Heartbeat

On Friday, for the first time in the last five and a half harrowing years of infertility, I saw and heard the beating heart of my growing child. No matter the outcome of the next 33 weeks, that swish and flicker is cemented on my own heart.

The whole of last week my brain felt like it was on fire. As much as I was genuinely trying to visualize the outcome I want to see, I couldn’t push away the intense anxiety leading up to the first ultrasound. I’m not being dramatic in saying that it was one of the worst weeks of my life. Every tiny pinch or twinge or pseudo-pain my brain told me, this is it, you’re miscarrying. This is happening again. There’s, unfortunately, nowhere to hide from the negative thoughts in your own brain.

I don’t want this post to be overrun with my anxiety, but I write this to say to anyone else out there in a similar position: I hear you. It is so terrifying to wait while you feel like your mind in running full speed toward a cliff.

On the drive to the clinic, I was, as always, looking for signs, wearing my magic bracelet. Anything to help prepare me for what was to come. The previous night I’d had only bad dreams. I’d texted my best friend that I was sure it was my subconscious telling me it wasn’t going to be okay. She replied, “NOT THIS TIME.” I wanted to believe her. Then, on the radio in the car played the song that I walked down the aisle to at my wedding. It was the first time in at least a week I felt like there wasn’t a boulder resting on my chest.

Fast forward to the exam room. My husband and I didn’t really look at each other while we waited. I don’t think we could. I closed my eyes and silently asked all of the people in my life that I’ve loved who are now gone for this to be okay. Please, let this be okay.

When my doctor and the greatest nurse on the planet entered, the tension was palpable. My doctor asked how I was feeling and I eeked out something to the effect of, “I’m really scared.” He nodded, in his warm way, and said, “I’m terrified.” That actually gave me a lot of comfort. He’s so invested in our outcome.

It didn’t take very long after he’d started the ultrasound for me to see the flicker. I said, quietly, “… is that…?” And he nodded with a huge smile. Then all the tears. I reached for my husband’s hand. I looked at him, and he started to cry, too.

Again, I’ll pause my touching story (ahem) to say here that infertility is incredibly hard on relationships. All relationships, but particularly marriages (or partnerships). Sometimes you feel miles apart in the same room. This moment, watching my Alpha Male ex-cop shows no emotion husband cry at the sight of the ultrasound screen allowed me to reconnect with him, and our passion to have a child. I’m so grateful we could share this.

By this time the greatest nurse on the planet was also openly crying. My doc definitely had tears in his eyes, too. Then he turned on the sound and the swishing of the heartbeat brought on another wave of tears.

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5BB is doing great right now. Heartbeat very strong at 123bpm. Measuring (then) at 6 weeks, 4 days, just one day behind my transfer timeline. All signs are positive. My husband has nicknamed the embaby Little Wookiee.

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The adventures of 5BB and the magic bracelet

On the morning of my embryo transfer with 5BB, I was anxious. We’d done this very quiet drive to the clinic three times before, each with a disappointing outcome.

I was looking for meaning in everything that day. Signs. As I do. Shortly after my husband turned on the radio in the car, a cherished song from my young adulthood came on. This song, “Call Me Al,” by Paul Simon, played before every performance I did with my musical theater group in high school. It was our hype song. Good start, universe.

During the transfer, I wore the magic bracelet. My high school best friend sent it to me earlier this year when she heard about my IVF experiences. It’s my favorite color, and reads “Warrior.” Attached to that bracelet is a Greek lucky eye that another friend gave me. I’ve worn that bracelet starting with this second egg retrieval and every important appointment since. A close friend of mine who is also going through IVF has borrowed it for each of her appointments, too. We’ve both had positive outcomes so far, thus dubbing it the magic bracelet.

On the ride home, with 5BB in place, the radio played “Sweet Child o’ Mine,” by Guns n’ Roses. I just stared at my husband like, are you hearing this right now?! The sign wasn’t even lost on him (and he often thinks my “signs” are signs of insanity). Thanks for the encouragement, universe. I needed it.

I spent the rest of the day trying to stay relaxed. I snuggled with our dog. I probably binge-watched something on Netflix, as I’m also known to do.

That evening, we ordered pizza for dinner. Comfort food is the best, isn’t it? When I answered the door for the pizza, the delivery person was very visibly pregnant. Because of course she was.

All of this leads me to later this week when we find out if little 5BB will surpass my previous embabies with a detectable heartbeat.

I’ve had moments in the last two or so weeks since the positive pregnancy test (beta) when I’ve felt excited. And nauseous. And tired. And a lot of the time when, in my gut, this time feels different.

Plenty of other times, of course, I just expect bad news.

I wish I knew what I’d see on the ultrasound later this week. I wish I could prepare for it. The idea that I can reach the six-week (and change) ultrasound and not have my hopes devastated is so foreign to me. But this time could be different. 

