When Infertility Updates Go Sterile

Sometimes it’s just too hard. Too hard to swallow. Too hard to breathe. To hard to share. Thus, my recent silence.DSC_2682

After our primary infertility struggles and IVF success catapulted me into the crazy, hectic, wonderful life that motherhood brings; I became an open book about our infertility journey. I hadn’t had the emotional support that I desperately needed while going through round after round of complicated infertility treatments. To be honest, even an army of supporters probably wouldn’t have been enough. With infertility…the best intention, the nicest phone call or text, the sweetest gift, the most compassionate comment…somehow it’s still never quite enough. The pain, the chronic patient role, the longing, the sorrow-it all outweighs the support. (for those showing support…please don’t stop! I’m just ranting.) I wanted to be real for other women struggling with similar issues. I wanted to break down the stigma that infertility builds and then reinforces with steel beams. Woman hiker on a top of a mountain

But, then I became an infertility patient once again. Optimistic…determined…nervous…and hopeful. At first sharing felt second nature. Our first frozen IVF success turned miscarriage made it a little harder. Repeated disappointments have continued to zap my desire to share. Instead, I’ve found myself withdrawing from the spotlight. In a way hiding. Clinging to privacy once again, as though it is a better comforter or coping mechanism to deal with my grief. My hope is still real, but the painful question of “Will it ever work?” plagues me each day. Blame it on the hormones. I do. But, my heart knows that my silence has simply been a way to quell my grief. Writing is acknowledging. Putting things into words makes them real…acute…like pouring salt into a wound. I like to think that I’m strong, but a girl can only take so much.

So, please forgive my silence. I don’t mind your curiosity. I love your support. But, to answer your question…No, we are not pregnant. Our most recent IVF cycle was more than promising. With 9 embryos to show for my efforts (yes, “MY.” I’m taking all of the credit. My husband would agree.) and the best cycle of stimulation yet, I was certain that it would work this time. So certain, that when we received the call 1 hour before our embryo transfer that none had survived to day 5, I went into something of a tailspin. NONE?? A statistical anomaly? A lab error? We made good embryos consistently. Only 10-15% not 100% should have arrested in development. WHAT? WHY? HOW?

The answer: ????????? Laboratory Fertilization Of Eggs In IVF Treatment

I hate the unknown. I hate the uncertain. As a physician, I want answers…reasons…solutions. I want to fix. I want to heal. I want to have a baby!!!! Instead, I’m starting from scratch once again, this time with a new doctor. Joy of joys. The idea of entering a third infertility establishment as a new patient just makes me feel warm and fuzzy all over again. Here goes!

Thanks for listening. Thanks for reading. Since silence hasn’t done the trick, I’ve decided to clink on the keys a little more going forward. My prayer is that for those struggling you will know that you aren’t alone. I’m here in the trenches with you. My prayer for myself is that even in the darkness I will not lose sight of the light…no matter how small it’s glimmer. I will hold onto hope, not blindly, but with the understanding that even if things don’t work the way that I long, there is still a greater plan. God may not answer my prayers the way that I want, but my story may just be the game changer to impact someone else. And, that uncertainty makes me smile. family, charity, healthcare, health. christmas, x-mas and happy

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What to Expect when Trying to Expect…IVF update from our April Embryo Transfer…

I had been crossing everything before our embryo transfer…fingers, toes, eyes…just about everything except for my legs. These were the last of our frozen embryos. If just one of them stuck we could wave our infertility treatment days goodbye. Only three were remaining, and while the quality wasn’t perfect, they were still little forces to be reckoned with.

I started my progesterone shots (YIKES THOSE ARE BIG NEEDLES), lupron shots, my estrogen patch, my estrogen pills and my routine blood work and ultrasounds. This had just worked several months before. Well…sort of worked. A 5 week pregnancy ending in miscarriage still counts as some sort of progress. It could work again. I had been praying for a miracle. Statistical success rates, odds, likelihood, all inconsequential in the presence of a divine intervention.Happy Family On The Beach. Baby Girl Hugging Her Mother

My typical outlook for infertility treatments has always been cautious optimism. I prepare myself for the worst because it’s so much easier to deal with the disappointment when things don’t work out. Why I decided to change my perspective this last time I’m not sure. For some reason the idea of a changed coping mechanism sounded refreshing. It would work. It was going to work. In spite of the odds it was going to happen. I was going to get pregnant and carry that pregnancy until I had a full-term healthy baby. I was going to have a story of triumph in spite of the odds. This was a simple miracle for God. What reason would he have for denying my request?

The embryo transfer went perfectly. Of the three remaining embryos, two survived the defrosting process. And, of those two, one looked incredibly promising. The catheter slid into place easily and within moments two precious little lifeforms were floating around inside of my uterus. Now came the waiting game. I was hopeful. I was actually incredibly excited. I even felt pregnant. I was tired, moody, hungry and sure that it had worked. I wasn’t cramping, and I wasn’t spotting.

