When your anxiety is as high as your estrogen

My husband called it “estroxiety.”

It is transfer week, which means it is crawllllling by at a snail’s pace. Aside from the side effects of my BFF Estrace — of which I have many — my mental health feels a bit like a teeter-totter. One moment: OMG I AM SO EXCITED THIS IS GOING TO FINALLY WORK ALL CAPS EVERYWHERE! The next:

giphy1

Actual footage of me?

Don’t get me wrong, not going into an embryo transfer blindly for once is a welcome change. I know my doctor (well, actually, not my Peyton Manning doctor because he will be on vacation) will place little PGS-normal 5BB in my now-optimized for receptivity uterus. Because my ERA test revealed that my lining is 12-hours pre-receptive, we’ve moved my PIO shots to the mornings, giving me an extra dose before the actual transfer. The same biopsy revealed no recurrence of endometritis either. So, basically, my uterus is as ready to grow a baby as it probably ever has been. I’m set up for success. Even my clinic’s internal stats on a a PGS-normal resulting in pregnancy and a live birth are killer.

And yet, the pressure is getting to me. My stomach is doing flip-flops. I’m not falling asleep easily and sleeping fitfully. My brain keeps telling me that normal embryos fail all the time. I’ve had anxiety before transfers in the past, but this is so heightened. I’m so hyper-aware that it could be successful and that’s just not my normal. I’ve had nothing but failure to point to; I’ve settled in and stayed awhile. As miserable as infertility makes me, it is my normal. I’m not resigned to it, but it is always there. It’s been the focus of my life for more than five years and it has become my every day. Popping Estrace pills morning, noon and night; the sore injection sites from the PIO; lying back and putting my feet in the stirrups for internal ultrasounds every few days. This is my life. It sucks so much, but there’s something that has become so comfortable, too.

Like many Type-A people, if I’m not good at something almost immediately I tend not to like it very much. I despise mediocrity in myself. When I was eight years old I played the saxophone for a little under a year. I was pretty terrible, and I quit because I knew I wouldn’t ever be first (or even second) chair in the elementary school band. Instead I did something I was much better at (cheerleading [current me still doesn’t fully comprehend how I was a cheerleader my entire childhood]), and spent the next 10 years engrossed in that. Captaining teams, winning an award or two and being pretty good at something like the Type-A in me wanted.

Somehow, I’ve never quit this. I’ve pushed through even though I am clearly terrible at creating babies. Infertility has taught me an awful lot about failure. And, in turn, resilience. It has absolutely shaped who I am as a 36-year-old woman.

With success as close as it has probably ever been, it is out of my hands now (and soon to be in my uterus). I have, officially, all the feels.

Also, f#*k you, Estrace.

Infertility grief

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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.

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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.