I am so incredibly excited to finally be able to announce that we are having A BABY!
The past few months have felt like the longest stretch of time to keep this joyous news quiet, but I am over the moon to finally share the news of my pregnancy. And while I am thrilled to finally be nurturing the growth of a healthy baby, our journey to this point was not as easy or straightforward as we had hoped.
Infertility or struggles conceiving are not widely talked about, and I have to admit that I was very closed off about our pregnancy efforts to most, but I feel that it is important to share our stories so that more women feel they are not alone in this frustrating journey. Today’s post is mostly a happy one- because it ends in the best way possible!- but it’s also a glimpse into my journey to conceive, how I challenged my relationship with food and exercise more than I ever had, and what this experience has brought to light about my own health.
When our journey began
My husband and I started to have the “when are we pulling the goalie?” discussion in the fall of 2018. We knew we wanted to get pregnant soon, and hoped it would be an easy road. I had been taking hormonal birth control for many, many years and had no idea what would happen once I stopped, but figured all would be well- I was in the best shape of my life and things were good! We officially started trying in January of 2019. My period came back as “normal” as I remember it, meaning every 28-30 days, and every month I did the typical pee on sticks and anxiously wait 2 weeks until, sadly, my period came. For 4 months we didn’t have any positive news, which was discouraging, but figured my body was still sorting itself out.
In May I landed my cookbook deal and let’s just say that the work and stress associated with a very tight deadline did not agree with my body. It was then that my period went into hiding and didn’t come back. I suspected it might be stress related, but a quiet voice in the back of my head also started to bring up questions about my body weight, eating, exercise, and the impact all of those have on a woman’s hormones. After two months of no period I started to get worried.
Figuring some things out
After 6 months of no success I was getting antsy, so I decided to go back to my OB. She did blood work and recommended that to get my period back I do a cycle of Provera, which is a synthetic version of the hormone progesterone. I took the course of Provera and a week later got a bleed- horray! I thought this was going to kickstart my body back on its merry way, but the blood work revealed some issues with my thyroid. My TSH was borderline elevated and she said it’s likely not impacting my fertility (which I now know that it was actually elevated to a point not optimal for fertility!), but I might need to be on medication when we do get pregnant and that I could see an endocrinologist for more testing if I wanted.
I balked at going to specialist, and so instead asked one of the doctors where I worked to run a full thyroid panel, including to test my antibodies. Well, turns out it was a good thing she checked those as I came out positive for having elevated anti-TPO antibodies, which is indicative of Hashimoto’s disease. Hashimoto’s is an autoimmune condition where the thyroid starts to attack itself, and over time can lead to hypothyroidism. I was confused and shocked as I in no way appeared to be your typical Hashimoto/hypothyroid patient- I was not overweight, didn’t have trouble losing weight, and didn’t feel tired! When I told my parents the news it was brought up that I actually have a family history of hypothyroidism- go figure! I suspect things were also a little crazy due to the recent professional stressors of the book and work in general.
With his information and learning through my own research that thyroid health can impact so many things, including fertility, I decided to go on low-dose medication. I didn’t, and still don’t feel any different, but my levels were lowered and I took that as a hopeful sign that our chances of conceiving just got bumped up!
At the same time I doubled down on my cycle tracking and ditched the ovulation sticks in favor of wearing the Ava bracelet, which is a convenient way to measure your basal body temperature. A rise in temperatures would indicate that you ovulated and if it stays elevated you likely conceived. I would awaken every morning around day 14 hoping that my temp spiked and we were a “go”. This didn’t really happen for me.
When things got real
Well, with medication in my system, the stress of the cookbook over with, and the excitement of starting a new job going on, I thought this is it- we’ll get pregnant in no time! Nope, this was not true. My period never came back after that first round of Provera, and since my OB knew we were serious about conceiving she referred us to a reproductive endocrinologist. We booked an appointment for what seemed like a lifetime away, in early November.
In the meantime I decided to do a little more homework and explore my relationship with my body more than I ever had. You may know that I had gotten very active with running over the past years, training for and completing my first marathon and continuing to run most days of the week. I truly never felt better and enjoyed the high and strength that I felt after runs. Yet there was a part of me that started to question if all my mileage was the healthiest habit for conception for me personally. I wondered if I had developed hypothalamic amenorrhea (HA), which can occur in women who might be over-exercising or restricting their energy intake. So, slowly over our slow to conceive year I stepped back from running and exercise more and more. I was still active, but had the thought in the back of my mind that intense training might have been doing me more harm than good. Yet, my period never came back.