And…I also wasn’t pregnant. Two home pregnancy tests and then a blood draw B-hcg level of less than 1 confirmed that my miracle had not happened. Disappointment has been followed by a firm resolve that there is a reason for everything. I don’t understand it, but instead of letting grief swallow me up (for more than a few weeks), I’m looking forward with hope once again. Since all of our frozen embryos are gone we must start from scratch with a fresh IVF cycle. This journey is far from easy, painless, or inexpensive; but, my desire for another child trumps the obstacles and challenges before me. I refuse to let infertility define me; but I am allowing it to shape me into a stronger woman, full of faith, hope, and love. This may sound trite or contrived, but trust me, this refining process has been neither trite nor contrived.

The struggle with infertility can be all-consuming. It can be and is devastating. I’m not going to sugar coat a horrible diagnosis. However, I can’t let it ruin the beautiful things that I do have in life. Infertility wins if I let it have that hold on me. I refuse to let it win. I am stronger because of it. I am a better mother because of it. I have a deeper respect for other’s pain and suffering because of it. I am learning to let go of the things that are beyond my control because of it. I am trying to make beauty from ashes. Some days I succeed…and for now that’s all I can EXPECT while I’m waiting to EXPECT!

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When Pregnancy Swelling Becomes Something More…

 

After years of trying to get pregnant, our dream finally came true. God had finally answered our heart wrenching prayers for a baby. Getting pregnant had been the hard part-being pregnant was a breeze in comparison. That is, until everything went wrong.

Because we had conceived with the help of IVF, I was already a paranoid pregnant lady. Even though I followed all of the recommendations, I still feared a miscarriage, a physical deformity, or a genetic anomaly. I had thought of most potential complications, and every little ting or pain alarmed my fragile state of mind. Knowing too much as a physician didn’t help. I reminded myself that it was normal to be overly concerned considering all that we had been through. It wasn’t like getting pregnant was a walk in the park for us. All forces of nature had conspired against us for years. Now that we had finally gotten a positive pregnancy test, I was a little leery that it was too good to be true. But, as months passed and our baby continued to be a perfect patient, the hypochondriac in me started to lessen. I resolved that I was going to have a happy and healthy baby.Love and new life concept. A woman's hands forming a heart symbo

Around 26 weeks of pregnancy, I suffered the worst headache of my life. My husband and I had recently moved states, and I had just established care with a new OB/GYN. I didn’t want to be the annoying patient who called about every little complaint, but when loads of Tylenol and sleep just didn’t cut it, I began to worry. Knowing that headaches can be linked with pregnancy induced hypertension and preeclampsia, I quickly checked my blood pressure. It was normal, but the pain in my head was not. With tears streaming down my cheeks, I asked my husband to call the doctor.

The physician on call recommended that I come into the hospital for blood work, to monitor the baby, and to get me something stronger for the headache. I couldn’t have agreed more. Thankfully, my blood pressure and blood work were fine, the baby was active, and the Percocet took the edge off.

After that episode, pregnancy life returned to normal. My follow-up blood pressures were fine. I hadn’t had another headache, and my only real complaint was the swelling in my feet. By swelling, I mean absolutely NO shoes fit my feet. I questioned, joked, and complained about my elephant feet, but I just assumed that it was part of the beauty of getting pregnant.

Since we had just moved to a new state without any family nearby, I knew that I needed to establish a support system before the baby arrived. This gave me the bright idea to join a Mom’s group while still only 32 weeks pregnant-I like to think outside of the box sometimes! I loved my “Real Mom’s” group from the moment that I met them. They applauded my assertiveness in joining the group while pregnant and welcomed me wholeheartedly. They didn’t, however, welcome my swollen feet! Instead, they insisted that I prop them up and have someone take a look at them. I reassured them all that I had a doctor’s appointment later that day, and that I didn’t have preeclampsia. It was simply swelling from pregnancy. I had noticed just the night before, however, that my glasses seemed a little tighter on my face, and my rings were even tighter than usual. I voiced my concern to my husband but then brushed it off as paranoia.

Fetus 7 Month In The Womb. Visible Head And Arms

At my 32-week prenatal visit, my blood pressure checked out fine. The Ob/GYN examined my belly and listen to the baby’s heartbeat. After measuring my belly, she recommended that we get a quick ultrasound of the baby since I hadn’t grown much since the last visit.

I waddled off to ultrasound, my feet aching with each step. The ultrasound confirmed that my baby’s growth had decreased to the 10th percentile from the 40th. Something was making her very unhappy inside of me. When I returned to the exam room, my doctor asked for a urine sample (which being pregnant I was easily able to give.) She reexamined my feet and decided to confirm my “normal” blood pressure. On recheck, my pressure wasn’t just a little high; it was stroke worthy! My urine dip screamed protein. And, when my doctor asked if I had been seeing any floaters, I dumbly responded that I had been having a weird, spotty kind of dizziness for months, but it seemed to be positional. Duh! Floaters! Wow, sometimes being a physician really doesn’t prepare you to be a good patient.

