Infertility is really just a crap-ton of waiting

I’m a few days from starting my period. While nothing tops the two-week wait (TWW) on the anxiety scale, the time waiting to start your next IVF cycle is also stressful. In early January my husband and I repeated our lab work, and I had my 8,000th mock transfer and saline ultrasound to ensure all systems were go to start my last stim cycle. Other than a high TSH (thyroid) level, I’m all set. I wasn’t that surprised that my thyroid check was elevated since I’d been off my hypothyroidism meds for about 10 weeks because it conflicted with the prescribed appetite suppressant I was on for weight loss.

[Quick update on the weight loss: Somehow I’ve managed to quell my emotional eating inner demons, and am down 29.5 pounds! I picked up good habits and flipped that elusive switch that allowed me to rethink how I approach food. Particularly sugar. Perhaps the only person more surprised with my progress than me is my husband who knew all too well how unlikely I was to follow-through with this. It certainly has been challenging, but it’s pretty nice to feel like I am crushing. it. in just this one aspect of my life. Having said that, I’m about to stim again with hormones aplenty, so we’ll see what I’m made of over the next few weeks.]

It feels like there’s nothing but waiting. It’s often infuriating. Particularly in those rare time frames when I actually feel physically and emotionally ready to go down the IVF rabbit hole again. Like, ya know, now.

The downtime between completing one cycle and starting another always varies wildly. In my case, it’s almost always been months when it comes to IVF. I did my first stim (and fresh transfer) in June 2016. In fertility terms, that’s probably 25 potentially good eggs ago. Who knows if it was one of those “wasted” eggs that was the golden one?

Then we did our first FET in November 2016. Bust. The second FET didn’t happen for another ten months. Then I got a little bit pregnant. While money was probably the most significant factor in that span of time, getting answers to why three perfectly normal-looking embryos in an otherwise healthy woman simply didn’t stick (spoiler alert: it was endometritis) was also on the list. Not to mention my emotional health.

Moving into this last cycle, we’re already several months removed from the chemical pregnancy, and we’ve decided to leave our last frozen embryo from our OG stim cycle in the freezer (we’ll test Kristoff with his future embryo sibs). Which, another aside: If Kristoff is the ONE embryo that turns out to be genetically normal after PGS I think my brain may actually explode.

While the Clomid made me insane and pack on the pounds, at least IUIs keep the pace moving. I knocked a bunch of those out in a couple of months.

So we’re into another year of this waiting. Year five. We’ve reached the five-year milestone in infertility even before we did in our marriage. How’s that irony. Just delightful.

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Second opinions

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.

manning

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

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.