The Working Up Chronicles: How to Deal with Fertility Issues

A.P.A.S.

You have A.P.A.S., they would say. I used to fantasize that it was something cool, something awesome and superhero-ey, like I had a special ability that only a select few in a secret society of agents were chosen to bear.

Turns out, A.P.A.S. is short for Antiphospholipid Antibody Syndrome, and it’s nothing as cool as I was fooling myself it was.

There are varying levels and cases and specifics, but what it simply means for me is that my antibodies are far too intense to the point of rejecting any foreign body, including my husband’s, including any future baby.

Surprisingly, the condition is pretty common nowadays, especially for Fil-Chi couples. (My reproductive immunologist is Dr. Eduardo Lim or Ed Lim in Maddocs for APAS). But in my case, it’s a little bit more complicated because of my PCOS, my Endometriosis, and my Dermoid cyst that may or may not return…let’s just say that it is going to be quite difficult to have a baby just like that.

Still, if you and your husband are working up to add a little bundle of joy into your family, here are just a few tips on how to deal.

When You’re Struggling With Fertility…

1. Know your body.

A pimple—that was where it all began. My husband’s sister-in-law is an awesome dermatologist, and when she checked my face, she knew that the red dots were no ordinary pimples. They were hormonal, and she told me I should get my ovaries checked.

True enough, my OB interpreted my ultrasound results and the cause of my pimples was hormonal indeed—I was suffering from Polycystic Ovarian Syndrome or PCOS. Having polycystic ovaries usually means that your periods are irregular, but as mine occur monthly, I didn’t realize I had the condition until after our sister-in-law suspected it.

PCOS is actually quite common, and despite it being detrimental to babymaking, it can be treated (not cured, but treated). However, what was more alarming during the ultrasound was the incidental finding of a dermoid cyst in my right ovary, large enough to be dangerous to my health and shaped like Mickey Mouse’s head. I felt no pain whatsoever and there was no visible bump near my belly at all, so if it weren’t for the pimple and the ultrasound, we never would have found out about it.

It had to be removed immediately, like having a C-section but not really.

There’s more about this in my other entry HERE, but the point is that it’s important to have regular checkups and to REALLY know your body. You never know how seemingly unrelated symptoms could lead to something else entirely, plus, your physician is going to need to know all about your medical history. So keep those regular appointments in check, because when it comes to having a child, it’s always better to be safe than sorry.

2. Your OB should be your best friend.

My OB is amazing. She was referred by our sister-in-law as well, and she was the one who operated on me to remove the Mickey Mouse cyst. Now that the 6-inch scar across my belly is all that’s left of it, I still owe her my safety when I was lying on the operating table a year ago, strapped down and drugged and fully aware of what was happening around me.

The crucial thing she did during the operation was not only to remove the cyst like a pro, but she also discovered that I had Endometriosis, a condition that basically mucks up your reproductive system and gets worse and worse with every period. There is no cure.

Given that it also has an adverse effect on babymaking, my OB does her best to keep it at bay. I’ve had GNRH Analog injections and various treatments to at least lessen the negative effects of my Endometriosis and my PCOS, and every time we visit the OB-GYN clinic, she already knows my history and all, because, well, she cut me open and stitched me back up.

So make sure you get a good OB who knows what she is doing, and stick to her. You can get second and third opinions or whatnot, but eventually, you have to pick one that suits you best. Having just one OB who knows how to deal with your body is always better than going to different ones. Remember: too many cooks.

3. Budget, budget, budget.

We are not rich.

My husband and I are significantly spending more than what we’re earning just to get all these fertility treatments going. But we’re trying, because it’s important to have a budget for all these, plus medicines, beforehand.

Working up is not cheap. For instance, we’ve already tried Artificial Insemination, or IntraUterine Insemination (IUI) twice. Each procedure costs anywhere between Php 20,000 to Php 25,000 bucks a pop, plus medicine. A GNRH Analog injection for Endometriosis costs Php 9,000 bucks each injection per month, for 6 months. Consultation fees are at Php1,200, ultrasound checkups at about Php 1,300. There is also an important test to see whether or not your fallopian tubes are blocked, and this costs about Php 20,000 as well. I am getting dizzy just pointing these out.

And I’m not just talking about financial investments. Time is also a huge factor, and you have to have enough of it. There are cycles when we have to go to the OB for ovulation monitoring every other day, sometimes every week, sometimes just once a month. And because the lines at her clinic are incredibly long, an appointment with her means spending the whole day there—my husband and I will just have to accept that we both won’t get any work done for the day. Be patient enough to spend your day waiting.

4. Keep your loved ones in the loop—you never know when you could learn something new.

No matter how dire the situation seems, remember that you are not alone. A lot of people could be experiencing the same thing, as fertility issues are quite common nowadays. Back then during our parents’ time, nobody has ever heard of these kinds of problems. But as science is evolving, so are our diseases.

My hubby and I thought that my immunologic problem is extremely rare, but as we grew more aware of the condition and its consequences, we found out that we actually knew a handful of people who’ve had the condition, too. So let your loved ones know what you're going through--they care about you and deserve to know.

5. Keep the faith.

Treatment is not easy. The tests alone are enough to burn a whole in our savings, and there was one particular test that had to be sent to the U.S. for a more accurate laboratory result. It cost us roughly around Php 100,000 just to get that one test aside from all the others. Now, we’re supposed to look for blood donors whose blood units are CMV negative, or someone who hasn’t been infected with the Cyto Megalo Virus just yet. There are no blood type requirements—the  only problem is that 90% of the people in the country are already CMV positive, so getting some CMV negative donors is a stretch. Each screening for every possible donor is at Php1,100, just to check if they are CMV positive or negative. We’ve already tried 23 donors. The odds are not that good.

After finally finding some who passed the test, they were screened for blood-borne sicknesses for Php3,800 per test per person. Afterwards, their blood is processed and the white blood cells are taken, all to be injected into my skin for Php 13,000 per injection per person, totaling about Php 70,000 for everything. That’s just for one month. I need to have the treatments done again for the next month and so on until my condition improves, and the cycle begins anew.

There is also another treatment called IVIG which costs Php 125,000 for a single dose for just the medicine alone. Top that with hospital room charges and doctors' professional fees and, well, the rest is history.

Like I said, the treatments are not easy. The appointments and the schedules with the immunologist are no piece of cake either, as these usually happen during midnight and dawn at various times of the week, again using up a whole day just waiting for our turn.

I have to admit that there are times when my husband and I wonder if we should even go on at all, but at our most disheartened, we somehow still try to keep our heads above the water. After all, I honestly believe that we are so incredibly blessed not to have any terminal illnesses or anything, and to be able to have such a wonderful and supporting set of families and friends. I have faith that we’ll make it through somehow after all this, and hearing the first cry of a healthy baby will make everything worth it.

So keep the faith. Do what you can. Keep trying. And at the end of it all, if it really wasn’t meant for you, have the courage to still smile. Hubby and I are determined to see this through, but we’ve also agreed that if after all this, we still aren’t blessed with a child, it’ll all be okay.

The important thing is that we have each other, and our love will be more than enough. Don’t you feel the same way?