Within minutes I was loaded into a wheel chair and whisked to the OB floor for overnight observation. I voiced my concern that my mom was coming from Michigan to pick me up and take me back for a wedding shower. My Ob politely but firmly replied, “Emma, you aren’t going anywhere. First we have to make sure that you and the baby are safe.” By the time I made it to the OB floor, my blood pressure was sky-high, my head was pounding, and I was starting to get very scared. The nurse poked and re-poked me to start the IVs for the blood pressure medications and the dreaded magnesium. In what seemed like minutes, I had developed sudden and severe onset preeclampsia.

I called my mom to let her know the change of events. Knowing nothing about preeclampsia, she asked, “Emma, is this serious?” That’s when I broke down sobbing. Yes, it was serious. I was getting sicker by the minute, and I knew that my baby needed to be delivered soon…TOO SOON.

For more about preeclampsia head to The Preeclampsia Foundation or March of Dimes. Both have their annual walks all across the country in May and June. Sign up to raise awareness and support women who have had pregnancy complications, and help prevent complications for others.

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Secondary Infertility…what’s the big deal?

My heart wrenching desire to be called, “Mommy” was enough to make me sob on countless occasions. If only…if only…if only…and then the day came. Our infertility days were over! She was born, and although the early days of preemie life were also heart wrenching, we made it through. Today, I hear my coveted name, “Mommy” more times than I can count. If only it were enough. I love my daughter more than words could ever express (actually, my heart and eyes are welling up as I write), and I’m more than content to be her mother; but, my desire to hear another little voice, to change another little one’s diapers, to cuddle another snuggly infant, and to wipe the spit-up off of my shoulder countless times each day is intensely real. I want my daughter to have a sibling to play with, and let’s be real, unfortunately boss around!Portrait of a mother with her newborn baby

For those who say that I should count my blessings and be content with one child…you’ve clearly never struggled with secondary infertility. I understand your perspective. When I was childless I held a similar view. I just wanted to be a mother; I wanted a little one to love and cherish. I now have that immense privilege and blessing (which I thank God for everyday), but my longing for another baby is real and natural. I shouldn’t be ashamed of this longing. I was meant to mother. It’s in my bones even if it isn’t in the cards I’ve been dealt.

These cards aren’t fair. The infertility game is fixed. I’m playing against the house…and the house always wins….well, almost always. But, I’m not cashing out. I’m not cutting my losses and calling it quits. I’m not a gambler, but in the case of infertility I’m willing to bet against the odds. It worked for me once before, and it was worth every penny, shot, procedure, complication and heartache. The deck may be stacked against me, but I know how to stack the deck too with unwavering determination, perseverance, faith, and sleepless nights filled with agonizing prayers.Pregnant woman with daughter

Many couples have the luxury of easily adding to their families. They simply plan how many children they want and then make it happen (Yes, I’m a little jealous). They are blessed. Secondary Infertility is a diagnosis, an unfortunate medical condition, a “disease”. It is something to grieve over. It’s something to challenge. It is something worth battling and treating. Please don’t minimize the intensity of this heart breaking medical condition by suggesting that I be content with a diagnosis of secondary rather than primary infertility. These days it all feels the same. I thought that it would be less painful, but going through repeated IVF cycles once again, counting pennies to fund them, having a miscarriage, and trying to keep my emotions in check while caring for a two-year old is something worth crying over. Infertility is painful in every shape and form that it takes. If only it got easier!Happy Mother And Baby Laying On Meadow

For those of you who have suggested that I be content…don’t worry. I’m not overly sensitive, nor am I keeping a tab. Goodness, on the flip side I can’t keep track of the number of people who’ve critically asked me, “You only have one daughter? Don’t you want more children? You aren’t done are you? She needs a sibling!” My response usually creates an intensely awkward moment. I’m aware that most people don’t know what to say regarding infertility, primary or secondary. Awkward conversations are the norm when the topic arises. It’s okay to not have the right words. It’s okay to just say you’re sorry. Sometimes simply listening shows the most support. You aren’t always going to get it right, but the fact that you are trying means the world.

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If you’re dealing with primary infertility then you are allowed to say or think whatever you want! You’ve earned that right. You get to be angry. You get to be sad. You get to be jealous. You get to judge my “discontentment” with “only” having one child. I was you only a few years back. I get it. Not that you need my permission…but just wanted to throw out the caveat. Hang in there. You are stronger than you know!

For more ways to support someone struggling with infertility check out these resources for family and friends at Resolve.org

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Our Infertility Journey (1.20): Could It Really Be Good News?????!!!!!!

