Category: things no one tells you

Letter to the new (infertile) kid on the block

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Dear newbie,

Whether you know me personally or not, I was you. I was at the beginning of this supremely shitty journey once.

A brief aside: I kinda hate the word journey. It’s both overused and trite, particularly in the context of infertility. It implies a destination ahead. And many days, you’ll have one. A baby in your sights. Some days, though, that destination may need to be relief from the physical and emotional pain you’re likely to experience. I’m truly sorry that you’ll feel this hurt.

When I was where you are on this road (that word somehow feels a bit more natural to me), I had few resources to talk me through what was to come. That was lonely, and it sucked. I hope that you’re able to take an exit ramp long before where I am now, but no matter where you depart, know that you’re never alone. Infertility is probably going be the most alienating thing you ever experience. It has been even more so than the chronic depression I’ve struggled with, although I’ve found they go hand in hand for me.

If you’re reading this, then you’ve likely found that within a few Google searches you can find others online like you. I urge you to use the web wisely, though. Seek out forums, communities and blogs that can be a source of strength for you. Just read, or share your own experience. Step away when the web becomes alarmist. Reading others experiences can be helpful, but do your best not to let these stories trigger your own fears. You’ll have created plenty in your own brain. Don’t fuel them. Remember that every woman is different and none of us have all the answers. That thought alone will probably land somewhere between comforting and frightening, and that’s okay.

When you’re ready, share your thoughts and feelings with someone. That person can be your partner, but it doesn’t have to be. Not every partner will be able to relate to the myriad of thoughts and feelings you’re having. That’s okay, too. They may grieve losses and manage anxieties differently than you do. It can make you crazy, but give them space to process infertility in their own way. It’s their struggle, too. Instead, or in addition to, seek out a therapist, a family member, a friend — whom ever you can feel comfortable and safe with. Resolve offers many peer-led support groups across many cities. When you find one, I urge you to give it a try. Talking aloud does help you feel less lonely. The strength of the women I’ve met in my local group can prop up the world. I’m grateful I can share in that.

This road may get scary. I’m sorry for that, too. I hope that those periods of fear are brief for you. If you do feel yourself wearing a little too thin, though, put yourself first. Advocate for yourself with your doctor. Ask the questions. Sometimes a little more information or a less jargony explanation can help ease your fears. Remember that the end goal of a baby isn’t the only thing that matters. You do, too. You’re here now, and this road is hard.

Sometimes you will feel afraid and empty, but you’re not a failure. What your body can or cannot do doesn’t determine your worth. I’ve spent far too many sleepless nights and dazed commutes focusing on how my body has failed me. Those thoughts only multiplied my frustration and left me drained of hope. Never once were they productive. Remember to be kind to yourself.

I don’t yet have a happy ending to my story to share with you. You’ll hear a lot of stories about how your friend’s cousin’s stepsister-in-law got pregnant after she stopped trying and relaxed. Each one will probably make you want to scream and curse. That’s okay. I hate hearing them, too. The majority of people who offer these stories have no idea what you’re navigating right now. They just want to offer their support. If someone who loves you asks if they can do anything for you, tell them what you need. Or at least ask for homemade brownies during your next two week wait. Those never hurt.

You can do this. So can I.

Your fellow infertile sister,

Ashley

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Photo by David Whittaker via Pexels

Maybe you’re just too fat to have a baby and other things no one said but I heard in my head

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I’ve struggled with my weight for much of my adult life. I was very active in as a kid and through my teen years, and with only a few exceptions of the low-fat lifestyle trends of the 90s, I didn’t think all that much about what I ate. I started pretty steadily putting on weight in college, but for much of my early 20s remained only about a size or two bigger than I was when I graduated. I wouldn’t call myself a yo-yo dieter, but an slowly-moving, unmotivated yo-yo is a fairly apt description of my weight after 26 or 27.

Three years into fertility treatments, the scale isn’t too kind to me. It started to tick up when I started Clomid, then exploded during the transition from IUIs to IVF. Much of this was related to the hormones pumping through my body. It is also more literally tied to eating ice cream to dull the feelings of unsuccessful cycles, miscarriages and feeling like I’m completely broken. I can own that. All total I put on about 35 pounds in these three years and, in October when I met with the doctor offering a second opinion, was the heaviest I’ve ever been.

