“You couldn’t just wait until you got to your new job?” was not what I expected to hear upon announcing to some colleagues that I was pregnant. Mainly because it had been such a struggle for me, for us, and not many knew just how hard the past year had been. No, it definitely was not my plan to have a due date of October 15, smack dab in the middle of my first semester as a brand new faculty member. My plan was to have a baby already. But making plans is like asking for them to be broken.
Unfortunately, what I’m about to describe is probably familiar to a lot of you reading. It affects about 10% of women in the United States, probably more. And, in addition to the slew of physical symptoms it can cause, it can also be a direct cause of infertility. I was diagnosed with endometriosis in November 2017, after more than a decade of doctor’s visits, invasive ultrasounds, and bouncing between different forms of birth control. This disease is characterized by endometrial tissue growing outside the uterus. These masses are activated by estrogen and so, they flare up and bleed every cycle, just like your regular uterine lining does. This can cause severe damage to tissues and can be on virtually anything in the abdomen. Endometriomas have been found on women’s digestive tracts, diaphragms, even on their appendix.
By age 15 I knew something was up. I had been having periods for 4 years already yet mine were nothing like my friends. They came irregularly and were almost always accompanied by severe cramps, a lot of spotting, and severe mood swings. When they did come they were heavy and long. Finally at 16 I went on birth control but to no avail. The PMS continued, the cramps got worse, and the periods, while now regular, were just as heavy and painful as before, if not more so. Plus now I had fun, new symptoms like incredibly painful sex. I tried several pills, had painful procedures like a hysterosonogram, and still nothing changed. Eventually, Obamacare made it so that I could get an IUD to hopefully stop my periods entirely. While my periods did completely stop after a couple months, the symptoms did not. Sex was still painful, I still had bouts of the horribly depressive PMS, and painful cramps were still common.
Fast forward a couple years and I’m now married to a super awesome guy, I have a stable, well-paying job, and it’s time to start our family. We talked about it for months and decided now was the time. I had my IUD removed in February of 2017. By March I was pregnant. Not that this was a total surprise. My family history suggests that we are the human version of Mesopotamia. After peeing on a couple sticks it was time to share the good news with our families – which we did immediately.
Our joy was cut short about two weeks later when I noticed bleeding, not spotting, but bleeding. We got an appointment with a local clinic and, after some bloodwork, I learned that my HCG was 27, only 2 above the cut-off for pregnancy. My NP tells me to go to the hospital for an emergency ultrasound. Their concern is an ectopic pregnancy. Ectopic pregnancies occur when a fertilized egg implants somewhere outside the uterus, usually a fallopian tube. These can rupture, causing infertility and, in some cases, even death.
My husband and I get to the hospital and are immediately brought to the ultrasound room. The tech shows me that my uterus looks like something should be implanted – but there’s nothing there. An empty womb. Nothing in my fallopian tubes. Nothing at all. This is what’s called a blighted ovum, and they’re incredibly common. So common that they’re estimated to make up 50% or more of first trimester miscarriages. This number may be higher because they tend to happen very early so a lot of women potentially experience a blighted ovum and never realize it. In my case I had begun experiencing the typical first trimester symptoms: fatigue, morning sickness, the whole shebang. There was no mistaking it. I miscarried naturally a few days later.
Everyone we talked to and everything we read assured us that this was not an indication of future problems and that most women go on to conceive within a couple months. Those hopes kept me going until late July. By this time my PMS had kicked into a gear I didn’t know existed. I was having days of severe cramps, random bleeding, and heavy, incredibly painful periods. The symptoms I thought were bad at 16 were now in overdrive. My estimate is that I was experiencing some sort of symptoms more than 50% of each month. After describing my symptoms to a nurse over the phone she scheduled me with a new doctor, this one in a bigger city, an hour and a half away. I was so desperate for relief I would have driven any length of time.
I described everything to my new doc. The years of horrible cramping. The painful sex. The miscarriage. Trouble getting pregnant again. Mood swings. All of it. He pretty quickly came to the conclusion that I probably had something called endometriosis. For the first time in my life, everything clicked. I am a poster child for endometriosis. He suggested I track my symptoms for a few more months and, if things did not get better we would move forward with a laparoscopy (surgery to remove endometriomas).
November rolls around and, you guessed it, my symptoms had only gotten worse. It had now been 9 months since my miscarriage (for comparison, over 80% of couples conceive naturally after 6 months). We were heading into “infertility” territory which is a terrifying territory to think about. My doc was certain that surgery was the answer so I scheduled it for the Friday before Thanksgiving to give myself plenty of time off.
The surgery itself only took about 30 minutes. One thing you learn quickly about endometriosis is that symptoms are not indicative of severity. Some women have severe endometriosis and no symptoms, others have little to no visible signs of it and are in constant pain. I was somewhere in the middle. These types of surgeries can take anywhere from a few minutes to several hours depending on the severity and complexity of the masses. He removed a large mass from behind my uterus (the most common place for endo to occur), a couple benign masses from my fallopian tubes, and several small spots from my uterus. He glued my three small incisions closed and sent me on my merry morphined way.
I can’t describe how immediate the relief was. Unless you have lived with this disease, it is impossible to convey. The pain was gone. The bleeding was gone. Recovery from this major surgery was actually more pleasant than any cycle I had had before. My symptoms were entirely gone. It amazes me still how something so small (the mass behind my uterus was about the size of a silver dollar) could wreak such havoc on my life. These little tiny spots were the cause of everything that had been so painful for almost two decades.
My doc said the first 4-6 months were the most crucial to get pregnant naturally after this surgery. Even removal doesn’t guarantee that the disease won’t come back so it was important to try now and not wait. By this time I had started looking for jobs and had even interviewed at a few places. But when you have been trying for a year and your doctor is telling you now is the time to try again – you don’t put that off for anything.
So two cycles went by and nothing. It’s now been a full year since my miscarriage – 12 months without naturally conceiving is considered infertility for women under 35. My period is due but absent. I grab a pregnancy test to jinx myself into starting my period so I can make that first infertility appointment (history tells me that your period starts about an hour after you pee on the stick). Only this time it said positive. So I took another one. Positive again.
So no, this wasn’t the perfect timing. No I didn’t plan to give birth halfway through my first semester. I didn’t plan to navigate morning sickness during campus interviews. I didn’t plan any of it this way. I planned on this happening a long time ago, and with a lot less pain and suffering. I’m just thankful it’s finally here.