My Fertility Journey...
- madeleinerowat
- Sep 6
- 16 min read
My husband and I met in December of 2017 on Bumble. We both had a love of Christmas and the whole season felt really magical and like kismet. We both had family living in the same smaller cities of BC so it made visiting family during the holidays super easy! We both knew we wanted kids young and shared so many core goals. By 2020 on a snowy day he proposed. Then began the whirlwind of the century (COVID) with lockdowns, stress, trying to schedule a wedding (rescheduling it many times) and finally getting married and buying our first homes together. Despite the crazy of the world we were still plugging along our way hitting career goals and focusing on building our future for our family.
We were married July 2021 and we knew that we wanted to begin trying to have babies pretty soon after. We moved into our beautiful 4 bedroom home in a great kid friendly neighborhood with amazing schools and thought to ourselves how amazing everything was. We were so prepared for this next chapter. I still sometimes think to myself that when everything is a little bit 'too good' it's a bad sign for something else to come. But perhaps that's trauma brain telling me that.
I had a friend who worked in an OBGYN office and out of kindness she offered to get me some basic hormone fertility checks done. She probably knew I was quite an anxious person and I like data to help myself calm down. All my hormones came back great! But the exception was they discovered I had severely low AMH of 4.6pmol (anti-Mullerian hormone) which basically indicates that my ovarian reserve is very low. I was horrified but after speaking with an OBGYN and naturopath I was reassured that you can still easily conceive even with low AMH. And they were right. After only 4 months of trying to conceive and learning about tracking ovulation, using LH test strips and tracking basal body temperature, we were pregnant! We joke that the first couple months we were 'doing it' at the wrong time because I didn't realize I ovulated a bit later in my cycle than the 14 day standard.
I was one of those women who immediately knew I was pregnant. I remember waking up in the middle of the night - it must have only been about 9 days post ovulation - and I felt a type of nausea I had never felt in my life before. This feeling continued for the next night until I took the at home Premom pee test around 11 days post ovulation. To our amazement we saw a faint line and knew this was it! My nausea continued to ramp up and my test lines continued to get darker. We were so excited we figured the hard part was done and we were expecting a baby in July 2022. However, the pregnancy was not the beautiful glowing pregnancy you see on tv. I felt horribly nauseous all day long. I could barely stand up to get to the bathroom or kitchen or sit up straight. I had to crawl to get places so I didn't get too sick feeling. Water, crackers, carbs, smoothies, nothing helped me. I was refusing to take any over the counter or prescribed medicines and focusing on ginger and B6 as the naturopath suggested. At the time I was planning for a very natural pregnancy, natural birth with a midwife and perhaps a doula even. I wanted a low intervention and no epidural birth if possible. But life has a way of doing its own thing. Unfortunately, nothing worked for the nausea though. I am grateful I was able to work from home during this time (thnx COVID) so I could lay in bed and work.
Our 8ish week ultrasound went perfectly! I was right on track, I was 27, young, healthy, no risk factors at all. For fun we did one of those self pay ultrasounds around 14 weeks thinking we just wanted to take some more photos. We knew we were having a little boy because we did the NIPT test (which also came back perfect). Our next official ultrasound is the very important 20 week anatomy scan. We were very excited and assumed it should be all good to go since we were past the 12 week mark. But in the back of my mind I was very worried. I believe instinctually my body knew something was wrong. The nausea was one issue but it was something else deep in my soul that knew. I wasn't looking forward to the appointment but kept that to myself. Ultrasound went fine, baby looked normal, had all his toes and fingers, heart and brain. The sonographer isn't allowed to make comments on their findings. But she was really kind and began telling me about the children's hospital and NICU success rates. I didn't think anything of it, but looking back I believe she was trying to impart some information to me so I was not shocked. Later that night we received an urgent call from my midwife - something was wrong with the babys size, possibly the placenta - we were told to take baby aspirin and wait for an expedited referral to an maternal fetal medicine specialist. The sinking feeling in my stomach felt horrible, pure dread and tears came out. Life was too good to be true - we had the perfect careers, the house, the dog, the cats, everything was ready so of course this must be the thing that suffers.
Within the week we were at an MFM appointment - he conducted a thorough ultrasound and was able to measure all the limbs, organs, stomach, head circumference, femur length and finally the placenta flow and the cord flow. When he was done the scan he told us the devastating news that our son was in the <1%tile for the gestation we were, that the placenta was failing and his cord flow is absent. We were 21 weeks at this point and when we asked is there anything we can do, take, medicine, we were told there was nothing, that whatever is happening is too late to recover from and the only option we were offered was a termination for medical reasons. He felt that our NIPT was good and the physical features of the baby looked totally normal so he did not believe there was a genetic issue at play. Something else was clearly affecting the placenta. We knew we had a cutoff to decide on termination by 24 weeks. But to make such a decision was unfathomable. I come from a very pro-life upbringing in the catholic church and not only that this was a very much wanted and hoped for baby. How could we be this far along and make such a decision. It was extremely scary and hard at the time, but looking back I am very glad we chose to not terminate. We decided that if the doctor says he is going to die and nothing will change it, then we will not be the ones to end his life. We will hold on to hope and wait until that happens or until we are lucky enough to make it to a viable gestation and viable weight to deliver him. We continued twice weekly ultrasounds where the doctor checked the cord flow.