Over the course of that conversation, the new RE suggested that because of my weight, I was probably producing poor quality eggs, resulting in poor quality embryos, leading to lack of implantation. I wasn’t shocked by this assessment, but I was taken aback. This wasn’t a factor on the table with my Peyton Manning doctor. He never once said to me that I should consider putting the spoon down. I’d certainly read a bit online about BMI affecting egg quality, but if I’d asked and my doctor didn’t think it was the reason for three years of ultimately unsuccessful treatments, then it probably wasn’t… right?

In the moment, I left that RE’s office feeling absolutely deflated (like Tom Brady’s footballs… [I’m just going to keep running with these weird football analogies, so roll with it]). It was a deep cut to hear that my weight could be preventing me from achieving success. He’d told me that to take me on as a new patient, he’d want me to first lose 20 pounds. Twenty pounds caused by Clomid and ice cream and Estrace and pizza and watching everyone else become a mother.

Over the last four weeks I’ve used every ounce of brain space that I once reserved for progesterone dosages and ultrasound appointments to retrain myself to eat. Knowing myself well enough to know follow-through isn’t my strongest quality when it comes to a new routine, I joined one of the medically-supervised weight loss clinics that seem to be popping up on every corner. The staff has been supportive and has helped me address the areas of emotional eating that are the biggest triggers and challenges for me. I feel better, and I’m doing really well on their program. I’ve said goodbye to sugar (again), and have actually started to like the taste of Greek yogurt. I belong in a Dannon commercial.

I’m going to tick that 20 pounds off and keep going until we’ve pulled together the financials for another stim round. I can’t be the thing standing in my way of being a mom, so I’m not going to be.

Second opinions

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The rollercoaster of emotion hasn’t stopped since my chemical pregnancy. Although I’d said before going into this IVF cycle that it would be our last one, I’m reevaluating the options. I feel pulled to continue IVF because I’m emotionally very connected to a successful pregnancy when I’ve only experienced unsuccessful ones for no obvious reason.

Last week I met with my doctor as a post-mortem this third IVF cycle. He’s a lovely, obviously caring man who has more than 30 years of experience with infertility. He’s the Peyton Manning of reproductive endocrinologists. He’s got that time and many wins under his belt; he’s consistent. Then he has a patient like me. During our appointment he referred to me, albeit very kindly, as an anomaly and his personal project. He’s determined to make me a mother in the same way that Peyton was determined to come back after neck surgery and win another Superbowl. No, this metaphor isn’t over-the-top at all, I don’t know what you’re talking about.

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As I anticipated, there’s not yet a good explanation for why five perfectly normal-looking embryos haven’t resulted in a sustainable pregnancy. He showed me the math of it and it was incredibly depressing.

So how does he recommend we move forward? The simplest possible response is another biopsy to check for my old nemesis chronic endometritis, and while we’re painfully removing my uterine tissue, reserve a sample for the ERA test, too. My lining is, perhaps, optimal for embryo transfer too early or too late for the standard progesterone window. The ERA test has been growing in popularity in the infertility community (I’d actually asked about it prior to my chronic endometritis diagnosis), but my clinic has only performed the test three times to date as they tend to be pretty conservative on new tech and labs.

Given that we have one remaining embryo, Kristoff, he also suggested that I consider another stim cycle to create more embryos and PGS test the whole lot of them to weed out the shoddy ones. We considered PGS in our first go ’round, but the added cost prevented us from moving forward.

Again, none of these recommendations came as a surprise.

What’s next? We’ve decided to get a second opinion. I really like my clinic, my doctor, and of course the greatest nurse on the planet, but my husband and I both feel like we’d be remiss if we didn’t at least talk to another doctor before making a decision. So I’ll be meeting with another doc, who has successfully helped two friends get pregnant via IVF, in a few weeks. His clinic also has a great reputation, and I’ve heard their treatment protocols are a bit less conservative, too.

