My journey to motherhood did not go as I expected it to. In August 2018, about a week before my husband and I were married, I was diagnosed with endometrial hyperplasia. Endometrial hyperplasia is a thickening of the uterine lining due to having an irregular menstrual cycle. I was not diagnosed with the actual cause of hyperplasia – polycystic ovary syndrome (PCOS) – until the following spring.
A uterine lining biopsy determined the presence and severity of hyperplasia. The results of my first biopsy determined that I had simple endometrial hyperplasia without atypia – negative for precancerous cells. Hyperplasia has a broad spectrum of severity levels, ranging from simple to complex hyperplasia with or without atypia. Complex hyperplasia with atypia is the worst level and would most likely show precancerous cells. Luckily, mine was in the earliest, least severe, and most treatable stage.
Our Treatment Plan
Hyperplasia can be treated by the following methods: a hysterectomy, a D&C, or a progesterone regimen. I had a D&C in October 2018 to reset my cycle. It also provided the opportunity for further testing on the removed tissue. Unfortunately, it did not reset my cycle. Biopsy results showed that hyperplasia was still present, so I was prescribed daily progesterone.
In addition to taking progesterone, I also had to go back to see my doctor every six months for biopsies to check the effectiveness of treatment. The biopsy I had in May 2019 had me extremely frustrated. I had been taking progesterone for over six months and was told that hyperplasia was still detected. My doctor said that I should either have a hysterectomy if I had no desire for children or continue with progesterone if I wanted to keep my uterus. I was so discouraged.
My husband and I decided it was time to get a second opinion. I made an appointment with a gynecologic oncologist. He reviewed my medical history as well as the results of my past biopsies. I was told the hyperplasia would go away if I got pregnant and referred to a fertility specialist. Because our end goal was to start a family, I thought this was excellent news. I made an appointment with a reproductive endocrinologist to explore the next steps. The appointment went well, and I was excited to proceed. However, the results of several blood tests showed that I had underlying medical conditions to take care of before I could move forward with fertility treatments. I continued taking progesterone through January 2020 but stopped as I felt I was not getting the desired results.
After a career change, my husband and I moved to Central Massachusetts in April 2020. I spoke with a local doctor here in June and was put back on progesterone but for ten days out of the month instead of continuously. I was also referred to Boston IVF. We were finally getting somewhere! For insurance purposes, we were required to go through six rounds of intrauterine insemination (IUI) before we could proceed with in vitro fertilization (IVF).
We started the process in November 2020. I was prescribed Letrozole (Femara) to stimulate ovulation, and an injection called Ovidrel to cause the ovaries to release the egg(s). Because of my irregular cycle, I was unfamiliar with keeping track of ovulation and cycle days. However, thanks to a couple of apps I came across, I figured it out fairly quickly.
Each month followed the schedule below:
- Cycle Days 3-7: take Letrozole.
- Cycle Day 12: have an internal ultrasound to check for follicles and a blood draw to check hormone levels.
- 24-36 hours before the IUI: administer the Ovidrel injection.
- Cycle Day 14: have the IUI.
- Cycle Day 28: have another blood test to determine pregnancy.
My husband and I went through this process every month from November 2020 to June 2021. We missed a couple of months due to travel and the pandemic, but we persisted for the required six IUIs.
Some months were extremely hard, especially the closer we got to that sixth required IUI. Anxiety and dark thoughts would overwhelm me after taking some of the medication. I constantly questioned if going through the process – all of the stress and appointments and medication – was worth it.
The large community of fertility warriors on social media was such an encouragement to me. People who were going through similar struggles as I was, people who understood, and people who would answer questions or offer kind words of hope and support. Knowing that I was seen, heard, and supported and that I was not alone gave me the courage to press on.
Our sixth IUI was on June 12, 2021, and we found out I was pregnant on June 26th. I will never forget that phone call. The smiling. The tears. The phone calls to our family who were so supportive of us. It changed our whole world! Our daughter was born on Valentine’s Day 2022 – the perfect end to my motherhood journey.