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.

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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Letter to the new (infertile) kid on the block

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

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.

IVF: TWW

Right now, there’s a blastocyst swimming around in my uterus looking for a cozy spot to park and grow. I picture it a little like Dory in Finding Nemo, actually, but I biologically know it doesn’t really swim. The embryo we transferred on Wednesday was a grade 3AB, which I’m told by the many, many trained professionals that have seen my anatomy in the last week, is great.

The transfer went smoothly and was not at all painful like my egg retrieval. Some discomfort and pressure with a very full bladder, but a cake-walk, relatively speaking. It took about 10 minutes from start to finish and was fascinating to watch on the ultrasound screen. On the grainy screen, my husband and I watched the entire process as my doctor put little 3AB in where he/she belongs.

Now, we wait…

I’m relieved to have the injections over, and certainly grateful for the end of the pain of my Dark Willow ovary. Every other time I’ve been in this TWW limbo has been me white-knuckling through the anxiety of the wait. And while I’m certainly eager to see if 3AB is successful, I feel mostly relief that I have my first IVF cycle behind me, regardless of the outcome. 3AB is in there now and I just have to keep it as safe as I can.

While 3AB swims around looking for that warm and inviting spot, Anna, Elsa, Olaf, Kristoff and Anakin are now on ice. We were able to freeze five embryos. Two more of good quality (two more 3ABs), and three more of good/fair that appeared likely to survive the freezing and thawing process. When I texted my sister-in-law  about this process, she sent me a gif from Frozen, and the embryo “names” were born. Its become an amusing inside joke, and one I’m sure I’ll repeat pretty regularly over the next few decades. I’ve denoted Anna and Elsa as the two superior embryos, only because they were frozen together, but I’m personally pulling for Olaf to make it to my uterus next time. If only because it will be endlessly funny to call him Olaf in utero.

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I’m listening

Probably one of the most important lessons I’ve learned about fertility over the last two-plus years is to listen to my body. Only a few years ago I likely would have thought this concept to be too new-agey for me, and in a way, it is. But when your month, every month, consists of testing things, prodding and then waiting, it’s natural to become hyper-aware of your body.

My husband and I tried to conceive naturally for nearly two years before we sought assistance. I was pretty well convinced when we first starting fertility testing that the doctors would find something wrong with me. Somewhere, in the back of my mind, I knew that to be true. Early on in that process, we got some mixed results which had be concerned. These red flags all but convinced me that I was right. I was so very thankful to be wrong. The red flags largely turned out to be caused by ultrasound shadows. By the time sat down with our fertility doc, our infertility was unexplained. My husband and I fell into that mysterious 10-15% of couples where there’s no discernible cause to have not conceived naturally in two years.

Less than a week after meeting with our doctor, we began the Clomid + IUI plan that we’re currently on. A friend of mine, when I mentioned that course of treatment mentioned that Clomid didn’t work for her, and she felt strongly about that very early on. She heeded, “listen to your body.” It’s great advice, and words I paid attention to.

In our most recent Clomid + IUI cycle, my OPKs never picked up an LH surge (this had also happened the previous month, and I missed the window for IUI because I never saw a positive OPK). But, I had all of my typical ovulation symptoms. Over the course of about 18 hours, I went back and forth with the incredible staff of nurses that I work with at our clinic, along with my husband, to decide if we should proceed with this month’s IUI. There are always a lot of factors to consider in fertility treatments, and, too often, cost is a major one. Our medical insurance does not cover fertility treatments, so we’ve paid for our visits and procedures over the last several months out of pocket. This cost is significant to any couple that doesn’t have a hefty savings to fall back on, as it has been for us.

So, a serious concern in deciding to move forward with this IUI was, obviously, cost. Without an LH surge detected, I had no firm indicator that I’d ovulated. It was more of a risk to decide to move forward with an IUI (and timing it, essentially, blind). I listened to the advice of the nurses that have gotten to know me, and that of my husband (who, ultimately said, “uh, I don’t know…”). And then I listened to my body. My body said, in her sassy way, “girl, you’re trippin’… you ovulating! Go make that baby!”

I’m happy that I listened, no matter the outcome. For now, though, to be continued….

She who pees on sticks

When you’re trying to conceive, it is easy to feel like much of your life is spent waiting. Waiting for a positive OPK. The two-week wait. It’s a frustrating cycle (pun intended) of wait. And for about as much time as I spend waiting, I spend an awful lot of time peeing on sticks, too. It’s kind of my job, for now. You could say I am an expert at it, in fact.

