IVF Isn't About the Journey, It's About the Destination
While some women may share their birth stories, I wanted to share our fertility story.
Translating my mind's weavings into words on paper has helped me weather numerous storms, but throughout 2015 -- a year marred by a lot of heartbreak and too many hormonal injections -- when I've needed this kind of therapy the most, I maintained silence on a subject that hit me like a piece of fallen scaffolding. Instead, I relied heavily on the physical support of my husband, family and friends, all for whom I am extremely grateful. With each setback along this grueling and at times never-ending journey, I would begin the story over and over again in my head, but I never got around to completing it. Until now.
After a year and a half of trying to get pregnant the old-fashioned way, which is to say without downloading ovulation apps and marking red Ps on the calendar every month, and just hoping it would take a few romantic evenings at home or on vacation with my husband, we consulted a local OB-GYN about our dilemma. She prescribed a few months of charting everything from my morning temperature to the location of my cervix.
That didn't work.
She then prescribed three months of Clomid -- a drug that helps women ovulate more regularly, which in turn can help you track when to have sex more accurately. My cycles were anywhere between 28 and 40 days, so I hoped this would be the wonder drug we needed to get pregnant.
It was not.
When I told my doctor I was ready to move on to the next phase, uncertain what that would be, she handed me a couple of pamphlets and said we'd come as far as we could with her assistance. It was time for us to see a fertility specialist.
At the beginning of a much-needed California road trip with my mom leading up to my first IVF transfer.
We had our first consultation with Dr. Schnorr in Lexington, S.C., last February. We looked at a few charts of our anatomy, various statistics related to age/fertility (not great for women over 35) and the success rates of our options.
I had an ultrasound so the doctor could see what my ovaries were doing, and I got an A+ for what appeared to be a perfectly healthy operating system. I would start with IUI attempts (intra-uterine insemination), which was the least invasive of the procedures. We all hoped that would do the trick. If 4-6 tries did not, however, we would proceed to IVF (in vitro fertilization).
IUI, also more commonly known as artificial insemination, or the turkey baster method, seemed simple enough. Then our doctor informed me I'd be giving myself injections leading up to the procedure. This was a surprise and a stark reminder my system was truly incapable of doing this on its own. Time to accept this and move on.
When the first box of medicine arrived, I opened it with glee like I was opening my first Sony Walkman back in 1988. My excitement quickly turned to dread as I began to separate the dozens of plastic baggies of different size syringes from the vials of clear liquid medicine. I thought surely there'd been an error. This looked like the kind of medical regimen one battling a terminal illness might be prescribed. I was overwhelmed and quickly covered this new supply of medicine with a towel so I wouldn't have to look at it until absolutely necessary.
When the first box of medicine arrived, I opened it with glee like I was opening my first Sony Walkman back in 1988.
Buck up. Beast mode. Buck up. A former boss and mentor of mine called me to share her experiences with infertility, which included multiple rounds of IUI, IVF and miscarriages, and she told me I had to "f*cking attack." I had to buckle in for what could be a long, tortuous ride.
While I wasn't fighting for my life, I looked at it as if I was fighting for the life of my future child. And I couldn't let him or her down. The first shot I gave myself was the hardest. Overcoming the fear of putting a needle willingly into my stomach took a strange kind of chutzpah. But once I did it, each time after became easier. I'd look at my husband instead of the needle and position it perpendicular from my tummy. He'd give me the "ready" nod, then still without looking at the needle I'd stick the syringe into my belly roll and press the end hoping the medicine came out in full.
After extremely close monitoring of my follicle growth, blood and uterine lining, aided by the shots I was giving myself on a daily basis, it was time. Our first IUI was on May 1. They simply put me on my back in stirrups, stuck a thin catheter up into my cervix filled with my husband's sperm, and hoped the swimmers would find their target. Ten days later we did the blood test.
I can't say I was surprised the first one didn't take. "It never works on the first try" is a reality that's engrained in your head if you're going through any kind of fertility treatment. You hope for that miraculous one-and-done scenario, but it's often the anomaly. I remember feeling disappointed, but this was door #1 of hopefully many more doors. We'd just try, try again.
Our second IUI was at the beginning of June. The benefit of doing IUI is you can really keep grinding away from month to month, as long as you're willing and able to face the repeated possibility of failure. Another round of shots and another pregnancy test later, we were successful.
Following each treatment, they give you an "earliest test date" where you can test at home. The roughly two-week wait (#tww) is brutal, but you get through it. I peed on a stick first thing on the day we were allowed to test. I thought there was only one line (which means you're not pregnant) and I walked away hurriedly, disgruntled and half-asleep. I told my husband the bad news and hid away downstairs. I returned to the toilet about an hour later only to notice two positive lines. We were actually pregnant. My excitement was matched with relief and disbelief.
