Tubal Factor & Hashimoto’s: Ruby’s Story [JOURNEY]

February 15, 2021

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Today’s journey story of a woman named Ruby. She is a 32-year-old marketing manager who enjoys playing soccer, redecorating, and yoga. After trying to conceive for a year and a half, Ruby and her husband saw a reproductive endocrinologist. All of her hormone levels were normal, so nobody suspected severe issues. Her husband’s semen analysis was also normal. Over the next year, they tried timed intercourse and IUI cycles, all without success. At that point, she started listening to this podcast and decided to pursue a laparoscopy. To everyone’s surprise, she had a hydrosalpinx and adhesions. Her tubes were cleared and are now open and looking well. Still, they proceeded with IVF. Four egg retrievals resulted in several 8-cell embryos and 3 expanded blasts, but poor egg quality is suspected. They switched clinics and she became pregnant after their fourth retrieval. Unfortunately, it ended in a miscarriage. Join us to hear how Ruby is recovering from a D&C — and what’s coming up next in her journey.

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What you’ll hear in this episode:

  • Before infertility, Ruby was happy, social, and ambitious
  • How she met her husband when they were teenagers but didn’t date until they met a few years later at a party with mutual friends
  • As a couple, they are a good team who are fun-loving, but they are opposites in many ways
  • How Ruby always wanted to have kids after spending her teenage years as a babysitter
  • Since Ruby’s biggest life plan was to have kids, she planned her education and career around plans for a family
  • When they married in 2016, they started trying to conceive right away, and Ruby tracked her cycles
  • When she had no success after six months of trying, Ruby switched doctors after her OB/GYN brushed off her concerns
  • When test results were normal, they tried several timed intercourse cycles with Clomid
  • When Ruby was referred to a reproductive endocrinologist in 2018, more tests showed a few concerns with high TSH and Chlamydia antibodies
  • An HSG showed that her tubes were “perfect,” and they started IUI cycles with different medications; five cycles later, they still had no positive pregnancy tests
  • When Ruby started researching, she found the Beat Infertility podcast, which led her to advocate for a laparoscopy before moving to IVF
  • How Ruby drove to a specialist four hours away for her first-ever surgical procedure
  • After a day’s delay, the procedure showed a hydrosalpinx on the right tube and bad adhesions on the left tube and ovaries
  • She was given a 5-20% chance of conceiving spontaneously and a high risk for an ectopic pregnancy
  • As they decided to proceed with IVF, they took time off from treatment but were thankful for the good healthcare coverage in Germany that covers three IVF cycles
  • With nine eggs retrieved, the fertilization rate was only 50%, only one embryo made it to Day 5, and ICSI was the recommendation for future cycles
  • When Ruby’s medications were changed, 18 eggs were retrieved, but there were no good embryos
  • In a natural cycle, two frozen embryos were transferred, but the result was negative
  • When the remaining embryos were thawed and cultivated to Day 3, there was still no success
  • With one cycle left to be funded by Germany’s healthcare system, Ruby was hopeful but had doubts about her clinic
  • Her doctor had no answers but was still confident; a new IVF cycle yielded 16 eggs, and two perfect Day 3 embryos were transferred, but the result was negative, and Ruby was devastated
  • Ruby suggested another laparoscopy, which showed clear tubes and a normal-looking uterus
  • When 2020 began, Ruby had an ERA test and planned for a FET; a Day 3 transfer still brought a negative result
  • With another FET, two Day 3 embryos were transferred–negative again
  • As they took another break, Ruby changed clinics for one more cycle; her new doctor was very honest about doing only one more cycle because her body had been pushed so much
  • Ten eggs yielded three blasts, and two were frozen and a fresh transfer of the other; things were looking good!
  • Ruby’s home pregnancy test was negative, even though she felt nausea and other pregnancy symptoms
  • A blood test and ultrasound confirmed her first pregnancy, but a later ultrasound at her Ob’s office showed no heartbeat
  • Ruby insisted on a D & C the next day and chose not to have genetic testing done
  • Now, eight weeks later, she has recovered and plans for a FET as soon as possible
  • How Ruby copes with ongoing disappointment and losses
  • A closer look at why Ruby ended up switching clinics
  • How Ruby’s support system developed and how it helped her day-by-day
  • Other sources of hope and strength for Ruby
  • How Ruby competes as a soccer player while having fertility treatment
  • How Ruby and her husband chose to open up to their bosses to justify the appointments and the flexibility they needed
  • Examples of how Ruby advocated for herself
  • What’s next for Ruby? “I think we will transfer one of my two frozen embryos when I’ve recovered from the D & C.”
  • Since it’s illegal in Germany to thaw and PGS-test her embryos, she could choose to have another retrieval with PGS testing to create more embryos

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