I don’t mean to sound insensitive, but…

…if you can help it, please don’t bring your kid to your fertility appointment. Believe me when I say that I don’t want to sound insensitive. I know that infertility and miscarriage do not only affect women without children, and I know that having to go through it is a nightmare no matter what. I get that. And I also understand that it is not easy or cheap to arrange for child care. But please hear me out. I went to a fertility appointment the other day, with my future plans very much in limbo. I was not happy to begin with, as I can imagine are most of us in that waiting room. Anyway, in the waiting room was a couple with a toddler, among others. The couple with the toddler were, understandably, making the most noise and drawing the most attention. The toddler was walking around, playing on her noisy iPad… things like that. Totally innocent! But it made me feel down. Obviously babies and children exist and I will be seeing them out in the world. But I don’t want to see them at my fertility clinic, the ONE PLACE where I don’t feel alone, the ONE PLACE where there are other women going through similar struggles. I fall into the category of women who would do anything just to become a parent. I don’t have a child to go home to and give extra hugs and playtime after coming home from my fertility appointments. I don’t have that.  I am not saying my struggle is better/worse than yours, but it is different.

Just like going to a baby shower is hard because it is a reminder that you are not pregnant, seeing babies in the fertility clinic is hard for me because it is a reminder that I am not a mother.  I’m not expecting you to agree with me, but I ask to at least try to understand where I am coming from.

 

 

 

No no no no. Not Again.

With a heavy, devastated and frustrated heart, I write this as I was given the news today that I will be having another miscarriage. My THIRD.

I thought this would be different. This time, I went through IVF (twice!), sent the embryos for genetic testing, and had an embryo transfer.

Yes, I had an embryo transfer in June, and it took!  Some people like to give updates on these blogs/forums every second, but I was hesitant to provide my update because I didn’t know how things would turn out in the end. But then again, the ones who are always like “OMG I’m freaking out!” always seem to end up with a good ending, am I right? Maybe I should have updated more frequently. By the way, I don’t mean to single anyone out or offend anyone, I am just being bitter.

So yes, we had the transfer, and when we found out we were pregnant we were “cautiously optimistic”. Obviously very happy, but we also knew that one good hcg or ultrasound today does not guarantee a good one tomorrow. In fact, we wouldn’t feel completely at ease until we had a live baby in our arms.

But something is clearly wrong. Three first trimester miscarriages. Most cases of first trimester miscarriages are due to chromosomal abnormalities, but we ruled that out with genetic testing. So something else is wrong and we don’t know what it is.

What IVF has taught me… a second time!

Hi guys! If you were following along, you may know that I was planning on going through another cycle of IVF so that I would have more embryos to work with (right now I have only one, which is amazing but I figured I’d do another round before the famous biological clock runs its course). If you are new to IVF and are looking for a general overview of it- like the process, what to expect, etc- you can start here (via IVF! The Good, the Bad and the Ugly). I think I did a pretty decent job summing things up 😉

But now, having gone through IVF a second time, I learned even more about the process! And it would be my pleasure to relay not only my experience, but also some tips and tricks I learned along the way. Because I’m technically an expert now, right?

Some advice, in no particular order:

1) Take some time to think about your previous cycles. What went well, and what could have gone better? Since hindsight is 20/20, was there anything you would have wanted done differently? Or would like to do differently in upcoming cycles? I find this to be super helpful before starting ANY cycle! Sometimes the fertility monitoring can make us feel like a mere statistic, but no. We are individuals and what works for some might not work for others. And to that end…

2) Schedule an appointment to meet with your fertility specialist in person before starting a cycle, especially an IVF cycle.  It’s nice to actually sit down with you provider and re-group to make sure you are both on the same page. If you have ideas, suggestions or questions, now is the time! Infertility has made me feel so helpless, so it is important that I advocate for myself whenever I can. I can’t recommend this enough- please advocate for yourself, and question any time something does not seem right. The worst that can happen is maybe we misunderstood something and the provider can re-direct us. The best that can happen is that we help ourselves. At the end of the day, we know our bodies best.

