Problem: Can't get pregnant!!

Brief History: I had severe (seriously - it was really bad) UC for 8 years. I had the j-pouch surgery done; step 1 in 08/2006 and step 2 done in 10/2006. My husband and I waited until we got the go ahead from my doctor to start trying which was in 05/2007. We have been trying for almost a year now. We have been pregant at least twice in the year, but I can't seem to stay pregnant. My husband has been tested and everything is fine on his end. So now we are approaching this as what do I need to do. I went to see my primary care doctor and she is referring me to a reproductive endocrinologist, at my request.

The Issue: I have read many of posts on here regarding IVF and various infertility treatments. Has anyone here been to see a reproductive endocrinologist? I have looked up the info from the Alan Beers Center in California and am contemplating using them in adddition to the doctor here in Louisiana. It makes sense what they say about people with immune system diseases and concieving. How our body in a sense attacks itself when our colon's are freaking out and how a baby would be a foreign object in our body and cause our body to attack it because it's used to that reaction. So - Before I sink the money into this, I want to know if anyone has found reproductive endocrinology to be helpful? I really don't want to do IVF yet - I'm 26 and know I have time - but I don't want to run out of time - and am trying to figure out where I should put my money now. IVF or Repro Endocrinology? Any help would be greatly appreciated.

Brandy
brandy_n_flores@hotmail.com

Most of the time, when you are being treated for fertility problems, you are under the care of a reproductive endocrinologist.
I saw one because we had trouble conceiving. I NEVER got pregnant and rarely ovulated...or if I did ovulate, it wasn't a good quality ovulation.
They'll probably do more tests on you and your husband. They will most likely test his sperm again. (strict morphology test). When my husband was tested through a regular clinic, his tests came back completely normal. When we went to see the RE, they sent us for the strict morphology test and found his problem. They also found that I had a few problems too...but I was never diagnosed with anything. All my bloodwork came back in normal ranges...except for when I should have been ovulating. They did ultrasounds and a hysterosonogram. They still didn't find anything. My tubes were not blocked but they did note that they weren't quite in the right place. They did not do a laparoscopy on me because they were too scared of there being too many adhesions sticking to my organs. They never found anything but said that with intrauterine insemination with injectibles, I would have an 8% chance of conceiving with the problems both my husband and I have. We conceived on the first try.
We did try clomid, and it did help me ovulate...but after 7 cycles, we moved on...

Good luck! Seeing an RE is a step in the right direction. They can perform tests that no other doctor can do. They are also experts on conceiving.

Keep us updated!

Thanks! I guess what I should've asked is how do you know if the RE you're seeing has experience with patients with UC/J-Pouch/RA, etc and is that experience relevant to the care they provide. I have been on the Alan Beers Center website and they have a lot of good info. If I can't find answers here in Louisiana to help us, I may go to California to see them for a consultation.
I am excited, scared and nervous about my RE appointment. But I also keep hoping I am going to wake up and find that there is nothing wrong and *poof* I'm pregnant.
My husband and I talked about the whole thing tonight and actually talked about getting a surrogate if getting pregnant doesn't work out for us. We'll see. I remember being told if I got the surgery I was cured, it feels like all they did was remove the colon problem but they didn't fix my immune system problem. I guess I went from one medical journey and on to another. I'll keep you guys updated. Thanks for the info. My husband will be glad to know he gets to do tests too.

You are fortunate that you have become pregnant, so that means that your tubes are open and adhesions related to the surgery are not your primary problem (that's the bulk of the fertility problem for those having j-pouch surgery). IVF may not be your solution, if your real problem is an inability to sustain the pregnancy. Your problem could very likely be something totally unrelated to your IBD and/or surgery. Most of the data indicates that UC does not lower fertility. So, I think you are on the right track in looking for a fertility specialist who will assess you individually to determine what is causing your inability to hang on to a pregnancy. You probably would not need to come to California for that though.
http://www.ccfa.org/info/about/pregnancy

Jan

This message has been edited. Last edited by: Jan Dollar,

I don't think UC (mainly the symptoms) inhibits fertility - but it makes sense that while UC is an immunological disease and has caused your body to have an abnormal reaction to its own organ that your body could have the same reaction to a fetus. Which is what I believe may be taking place. I can only assume that my reproductive anatomy is fine (I actually asked my doc mid-pap exam if everything felt okay). I had a child 9 years ago pre-UC diagnosis totally unassisted and truly beieve that I can again - maybe with a little help this time around We'll see!

1 in 4 couples in the general population have trouble with fertility - meaning that they do not have a successful pregnancy after 1 year of unprotected sex. There are a lot of things that an RE can evaluate, even without any UC/pouch experience. ONce those things are ruled out, then pursuing something more specific may make sense.

A few things to have done immediately - check your thyroid. If it is off, it could absolutely impact a pregnancy. Have your progesterone checked. Low progesterone levels have been show to cause early miscarriage (my girlfriend miscarried twice at 8 weeks, was found to have low progesterone, was treated with progesterone suppositories for the first trimester of her current pregnancy and is now 24 weeks and expected to deliver full term). Both of these issues are easy to test and fairly easy to treat.

Another possibility is that the embryos that are formed when you have gotten pregnant are not healthy. My cousin had this issue. Her husband's sperm, when it fertilized an egg, half of the time the chromosomes did not line up. That meant she had a 50% chance of miscarrying. She had 4 miscarriages before her 2 children were born. Testing of the sperm from the usual method does not identify this issue. It was only dx through testing of fetal tissue from one of the miscarriages.

So, it is worth seeing an RE. IF you find one wtih pouch experience great, but not essential in the early stages.

As you probably know, your chances of IVF working are higher the younger you are...so, find out asap if there are technical issues and get those worked out so you can decide if and when you want to try IVF.

Finally, just because you had one child without difficulty, doesn't mean problems (outside of UC) couldn't have developed since, especially since your first child was born when you were quite young when getting pregnant is the easiest. Secondary infertility is quite common.