Ninth (long sigh) time’s a charm? Another TWW

Embryo 5BB is in and we’re in the dreaded two week wait. When I realized this was our ninth medically-assisted attempt to get pregnant I felt pretty deflated. We’re so far down this road.

Then I started to feel the twinges. Of implantation? Could be! My boobs are sore. Because 5BB is settling in? Perhaps! My lunch is feeling far from appetizing? Maybe yay!

I’m cautiously optimistic. 

I’ve said that before.

Infertility is such a mindfuck.

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:

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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

Understanding PGS: Why we’re doing it

PGS (pre-implantation genetic screening) is a complicated topic. While I knew we would opt to use PGS during our upcoming stim cycle prior to a transfer very early on, I didn’t know much about it. I’d watched an animated video on the website of the laboratory that my clinic uses for PGS, and it felt a bit Schoolhouse Rock-esque, without the clever puns and music. This video could have used those. I felt like I knew the basics of what happens to the embryo/blastocyst during the PGS testing, the lab counts chromosomes, … blah, blah blah… and then following testing my husband and I would see a report on our embyros each characterized into two neat little columns — normal or abnormal.

At least some of that was correct.

I’ll say before I move on that I am not usually one of those infertiles that spends hours in the middle of the night on message boards comparing IVF stories with other women. I’m not passing judgement on the women that do that, mind you. For me, and my mental health, I have to sometimes turn down the fire hose of infertility information. I very much pick and choose when I consult Dr. Google or the message boards because when I know too much, my anxiety hits dangerous (read: 1947-era padded room, straight jacket) levels. Too much research can cripple me. I try to be well-informed about my treatment options and protocols, and I think I am, but I know my limits. I’m good without knowing that Jane Doe in Oregon also had a Lupron-down protocol resulting in 20 eggs at her retrieval and then experienced this freak thing… yeah. I, personally, don’t need to know. I advocate for myself but I also trust my doctor and the greatest nurse on the planet.

So while I knew I’d move forward with PGS almost regardless of my research, I still wanted to learn more about it. If anything, I wanted to confirm that I was making the right call about doing it, and gain confidence that we’d have some clear answers after the tests were complete.

Where did I land? Well, I will say that PGS is (still) the absolute right step for us at this point (more on that in a bit). But, dayum, I got schooled.

First, all hail FertilityIQ. Their online course on PGS is the absolute best, most comprehensive resource on the subject I’ve found. If you’re considering this as part of your treatment plan, take 30 minutes to watch their helpful videos and read through their detailed written material. Deborah and Jake, the founders of the site, host the videos and I’d like to be friends with them. They’re clearly knowledgeable (fertility clinic vets so they totally get it), but they also include interviews with doctors on both sides of the aisle in this PGS debate. The course has easy to understand patient examples, visuals and just a ton of great information. Honestly, it’s not only worth your time, but in my opinion you owe it to yourself to understand the intricacies of such a complex fertility topic.

This post isn’t sponsored by the site, nor do I have any relationship to it, I am just a big fan. Also, I probably don’t need to mention this but I am NOT. A. DOCTOR. I am a fellow infertile sharing her experience. 

Remember when I said that I thought after PGS all of our created embryos (and Kristoff) would be put into two nice little black and white buckets? Nooope. Because mosaic embryos are a thing. As a woman lumped into the unexplained infertility category I’ll say they are a potentially confusing, frustrating thing. I don’t need more unexplained science, world! I need answers. The FertilityIQ videos and text were extremely helpful in explaining not only what mosaicism is, but that there are questions I need to ask my clinic about their policies on identifying these gray area embryos. (Aside: And because I now knew to ask this question I got an answer about my clinic’s policy! #winning)

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What this all comes down to is that I’m glad I did the research on PGS. While the idea of mosaic embryos does kinda make me want to cry in the corner, simply because it’s just more uncertainty when I’ve had my fill of that, I’m glad I’m armed with this information to better advocate for myself and my future blastocysts. I can ask the questions of my clinic, talk to a genetic counselor if I’m in a position where we only have mosaic embryos available, and then decide what’s right for us. If any of that happens.

Here’s why PGS is right for us at this moment in time: I’m 36. I’ve had two miscarriages, a chemical pregnancy and three failed embryo transfers (with a total of five embryos). Other than chronic endometritis, three years of infertility treatments and countless tests have not brought us any closer to a baby. This road is ending for us soon, with or without a biological child. I’m tired. We’ve reached our debt ceiling. PGS will allow us the best possible opportunity to have that baby. We will carry more debt with us because of it, but we’re going for broke this time (perhaps literally as well as figuratively). This is it.

If there’s one thing I feel really positive about heading into this last stim cycle, it’s the decision to have our embryos tested. And honestly, I really need that sliver of hope.

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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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.