Thursday, July 19, 2012

The cause of my infertility

I have had a lot of people ask me about the cause of my infertility so I thought I would explain everything on my blog.  If things gross you out easily or if you don’t want to know the details of my messed up reproductive system then please don’t read this. Also just so this doesn’t come off wrong, I don’t mind AT ALL talking about my infertility this has been my life for 3 years now and I love helping people understand what it’s like to go through all of this because most people have no idea. 
Each month our ovaries produce hormones that cause the endometrial cells in the uterus to thicken. Our bodies remove extra endometrial cells from the uterus when you get your period, but if these cells implant and grow outside of the uterus then endometriosis occurs. 
How do endometrial cells get on the outside of the uterus?
 I have been told from a few doctors that it gets there from something called retrograde menstruation, this happens when the endometrial cells shed when you get your period and travel backwards through the fallopian tubes and into the pelvis. After this happens the tissue implants (most commonly on the ovaries) and will continue to grow when you get your next period and sometimes the tissue will even bleed a little. Endometriosis typically implants on the ovaries, bowel, rectum and bladder but it can also grow in other areas of the body as well.  
There are 4 stages of endometriosis and unfortunately I am in the 4th stage which is the most severe. I have endometriosis on my ovary, pelvic wall and bowel; I would also get endometriomas (chocolate cysts) which are ovarian cysts that are filled with menstrual blood. 
I have had a few women say that they think they might have endometriosis but the only way to tell is to go to a doctor. If you have a doctor who says that you have or don’t have it just by doing a pelvic exam or just by your list of symptoms then you need to get a second opinion because there is no telling for sure if you have it or what stage you’re in without having exploratory surgery, in which if you DO have it they can remove some of your adhesions.
 I have always had painful periods which are one of the symptoms of endometriosis but when I was around 21yrs old the cramps I had were so bad that I would pass out from the pain. I went to my doctor and they did a pelvic exam and ultrasound and they said everything was fine, but about 10 months later I started having abdominal pain all of the time, so when I went to a different doctor they discovered that I had large ovarian cysts, after I had surgery to remove the cysts they told me that I had severe endometriosis. The point is that even if you have a normal pap and ultrasound they really don’t know what is going on unless they go and look. Listen to your body, if you have severe cramps during your period or a couple of weeks after your period (during ovulation), pain going to the bathroom during your period, lower back or thigh pain and last but not least pain during sex, these can all be symptoms of endometriosis.

Polycystic Ovarian Syndrome (PCOS)
This is hard for me to share because some of the symptoms are VERY embarrassing!!!
 PCOS is caused by a hormone imbalance. Women with PCOS usually have irregular periods, anovulation (no ovulation); some women may have multiple cysts inside of the ovary, acne, hair thinning, facial hair growth, insulin resistance and weight gain.
I started with symptoms of PCOS around the same time I was diagnosed with endometriosis. I first  noticed that I had some facial hair but thought “well since I am Italian I knew this day was coming,” but then my hair started to thin out and I started getting acne on my back. I didn’t get anything checked until Josh and I started trying to have a baby and that’s when they discovered that I wasn’t ovulating every month and that I also had multiple cysts on my ovaries. They ran a hormone panel and saw that my hormones were not at the level that they should be and that was why everything was so out of whack, because when one hormone changes it triggers another, which changes another.  Naturally, ovaries make a small amount of androgen (male sex hormones) but when you have PCOS the ovaries start to make a little more androgens which can cause facial hair growth, acne and can causes ovulation to stop which is clearly important when you are trying to get pregnant. 
My fertility doctor in NY said that my PCOS case was unusual (go figure) because although my hormone levels were lacking in some areas, some of the other hormone levels were high compared to most women with PCOS.  The hormones that I am lacking affect my egg production so they have found that I am closer to menopause then I should be at my age.

A hydrosalpinx in fluid that is in the fallopian tube which makes it close to impossible for an egg and sperm to meet.  The fluid is also toxic so in my case I only had one fallopian tube and it was filled with the fluid, when we did our IVF cycles the fluid leaked into my uterus and made it hard for the embryos to survive. A hydrosalpinx can be drained but it will come back so the only treatment is to have the tube either tied or removed. 

Well, there you have it. If you know someone who suffers from infertility talk to them and try to understand their condition, it’s not an easy fix like a lot of people think it is.