We were scheduled for our fourth embryo transfer, and this time my primary infertility specialist made sure that she would be present to do the procedure. She agreed that given all of our complications it made sense that she be the one to perform the procedure. This time went so much more smoothly (the way it was supposed to go). After only a minute, two perfect embryos were in my uterus.Golden Egg

I decided to stay on my back with my legs up for a while. (30 min. to be exact.) I didn’t care if there wasn’t any medical evidence for this, I needed to do something different. I needed this to work. I went home and propped my legs up again. Then we waited once more. I was somewhat pessimistic. I didn’t know if this would work. I wanted it to, but it hadn’t yet. And, after 5 cycles of IVF (the first once being cancelled due to hyperstimulation and the others never resulting in a pregnancy) I doubted that things would ever work for us. In the midst of my doubt, I still held onto a thread of hope. This cycle had been as close to ideal as we would probably ever get…great embryos and a great transfer. Two weeks of waiting felt like an eternity.Biological clock ticking - woman holding clock in front of stoma

A few days before the pregnancy test I began to feel crampy. I was heartbroken. How is it possible that it hadn’t worked again!  The day I went in for my blood work, I told the nurse that I was sure that I wasn’t pregnant. I felt like I had after each cycle…crampy. I hadn’t started bleeding yet, but I was sure it was only a matter of time. I waited for the typical call from the nurse. I was at work and had been talking with my coworker who was waiting for an adoption opportunity. Just minutes before she had received the news that a baby boy was going to be born within the next couple of days, and he could be hers! She was ecstatic! I was so happy for her. She left the room to see a patient and in the meantime, my call came.couple, pregnancy and love concept - close up of woman and man h

I saw that it was my infertility nurse, and my heart leapt and then sank all at the same time. I knew that I wasn’t pregnant. I didn’t even need her to confirm it. I answered the call just as my coworker walked back into our office. “Hello”, I said. “Emma, its Libby.” “Emma, you’re PREGNANT!” What! What! No, that couldn’t be right! How could I be pregnant. I was crampy. I didn’t feel pregnant. They must have been looking at someone else’s results. “No, Emma, we double checked. These are your results. You are pregnant. Congratulations!”

I was in shock. I was through the roof! Oh, my goodness. You have got to be kidding me! It finally worked!! I was pregnant. I could get pregnant! It was all worth it. I wanted to jump up and down, but I didn’t dare for fear it would expel the precious embryos. But, how good were my levels? I knew that this mattered. Was I really pregnant or just a little? No, I was really pregnant. My hcg numbers were high. They were prefect. I would have to have them repeated in 2 days just to make sure that they were doubling, but I was definitely pregnant.Baby Fetus Newborn Over Isolated White Background. New Born Chil

My coworker knew immediately when she saw my face. We were both going to be having new babies! I immediately tried to call Dave. He needed to be my first call. Voicemail. I paged him but didn’t get an answer. I knew that he should be the first one to know, but if I couldn’t reach him, I couldn’t keep it to myself after everything I had been through. I quickly dialed my parents. My mom was thrilled! We were all cautiously optimistic. We knew that a positive pregnancy didn’t necessarily mean we would be having a baby. We still had a lot of hurdles to get through, and the pregnancy rates were always much higher that the delivery rates for IVF. Although I was cautiously optimistic, I was also full of hope. I couldn’t wait to make it past 12 weeks. I just needed to get to the safe zone,  and then, 2012 would be my year of motherhood!

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An Update on Our Current Pregnancy Situation (Jan 2015)…unfortunately, labs don’t lie

I know I’ve been posting a lot lately about our struggles with primary infertility (trying to finish out the story for everyone). However, as most of you know, we are currently undergoing infertility treatments in an effort to make baby #2. Christmas Eve I found out that I was pregnant after a frozen IVF cycle. But, after several ultrasounds and repeat labs, I’m sad to say that we are having a miscarriage. Our little one decided not to stick around.

Thank you all for your kind words, prayers, and support along this journey. As I watch my beta-hcg levels fall it’s a little surreal and incredibly sad. Seeing an empty uterus on ultrasound confirmed the diagnosis and cemented the fact that our infertility journey is not yet over. When we received the news that we were pregnant it seemed too good to be true (and it was). No more stimulation cycles, no more needle pokes, no more financial planning for fertility! We were going to have another baby! Sadly, that’s not the case, at least not yet. So, I’m pulling myself up by my Hunter boot straps and gearing up for what’s to come. With two more frozen embryos left, our IVF journey continues. Maybe this next cycle will be the end of our infertility road? If not…ovarian stimulation and fresh IVF here we come!

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Our Infertility Journey (1.19): An Egg Retriveal Without Pain Meds or Anesthesia!

The plan was to start the process of a full IVF cycle all over again as soon as possible so that my cervix wouldn’t have the opportunity to become windy again. I was ready, but I was also exhausted. I admitted to Dave that I wasn’t sure how much more I could take. We went with the antagonist cycle again because this had given the best response with limited hyperstimulation. Back to the shots, the ultrasounds, and the early morning doctor visits…blood work galore. It was all so routine now that I couldn’t even imagine life without IVF.Sperm injection

Walking into the clinic each morning, the secretaries greeted me by name. That’s not really a positive thing in an infertility clinic. You want to get in and out with success as quickly as possible. Becoming a regular is not the goal. The stimulation went well this time. It actually looked like it was going to offer the best egg retrieval yet. The retrieval day was set once again, and once again we arrived early in the morning to the hospital. I had taken my Ativan and Dave was at my side. My assigned infertility nurse was also present which was always comforting. But today, another nurse who was new to the department was also present. She was the one who would be pushing my pain medications.

