Infertility and Weight-loss Surgery: The Bagley’s Story

THE BEGINNING

The ring was on my finger and the date was set: August 16, 2008.

(Weight – Evan: 380, Lacey: 325)

As members of the LDS faith, we practiced abstinence before marriage. So in preparation for the pending nuptials, I scheduled an appointment with my gynecologist. We chatted about birth control options and landed on using the Nuva Ring.

Two months into our marriage, Evan and I looked at each other and said – let’s not prevent having a baby and see what happens! We were officially “not-not trying”. Since childhood, I had experienced irregular periods. Without more to go on, I attributed it to my weight. I also had no knowledge about what irregularity might mean for “not-not trying” to get pregnant. But life moved forward!

I graduated with my bachelors degree in Sociology, Evan got accepted into a master’s program for Geology at Oklahoma State University and we were off into the world! We packed everything up and drove from Idaho to Oklahoma to start our journey.

While in Stillwater, I worked to support our little family and poured all of my energy into church activities. We continued “not-not trying”. I also joined the weight watchers group at work. I wasn’t blind to my weight and I knew I needed help to change. I had friends in the weight watchers group, liked the program just fine, but half-heartedly followed through on my goals.

THE FIRST MISCARRIAGE

Now, instead of just irregular periods, I also experienced sporadic “periods” with heavy clotting. One particularly odd event happened about six months after we moved. I had experienced light bleeding that morning before heading to work. I hadn’t had a period in a while (several months) which was usual for me, so I thought nothing of it. However, just an hour into work I felt an internal pop and quickly rushed to the restroom. The bleeding seemed uncontrollable! I sat in the bathroom for a long time trying to clean up. When I felt confident enough, I briskly walked to my bosses office and with tears streaming down my face asked if I could go home. When she asked why, I said, “I think I just had a miscarriage”. Once home, the bleeding continued as well as heavy cramping. I felt dead inside. Because I didn’t have an OB or even a family physician yet, I called the ER. They said it sounded like a heavy period and that nothing was wrong, no need to come in. Something felt wrong. I laid on my bed for the rest of the day, in a haze of physical, mental, and emotional pain. What just happened? When Evan got home, he laid with me and we talked and cried and wondered about our family’s future. Would kids ever come?

We called and scheduled an appointment with a family physician. He looked at us (two very, very large people) and said diabetic? No, but after testing, found out we were both on the verge. Tested my hyroid? Nope, everything good there. And that’s the furthest we got.

There have been other miscarriages since this one, but this moment was significant because it was the first time I thought about getting help with weight/ fertility.

ADULTING

2.5 years after moving to Stillwater, Evan graduated and got a job with an oil and gas company. We moved to Oklahoma City and began our lives there.

Shortly after moving, we found a house and put an offer in. Our first home! We made sure to have enough bedrooms, in case our family expanded. At this point, we hadn’t had success getting pregnant and only our weight had expanded. We were both at the highest weight we’d ever been, Evan at 475 and me at 375. With new, super amazing insurance and a call to get check-ups with a family physician, a new chapter in our journey began.

Our physician talked with us about weight-loss and diet options. We started with a plant-based diet (no meat, but as much veggies as we wanted). Evan had success, losing 20 pounds in two months! I lost 5 pounds and then plateaued. We then went deeper into eating vegan, restricting the type of food we ate but not the amount. After three months, Evan was down another 15 pounds and I was down just another 5 pounds. Eating vegan was extremely difficult so we added back in dairy and eggs. Evan and I plateaued. During this process, I also had started walking daily and eventually running. I got to the point where I could run a 5K! Still no weight-loss…

Frustrated but not giving up, I tried to focus my efforts in a different direction and set an appointment with the fertility clinic at the University of Oklahoma. It took me a while to find it because when I went to google’s homepage to type something in, I wasn’t sure what to type. Infertility? Was I infertile? I had never said the words out loud before. Typing them in and scheduling the appointment (5 years after we’d started “not-not trying”) felt surreal.

FERTILITY/ INFERTILITY

My fertility doctor started from the beginning: testing. We tested everything. Hormones were fine. Thyroid was fine. Lining of my uterus was thick, hm… Tested for cancer (biopsy – terribly painful). No cancer. Internal ultrasound to check my ovaries for cysts, no cysts. Hm… but no regular periods with no explanation? The final diagnosis was poly-cystic ovarian syndrome (PCOS) but only because nothing else fit. Prescription: metphormin and clomid. My weight was also a concern, so she prescribed a common weight loss agent. I took it for only one week because the jitteriness was unbearable.

