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Episode 343

Alana

In this episode, Alana details her long and challenging fertility journey. After years of IVF using her own eggs and donor sperm, she navigated the loss and grief of multiple chemical pregnancies and miscarriages. Alana and her partner, Amanda, made the decision to use Amanda’s eggs because the quality of Alana’s weren’t genetically viable. After the first transfer Alana fell pregnant and, despite a scary bleed at six weeks, her pregnancy was a relatively smooth experience. A self-confessed researcher and planner, she opted for continuity of care with a private obstetrician and when her waters broke at 36 weeks, she laboured beautifully and experienced a physiological birth and third stage.

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“When I met Amanda I was researching being a single mum by choice but then we got together and we talked about starting a family quite early on. Amanda loves kids but knew she never wanted to carry a pregnancy whereas I desperately wanted to be a mum and experience pregnancy and birth. That was that for us, I was going to be the biological and birth mum and be the one who went through IVF.

“We had friends who were pregnant at the time that we started researching so we went through the same clinic as them. I thought I’d done a lot of research but I was also quite naive. IVF isn’t a miracle cure so even though we’d done lots of testing and everything looked fine, it was a very complicated process for us.

“The options for sperm are to find our own donor – someone you know or someone you find on the internet – or you can have a clinic-recruited donor. There is a bit of a donor shortage in Australia and Australian donors are few and far between because there’s no compensation for it but there are American donors because they’re compensated for it.

“We started with IUI and we did three rounds and it was crushing when it didn’t work out. The doctor wrote me off as infertile after those rounds which was really hard to hear because I thought that all I needed was a sperm donor, not that I’d have trouble falling pregnant. I was excited to start IVF and we started that in early 2018. I got a few good embryos from the first cycle and did the transfer and I fell pregnant. There was a heartbeat at the six week scan and we were over the moon but then at 9 weeks there was no heartbeat and it was heartbreaking; we never expected it and I took it really hard.

“I got depressed and there were lots of friends and family members pregnant at the same time and I didn’t cope with that at all. It definitely took a toll on our relationship and Amanda would stay at work late because coming home to me was hard because I was obsessively researching, I was desperate to fall pregnant and I was just raging with hormones.

“In mid-2018 I did another IVF round and that was a chemical pregnancy. We did three back to back cycles at the end of the 2018 and that resulted in two more chemical pregnancies. The hormones that come into play with IVF and chemical pregnancies are intense…not to mention the effect on my body and our finances. It was at this point that we decided to change clinics because we weren’t getting any answers from our doctor.

“We changed clinics and did my third round of IVF and it was the worst cycle as I only got two embryos and one didn’t look great. We transferred the embryo and it was negative and the doctor called and said to me: some women just never get pregnant. 

“We moved to another doctor in the same practice and he was fabulous, he really took the time to talk to me, he made sure I was okay and he did a lot of testing. I did a fourth round of IVF in December 2019 and I didn’t get many embryos again and I knew I’d fallen pregnant on the transfer but it didn’t feel right. Our first scan showed a heartbeat but it was slow. We had scans every week but eventually we lost that baby as well as 9 weeks. We got our embryos tested to find out what was going on and the day that the nurses called to tell me I was pregnant, the genetic counsellor called to tell me that my other embryos weren’t genetically viable and would have to be discarded. It had been four years since we started and 14 failed attempts; it was so much strain on us mentally, physically, emotionally and financially. At that point I said I couldn’t use my eggs anymore and Amanda said she would do an egg collection.

“She got amazing results; 8 embryos made it to the freezing stage and they were all genetically tested and they were great quality. We had renewed hope at this stage but we didn’t want to rush it. It was also the middle of covid and I had a back operation so I needed to recover. We started reciprocal IVF in November 2020 which was when they transferred Amanda’s embryo into me. It all felt fresh and new and that was Leo.

“Amanda was against doing pregnancy tests before the blood results but I couldn’t help myself. I went off coffee and I absolutely love my coffee so I knew straight away. The friend who introduced us was terminally ill at the same time and the day we found out we were pregnant was the day we had to say goodbye to him. It was such an intense period of life but we really felt his presence throughout the pregnancy and even now with Leo.

“I was terrified. Week by week I could breathe a bit more and I actually had a bit of a bleed just before six weeks and I was an absolute wreck. I was sobbing and saying I can’t do this again. My obstetrician encouraged me to come in for an ultrasound and everything was perfect; a perfect beating heart and he scanned me weekly for the first 12 weeks and that helped me a lot. But the anxiety and fear was insane. I never wanted to go with an obstetrician, I really wanted to go through the midwifery programme, but my fertility specialists encouraged me to have continuity of care with an obstetrician. My sister (a midwife), my acupuncturist and GP all recommended the same obstetrician – Dr Miller at Hurstville Private – who specialises in high risk but he was also a great fit for my personality. He recommended a psychologist to me and she is brilliant. She’s a midwife and really understood pregnancy and pregnancy loss and she’d also worked in IVF clinics and she became a huge part of my pregnancy. She is loving and very motherly and we had her lined up for my postpartum period as well because I was at higher risk of developing PND or postnatal anxiety.

