Ovulation Induction for natural pregnancy

Due to erratic ovulation Kim couldn’t get pregnant – now she is a mum-of-one with another baby on the way.

Irregular periods sign of ovulation issue

“Having irregular periods wreaks havoc with your life and is really disruptive,” says Kim from King’s Lynn. For as long as she can remember Kim has kept a diary detailing when her periods start and end.

“I could literally go for four months without a period and then have a short period followed by a longer, heavier one a few weeks later,” she says. “Then I could go for months without another one. Having regular monthly periods is something which a lot of women take for granted but mine were all over the place and completely random.”

Kim got so fed up with the disruption that when she was in her early twenties she went to her GP who put her on the pill: “At the time that was fine because all I wanted was to make my periods regular,” she says.

Kim then met Adam and the couple were married in 2014. Keen to start a family, they started trying for a baby shortly after the wedding. “I came off the pill and, I suppose, bearing in mind the issues I had always had with my periods, I was a bit naïve really about how difficult it might be for me to get pregnant,” says Kim.

“Once I had come off the pill my periods became irregular again and so while we were trying to conceive I had to regularly take pregnancy tests to determine if my lack of a period was because of my irregular cycles or because I was pregnant.”

Irregular periods are a sign that a woman is not ovulating (releasing a ripe egg in to her fallopian tubes) every month. For natural conception to take place the eggs and sperm must meet in the fallopian tube and if a woman is not ovulating regularly the likelihood of her conceiving is greatly reduced.

New Fertility Diagnostics and OI Treatment service 

After a year of trying and not getting pregnant, Kim went to see her GP who referred her and Adam to the Queen Elizabeth Hospital in King’s Lynn.

“I had my first appointment with a consultant at the hospital but then shortly after that I received a letter to say that Bourn Hall now provided the fertility diagnostics and also Ovulation Induction for natural pregnancy and so all of my subsequent appointments were at Bourn Hall’s clinic in King’s Lynn,“ says Kim.

One of the first steps which Bourn Hall took with the couple was to test Adam’s sperm and to undertake a Hycosy diagnostic test on Kim which involved inserting a dye into her fallopian tubes followed by an ultrasound scan to see if there were any blockages in the tubes.

“Adam’s sperm tests came back all fine and the Hycosy showed that my tubes were not blocked,” says Kim.

The couple then met with Carol Steel, Lead Specialist Fertility Nurse at Bourn Hall, King’s Lynn, who has more than 25 years’ nursing experience in the field of fertility.

“Carol explained to us that once we had completed a few more investigations, we would have an appointment with the doctor who would probably prescribe some tablets to try to get the eggs released.” says Kim.

“She said that my hormones weren’t behaving as they should and that hopefully this could be managed with tablets.”

Monitored OI treatment produces higher success rates 

There are a number of reasons why a woman may not be producing eggs but regular ovulation can often be restored using fertility drugs (pills or injections). About 70% of women will ovulate with this treatment, the majority within the first three months. Of those who ovulate, between 20% and 60% will become pregnant – the wide range is due to many other factors affecting fertility such as age, weight, sperm quality and lifestyle or other health issues.

Fertility drugs stimulate the development and ovulation of mature eggs to be released ready for natural fertilisation and during an ovulation induction (OI) cycle, a woman will have ultrasound scans and blood tests to ensure the treatment is resulting in eggs developing and ovulating correctly.

“The doctor explained to us that they would try me with Clomid to start with and if that didn’t work we might move on to injections and if that didn’t work the next option would be to have IVF,” says Kim.

Clomid stimulates egg production

Clomid is an effective treatment which stimulates a woman’s ovaries to produce eggs. It is often the first course of treatment for women with polycystic ovaries but can also be used by women who have late or irregular periods.

“Clomid tablets are taken from Day 2 of the period until day 6, just 5 tablets each month ,” says Kim. “I had to call Carol on the first day of my period and arrange to see her for an ultrasound scan on day 10-12 to see if the Clomid was working, she checked how thick the lining of my uterus was and also if there were any follicles maturing in the ovaries that could release an egg.”

Whilst Clomid is highly effective for many women it does not work for everyone and this was the case for Kim. “I tried not to be too downhearted but it was difficult,” admits Kim.

Screaming inside

“Part of me was thinking ‘come on, get real, we have only just started,’ but the other part of me was just desperate to have a baby and was really worried.

“I am normally quite an upbeat person but even people at work noticed that I wasn’t my normal self. I hadn’t told them about my fertility issues and so when people asked me if I was okay I would say that I was fine when I actually felt like screaming.”

Gonadotrophin injections

The next step for Kim was to be put on a course of Gonadotrophin injections – which can be used by women who do not respond to Clomid and are not ovulating. The injections are usually Follicle Stimulating hormone which is injected once a day from day 2 or 3 following a period to get the ovaries to mature an egg (ideally only one or two follicles).

“Carol explained that I would have to inject myself with the drugs and I said ‘I will do whatever it takes,’” says Kim. “I work in the NHS and am used to seeing people injecting themselves with Insulin for diabetes and so I saw this as a positive thing. I wasn’t injecting myself because I was ill, I was injecting myself to get our baby.”

When Kim started her period and started the injection treatment, she had to see Carol on several occasions over the next 2-3 weeks.

Careful monitoring of Ovulation Induction for natural pregnancy

“Carol did a scan before the first injection as a baseline and then I had a scan after around 6 days of injections; after this I had a scan every 3-4 days.” says Kim.

On the first injection treatment after about five visits Kim had two follicles that were mature; for the last scan – about 22 days from her period – the couple rushed back from a five day break in Devon so that Carol could do a scan on the Friday afternoon.

“Carol gave us the news that she could see two follicles which had developed to maturity, we had to give a trigger injection that evening to get the eggs to release and she started smiling and told us to go away, enjoy ourselves and have lots of sex for the next week. At last we had our window of opportunity,” says Kim. “We didn’t feel under pressure because Carol was always so calm about everything and we just went away and did as we were told!”

Moment of truth

Two weeks later Kim did a pregnancy test and it was positive. “I just stood holding the test in the bathroom and I was sobbing,” says Kim. “Adam and I just clung to each other and kept looking at the test it was surreal.

“When I told Carol that I was pregnant she said ‘congratulations’ and I said ‘you did this for us’. Carol said ‘I didn’t do it you did!’”

On 28 June 2017 son Callum was born and recently the couple took him in to meet Carol. “We wanted Callum to meet the woman without whom we wouldn’t be where we are now were it not for her guidance, care and kindness. We told Carol that it takes a very special person to do her job.”

Since Callum’s birth Kim has found that her periods have become more regular. “I get a period at some point every month now,” she says. “Having Callum seems to have done something!”

A lovely surprise 

In March 2019 Kim and Adam thought that they would try for another baby. “We said to ourselves ‘if nothing happens we will go and see Carol,’” laughs Kim.

The couple were astounded when in just two months Kim fell pregnant. “We are still in shock!” says Kim. The couple find it hard to believe that they will soon have two children conceived naturally – all it needed was some expert help to boost Kim’s ovulation alongside careful monitoring.

“We are just so grateful to Carol and everyone at Bourn Hall,” says Kim. “They have changed our lives.”

Carol Steel with Callum and Kim

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