I wasn’t all that thrilled at the idea of having an extra person in the room (especially one that I didn’t know), but I didn’t really have an option. Things got started and were going fairly well except for the fact that this time was much more painful compared to my previous egg retrievals. I kept asking for more pain medication (which wasn’t typical for me), and I repeatedly asked how close we were to being done. Pain, Pain, Pain! I squeezed Dave’s hand so hard that I thought I was going to break it. Why was this time so much worse? I wasn’t sure how much more I could handle. I never asked for the maximum amount of narcotics!Cropped image of nurse attaching IV drip on male patient's hand

The physician told me that a significant number of the follicles were close to the ovarian wall. This location was often more painful for egg retrievals. Maybe, but as they wheeled in the gurney I noted that I was much more awake and lucid than the last two times we had done this. I was actually carrying on a full conversation with the nurse, which I had never previously been able to do. On the other retrieval days my mind had been sluggish and my mouth always had trouble forming the words that I wanted to say. A “yep,” or “huh” were typically all that I could utter due to the sedating effects of the pain meds and anti-nausea medications (I’m something of a light-weight). Usually, my legs were so heavy that I couldn’t even transfer myself to the stretcher without significant help. This time I practically hopped from one bed to the other.

I mentioned how strange it was that I felt this awake. Ah, well, it was over. Off to recovery once more. A new nurse came in to check on me and to flush my IV line. As she was flushing, I began to panic at the sensation. What horrible medication was she giving me? She said, “Nothing, just flushing the line with saline.” As soon as she left the room I went bizirk. My hand and arm were on fire and the pressure was unbearable, almost like compartment syndrome. Something was wrong. It was burning. It wasn’t stopping. I called the nurse back in, but she wasn’t sure what was happening. “Maybe a little bit of the medications were left in the tubing,” she suggested.

Well, that was an understatement because then my heart started racing, I began profusely sweating, my head was spinning, and I felt like I was going to pass out and throw up all at the same time. I must have looked as bad as I voiced because she quickly sprang to action, shut off the IV line and grabbed my vital signs. Sure enough…something was definitely wrong. All of the pain meds and anti-nausea meds had been sitting in my IV line, un-administered during the egg retrieval. Either there had been a problem with the IV tubing, or the new nurse hadn’t actually opened the valve on the tubing. Now I had just gotten a whopper dose of narcotics and phenergan (anti-nausea medication known to burn like crazy if not diluted properly) in one quick push!

This all explained why the procedure was so painful this time, and why I had been so alert. Within minutes after the medication overload, I was gone to the world, knocked out until late that evening. A junkie lifestyle is definitely not for me. I felt horrible. The nurse typed up an incident report, but there really wasn’t much else to do now that it was over. It wasn’t like they could take back my extra painful experience.Laboratory Fertilization Of Eggs In IVF Treatment

The good news was that our embryos were gorgeous. They were the best that we had ever obtained from a cycle. Only a few more days and once again two embryos would be transferred into my uterus. I prayed that this time it would work. I wasn’t sure how much more I could go through. My ovaries were huge and aching. My heart was heavy and aching. My endurance was waning.

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Our Infertility Journey (1.18): My Tricky Cervix

I met with our reproductive endocrinologist again, and we discussed what may have contributed to the cycle not working this time. The working theory now was that my windy cervix (which was making the transfers difficult) was probably compromising the quality of the embryos. They needed to be placed in the tubing, transferred from the incubator, and injected into my uterus quickly. 30-40 minute transfers with embryos being exposed to the environment countless times was a huge problem.

My reproductive endocrinologist had the bright idea that we should try dilating my cervix in order to get a straighter path into the uterus. This would require a procedure done under general anesthesia in the operating room. I was willing to try it. It made sense to me that this was one of the only factors that was complicating the process now. We had good quality embryos. I didn’t have any fertility issues. What else could it be?Sperm injection

The date was set, and I was scheduled for surgery. It was now February. I arrived to the operating room with Dave at my side. He was allowed to be present during the procedure just because he was a resident. He wasn’t allowed to touch anything, but he could stand by my side. He knew many of the people in the room. It felt strange to have such bright lights shining on my naked “waist down”. The mask when to my face and the meds went into my IV. I was gone. The next thing that I remembered was waking up behind a recovery curtain.

This was the step-down recovery unit. It wasn’t quite as private because there were only hanging curtains separating the beds. I woke up to severe cramps. A catheter had been placed in my cervix and left there. The idea was to keep it in for 14 days to stretch things out and make the path less difficult to navigate. 14 days of bliss!