Unfortunately the flow remained absent and sometimes even reversed. When cord flow is absent the umbilical artery shows blood flow during systole (when the fetal heart contracts), but there is no flow during diastole (when the heart relaxes). This means the blood flow stops completely between heartbeats. A more severe abnormality where blood flow in the umbilical artery reverses during diastole, moving backward (from placenta to fetus) instead of stopping or moving forward. On Doppler, this appears as a negative waveform was also seen. We knew once this happened our baby would not get any more blood or oxygen and not be able to survive. At this point we were 25 weeks but he was still too small to attempt to deliver as the level 4 NICU wouldn't have needles or devices small enough to fit his veins or lungs. On Friday we went to that ultrasound and the reversing was showing. We went home and were told to come back Monday for another ultrasound. That weekend, for the first and only time at that house (we lived in for 4 years) we found a dead red robin bird laying peacefully in our backyard. I later learned robins are a symbol for babies, death, peace and the afterlife. I believe that weekend on Sunday our sons heart stopped beating and we had a final goodbye from him.
On Monday we went for our MFM appointment. I could tell right away there was no heartbeat. He was so still on the screen; just floating in the amniotic sac. Our doctor calmly said "I'm so sorry, I don't see a heartbeat anymore". We were devastated. I remember we didn't cry the whole way back to our car. I remember walking out of the room and seeing other moms and dads waiting for their high risk appointment after us. Thinking will they be having horrible news as well and how horrible of a place this is. We knew there was two options ahead - induce and vaginally deliver or opt for a D&E (dilation and evacuation). I remember crying in the car, sobbing 'I don't want to give birth to my dead baby'. The concept of him being gone wasn't hard to understand, it was the thought of labor with no baby at the end of it that hurt so bad. The thought of pushing my baby out knowing he was gone was too much to think of. This was the opposite of any sort of birth plan I had in mind. We wanted to be able to hold him, bury him, and the only option for that is to deliver vaginally. Unfortunately the way a D&E is performed, the baby is ripped out piece by piece. For us, this felt unbearable and we could not do that method.
The next day we went to the labour delivery ward where they explain the process of how they induce, when to come back to hospital and what to do. I was told to take mifepristone to halt the progesterone still flowing in my body to sustain the pregnancy and help prepare my cervix to soften for labor. 24 hours later we were to come back to the hospital where they would give me misoprostol pills every 4 hours to continue to progress labour, contractions and dilate the cervix. I was allowed morphine and nitrous oxide for pain management. What I tell all fellow loss moms who go to hospital for their stillbirth is to please have someone leave a sign on the door that there is a loss progressing. I had too many nurses and medical professionals coming in to congratulate me on 'an exciting day' without realizing it was a stillbirth. I never knew to ask for a private or quiet corner room as well. I was right next to the nurses desk and hearing laughter and babies crying during my labour was emotionally painful. My 24 hours of labour is hard to remember, I did not cry once or make a peep during the whole process. I must have disassociated and was holding onto all my mental strength to get through it. After 22 hours they said they couldn't give me more misoprostol pills and if things didnt progress they may have to do D&E. My blood pressure was also very high during this whole process - 140-150/120 - maybe even higher sometimes. I don't know if it was extreme stress or some sort of eclampsia beginning but they were a bit worried about it and said if it stays high we could opt to a procedure.
But, finally after 24 hours I felt him move into my pelvis, and suddenly the urge to push. It was a flurry of activity and nursing came in to catch and help deliver him and the placenta.
Our son, Grayson, was born still at 25.5 weeks along on April 22, 2022 (I still think his birth date is the most beautiful numbers). He had all his toes, fingers, eyes, ears, a bit of hair. I thought he had my husbands nose. My mother was able to help nurses get finger/hand prints. The nurses carefully swaddled him in a hand knitted outfit and we were given a 'birth certificate' and butterfly flower seed mix to plant one day. These little touches were honestly so appreciated and treasured and I am glad we have a little box of his things still. We were able to hold him for a few hours, just three of us together until finally it felt like the time we had to say goodbye. My mother arranged all of our funeral services and coordination between hospital and cemetery. I don't know how I would even do that by myself back then.