Until I’m not. Exhibit A… this afternoon’s failed OPK:

What the what?

What the what?

Seriously? I take this to mean, “you’re an idiot. Read a book.”

What to expect when you’re not expecting

For a long time, probably years before I was actually ready to become a mother, I have had a vision of purchasing a copy of “What to Expect When You’re Expecting” the day that I find out I am pregnant. This book, to many women, is much like a bible for pregnancy. I’ve purchased copies for friends when they’ve announced their news, always secretly knowing that I would be standing in line at Barnes & Noble or Target with the latest edition in-hand when my time had come. I realize that the modern woman has likely moved past “What to Expect…” (there was that terrible movie after all). A close friend of mine who became a mama last year read, and adored, “The Girlfriends’ Guide to Pregnancy.” (I’m sure I’ll buy that one, too.)

IRL, I know one other woman who has been on a similar infertility path as I (a friend/former coworker). One thing that she warned me of, that I never in a million years would have otherwise believed, is that many women experience pregnancy-like symptoms while on Clomid. From an “outsider’s” perspective, this makes little sense. A round of Clomid lasts only about five days of the cycle (mine is days 3-8)… so why would I experience symptoms like nausea, headaches and fatigue a full 10+ days later (when I hadn’t experienced anything of the sort elsewhere in my cycle)? If you’ve done the math, the time inconveniently coincides with the TTW… exactly the time I want to be feeling the annoying symptoms of pregnancy. But this is exactly what happened to me following my first Clomid/IUI cycle. For any woman trying to conceive (TTC), this is maddening. I am already paying an absurd amount of attention to my body (comparatively to my level of attention when I wasn’t TTC), and then, Clomid, you want to lay pregnancy symptoms on me?! Not cool, bro. (I generally associate Clomid with feminine terms, but “Not cool, sister” doesn’t pack the same punch.)

Chalk it up to stupid, misleading and damn confusing. As I said, I never would have believed that phantom symptoms would be a thing. But it totally is. Ask the package of plain crackers I bought and devoured…

The shift

Sometime in the last hour my outlook on the day changed dramatically. That happens to me frequently, as I’m sure it does to most women trying to have a baby. That dramatic, sudden shift – the certain to uncertain – is a source of fear and loneliness for me, not to mention it can physically hurt.

This month I had my first fertility treatment – a five-day round of Clomid, paired with intrauterine insemination (IUI). These past 24 days have felt like some of the longest in my life. Never have three plus weeks crawled so unbearably slowly. In fertility lingo there’s an acronym – TWW (the two-week wait), of which I am more than midway through. TWW refers to the void of time between an insemination and the pregnancy test.

I’m scheduled to take my test this Friday, but about an hour ago, in the restroom, I feared that I wouldn’t have to wait out the calendar for another few days. Now my heart hurts. The last few days I had essentially convinced myself that I was, in fact, with child. Headaches, fatigue, nausea for no discernible reason… classic pregnancy symptoms. It’s a strange thing to be happy about feeling bad. Yesterday when I felt like I could barely keep down some fruit for lunch, turned my nose up at my large iced coffee, and then sat most of the afternoon at my desk with a box of crackers in my lap, I was feeling elated. When I packed my crackers in my desk drawer at the end of the day I thought gotta get used to this…with a smile on my face.

Yes, I know that a successful round one of fertility treatments isn’t that common. Tries three and four are more likely to work. I know. But, you see, I did some simple math and it added up to a sign. Insemination (and therefore conception) took place on my father-in-law’s birthday. We would find out if it “stuck” on the 13th – my mother’s birth date and (deceased) father’s lucky number. Then, 40 weeks later would take us to November 6th. A lucky six dead in the center of my husband’s lucky five and my lucky seven. That math just couldn’t lie.

Since that moment I’ve treated every second as though I’m carrying the child that I’ve waited for. The nurses tell you after insemination that while nothing is restricted, you should behave as though you are pregnant – stay away from alcohol, take good care of yourself, and the like. I have. I will. Until that little stick shows me one line or two. That stupidly small piece of technology that determines if I get the job as “mama.”

Right this second I’m less sure that I will get that job this month. I want to go back an hour and unsee the spot of red that suddenly, like a shot, made me feel hopeless and helpless again. Just as I have every month before.