I could hear voices down the hall. An older man was complaining in very loud tones. The person responding sounded familiar. I identified her as one of my husband’s coresidents. My nurse appeared and asked how I was feeling. I was dying. The cramps felt like labor (not that I really had labor as a comparison…clearly). I needed more pain medication. The nurse said that she had given me all that she could and that she had never had anyone with this procedure before to know what else to do. I was too groggy to argue. I felt the weight of the pain meds, but they weren’t touching my pain. Narcotics are worthless for cramps. I needed anti-inflammatory meds.

Hospital Corridor With ChairsAfter a while I was transferred to a real room. Only after the fact did I find out that Dave never pulled my curtain fully across in the step-down unit. I was in view of everyone coming down the hallway, including a medical student that both of us knew. Why hadn’t he protected my privacy! He was supposed to be my shield and my protection. He had failed me. How could he have been so thoughtless in my state of extreme vulnerability? Such an innocent mistake, but husbands…pull the curtain!

My discomfort continued. The nurse called my physician to see if there was anything more that they could do. She encouraged me to empty my bladder because a full bladder could be making me cramp more. I think that it took me 10 minutes to walk to the bathroom and then another 10 just to empty my bladder. I was more than a little full, but the cramping was not much better. Another phone call to my physician with another recommendation for increased pain medications. The nurse was a little nervous to give me the full dose that she had recommended. I was still to groggy from anesthesia to really argue. I went home, crampy and groggy, but happy that this might be the key to our success.Woman With Stomach Ache

Day one after surgery, when I was much more alert, I was also much more aware of the uncomfortable sensation of plastic sticking into my vulva. Every time that I moved or sat down I could feel the catheter poking into me. My infertility specialist called to see how I was doing. “I would be much better if I didn’t have a plastic dagger killing my vagina,” I informed her. Thankfully she quickly suggested that we cut the length down so that I wouldn’t feel it. I readily agreed. Once again, my legs found their way into the stirrups and a light was shown where no light should shine. After the shortening of the catheter I was much more comfortable. Now I only had to get through 2 weeks before the catheter was removed, and then we could start the IVF process again.

Unfortunately, Valentines Day fell during those two weeks. So much for romance and intimacy! Both of those sort of drop to the bottom of your check list when you have a plastic tube shoved through your cervix and hanging into your vagina. One of the infertility doctors actually asked how my Valentines Day had been. Really??? Young couple  next retro car  in smoke

On the day that I went in to have the catheter removed, I was relieved but a little nervous at how painful it would be coming out. They had told me that I wouldn’t need any numbing or anesthesia; just a good old fashion tug was the way to get it out. With a sheepish look on my face, I asked the doctor if it was going to be very painful. His response made my day. “For some women this would be unbearable, but, Emma, for you this will be a piece of cake.” “Really?” I retorted not really in disbelief, but more as a way to confirm my strength. He proceeded to tell me that I was pretty darn tough. With everything that I had already been through, I really hadn’t complained much. Some women he informed me had a really hard time with even the least invasive portions. I’m not sure if it was my personality that drove me to hide my discomfort, or my pride, or my determination to stay strong. Either way, it felt good to have someone acknowledge that I was tough. I had been through a lot, and I was still pushing ahead. I prepared myself for the catheter removal, now resolved not to show any signs of pain. One quick tug and it was over. Not too bad after all. I mean, I wouldn’t want to repeat it if I didn’t have too, but in general…not too bad.Determination

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Our Infertility Journey (1.17): Exploring Other Options…Adoption?

Dave was in the process of finishing up his residency program…finally! He was looking for a job and had been on several interviews. Although he had multiple job offers, nothing felt like the right fit. He had one more job possibility that sounded promising in Indiana. It was now December, and since we had been going through IVF non-stop since August we decided that we needed a vacation. An inexpensive vacation was the only thing that would fit our infertility sabotaged budget so we decided on Chicago (Yes, Chicago in December…we really are mid-westerners). Infertility treatments had actually bought us a free hotel room for the week. We had put all of our IVF cycles on our credit cards which racked up our Hilton Honor Points in no time. Over 30 grand has a tendency to do that. We decided to take a detour to Indiana on the way to Chicago for Dave to have the job interview. That way at least some of our travel costs would be covered.Home Finances

I didn’t want to take the chance of flying. We had already done some flying while I had been going through the IVF cycles, and I wanted to minimize any potential factor that may have led to a lack of success. Dave’s interview went very well. It was also very promising because if this cycle didn’t work, we had zero dollars to proceed with any additional cycles. This job offered a sizeable signing bonus that would allow us to continue with our infertility journey.Young woman stroking her belly becouse of bellyache

Unfortunately, it ended up that we were going to need the additional money. Once again, I started to spot, got moody, and knew that I wasn’t pregnant. The infertility nurse call now almost felt like a recording programmed into my phone, scheduled to recite after each cycle. That was the worst vacation. I felt sick. Sick from my period…sick from my infertility…sick from my increasing despair. I didn’t care about anything else. I just wanted a baby. Doubled over while sitting on the toilet, I cried tears of pain and tears of loss. Each failed cycle felt like miscarriages. Maybe they were. Maybe the embryos had only been present for the day they were transferred. I will never know.