3 months after delivery we were finally given the diagnoses from the placenta pathology. Massive Perivillous Fibrin Deposition/Chronic histiocytic intervillositis. It is caused by an alloimmune response in my body - they have no idea why, how or what to treat it with. We were told there is less than a handful of cases every year with this condition and the studies are so small that they don't know much about it. I was told the reoccurrence rate was anywhere from 30-100% and a mix of immune modulation medicine may help but likely still won't. I was also told by some doctors (which forever angers me) that it might all be a fluke and since I am young and healthy the next pregnancy might be just fine. But I knew deep down this would not be fine. This sort of thing doesn't just appear and go away after. At this point I was freaking out though - not only do I have this horrible condition, I also have a shorter timeline due to my low AMH. We decided to try to conceive again and hope for the best, I was able to convince some doctors to give me Plaquenil, baby aspirin and upon confirmed pregnancy Lovenox injections/steroids to hopefully modulate the immune issue. After 6 or so months of trying and not getting pregnant we decided to do IVF to preserve some embryos just in case my AMH dropped down to nothing or I hit menopause early.
In December 2022 we began IVF - due to the low AMH I only had a few follicles showing. We went for retrieval and they got 3 mature eggs only. But we were hopeful. They all fertilized but on day 2 were told they seem a little slow and recommended we do a day 3 transfer of the 2 best ones. By this point I had the Lovenox injections starting from a hematologist, aspirin, plaquenil and steroids were starting as well. I was beginning on 20mg of prednisone. The two embryos were transferred and I was pregnant. However my HCG test was too low for what it should be at 12dpt and it became a chemical pregnancy. I now know that my immune system was working in extreme overdrive and the steroids/meds I was on did not make a dent to fight it. The 3rd embryo arrested in the lab and was discarded. Our first round was a fail. It was right before Christmas.
February 2023 we started round 2 IVF. This time we had 8 follicles showing! A miracle. They retrieved 8 mature eggs and on day 5 we had 4 embryo frozen. This was truly a miracle round and thought we had more than enough embryos for at least 1 baby. In the back of our minds we wanted to save these for a surrogate as our backup plan. So we left them in the freezer. By this point we had had 1 stillbirth and 2 chemical pregnancies. We continued to try to conceive again but it just was not happening. I later learned that with immune problems in pregnancy, the body learns how to attack the pregnancy better and better every time. Much like our body learns to fight off flu. I believe this is why I was not able to get pregnant. I was also struggling to find any doctor in Canada who would help with the immune side of things - I had read many studies of my diagnosis with patients receiving stronger medicine than I was being offered. Things like Immunoglobulin (IVIG), Tacrolimus or biologics along with the other drugs listed before. I frustratingly learned that the Canadian government used to cover these medicines but in recent times due to cost stopped. So not only did we know what may help but I was not able to even get help. I kept being told by doctors that I am young and its all a fluke. The most invalidating thing you can say to someone who literally birthed their dead child. Spring 2023 I got pregnant again though! Naturally. But I called up my IVF clinic and they were kind enough to bring me in for monitoring very early on. Again I began the medicine I was able to get, prednisone (this time 35mg dose), Lovenox, Plaquenil, Aspirin. I was hopeful the higher steroids could help but also terrified and feeling trapped in my own body that is killing my babies.
Again, we knew from the start something was wrong. The baby was growing at the right pace but the sac around was not keeping pace. This is often the first sign of a miscarriage to come. At 10 weeks we were told there was no more heartbeat. I had the miscarriage at home, collected all the tissue I could, and brought it to BC Womens pathology for more testing. We were told it was another healthy genetically normal boy and the same placenta issue was present which caused the loss. By this point we had 1 stillbirth, 2 chemicals and now a 10 week loss. It felt extremely hopeless. I ceased the prednisone and immune medicine and decided I needed a break to be healthy again. I was the heaviest I ever weighed, I felt like total garbage, I had no energy, my fitness was in the dumps, severe hair loss due to prednisone and all the hormones of IVF, mental health bad, no joy or happiness anymore. I had literally tried to do everything in my physical and mental power to make it work and knew I could do nothing more here. After much crying, fighting and decision making we decided surrogacy is our next step. To preserve privacy I will not go deep into it, but we were introduced to a local mom who was interested in being a surrogate. Summer/Fall of 2023 we thought this would be it! We had the embryos and a surrogate willing to help us. But sadly after 3 transfers (results in 2 fails and 1 chemical) we were out of embryos and no baby again.