“At 17 weeks I felt the first kicks and I could breathe a little more then. At 20 weeks the morphology scan was incredible but I was also diagnosed with excess amniotic fluid so I had to have more scans to monitor that. My pregnancy was tough, it was physically challenging, but I also loved it. I was low risk and while I didn’t want to have a plan, I had birth preferences and I liked the idea of a low intervention birth. I wasn’t willing to risk the late-term IVF risk of a failing placenta so we discussed pretty early on in the pregnancy that I would be induced at 38/39 weeks.

“At 34 weeks my ankles had started swelling and I was really emotional.  I had a scan and the ultrasound tech asked me if my bag was packed because my cervix was really short and the baby was engaged. We had an appointment with my obstetrician afterwards and he advised me to stop work and then we went into the second lockdown in Sydney. It forced me to stop and slow down and I was so exhausted that in hindsight, birth was imminent.

“At 36+1 I felt something come out and it was my mucous plug. Soon after I went into the bathroom to have a shower and my waters burst everywhere. I’ve never been so calm in my life; it just felt right and I just went with it. The midwives told us to make our way in because Leo was going to be premature and it was covid times and once I was admitted I wouldn’t be going home. I went on the CTG and I had a midwife who didn’t believe that my waters had broken so she threw my pad in the biohazard bin. Because of IVF I was used to advocating for myself so I told her that my waters had broken and she tested it and I was right, my waters had broken. Thankfully there was a shift change and another midwife came on and she was absolutely brilliant and she was with us the whole time. My obstetrician was on holiday but I really liked the back-up obstetrician and he encouraged me to rest through the night and if contractions hadn’t begun the next morning we’d reassess and most probably start induction.

“At 11:30pm I had another gush of fluid – there was so much of it that I soaked through eight pads. At 11:45 I could feel a bit of cramping so I started timing them and they were five minutes apart. This went on till about 2:45am which is when I had a huge contraction and I made noise which woke Amanda up. I started vomiting and Amanda looked at my contraction timing and they were one minute apart. The midwife put me on the CTG and confirmed that I was definitely having contractions; I couldn’t talk through them so they were definitely building in intensity. They weren’t painful, but they were intense and I’d completely internalised, I wasn’t speaking. At 4am I was 5 cm and I was pretty confident at that point. I felt really calm and confident and Amanda was diligently using her tools to support me.

“Amanda all of a sudden asked if I was pushing and then I got a huge contraction and my body was bearing down. At 4:30am I started making that deep guttural noise and I was 10cm. The obstetrician came in and the midwife encouraged me to push but Leo was flying out; I only pushed three or four times but his heart rate really plummeted and at that point all the alarm bells started ringing and the midwives glanced at the obstetrician. He told me we only had 15 minutes and that it was important to get Leo out. I pushed again and his heart rate plummeted again and the midwife that was holding my leg started setting up the resuscitator. On my next push Leo crowned and I felt myself tear, the obstetrician unwrapped the cord from his neck and then he was born on the next push, at 5am. He was only on my chest for a few seconds before they took him and I knew he would have to go to special care because he was preemie. I didn’t find it traumatic, I was just so happy to have my baby.

“My placenta was born at 5:03am and my obstetrician said it was the biggest and healthiest placenta he’d ever seen and he even called all the midwives in to see it. They put Leo back on my chest and then he was taken to special care and Amanda went with him. I saw him at about 7:30am and he was doing well but he ended up being in special care for 12 days because of a blood incompatibility. Both Amanda and the donor are A blood types and I’m O+ so my blood attacks his blood, but it was only relevant once he was born, hence he was very jaundice and his bilirubin levels were very high. He had to be under the lights for a minimum 23 hours a day and the midwives were saying that they’d never seen a baby with jaundice this bad. We slowly weaned him off formula and onto breastmilk but I was nervous about feeding him without being able to measure it so we fed him expressed breast milk until his jaundice was sorted. I got my period back at 10 weeks postpartum and it changed my milk, it was quite watery, so we switched to formula at six months.

“Motherhood feels like something I was always meant to do. I just love it. And even while we had a postnatal mental health plan, I haven’t needed it because I’ve been on such a high since birth. We’re in the process now of starting IVF again and I chatted to my obstetrician and fertility specialist last week about the blood differences so we’re planning and hoping and we are a bit nervous. It is triggering going back into the process but I think Amanda and I know that we can’t spend the same amount of time and money as what we did to get Leo.”

Topics Discussed

Anxiety, Chemical pregnancy, IUI, IVF, Jaundice, Miscarriage, Physiological birth, Private obstetrician, Same sex couple, social infertility

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