Age at interview: 40
Infertility diagnosis: Yes
Contributing factors to fertility problems: Hormone imbalance (low progesterone)
Age at diagnosis: 37
Fertility treatments: ICSI
Background: Belle is on parental leave from her job in communications. She lives with her partner, step-child and baby in a metropolitan city. Belle is from a white Australian background.
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Trying to conceive and first seeking help
So in 2016, we did naturally fall pregnant, but, unfortunately, that wasn't a successful pregnancy. So the obstetrician at the time, after losing that pregnancy, said, "You've fallen pregnant naturally. Go away. Come back within six months if you haven't fallen pregnant again." So we did that and we probably tried naturally for another eight to 10 months before going back to see the obstetrician. Because in my head, I suppose, I was like, "Well, it's happened once before, it will happen again."
After, let's say, another 10 months from losing that pregnancy, we went back to the obstetrician and my ovulation was tracked for a period of three months. And basically, they were then sending me on my merry way home, to say, "You're ovulating, now's a good time to have intercourse and try and make that baby." So we did that for a period of three months and had no successful impregnate naturally, with that help either. And so, as a result, we were then referred to a fertility specialist because [background noise – baby fussing] it had probably been about 14 months since we had naturally fallen pregnant the first time.
Fertility testing and deciding to try IVF
The fertility specialist initially organised for a dye test to be undertaken where they inject dye into your fallopian tubes to make sure that they're not blocked. There was an indication that one of my fallopian tubes was blocked and that the other one wasn't, and so with that, he recommended IVF as something that we probably should consider.
Then I think we took that information away and I was keen to get started on IVF pretty quickly because I was conscious that I wasn't getting any younger because at this stage, I was 37. But my partner was still, I guess, of the opinion that it had happened naturally before, why don't we keep trying naturally, and he didn't necessarily want to embark on IVF straight away. So basically, we continued to try naturally for a few more months, I suppose, and then went back and saw the IVF fertility specialist to say that we were ready to commence IVF, and that was in late 2018.
First IVF cycle and three unsuccessful embryo transfers
In October 2018, we had my eggs collected. We received 23 eggs, and from those 23 eggs, we had eight embryos that we sent off for genetic testing. We had four of those embryos come back as genetically healthy and able to be implanted. And one of those embryos was what they call mosaic and the other three were genetically abnormal, so were disposed of.
That was in October 2018 and so we effectively implanted one of the healthy embryos in December 2018, it wasn't successful. We implanted another embryo in January 2019, and that wasn't successful either. And in January on thawing of the embryos, we also lost one of the genetic embryos that we tested when it had thawed. Then in February 2019, we put the last healthy, genetically tested embryo in, and that was unsuccessful as well.
The fertility specialist was... I guess we weren't expecting that result that three from three wouldn't have worked when they had been genetically tested and thought to be healthy embryos.
Further testing with no clear answers
So with that, the fertility specialist undertook a hysteroscopy and laparoscopy on me in March 2019 to make sure that there was no signs of endometriosis. Now, through ultrasounds and previous investigative works, nothing had shown up to indicate that there'd been endometriosis, but he obviously, in light of having three that hadn't worked, wanted to get in and have a closer look. And basically, the results that came back from that indicated that everything was looking good in my uterus and that was when it was deemed to be unexplained infertility.
We were then referred to a fertility professor, because at this stage we only had the one mosaic embryo left and we didn't want to keep putting...We didn't want to put it in, I guess, if we didn't have to. We were happy to go another round of egg collection, but didn't want to go to that expense, I guess, and that trouble, if there was something wrong that may have prevented us from falling pregnant through IVF, anyway.
Getting a second opinion and being diagnosed with low progesterone
We were referred to a professor. The professor went through obviously all the information, my file, documentation, asked a lot of questions. And basically, one of the questions that he asked was, after the embryo had been implanted those three times, was I getting my period when I was on the progesterone medication? To which I said, yes, I was. So then he said that my progesterone levels, instead of increasing, after embryo implantation, were potentially decreasing quite significantly. And that that would indicate that I needed more progesterone medication to maintain the pregnancy.
Second IVF cycle
We then went in for another egg collection round and got 23 eggs again, ironically and from this batch, we only ended up with three embryos. This time we didn't genetically test them because we couldn't afford to do so after having spent so much money that we had already and the first of those embryos we implanted was also unsuccessful, despite having had an increase in my progesterone medication. For that round, they had increased the dosage of my progesterone orally and had also increased the compound makeup of the pessaries I was using. But that, unfortunately, at round four was unsuccessful.
So we went again round five, and this time they included progesterone injections on top of the oral progesterone and the pessary progesterone.
Deciding to stop IVF after final embryo transfer
So for us at this stage of putting the 5th embryo in, we had one more, we had the 5th that was being implanted and then we had one more frozen. So I was 39, we had got to a point in our IVF journey where financially, we weren't in a position to continue to commit to IVF. And emotionally and physically, I didn't want to commit any further.
So we were at the point where we'd said, “We're going to put the 5th one in, we'll put the 6th one in if we need to.” We also contemplated putting the 5th and the 6th in together, but decided against that because the odds of having a healthy pregnancy are higher if there's only one implanted versus two. So we put the 5th one in, and I think at that stage mentally, I was like, ‘You know what? What will be, will be. If I am unsuccessful in being a mum in the future, I'm lucky to be a wonderful step mum.’ And then started to plan, I guess, for my 40th.
That's in anticipation that if the 5th embryo implantation and the 6th embryo implantation weren't successful, that we'd have a big, big bang 40th party and start to sort of mentally think about other things in life and look forward post IVF.
Conception and a successful pregnancy
And then miraculously, the 5th embryo implantation was successful. They called after the 2 week wait with my blood test results that afternoon. And there were three lovely nurses that worked to support my fertility specialist. Generally when it was bad news, there was one nurse who always called me because the other two nurses weren't as good at delivering bad news, I suppose. And this particular day, one of the other younger nurses was down the end of the phone. And I could already tell as soon as she said hello that she had an element of excitement to her voice.
And yeah, she said, "Can you talk?" And at this stage in your life, you're seeing these nurses and you're talking to these nurses every three days to five days, for what, two and a half years, they become friends. And they said, we've got some good news, your result is positive. And so at this stage, you're only 2 weeks pregnant, but it was the first time after five goes that we'd actually got a positive result. So I burst into tears was extremely happy, obviously, but you are also at that point, so conscious of the fact that you've made it through a hurdle, but there's still so many hurdles that you have to get through.
So it's that moment of joy, but also you're very cognisant of the fact that it doesn't mean that it's all over. You’ve still got a long hill or a tall hill to walk up and it was really, to be honest, only until we got to our 20-week scan, that I started to relax a bit thinking that the odds of this being a successful pregnancy are now in my favour, but up until 20 weeks, we didn’t count our chickens so to speak, we waited until that 20-week scan and then started to actually feel a bit more excited about the pregnancy.
We were lucky, I guess, in the sense that we did finally get there and the embryo was healthy and genetically all good and then they kept me on that progesterone to 16 weeks of pregnancy and it all worked out okay in the end.
Find out more about Belle’s experiences in the following short films:
Experiences of Fertility Testing
Experiences of Conception, Pregnancy and Childbirth
Navigating Infertility and Fertility Treatment: Relationships with Family, Friends and Peers
Infertility, Fertility Treatment, and Work
Advice for Health Practitioners and Health Services