When I was 19, I was diagnosed with a Bicornuate Uterus with a double cervix and partial vaginal septum. I was told it meant I was at higher risk of miscarriage and pre-term labour, and I would definitely need a c-section to deliver due to the septum. I embraced it and, for the next 10 years, was mentally prepared for a high-risk pregnancy down the track but never thought we'd have any difficulty conceiving. That was supposed to be the easy “fun” part.
In October 2019, my partner Luke and I decided we were ready for a baby, so after 16 years, I stopped taking the pill. Naively, I thought it might take a few months. After 18mths TTC with no luck, I saw my Dr, who ordered tests that showed I actually have a Complete Septate Uterus (a fibrous septum completely divides my uterus in half), and Luke has low sperm count and low morphology. We were told we had very little chance of ever conceiving naturally and that our only hope would be IVF.
I stupidly thought IVF meant we’d just pay a lot of money and were guaranteed a baby.
Starting IVF
As we live in Gladstone (Central Queensland), we had limited IVF options locally. So I researched and researched and found a fertility clinic and specialist on the Sunshine Coast we liked the sound of. We got all the required preliminary tests done, had our first consultation, and signed all the paperwork to start our first IVF cycle 2 months later.
Initially, I was really scared about what effect the hormone injections would have on me, but I soon discovered one of the worst parts of IVF for me was the waiting. Waiting for your period to start. Waiting for ultrasound appointments to see if any follicles have grown. Waiting for the egg collection procedure. Waiting to see how many eggs were collected. Waiting to hear how many eggs had fertilised overnight. Waiting to hear how many embryos had made it to Day 5. Waiting for the day, you can take a pregnancy test to see if the embryo transfer worked or not.
Our first IVF cycle resulted in 6 eggs collected, 4 fertilised, and 2 embryos. We were ecstatic. We did a fresh transfer, and 6 days later, there was a faint second line on the pregnancy test. It’d worked, and we were one of the lucky ones. It worked for the first time around!
Two days later, I started bleeding and was sent for bloods. My HCG came back at 8 (ideally 100+), and our specialist said it was a chemical pregnancy. We decided we didn’t want to transfer our last embryo without having more in the freezer, so we decided to do another full IVF cycle to bank some embryos for future kids.
My dosage was increased, and our second IVF cycle resulted in 10 mature eggs being collected! The relief I felt at that number was indescribable. It came crashing down the next morning when the embryologist called and said that 0 eggs had fertilised overnight. None. We were allowed to transfer our remaining frozen embryo on Day 5 and decided to do it.
Six days post-transfer, there was a definite second pink line on the pregnancy test, but it no longer brought me joy or excitement or relief. I now knew a positive pregnancy test didn’t mean a baby. A few days later, on the day of our blood test, I started spotting and braced myself, but my HCG came back at 170! I continued spotting over the next few days, but follow-up bloods showed my HCG was perfect at 450. I was 4w6d pregnant. As we’d been so open with our families about IVF, we shared the news with them and celebrated.
At 6 weeks, I started bleeding heavier. I went to the hospital, where blood and ultrasound both showed I’d had a miscarriage. We had a follow-up consultation with our specialist, who said he wouldn’t run any further testing until we’d had a third loss and that it was just bad luck and a numbers game.
He wanted to follow the same protocol as previous cycles and not change a thing.
I followed my gut, and we left that fertility clinic.
IVF round 3 and 4
I did more research and found a highly recommended clinic in Brisbane. Our first consultation with our new fertility specialist was fantastic! He wanted to change me onto a different stim medication that would help with egg maturity and use ICSI to help with fertilisation. We also decided to have further testing and investigations done to see if there were other infertility factors we weren’t aware of. I had a Laparoscopy to check for endometriosis, a Hysteroscopy to get a closer look at my uterine septum, and an endometrial biopsy to test for elevated Natural Killer (NK) Cells.
The surgeon found (and removed) Stage 3 Endometriosis covering my uterus, ovaries, uterine ligaments, and bladder. I’d had absolutely no symptoms or pain; my only symptom was infertility.
