokyo to Boston. Before we’d even finished unpacking, I booked an appointment at a fertility clinic famous for its success stories. Our assigned endocrinologist, Dr. B, had us fill out a six-page questionnaire about our health and family backgrounds to rule out any possible genetic hiccups that could be hindering our fertility; again, everything appeared normal. I was sent home with clomiphene citrate, a drug used to stimulate ovulation. The side effects for me ranged from headaches and hot flashes to moodiness and painful cramps. Suddenly soaked with sweat while walking on a cool fall day, I’d have to remind myself that it was the medication and not early menopause. All of this was a small sacrifice for the possibility of pregnancy. In addition to clomiphene, I began weekly acupuncture sessions, which were costly but helped to alleviate the anxiety. I began to feel hopeful.

Imagine our surprise when, after one month on the drug, we discovered I was pregnant. But happiness was fleeting: At our first ultrasound, at nine weeks, the heartbeat was too weak to detect, and the embryo wasn’t growing like it should. Soon after that, the spotting started and a miscarriage followed. I was so angry with my body and felt such a swelling sense of sadness that I believed my heart would burst. I sunk into a depression and tried to dull the pain by watching endless hours of mind-numbing reality TV.

In January 2010, I did a second round of clomiphene only to experience a type of miscarriage called a blighted ovum, when a gestational sac develops without an embryo. Our doctor urged another month of clomiphene along with metformin (a medication that controls the amount of glucose in the blood and increases the body’s response to insulin), which came with the horrible side effects of nausea and diarrhea. By now I seriously doubted the treatment plan. But feeling vulnerable and desperate, I downed the drugs for four more months, only to experience two more miscarriages.

After yet another unsuccessful round of drugs and a failed IUI (intrauterine insemination), I was done. The treatments were doing nothing more than hurting my health, testing our marriage and depleting our bank account.

I took the first step in listening to my gut, cut off all contact with the clinic and quit all medications. Our trust in Dr. B had been gradually dwindling as he continued to suggest more expensive treatments after several negative outcomes. We felt he wasn’t listening to our concerns during visits. His treatment plan wasn’t working for us, and he was unwilling to suggest anything other than IVF as the next step. I needed time for my mind and body to heal before moving forward.

As we drove that summer through a desolate stretch of Montana backcountry en route to the west coast for a friend’s wedding, the scenery before me was a reflection of how I felt inside: barren and empty. A rage burned through me; I had a nagging feeling that something was being overlooked. I decided to take action and dialled the number of Dr. L, another endocrinologist my GP in Boston had recommended.

Read more: Fertility and conception tips >

Dr. L looked at the six-page blood workup from the previous clinic and noticed that they’d neglected to test for a few key genetic disorders. I was sent to the lab, where they took 14 vials of blood—so much I practically passed out.

The results showed that I tested positive for MTHFR (methylenetetrahydrofolate reductase) deficiency—a genetic condition. An estimated 10 percent of the North American population has a mild version of it, although it’s less common in some ethnicities. We learned that a woman with MTHFR can’t properly metabolize and absorb folic acid and vitamin B9, which are both essential for the healthy development of a fetus. Symptoms of the condition vary according to the exact genetic mutations, but they can include depression, anxiety and recurring pregnancy loss—all of which I had experienced over the years. My husband and I were both relieved and horrified at the news. Why hadn’t our other doctors tested me long ago?

My treatment plan was to take a daily megadose of folic acid—4,000 micrograms, which is much more than what’s recommended for a healthy woman trying to conceive. Within just a few days, I felt a surge in energy.

And 10 days after going on folic acid, my period was officially “late.” A blood test at the doctor’s office confirmed the news: I was pregnant. I felt a rush of joy but also fear; I was hesitant to celebrate in case of another loss. The high-risk team kept a close eye on me until we reached 12 weeks, and then I got the all-clear to continue my pregnancy with a midwife. My history had me so anxious I don’t think I once exhaled fully during the first trimester.

Our daughter, Cali, celebrated her first birthday on May 28, 2012. Six weeks later we learned I was pregnant again. I was initially monitored again by the high-risk team in Boston, before moving back to Canada just before the end of the first trimester.

My second pregnancy was a lot less stressful, and baby Elle was born February 24, 2013, in Ottawa.  We feel doubly blessed, as not long ago we weren’t sure I could carry a pregnancy to term.

Read more: Secondary infertility >

Now, as I watch Cali, two and a half, proudly chatting up a storm to Elle, now 11 months old, I vow to always be an advocate for my girls, saying goodbye to my former passive, easily intimidated self. It was my decision to not let myself be an ongoing experiment—to not let my questions go unheard and unanswered—that gave me the gift of my two daughters, who are forever a reminder that we as women know our bodies best.