 

Four-day pregnancy

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Last Wednesday night I had a dream that my beta test was negative.

On Thursday morning I woke up, still recalling the dream, and wishing it not to be true. I found a leftover home pregnancy test and went to town. It was positive.

I snapped a photo and immediately texted it to my husband, who is working out of town for the next several weeks. He replied with appropriate emojis.

The next two days were spent secretly happy, but cautious. Sore boobs. Intermittent nausea. Fatigue. I decided not to move up my beta, which was scheduled for Saturday. That morning I woke up, went to have my blood drawn, and then waited.

Since it was Labor Day weekend, I heard back a few hours later from the doctor on duty. My beta was, indeed, positive, but my hCG was a little on the low side at 31.5. Commence Googling. I knew enough to know that at four weeks pregnant “normal” hCG levels can vary wildly. As long as the number doubled in 48 hours, things could still be perfectly fine.

I tried to spend the rest of Saturday and Sunday off of Google, and allowed myself to be a little bit excited. I had noticeable symptoms. Before I went to sleep each night I talked to Olaf and Anakin in my head. I told them to stick around, please. I was ready for this. I promised my endometritis-free uterus could take good care of them if they just stuck around.

Monday morning I went in for my second hCG check. I felt like things were on track.

It’s all too easy for me to ask myself why I even bother being happy or excited about anything when it will just be taken from me. That was my first thought when the doctor called on Monday. My levels has dropped by half. She said she was sorry. I could stop the PIO and estrogen. I should expect a slightly heavier period soon. Did I have any questions?

My husband was sitting on the arm chair to my left and I just shook my head as I finished the call. He buried his head in his hands.

This was the briefest of all of my pregnancies. Because I was only four weeks and two days, it’s classified as an “early loss.” A chemical pregnancy. It was barely real. It felt barely real, too, I guess.

We’d said this was going to be our last try. A large part of me still feels that is the right call. The emotions are raw, though. I ask myself, as if on a loop, if I’m okay with never experiencing a baby kick me from inside my body. I don’t know. Why do other women get to experience this, and I don’t? I don’t know. I never seem to get closer to the answers.

These questions and many of these feelings are wrapped up in the idea that my body continues to fail me. I’ve talked in therapy about this at length. I want to forgive my body and make peace with her. I hope that I can.

Of all of the outcomes going into this last FET, pregnant for four days wasn’t one I’d considered.

Later days, endometritis

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The super annoying, potentially infertility-causing house guest in my uterus is finally gone! Following my third (and heaven willing my last) biopsy earlier this month, my chronic endometritis has cleared. Boatloads of antibiotics did the trick.

The day that I got the good news, I was actually terrified that it would be bad. I just had the worst gut feeling that the condition was still lingering, and had, perhaps, gone too long untreated leaving my my uterus permanently inhospitalable.

I’m incredibly thankful that doesn’t appear to be the case.

While the coast is currently clear, I’m eager to move forward as quickly as possible. “Quickly,” though, in infertility land almost always means waiting for your next cycle to begin. After some back and forth with the doctor and input from the most amazing nurse in the world, my husband and I landed on returning to IUI for just one more cycle.

That decision was primarily driven by financials (IUI is pocket change compared to IVF), but also by the tried-and-true approach of “well it worked before…” Said with a shrug, of course.

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Both times that I’ve been pregnant were a result of IUIs. Since both of those pregnancies ended in miscarriages, though, we’ll this time supplement the IUI with progesterone shots (Crinone suppositories historically haven’t worked for me).

I’ve started the Clomid regimen. In previous cycles Clomid has flattened me like a pancake, although it has done what it’s intended to do. I decided I was willing to deal with the side effects one last time.

Mentally, though, I’m already checked out of this cycle. Although it has been successful in the past, Clomid + IUI has failed me twice, too. I expect it will again. My expectations are low — where I hope they will stay.

This will be my seventh attempt to get pregnant with medical intervention. That number seems very high, but also not high enough given that we’ve spent more than two years and thousands and thousands of dollars doing it.

Me versus antibiotics: A battle for my body

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Warning: This post is mostly one long complaint. I’m aware I have it better than some on this infertility “journey,” and for that I am grateful. But right now I’m just going to bitch.

