IBD & Fertility: My Journey to Motherhood
If there’s one thing I know for sure, it’s that I was born to be a mother. I started babysitting at age 11, and immediately was drawn to the art of caring for others. Also, I love children. I always have.
Growing a family
From the time my now husband and I started dating, we talked openly and extensively about our hopes and dreams with regards to our future and growing a family. Because I have Crohn’s disease, I didn’t exactly know what the journey to motherhood might look like for me. The more I was open about this, and the way it made me feel, the easier it was to talk to my partner about it. We talked specifically about how if I couldn’t get pregnant, or if I couldn’t stay pregnant due to my complicated health history, our hearts were open to both surrogacy and adoption.
After our engagement, our conversations began shifting from faraway dreams to close up action steps. With each passing day, my heart started to get louder and louder. I realized that I couldn’t deny what I was feeling. I was adamant about trying any way possible in order to carry my first child.
Early in 2017, I began receiving Remicade infusions for my Crohn’s disease. I had already failed oral medications and had adverse reactions to self-injections. I also knew, in the back of my mind, that Remicade has been deemed safe for pregnancy and breastfeeding. I felt comfortable with the research I’ve read and other patient’s I’ve talked to, and this felt like the best possible treatment option - not just for my disease activity, but also for building a family and our future.
Approval to try
Over time, I began feeling a significant, positive shift in my health for the first time since became symptomatic in 2009. Being proactive (call it slightly neurotic, careful, worried, or just an experienced patient), we scheduled a meeting with a highly recommended Maternal and Fetal Medicine physician, also considered a “High-Risk OB/GYN.” During our two hour appointment, we reviewed the most recent years of medical records, my prescription history, and my current medications and supplements. The rest of my specialists already knew pregnancy was on my hopeful horizon, and so the medication regimen I was on had already been modified to reflect what would and would not be safe for a baby. The Maternal and Fetal Medicine doctor suggested a couple of small changes, and then we were sent on our way with “official” approval to start trying to conceive.
We were ecstatic and so grateful. Truthfully, as a Crohn’s patient, it’s rare that I walk out of any doctor’s appointment feeling optimistic. This felt like a sign that my body might let us move in the right direction.
I went out and bought two different ovulation testing kits, and found an app I liked for my phone to keep track of everything. I even made my husband download it so he could see in advance what days would be most important for being intimate.
This was all well and good, except 8 months passed without any success. My Crohn’s disease was managed better than it had ever been, and yet, I still wasn’t pregnant. Every time I got my period, my heart sunk a little more.
Concerns about Crohn's
I started becoming concerned that maybe Crohn’s disease was standing in my way of conceiving. I also noticed some inconsistencies in the length of my cycles, so I scheduled an OB/GYN appointment with my regular physician.
I was overwhelmingly relieved when she confirmed everything I had read, researched, and spoken to other IBD patients about - having Crohn’s disease did not automatically imply that I would have difficulty with conception.
(Please note - there are some aspects of IBD that could impact fertility, pregnancy or delivery - but it’s best to speak directly with your physician about your individual situation)
My doctor recommended that my husband go for a semen analysis, and said that she would follow up with us after she got the results.
Her insight that Crohn’s alone shouldn’t be preventing us from getting pregnant was correct. My husband’s analysis was deemed “poor” - indicating a lower number of sperm, reduced sperm motility and abnormal sperm shape/size. It was then that my OB/GYN let us know that we would not likely be able to get pregnant without the help of technology.
I feel horrible to admit that this provided me with a sense of relief. My husband is as healthy as a horse. Besides a running injury and kidney stones, he has only seen a doctor for a few colds or sinus infections in the 4 years I have known him. To hear outright that my non-chronically ill spouse was also experiencing problems impacting fertility helped me realize that our challenges in conceiving may not be because I have Crohn’s.
Nearly a year after we started trying to conceive, our fertility journey shifted. We began working with a Reproductive Endocrinologist and Infertility Specialist. Both my husband and I underwent several additional tests. The positive was that his analysis results improved, and all of my tests came back completely normal. The negative was that this meant our challenges with conceiving fell under “unexplained infertility.”
I recognize these feelings
This new diagnosis felt cold and hard and frustrating. Much like my IBD, there wasn’t one specific thing that caused our struggles with infertility, and there wasn’t one certain route to fixing them either. As my husband and I began walking through the trial and error part of our journey, I noticed that the emotional ups and downs were familiar to me. I was able to recognize that disappointments on our conception journey felt eerily similar to unexpected Crohn’s disease flares. When my body has let me down or when I have failed on medications for IBD, I have felt vulnerable and frustrated. When another month of fertility treatment has passed and I take another negative pregnancy test, I feel those exact same feelings.
The thing that makes me grateful is knowing that my experience with Crohn’s has empowered me to handle whatever happens during our infertility journey and that I am emotionally prepared for this difficult time, even though I may not have recognized that right at the beginning. I have started feeling grounded in the familiar. Knowing that I have gone through such difficult times with my IBD and come out the other side, even when there felt like there was no light at the end of the tunnel, has really led me to the place where I know my husband and I will start a family one day, and that I can be patient, even when it feels so so hard, because I’ve done it all before.
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