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.

 

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#TheStruggleIsReal

One week down. 

As someone who struggles with depression, I often have to focus on how far removed I am from my trigger incident to move forward. It’s a coping mechanism I’ve had in place since I was a teenager to remind me that I can move forward.

I work for a large company where we have our own campus. During the workday I spent 99 percent of my time in one building. In the last week I’ve encountered seven new pregnant women. This is in addition to the handful I’d already seen in the cafe or milling about in the hallways. I can’t escape them as I’m slowing expelling my hopes and dreams onto a maxi pad. I’ve heard all of the “it’s in the water” jokes. Trust me, it’s not.

Sorry if that maxi pad bit was too morbid. I’m feeling a touch filter-less.

Emotionally I’m all over the place. My mood turns on a dime. I remind myself that it’s okay to be upset; not only am I grieving another loss, but I’m also facing an enormous decision about what comes next. I spend a lot of time feeling lost. A lot of time feeling jealous of every mom or dad who posted a first day of school photo on Facebook or Instagram. For as much as I want to believe I’ll make that same post someday, the reality is that I may not. And someday isn’t now. Or tomorrow. Or even next year.

I’ve had so much support in the last week that I should be bursting with gratitude. And I am. I am incredibly grateful for the well wishes and the amen, sistas. You all completely understand these feelings. This insane emotional rollercoaster that you both desperately want to get off and are too afraid to leave behind.

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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.

Learning not to live in fear

If there’s one key thing that I’ve learned from spending time around other women who struggle with infertility, it’s that nearly every one of us lives in fear. When we see two pink lines or hear that we got a positive beta, we can allow ourselves to be happy for a second, but that happiness can quickly turn into fear. Grave thoughts of miscarriages past don’t leave us with passing weeks. The mindset can easily become why be happy when it’s just been taken away from us before?

I’m a few days away from my beta following my FET, and am feeling the sore boobs, fatigue and twinges of nausea. But I know well that those symptoms could just be the meds. I have a positive gut feeling, though. And that makes me anxious. I feel a bit like a tennis ball mid-match. Back and forth.

I was describing to my therapist that while I have this positive gut feeling, the idea of being pregnant again is shrouded in this fear of loss.  Will we tell people — our families and close friends that know about the IVF — this time? Is it worth it?

But on the flip side, if I am pregnant and, heaven willing, am able to carry successfully, will I look back in a few years and know that I didn’t allow myself to fully enjoy the experience? (Because, for real, at this rate I’m not sure I’m going to do it again.)

And then my therapist said something brilliant: If I feel happy because I am pregnant, then give myself permission to be happy. If I’m trying to protect myself by not allowing myself to enjoy it, it won’t work. Protecting myself in this way will not make it any easier should I miscarry again. It will be awful no matter if I was or wasn’t happy or excited.

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I’d never thought of it that way before, but YES! If I should miscarry again, that would be awful. But trying to pretend that I am less invested in the pregnancy won’t make it any easier for me.

As should come as no surprise to anyone reading this, I’m not really a “the world is rainbows and sunshine” kind of person. I’m just not. The “choose happy” mantra isn’t really my jam usually.

So if I am pregnant — if Olaf or Anakin or (gulps) both of them hang in there — then I’ll take the happy moments as they come. Of course I’ll be anxious sometimes, too. Because that’s completely normal. But I’ll work on living outside of the fear. It may be challenging, but this whole damn ordeal has been so I’m familiar.

Transfer Day


Olaf and Anakin thawed well and are already starting to hatch. Let’s do this thing.

Edited to add: My sister-in-law, who accompanied me to my transfer since my husband is out of town, surprised me with these baller socks that have MY DOG’S ACTUAL FACE ON THEM!

Desperately positive and hopelessly negative

When you’re infertile, there rarely seems to be a middle ground in anything. Emotionally, I am certain that my next fertility treatment will be successful one moment, and I’m a dumpster fire of despair the next. Nothing will ever work, I tell myself as often as I silently say this is it.

Starting this last round has probably amped up these disparate feelings. I’m two days into my estrogen (Estrace) regimen to build up my uterine lining pre-transfer, and my emotions are already on 11. Plus, my feeling nauseous. I asked my husband last night if he remembered me feeling sick during my last FET cycle when I started the estrogen, but neither of us recall it. It’s funny how every cycle is just a little bit different. Funny in an oh lord what’s next way, not in a haha way.

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As I’ve written about before, I see signs in everything. There’s already so many in this last round. Despite my best efforts to plan, my transfer of Olaf and Anakin will be after my husband has left for a three-month new job training. One day after. This, of course, makes me sad. If the transfer does work, he missed it, and he’ll also miss almost my entire first trimester. Which means I have to get my own damn ice cream at midnight. If it doesn’t work, I’m alone to process it. If it works and then I miscarry again, then just commit me to the psych ward because I’m likely to break.

Another sign in the positive column is that my husband got this new job at all. He’s been stuck in a crappy job that he hated for years and no leads had panned out in a very long time. In fact, the last time he got a new job, we were also apart. Two days after our wedding he left New York to interview in North Carolina for his (still) current job, and less than two weeks later he moved here. We spent the next five weeks of our newlywed lives hundreds of miles apart until I could move South as well. Major life change seems to equal time apart for us.

The final sign is that, if this transfer sticks, my due date would be sometime in April. And previous Aprils have sucked hard. The birth of a rainbow baby would certainly have a lot of meaning during that difficult month…

One last time: Olaf and Anakin

I’m in a weird place fertility-wise.

After several months of considering and discussing our next steps, we’ve decided to do one more FET before pursing non-treatment options in earnest. I didn’t come to this decision lightly, of course. I say I here, because it was primarily my call. My husband has graciously allowed me to steer the ship since we began fertility treatment two and a half years ago, and he weighs in when he has strong feelings one way or another about something. While this decision-making compromise can feel lonely for me at times, I’m ultimately grateful that he understands it is important for me to dictate what happens to my body. The feminist in me has trouble with that phrasing, but I’m going to leave it be. Infertility is complicated and does affect both partners.

Much of the continuing conversation about how to proceed happened between me and my therapist, actually. Last fall, after our second failed FET, my therapy sessions started to revolve around moving forward. I questioned whether I was ready to try again. What if that meant another failure? Or worse, another miscarriage.

One of the very important things I had to start working through was if I could forgive my body for failing me. Following my diagnosis of chronic endometritis earlier this year, I started to make peace with myself. This was the reason I wasn’t pregnant and once it had cleared, I felt almost renewed.

That feeling of renewal was short-lived.

I’ve worked hard in therapy to better understand myself and accept that, without unlimited resources at my disposal, perhaps my body cannot sustain a pregnancy. I’m still working on this acceptance. In many ways, it feels just as emotionally painful as my miscarriages. Accepting that I can’t do what I want is as much a loss.

So the decision to conclude our treatment following this last IVF cycle didn’t come easily. But we’re preparing to move on.

My period should arrive this week, we’ll shell out the cash, and I should begin the preparation to transfer two of our last embryos, Olaf and Anakin (Kristoff will remain frozen for the foreseeable future, provided O and A survive the thaw).

So I’ll be here, singing “One Last Time” from Hamilton under my breath. Apt and giving me all the feels.