I’ve been a human pincushion. I’ve grown gotten accustomed to having any number of wands and OB tools shoved up my lady parts. I’ve had a D&C and a medically-induced miscarriage. And then there was that epic biopsy. I get it — infertility is pain (and I’m just talking physically here, I won’t dare scratch the surface of the emotional). Of all of the things I’ve undertaken physically, I’m currently ranking side effects from my endometritis antibiotics among the crappiest (literally and figuratively).

I am taking 2,000 milligrams of antibiotics per day, for two weeks. That much should knock an infection out of an elephant. For reference, 2,000mg is more than double the amount that is typically prescribed for a common infection, like a UTI. It is A LOT of medication. A lot of medication that has been incredibly unkind to my gastrointestinal tract. Any GI issue you can think of I have probably experienced in the last week. Sometimes several at once. When it’s not painful, it’s irritating nausea (etc.) that just never goes away. I haven’t felt like myself (or, let’s be honest, anywhere close) since mere hours after I took my first dose. I’ve resigned myself to the fact that I’m just not going to feel any better until the antibiotics course is over. THREE MORE DAYS HALLELUJAH.

As I said, I get it. This infertility business hasn’t ever been easy. But man if this doesn’t really suck.

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Image from KevinMD.com

All hail me, the antibiotic queen

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The last two months have been, shall we say, a bit confusing in Infertility Land. Following my second unsuccessful IVF transfer in November, my doctor was puzzled why three seemingly good (day 5 and 6) embryos had failed to implant. Statistically, given both my and my husband’s genetic screening are normal, it is extremely unlikely that they were all abnormal.

My doctor:

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The most likely candidate for failed implantation in my case (to recap: two failed IVFs, two miscarriages, and a boatload of IUIs totaling more than four years of unexplained infertility) is endometritis.

WTF is that and why does it sound just like endometriosis?

Endometritis is inflamed uterine lining, and I have it. Chronically. And how did we land on this diagnosis? With the most painful biopsy of my uterus I could imagine. I do not mince words here. I have a reasonably high tolerance for pain. I’ve had sporadic kidney stones since I was about 17 years old. I bite down and bear it. A uterine lining biopsy is no joke. I, in fact, nearly fainted. I sat up following the procedure, felt weird, and then hear my doctor and nurse yelling into the hallway for juice and a cold compress as they each grab my hands and check my pulse. It had slowed to about 50/bpm.

This endometritis thing is wack, but at least we’re starting to get some answers. I was asymptomatic, so there was no real reason to test for this before. It’s possible that I contracted the initial infection that lay essentially dormant when I had my D&C for my first miscarriage. The timing of that makes complete sense, actually. Nothing has worked since then. The number one complication of endometritis is infertility. Check! I got that.

I was relieved to have a diagnosis and something to blame the stress of the last few years of fertility treatments on. And thankfully, chronic endometritis is treatable. Just a course of antibiotics should clear it right up! Yes, there would be another painful biopsy waiting for me on the other side of that treatment, but so what?

I dutifully took my two pills a day for three weeks (thanks to a sinus infection prior to my treatment, my course of antibiotics was more like four and a half weeks). Then tried to keep my anxiety at bay for the next invasion of my uterus. You know what helps, though? Valium! The most wonderful nurse on the planet gave me one about an hour before the procedure and I’d slide that pain scale on down to a seven this time around. I was also pretty high most of the day, so I joyfully spent the following few hours in my bed.

Fast forward one week to yesterday… results day. No bueno. The tissue remains inflamed. Three weeks of antibiotics is no match for MY chronic endometritis!

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So, ya know, that’s not fair. The next step is a double dose of antibiotics for two more weeks. And then we biopsy again. Cannot wait for that good time.

In all seriousness, I’m sad. Sad that this easy treatment for this condition we didn’t know I had didn’t work. Sad that the timing of all this effectively prevents us from having a child in 2017, even if I were to successfully get pregnant in my next FET cycle. Which, sure, is fine, but it’s just one more thing that sucks. I made an effort to start the year positively after the last few have beat the crap out of me, and it makes me question why I’m ever positive.