My journey felt like it was coming to an end. I decided that we needed to explore other options. Maybe adoption was the right choice. This had been suggested by people all along the way. Some people didn’t fully understand my desire to have a baby that was “made” from Dave and me. Some didn’t understand my desire to be pregnant. People would throw out the comment, “Well, you could always adopt.”  As though the idea had never occurred to us. Yes, we could, but I wanted a baby from my own flesh and blood. I wanted to feel a baby moving in my belly.Pregnant Woman Holding Baby Shoes

Would I consider adoption if I had exhausted all efforts to get pregnant? Of course. What I wanted most was to be a mother, but, if I could have my own biological child, that was what I wanted. I wanted to look at his or her face and see something from me. I wanted to laugh at the characteristics that were from Dave. There is nothing wrong with adopting a baby. Actually, I am a huge advocate of adoption. I had often thought about adopting a child from an underdeveloped country. I still have that desire, but I also wanted to have the experience of giving birth to my own flesh and blood. I wouldn’t love my own flesh and blood more than an adopted child, but I just wanted a baby in my belly.Missing Child

People judge when you say these things, or they don’t understand. Some who have adopted feel that you are minimizing their love for their children or are undermining the choice that they made. I’ve heard people say that if adoption is good enough for them, then why isn’t it good enough for me? I feel that this is just a personal choice. We are all entitled to our opinion, and we all have different needs, wants, and desires. None of them are wrong. No one should be made to feel guilty that they want their own biological children, just like no one should be made to feel that their children are less valuable or loved because they are adopted.

I started to look at adoption organizations. Maybe that would be our only option. We discussed what it would be like to have a multiracial family. How would our families respond? How would our friends and neighbors interact with a baby that we adopted. We had been assured by all of them that they would love an adopted child just as much no matter what their race was or who their parents were. My coworker who struggled with infertility had decided that she also wanted to get pregnant. She had successfully gone through IVF several years before, but this time after two unsuccessful cycles she was ready to consider other options. She wanted to know that what she was investing in would actually result in a baby. Adoption seemed like the best option for them. Things were falling into place quickly for her. Could adoption be the best option for us too?Business man house in human hands

While focusing on our infertility, we also needed to focus on our future as physicians. Dave decided to take the job in Indiana. The signing bonus would mean that we could start from scratch with a new IVF cycle. Although at the beginning of my story numerous blogs ago, I mentioned that I was in this for the long haul, I was now starting to get very tired and weary. I had gained more than a few pounds from the hormones, steroids, bloating and from my overindulgence in comfort foods. I was used to the shots but was tired of being such a regular in the clinic. I hated having to rearrange my work schedule. I hated having to pick up extra shifts to make up for coming in late so many mornings. I hated having to take days off last-minute in order to have a procedure done. I was starting to wonder if this would ever work for us. I continued to pray. I also started to come to terms. Maybe it wasn’t in God’s plan for us to have our own biological children. Maybe he had a greater plan that I just didn’t understand.

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Our Infertility Journey (1.16): When Hope Outweighs Despair

I was starting to despair, but I had not yet lost hope. Despair is a terrible thing. It’s that sick feeling in your stomach that slowly creeps in. It makes you want to curl up in a ball and ignore the outside world. It makes you feel that your problem is the only and most important in the world. It definitely causes you to become self-focused. Holding onto hope was my only hope. I couldn’t despair. I had to trust that this would work. If I was negative about it what good would it do? Somehow the power of positive thinking was going to make a difference. I begged God. I cried. I pleaded. I told him that I was angry that he would do this to me. I had followed what I felt was a calling to go into medicine. I had dedicated my life to helping other people. Why wasn’t he helping me now? My anger turned into remorse. I apologized for anything and everything that I had ever done wrong. Was he holding out on me because of some unconfessed sin? I didn’t know, but I wanted to clear up anything that could possibly influence his response to my desperate cries for help.Anxious woman thinking in her bed next to her sleeping partner

I had to wait several weeks before starting the frozen cycle. All during this time I had been trying to act normal at work. Only a few people there knew what was going on. I didn’t want to make my private business public to the whole office (ironic since I’m now sharing it with the world). I didn’t want them to ask me how things went or to look at me with pity. I wanted to see my patients and then go home.