What was wrong with my body? Why couldn't I see this through? What had I done in a past life to deserve this? Nothing had prepared me for this.
I waited a couple of hours before making tearful, joyous calls to friends -- those who'd followed our path closely to this point and knew my IUI and subsequent test date. I Facetimed my mom as she took a break from swimming laps at her local YMCA. We called my in-laws, who were speechless and overcome with emotion. I requested my mom's stash of '70s baby books from the basement of our house in Connecticut, including Dr. Spock's tome, and received them within a couple of days.
Three days later I went in for a follow-up blood test. They look for the HCG hormone to have exponentially increased in your system. My levels were slightly lower than ideal.
"This could result in a healthy pregnancy, or this could result in a miscarriage."
I started shaking. A nurse, and not even our nurse, had just dropped the "M" word on me. I was sick with shock. Confusion. Anger. Every negative feeling you can have I experienced within those first 30 seconds after hanging up the phone. Talk about the ultimate mind-f*ck.
How was this happening? What was wrong with my body? Why couldn't I see this through? What had I done in a past life to deserve this? Nothing had prepared me for this. And there is nothing anyone can do or say that can ease the agony and suffering you feel upon hearing such mind-heart-soul-crushed-by-wrecking-ball news. A hug from my husband was soothing, flowers from a friend were in moments life-saving, cards, texts and other thoughtful gestures reminded me we were loved. But it was the days in between where I wasn't sure I was cut out for this.
My doctor called us later that afternoon. I couldn't talk I was crying so hard. My husband Billy led the conversation. There was still a glimmer of hope. Dr. Schnorr told us he had a client with lower numbers give birth to healthy twins, but we had to be smart and be prepared for the worst.
The most horrifying part was I had to show my face at my clinic every couple of days. The levels kept climbing for the first 6-8 days, so we really tried to keep our spirits up. Then they plateaued, and that's when the nurse told me I had to have an ultrasound.
Like a cruise ship sinking one compartment at a time, our chances of having a healthy pregnancy this round faded gradually with each day. If my numbers didn't drop, i.e. if I didn't miscarry on my own, I'd have to have a procedure known as a D and C (or dilation and curettage procedure). In laywoman's terms, this is when they scrape tissue out of your uterus so anything that's in there doesn't become cancerous. To this day it baffles my mind that nowhere, in not one science class I took in 16 years of school, did any teacher once mention this as a possibility in my future life as a wannabe mother.
...nowhere, in not one science class I took in 16 years of school, did any teacher once mention this as a possibility in my future life as a wannabe mother.
I hadn't felt the lowest point in our story until about two weeks after our positive pregnancy test when a doctor who I'd never met before told me to lie in the ultrasound room on my back and she was going to see if they could "find a pregnancy." I heaved hysterically on my back with my head turned away from the monitor as she dug around my uterus with an ultrasound wand. Looking at my empty uterus was like looking into the eyes of a friend who'd just betrayed me. I wanted to shatter the screen with a baseball bat.
Bleeding while you're on your period is bad enough. Knowing that you're bleeding out what was supposed to be a fertilized embryo is sickening. And of course, to really hammer it home, the miscarriage takes almost twice as long as your period. And it's a lot more painful. At the end, I was crippled by cramps, contorted over the toilet shouting in agony, "Get the f*ck out!!"
Doing two IUIs is not standard. Many people attempt more. But I felt in my gut that it was not working, and I didn't want to waste any more time. IVF was going to be a considerable leap for us financially, but we were fortunate to have the means to do it.
IVF is a serious commitment. You don't hop on and off the bus.
One month you're taking shots and having eggs surgically removed from your ovaries. The next you're having a period au naturel before a transfer. And the last month you're getting two shots a day of progesterone and sticking a progesterone pill up your vagina every night before bed. You hope the eggs taken out meet up with the sperm and get fertilized. And then you hope the fertilized eggs grow into healthy embryos.
We opted to do something called preimplantation genetic diagnosis, or PGD, to ensure after all the time and money put into this that they were transferring the healthiest embryos they possibly could. Like straight up Gisele Einstein embryos, please. We paid about $3,000 extra for this step, but with the cost already approaching $20,000, what was another few grand for an added safety net?
Here was our breakdown: We had 32 eggs extracted from my ovaries. Of those, 16 were fertilized by my husband's sperm. Of those, 14 were deemed "viable" embryos. Of those, nine kept growing at a healthy rate. Of those, seven were sent to the PGD lab. And we ended up with four healthy, baby-promising embryos. Looking at how quickly these numbers dwindled, it really is a miracle anyone can get pregnant without a doctor's or a lab's assistance.