Yes, I’m selfish — I want a baby and I’m pissed that I’ve waited so long to get what I want. Only to just keep on waiting. Now I’m waiting with boxes of probiotics and Monistat to quickly clear the inevitable yeast infection.

In hopes of a false negative

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Anna and Elsa didn’t stick. Probably.

Does anyone have experience with a false negative pregnancy test following an FET? My husband, ever the online researcher, immediately hit the message boards yesterday following the call from my doc saying that our IVF was, again, unsuccessful. He found many women had experienced a false negative in their first HCG test. The “many” was enough for him to suggest that I retake it later this week. So I am.

I really was not prepared for another negative this time; I was feeling incredibly positive about a good result. The news of another failed IVF hasn’t completely sunk in yet. I don’t know what’s next, other than retaking the test. I’ll do that to give him some peace of mind. He deserves it, too.

One or two

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If you had asked me 10 years ago about my future family, I more than likely would have said that I would be the mother to twins. Twins run in my family in every generation. My father is a twin (identical). My aunt (his older sister) has twins (fraternal). Twins go back several generations on my father’s side. I always assumed I’d be the next one to have them. I accepted it as my fate and moved on.

During the post-mortem on my first (failed) IVF cycle with our RE a few weeks ago — in which he said that my cycle was absolutely textbook perfect minus the lack of pregnancy (not as comforting as it might sound) — he asked whether we would like to move forward with a one or two embryo transfer for our second cycle. As soon as I opened my mouth to answer, my RE jumped in with the laundry list of complications that are more likely in a twin pregnancy. Increased risk of preeclampsia, gestational diabetes, low birth weight… yep, check.

For these reasons, as well as the perceived quality of the embryos we currently have frozen (Anna, Elsa, Olaf, Kristoff and Anakin, you may recall), he recommends another single transfer. And while this is his recommendation, he is open to transferring two because of the practical and logistical factors involved with IVF.

I left the office that day with my husband — me headed back to work and him home — and said in the parking lot, I don’t know what to do. This surprised him, mostly for the resigned to twins reason above. And honestly, it surprised me a little, too.

One of the very (very, very) few positives of medically assisted reproduction is that I have some small amount of control over having twins. In the future my 20+ year old self envisioned I did not. Our odds of having twins with a two embryo transfer is about 25 percent, per the RE. That seems somehow more significant – heftier – now when I have the option, technically, of choosing a singleton pregnancy and child.

I’m struggling with a few things as I try to make this decision (presently my husband has allowed me to make the choice). Perhaps most seriously with the practicality of caring for and raising two children at the exact same time. I’m not naive – that shizz is hard. That shizz is expensive. I ask myself if I could be a good mother (or perhaps more accurately, the kind of good mother I aim to be) to two as to one. The questions I ask myself are honestly exhausting.

Residing on the other side of the fence, of course, is the part where I’ve tried for three and a half years to have a baby and create my family… I can’t possible say, oh, I only want one at a time. Nope. Give me all the babies!

I don’t really see myself coming to a resolution on this any time soon. Overthink, much?

When your heart keeps breaking

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Going into my first IVF cycle I didn’t understand just how high my hopes would be. I thought, as long as we come out of this stim cycle with frozen embryos, I’m good. And we did.

But I’m not good. I got my period several days ago and have been stewing ever since. I went through the stages of grief. Spotting is normal during implantation and this is only a little more than that… Then my period would all but stop and I’d feel relieved and silly that I overreacted. Then, hours later, more red.

Little 3AB didn’t stick around and that sucks. It really just sucks. I’m angry that for what I’ve put my body through over the last several weeks I don’t have much to show for it. I’m still waiting. How am I still waiting?!

How has this thing that happens for a majority of the population — often by accident — not happened for me after three and a half years of time, money and effort? I’m angry. I’m sad. I don’t understand it. I can’t understand it. I can’t let it go.

I’ll focus on the positive — a future Frozen Embryo Transfer (FET) — later. I’ll dust myself off and gather the pieces… later. For now my heart is broken again. It’s my new normal and I hate it.