After three months and no weight change, she sat Evan and I down for a serious talk. She did not feel comfortable helping us get pregnant at my current weight. She could not guarantee success or safety for me or any potential child. She slid a brochure across the table and asked, would we ever consider weight-loss surgery? I said no, without even thinking. I was young still and could try dieting harder and exercising more. After a minute, Evan looked at me and said, I want to try it. Stunned, I said, okay – let’s check it out.

WEIGHT-LOSS SURGERY

My dad had had weight-loss surgery, gastric bypass, six years earlier and had great success! In my mind he was the target market: older, diabetes, and not physically capable of the intense exercise weight-loss requires (in my mind).

We signed up and attended a seminar. Initially thinking, maybe we’ll try the lap-band. After the seminar, we were 100% sold and both wanted gastric bypass. With as much weight as we needed to lose, it was our best hope. We hoped.

Our insurance would cover the bulk of the surgeries and our families offered to support us with the rest of the finances. We were extremely lucky and blessed, for most patients finances can be the largest obstacle.

Another obstacle: weight. We each needed to lose 10% (or more) of our body weight before having surgery (Evan 48 pounds, me 38 pounds). After almost a year’s worth of trying to lose weight with a doctor, that amount felt impossible.

We met with the best nutritionist in the whole world and made a hard correction from vegetarian-ish to a protein-based diet. We stuck with the diet and the results were incredible! Within months we both hit our goals and set surgery dates. Evan went first in October and, after he healed, I went in December.

The weight came off rapidly. We continued with the diet plan and with regular exercise, including running 5K’s and a 10K.

NOT ALL ROSES

Per the doctor’s counsel, we waited 18 months before starting to try for kids again. We had both plateaued and were much healthier now.

End weight: Evan – 202 and Lacey – 210.

Post-surgery, a big fertility change had taken place in my body! As soon as I got under 300 pounds my period started coming regularly EVERY MONTH! That had never happened in my entire life.

Right when we would have gone back to the fertility specialist, life threw us a massive curveball. Because of the downturn in the oil and gas industry, Evan got laid off from his job (and we lost our incredible insurance). After several months, he accepted a new job teaching geology at the University of Southern Mississippi in Hattiesburg, Mississippi. So in May 2016 we packed everything up and moved.

While in Oklahoma I had started my master’s degree in marriage and family therapy. Thankfully I was accepted into the master’s program at Southern Miss, but it meant I had to start over. I knew it would be worth it. It also meant my insurance would be through the school but wouldn’t kick in until August.

ROUND 2

Once my insurance kicked in, I scheduled an appointment with an OBGYN – to get a referral for a specialist. After our first visit and a few tests, he approved me to see a specialist. We selected a group in Mobile, Alabama. During the first visit with the specialist, he directed us to start with testing all of my stuff again (with my new post surgery body).

Periods were back and 100% regular. Hormones were great. No cysts on my ovaries. Thickness of uterus lining, good. A dye test was done to see if my tubes were closed or if there was other leakage issues (super painful). All good there. So? The specialist said there was no medical reason for me to not be able to get pregnant!! No more PCOS!

Our attention then turned to the other half of the baby making equation, Evan – more specifically, Evan’s sperm. One outcome of being a very overweight man is that the heat “down there” can impact sperm production, speed, and shape. Also, hormones can be effected. Through previous testing (pre-weight loss surgery), we knew that Evan’s testosterone was low. So we were referred to an urologist, who specialized in fertility. Evan had a normal sperm count with low morphology (shape) and motility (speed). Additionally the urologist found that Evan had developed a varicose vein in his left testicle, which would require surgery to correct. This surgery was not a guaranteed fix to the fertility/ sperm issues, but was our next step.

The surgery was out-patient and his recovery time was one day with slight tenderness for about a week. The urologist suggested we continue to try getting pregnant and that he would retest Evan’s numbers after three months. Well…

THE END/ THE BEGINNING

After two months we had our first successful pregnancy!! Nine years after we had started “not-not trying”.

As I sit here writing, with six weeks left until I get to hold Dax in my arms, I’m reminded of a common metaphor for infertility: it’s a marathon. For me, there were miles that flew by with ease while others felt like each step took every ounce of energy I had in my body just lift my foot up and move it forward. So what kept me going?

You know those water stations along the running route – where volunteers cheer you on and fill you with the energy to continue? I survived because of the countless women who stood along my path. Who cheered me onward, running with me when I couldn’t do it alone, and who replenished my spirit exactly at the moment when I needed it the most.

I found that so many women have a story of infertility! Sometimes all I could see what the beautiful family portrait that hung in their homes or the annual family photos they posted on social media. When I mustered the strength and courage to ask, they poured their hearts out to me with incredible stories of strength and fortitude.

I promise that as you reach your hand out for help, angels will reach back, wrap their arms around you and let you know that because they did it – you can do it too.