Reproductive Immunology
While our surrogate was doing her part, I was working in the background to get help from 1 of 5 Reproductive Immunologists in the USA. I was able to get bloodwork sent down to California and finally some real results and real ideas to see if maybe I could be pregnant again. Finally after 2 years of being gaslit by doctors saying its all bad luck and I am young, I had my answers. I had flagged for antiphospholipid syndrome (a blood clotting issue), Factor XIII (which is also a placenta clotting gene variant), 1 mthfr mutation (could slightly increase clotting issues / absorbion of B vitamins), elevated Cytokines, but normal NK cells. The reason I couldn't get pregnant anymore was due to my elevated Cytokines and the Factor XIII - it would flare on cycle day 6 to impede implantation of the placenta. I was told to take humira, IVIG, steroid, lovenox, aspirin, plaquenil and this would be my best chance. I knew if this did not work, there is no other drug in the world that will modulate the immune system.
But I was hopeful. In this time, our surrogate had done 3 transfers and we had 2 failed to implant and 1 early chemical loss. It was a devastating end to our first surrogacy journey.
I switched doctors in Vancouver to Olive Fertility because they believed in the immune issues and were willing to follow the protocol that Alan E Beer Center (https://www.repro-med.net/suggested). I had to go to the USA every 3 weeks for immunoglobulin infusions, along with 2x monthly Humira injections, twice daily lovenox etc. We began a round of IVF at Olive Fertility because we also wanted to preserve whatever eggs possible given my low AMH. Somehow we had the worst start - in the recent months I had always seen 7-8 follicles but suddenly only 1! But upon the advice of our doctor we kept going and a few more popped up. But, with only 3-4 showing we stopped and 'tried' at home and kept my immune medicine going. Amazingly we got pregnant that try! We were so hopeful but so scared. Frequent checks at the clinic unfortunately showed the same results as last year. We were having another miscarriage at 10 weeks. My immune labs came back elevated and suddenly natural killer cells were high despite all the medicine I was on. Again I miscarried at home, collected the tissue I could, sent it to BC Womens Pathology and was told it was the same CHI diagnosis. At this moment it was like a light bulb was flicked off. I knew this was the end of the road for me physically. I had truly tried any and all medicine to make things work, I had bruised and battered my body with injections and who knows what else this was doing to me longer term. At this point my only goal was to have a healthy baby - not make my body do it. So we decided surrogacy is our only way forward.
2024-now...
In May 2024 after our 5th loss we knew the only path forward was either to stop and be childfree not by choice, consider adoption, or consider more IVF and surrogacy. We decided surrogacy was our best bet forward but I knew that meant I had many rounds of IVF ahead of me. At this point my AMH was even lower - 1.1pmol (almost menopause levels). Due to all the steroid use, insulin resistance exacerbated by steroids, constant stress, etc. I knew I needed to get on track with my health. I called my doc up and asked for a SSRI prescription (to take the mental edge off of my grief and sadness) and a semaglutide prescription to assist with the insulin issues. Between May and August I finally dropped 30 excess pounds, was hitting the gym weekly, went on lots of long walks with my dog, felt mentally better than I had in years. My hair was growing back in! Finally I could focus on me again and my body. I continued following the lifestyle changes and continued to lose more weight but also feel better. In August 2024 we began our series of IVF.
Some of the tests/supplements I took: https://www.butterflybeginningsdoula.ca/post/foods-and-supplements-for-fertility-and-ivf-prep
To summarize the next IVF rounds:
August 2024 - 1 egg retrieved. Complex mosaic embryo.
September 2024 - 1 egg retrieved. Euploid!
November 2024 - 2 eggs retrieved. Both euploid!
January 2025 - poor response, but we went forward anyways for the 2 follicles we saw. No mature eggs retrieved. This cycle was the most high stress for me as I had a lot of massive career, legal and family changes happen. In hindsight, I should not have proceeded with IVF in the midst of this.
March 2025 - 5 eggs retrieved! A miracle for me. 4 embryos. 3 euploids and 1 abnormal.
The very interesting thing about all of these rounds was every single egg that was mature would fertilize. 100 fertilization rate. This is amazing in the IVF world. And we also had a 100% blastocyst rate as well, which is also unheard of in IVF. The other interesting thing about these rounds was that on day 2 of the embryo dividing they were all very advanced for the stage they should be. I recall the prior year doing IVF they would only be 1-2 cells on day 2. But with these rounds they were all 3,4 or 5 cells on day 2! Again, this is truly amazing and unheard of for IVF. All of our embryos ended up being a mix between 5AA, 4AA, 5BA, 4BA which are all amazing grades. Even the mitoscores from Igenomix were all the low 10's or 20's which means they barely used any mitochondrial energy to form.
In this blog: https://www.butterflybeginningsdoula.ca/post/foods-and-supplements-for-fertility-and-ivf-prepI I spend more time focusing on mitochondrial health, what you can do for this to support egg/sperm quality as well as stress on success.
How this story ends?
Well, in early 2025 we were met an amazing surrogate! We are beginning the process with her and hope to report back good news one day - but for now we will leave these pages open and waiting <3
Comments