Along with stepping back from exercise, I also decided to do a deep dive into my hormones and had an RD friend complete a DUTCH hormones panel test for me. With constant acne on my jaw line, and now the missing periods I was also suspecting I may have polycystic ovarian syndrome (PCOS), despite my doctor not seeing an overgrowth of follicles on my ovaries. The results from the DUTCH test were enlightening and showed that I had an imbalance of estrogen and progesterone and that my testosterone levels were quite high. At last, this seemed to explain why I wasn’t ovulating, had missing periods, and suffered from acne. I was never given a formal diagnosis of PCOS by a doctor, but I seemed to fit some of the criteria. To help reestablish my hormone levels my dear friend recommended some supplements and also nudged me to consider gaining some weight as while my BMI might be “normal” it’s possible I just wasn’t at MY optimal weight for conception. Eat more? Sure thing!
I spent the next month really tuning in to my hunger signals and often times overriding them because I was trying to put some pounds on the scale. I continued to exercise in a gentle way, and started a supplement regimen. And do you know what happened? I came home one night, after attending a talk for a fellow RD’s book about menstrual health ironically, and cried with joy that MY period had come back!
Of course it would happen that things seemed to be naturally turning around right as we prepared for our appointment with the reproductive endocrinologist in early November. We went to the appointment, told her the happy news of my body seeming to sort itself out, and did some blood work. She concluded that based on my blood work I was still not ovulating and she couldn’t predict how/when/if that would regulate. She said our best option was to start the fertility treatment Clomid, which would help grow some big healthy follicles. I was a bit apprehensive at first and really wanted to trust that my body was on the road to repair, but I also didn’t want to waste more precious time. So, we ordered the medication and hormone injection, which is used to “trigger” ovulation, that would come in the mail in a few weeks.
Prior to taking the medication and doing “the dance” I was also scheduled to have an HSG procedure to ensure there were no issues with my fallopian tubes. Not looking forward to this procedure at all, I showed up to the hospital the day before Thanksgiving to get this painful part over with. Upon arrival they make you take a pregnancy test and of course mine was negative so they sent me across the way to check in for the HSG. As I checked in I got a phone call from their office that they’d like to repeat the pregnancy test…
I thought, “you have GOT to be kidding me. This isn’t funny.” I marched back over there, a bit frustrated but also shaking with nerves and excitement, and peed on another stick. And lo and behold, they see a very faint line! I’m still not believing it and neither are the 5 other nurses standing around my urine dip, so we decide to do blood work that would tell us for sure.
The big news
The blood results, which are much more accurate than a urine pregnancy test, would take at least an hour to come back. At this point I was more than freaking out and called my husband, who was already in Pennsylvania for Thanksgiving. I left the hospital and headed uptown to meet my brother-in-law and niece, whom I would be driving to PA with. As we were about to leave my phone rang- it was the doctor.
I stepped away and she confirmed the unexpected but surprising result that
I was in utter shock and at the same time so incredibly happy. The drive to get to my husband felt like forever, but I had my precious niece to keep me company and smiling from ear to ear that in 9 months I would have one just as perfect.
We were ecstatic and anxious the entire holiday weekend, but it was such a special time to keep the news to ourselves until we had definitive confirmation through bloodwork and our very first ultrasound with the doctor.
We spontaneously, naturally, and happily got pregnant in what I think was the best way possible.
It’s hard to say what exactly “did it”- whether it was slowing down with my exercise, eating a bit more and gaining just the right amount of weight for my body, getting my thyroid in better health, the supplements to balance my hormones, managing my stress better and practicing more self-care, or just stopping trying and forcing it so much. But whatever did it, I am eternally grateful that we are blessed with this little miracle.
I know so many women deal with their own hormone and fertility issues, and many of you struggle for much longer than I did to get pregnant. I see and hear your stories every day at my job, and I always want to extend compassion to you. I don’t share my story in an effort to compare myself to some women who undergo years of treatment or have unexplained infertility, but I know that any issues related to your fertility and feeling like you can’t trust your body can feel isolating and hopeless at times. I want you to know that you are not alone. Doctors, dietitians, therapists, and many more people are in your corner to help you create the family you’ve always wanted.
I am happy to get to share more about my journey through pregnancy to motherhood with you all, and also talk more about nutrition as it relates to women’s health, hormonal imbalances, and prenatal and post-natal care.