Looking hot in my hospital blues.
The worst part of IVF is the progesterone shots. In the ass. The syringes I used for the IUI were about the size of my thumbnail. Looking at the bag of syringes that came for the IVF, I nearly fainted. And nobody tells you about this part. The length of the syringes was the size of my pointer finger, and the whole thing has to go into your butt muscle. My nurse told me she did it to herself and I looked at her cross-eyed. No f*cking way.
Thank god for my husband Billy (and my friend Danica who sadly had to administer these shots to me while we were in Toronto for a friend's funeral).
Our doctor is based out of Charleston and for the major procedures like the egg extraction and the embryo transfer, we drove two hours to their facility. We tried to make our first transfer as fun as it could be. We took pictures of ourselves in the silly hospital jumpsuits, booties and hair nets.
We even took photos of the photo of our frozen embryo #1 -- the embryo they picked to be our first born. The surprisingly simple procedure felt less invasive than a visit to the OB-GYN for your annual pap smear. Billy had to drive me home lying horizontal in the backseat. I was put on about 12 hours of strict bed-rest, followed by about two weeks of low-level activity. No running, jumping, carrying heavy items, vacuuming or exercising with Agnes.
The first IVF resulted in a positive pregnancy. But once again, like a smashed record, my levels were extremely low. My nurse's voice was sullen on the other end of the line. "I'm so sorry," she said. Billy had come home from work early in case of bad news. After the miscarriage from our second IUI, I prayed for either a miraculous jump in levels on Monday or for this pregnancy to disappear as quick as it came. I was incapable of facing another two weeks of maybes and limbo.
The best worst came true. Monday I went in for a blood test, hiding my tear-flooded face from other hopeful patients in the waiting room, and four hours later our levels had dropped to almost zero. While once again my will and strength were crushed, a friend reminded me we still had three more embryos that were on ice waiting their turn.
We had our second FET (frozen embryo transfer) on the Friday after Thanksgiving. Our in-laws were in town and we had a huge Thanksgiving feast the night before. I teased Billy that this embryo (#7) would have no choice but to implant with all that good food in my belly.
I struggled to stay positive this time around. I wanted to wash my hands of the whole process. I even emailed a couple of friends who had adopted babies. I actively started to visit the websites and agencies they recommended for adoption. I embraced a laissez-faire attitude. Que sera sera.
For the first time I had a soothing realization: Maybe this was it. Maybe this was meant to be our family.
One night during the dreaded two-week wait, I had Agnes, our 70-pound bulldog, nuzzled up against me on the couch, with her face squished under my armpit. For a moment, she looked up at me and rested her big, bulky head on my chest staring into my eyes.
I looked over to see if my husband caught the moment and found our 6-month-young kitten sprawled out over the top of the La-Z-Boy chair, paws outstretched with his eyes barely open, hovering over my husband's head. I smiled and felt tears welling up. For the first time I had a soothing realization: Maybe this was it. Maybe this was meant to be our family. It was pretty peaceful and awesome at that moment.
The following weekend, I had several of my best friends from college to our house for an annual Christmas weekend a day before I was scheduled for my pregnancy blood test. It was a wonderful, much-needed distraction for me and it reminded me no matter the outcome of that Monday's test results, I'd be OK. We'd be OK.
Then a funny thing happened on a Monday in December. I got a call from my nurse Heather, two hours earlier than normal.
"Monica, dear? You're pregnant! And your levels are through the ROOF!!!"
My husband and I received this thrilling, life-changing phone call nearly five months ago, which puts me currently at 24 weeks and 4 days of being pregnant. We are due August 15. To say we are overcome with joyfulness, radiance and excitement would be the understatement of the century. We're still processing it. We have seen our baby floating around upside down and I have watched and heard its strong, fluttering heartbeat.
Within the past couple of weeks, I have started to feel it bouncing around daily in my tummy. Seeing Triscuit (our name for baby -- we are not finding out the sex) on the screen in my OB's office is a magical, awe-inspiring site to behold, and when I asked my fertility doctor when it would sink in, he jokingly responded, "Not until it pops out!"
If anyone reading this finds themselves in a situation like the one we faced, let this be hope for you and your partner. My aunt texted this message to my mom when she heard the news and I wanted to pass it along: "Tell Mon we love her and to take care of herself and enjoy having that little baby so close to her heart now, before she has to share with everyone." Will do, Aunt D. Will do.
To be continued...
A version of this post originally appeared on Wine + Quill.