My uterine septum apparently wasn’t too thick, and each uterine cavity could likely sustain a pregnancy. I was told my NK Cell levels were ok. Luke’s test showed he also had high DNA fragmentation. After I’d recovered, we started our third IVF cycle. This was it. Our “clean slate” round. I had 11 mature eggs collected, 10 fertilised, and we had 4 embryos on Day 5. We were over the moon; we had 4 embryos!
We did a fresh transfer, and 6 days later, there it was. That second pink line. But I’d also started spotting.
A few days later, my bloods showed my HCG was 120, which was exactly where my specialist wanted it. I was 4wks pregnant. Follow-up blood tests showed my HCG was continuing to rise but wasn’t doubling as it should, and I was still spotting. I was pregnant, but… At 6 weeks, I started bleeding heavily. An ultrasound showed only a gestational sac measuring 5w3d but no yolk sac or foetal pole. I continued bleeding heavily over the next few days, and bloods showed my HCG had dropped from 1700 to 140. We’d had another miscarriage.
We were told it was likely due to chromosomal abnormalities or the embryo had been implanted on the septum rather than the uterine wall. The following month we decided to transfer 1 of our 3 frozen embryos. Our fourth IVF cycle was a low-dose stimulated natural cycle, and the embryo was transferred 5 days after I ovulated. 6 days later, there was no second line. Not even a hint of one.
My blood test confirmed the embryo hadn’t implanted, and we weren’t pregnant. Over the following weeks, I thoroughly reviewed our results from our tests so far to see if anything had been missed or if there were any other tests that might help us. I found the results from my endometrial biopsy that revealed my NK Cells were 16.2%. From the extensive research I’d done, I knew that anything over 10% should be treated with an immune protocol. I was frustrated and angry at the surgeon for telling me the results were ok and at myself for not requesting the results sooner.
IVF round 5
Elevated endometrial NK Cells mean my immune system is essentially attacking embryos thinking they’re bad for me. After speaking with our fertility specialist, we decided to do another full IVF cycle to try and get some more embryos frozen (we still had 2 frozen but wanted to try and get a couple more just in case).
This time I’d also be on an “immune protocol” (Prednisolone and Clexane) to treat my elevated NK Cells. Our fifth IVF cycle resulted in 13 mature eggs, 11 fertilised, and 5 embryos made it to Day 5. We did a fresh transfer, and 5 days later, there was that second pink line. And no spotting! For the very first time, I had a positive pregnancy test with no spotting. And so I hoped.
Three days later, my blood test showed my HCG as 89. A little on the lower side, but still ok. I was 4wks pregnant. 3 days later, my HCG was 310. It had not only doubled but more than tripled. Over the next 2 weeks, my HCG increased perfectly, but at 6wks I had heavy bleeding for 3hrs and was instantly terrified. Blood tests showed my HCG was still perfect at 14,707, and we were booked in for an ultrasound 3 days later. Our first ultrasound at 6w3d showed our baby with a perfect heartbeat of 108 and measuring right on time. The tech also saw a small subchorionic hematoma (SCH), and we were told that was responsible for the bleed, and it was really common in IVF pregnancies.
Our baby is on the way
We had follow-up ultrasounds at 7 weeks, 9 weeks, and 11 weeks to monitor the SCH, and by 13 weeks, it had completely resolved and was no longer there. Our baby has been measuring on track and looks perfect in every way. My placenta was overlying my cervix until 22 weeks. I’ve had additional ultrasounds to monitor my cervical length and marginal cord insertion, so it’s been far from a stress-free pregnancy.
Still, so far, everything has been looking good! I’m currently 29 weeks pregnant and sitting here feeling him wriggling and kicking, and it makes IVF and all our pain feel like another lifetime.
My biggest advice is to trust your gut and be your own biggest advocate.
Nicole shares her story from Gladstone, Australia.
Thank you for sharing x Emma & Lynette.
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