In primary care you get to know your patients fairly well. I sat down and started to ask my patient how she was feeling? I knew that she was pregnant. It hadn’t been planned, and she wasn’t all that happy about it. I had actually been the one to diagnose her pregnancy several months before. I then asked her how the baby was doing. She gave me a strange look, then glanced toward her young daughter who was playing in the room. She then whispered to me that she wasn’t pregnant anymore. Oh, I said, “I’m so sorry. What happened?” I assumed that she had a miscarriage. It didn’t even occur to me that she would have ended the pregnancy. All I wanted was to be pregnant, so the thought of giving that up was far from my considerations.Baby Holding Mans Finger

She responded in a whisper that she had an abortion. Now was not good timing to have a baby. Regardless of my position on pro-choice vs. pro-life (I’m not here to get into a debate. I am just sharing from my infertile perspective), in that moment, I felt like someone had punched me in the stomach. The only thought that kept going through my head was that, “I would have taken your baby. I would have loved your infant. If only you knew what a precious gift you had. I would give anything for that.” I swallowed my stomach, forcing it to go back to its normal position, and I responded without missing a beat. My face did not show my sorrow or my surprise, instead, just as medicine teaches us, it showed no signs of judgement. I simply said, “Oh, are you happy about that decision, and how are you feeling since the abortion?” I became objective because medicine mandates objectivity. As a physician I was forced to be objective and non-judgemental, but as a desperate woman wanting to become a mother…I grieved.

The beautiful thing about the frozen cycles was that I didn’t have to do a stimulation cycle. This meant that I only had to do a portion of the shots, and I had to take steroids. Unfortunately, the protocol for frozen cycles was that the progesterone had to be given as shots…Not the small needles, but the intramuscular shots in the butt twice daily. Usually, the spouse was the one to give these shots because it was a little hard to reach the correct spot on yourself. Besides, the needles were like torture devices. No one in their right mind would want to see that going into themselves. I surely didn’t. They had to be spaced out by 12 hours, one in the morning and one in the evening. The problem was Dave’s schedule. As a surgery resident, he was getting up at 4:30 in the morning in order to leave by 5 on certain days. I am not a morning person to begin with. Just imagine being awakened just so that you can bend over and have someone drive a needle (two by four) into your butt cheek.

.Money in syringe

The first time I was incredibly nervous. It was about as bad as I thought that it would be. Having your husband inflict pain on you makes you somewhat more of a wimp as well. You have to put on a brave show for someone you don’t know, like a nurse, but you can whine and complain and say what you really feel when it is your husband. I am not one to get light-headed and woozy at the sight of needles, but after the first shot, I had to lay down…immediately (I’ve since gotten a lot tougher:) I thought that I was going to pass out. That sensation did not diminish over time. With each shot I felt more than a little flushed and light-headed. Then my butt began to get pretty sore. I started to have a pretty red spot on each cheek and decided that someone should take a look to make sure nothing was wrong. It turns out, that my husband has a very precise aim. He was giving me the shots in exactly the same spots every single time. You don’t really want this much precision! He was instructed to widen his aim to prevent a site reaction from getting worse.

It hurt to sit, and it hurt to stand. I started to long for the Crinone progesterone gel that turned into a cottage cheese curd-like discharge. It may have been gross and messy, but it certainly didn’t hurt like this. I decided that I could do anything at this point though. I could even give myself the shots; And, well, I had to. Dave was running late one evening (as in I don’t think he left the hospital until the next day.) I was on a strict schedule with my shots, and I wasn’t about to mess things up. I didn’t really have anyone else to ask, and I didn’t want any of my neighbors seeing my assets. My coworker had mentioned that because of her husband’s schedule she also had to give herself the IM shots at times. If she could do this so could I! I loaded the syringe, attached the mile long needle and prepared to self-inflict torture. I had to contort my upper body while looking in the mirror in order to make sure that I was in the right spot and wasn’t going to hit a nerve. After several start and stop attempts, I just decided to get it over with. The funny thing was, it was so much better when I gave it to myself than when Dave did it. It’s like getting your own splinter out. Somehow it just hurts less.

Transfer number three was scheduled. Again my primary infertility specialist was not going to be present for it. Instead it would be the head of the department. I was informed that his technical skills were very good, and we shouldn’t have a problem this time. Well, that was not entirely true (I’m sure his technical skills are fine…but we still had a problem). All three of the embryos survived the thawing process. The plan was to transfer all three because frozen cycles are known to have lower success rates than fresh.The Equipement Of Gynecologist Room

Striped down, knees in the stirrups, ultrasound smashing my belly once again, the transfer started, only to be started and stopped several times. The physician confirmed that my cervical pathway was more than a little tricky. It was winding and somewhat challenging to feed the catheter through. I lay there with my legs in the air panicking. Not again! They had to get the embryos in. The concern was that embryos are very temperamental to their environment. They should either be in the incubator, or they should be in the uterus. Any time out of these environments could compromise their quality and ability to survive. Eventually, the infertility specialist was able to get the catheter in place. The embryos were transferred, and we had three embryos floating around in my uterus. The idea that we could get pregnant with triplets and even as many as six babies put me into a little bit of a whirlwind; But, who were we kidding, we hadn’t been able to get pregnant once yet, so what where the odds that we would get pregnant with three?

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