3) Determine the anesthesia to be used and come up with a “pain plan.” Both of my retrievals were under conscious sedation- aka I was awake and alert (even though I technically was not supposed to be alert. I was alert alright!). Both of my retrievals were painful, I will not sugarcoat that. BUT- my second retrieval went a lot smoother. Here’s why. With conscious sedation, my nurse would alternate giving me painkillers and anti-anxiety meds through an IV.  During my first retrieval, she was pushing meds IN RESPONSE to SEEING ME in pain. For my second retrieval, I did not wait for her to see me whimpering in the chair. If I felt something that hurt, I would ASK the nurse to please give me something before the pain became unbearable. And yeah, I asked a lot. Call me whatever you want, but this method helped a lot more.  Again- advocate for yourself. I would say the worst pain is at the very end of the procedure, and the first few hours after. When my first retrieval ended, I was given extra-strength tylenol. I then had a 1-hour car ride home and the pain was still there. It did get better by the time I got home, but it was not fun. So I asked my doctor what to do about pain to prepare for my second retrieval. He actually prescribed a painkiller and allowed me to take it as soon as I was allowed to eat after the second retrieval. That time around, the car ride home was fine! I can’t speak to what the experience is like for general anesthesia, but I’m sure after the procedure, there is still soreness.

4) Don’t forget about constipation! Sorry if this is TMI, but after the retrieval, everything in my lower region felt sore. Having to poop was painful especially the first few days after the retrieval (is there a more sophisticated way of saying poop?). So here is my recommendation- on the days leading up to the retrieval, eat lots of fiber-rich foods. You want to be able to empty your bowels before your retrieval because if you don’t you will feel sore AND constipated. And that is no fun.

5) Put yourself first. Please! It’s important to be relaxed, so don’t push yourself during the days leading up to and even after the retrieval. It’s okay to decline social events for a little self care. On the other hand, if social events relax you, then go all out! In case you can’t tell, I’m an introvert 😉 But seriously though- it is very important to take the stim injections around the same time every day, and you don’t want to be stuck rushing home worrying if you’ll make it in time. These medications have to be refrigerated so it’s not like you can take them with you anywhere you go.

6) Do whatever you can to make you feel stress-free. For me, it was upping my organization game. I set alarms in my phone for all the different meds I needed to take. After I injected the meds, I would record it in my planner- the cycle day, the stim day,* the medication, the dose, and the side of my abdomen that I injected. This made it easy for me to rotate sides. Yes, I could have very easily used my memory, but it was nice to have an extra backup. It’s also helpful to have a written copy of things so you can look back.  *(So if my first injection was on cycle day 3, I would record that as cycle day 3, stim day 1. And then the next day would be cycle day 4, stim day 2, etc… )

7) It’s okay to be emotional. Infertility is no walk in the park! For my first IVF cycle I was very hopeful and in a great mood throughout. But having to go through another cycle again, I felt soooo defeated.  I would have to take a step back and re-frame my thinking so that I wouldn’t go down a rabbit hole of negative emotions. It took effort, but it was better than blaming myself for feeling bad. Instead, I accepted the fact that I have every right to feel bad, but for now, let’s try to focus on the good.

8) Be prepared to constantly feel “in limbo”- this applies to anyone in the infertility process. We try so many different ways to get pregnant, and while there may be small victories along the way (nice follicle growth, good hormone levels, even a positive pregnancy test) for me, it’s not a complete victory until the bundle of joy is in my arms. I hate to end on such a cynical note, but I’ve been through my fair share of disappointments. So for now, I take everything in stride.

I hope this was helpful! I would love to answer any questions you may have!

When the glass is always half empty

I’ve been feeling a lot more down lately- mainly defeated and frustrated. Maybe it’s just PMS. Maybe it’s because it was just Mother’s Day. Whatever the reason, I am failing to see the good in things, and that is not the “old me.” And since I am starting a new cycle, I really need to be in a better frame of mind. So I write this post for selfish reasons, as a way to help myself.

I’m still trying to improve my wellness- eating better, working out, meditating- but this time I have so many other things going on in my personal life that I just feel overwhelmed. Most things are good things, but I am getting hung up on the deadlines. I will be “graduating” my current job and moving on to a new one, which is great! But now I have to wrap things up with my current job and get onboarded with my new one. It seems like every day I have more tasks added to my to-do list. I also have to go house hunting since I will be moving to a new state. It was fun in the beginning but once we involved our parents it became way too many cooks in the kitchen. I can’t afford the house I want, which is frustrating because I put in so many years into my education and training, yet it seems I would have been better off getting a job straight out of college. I have a few conferences lined up where I will be speaking, which is also exciting, but that also means working on my speech and presentations.  All this during a second round of IVF. During my first round of IVF, I was pretty relaxed and hopeful. Now, I feel super tense and doubtful. I don’t know if I am doing this as a defense mechanism, like if I expect to fail, then maybe I won’t be as upset if I do fail. But this is such negativity! And I don’t like it. I literally have to remind myself about all the good things in my life to temporarily get out of my negative state. But the negativity always comes back.

Well, this didn’t particularly lift my spirits, but it did give me an outlet to vent. Thanks for listening.

IVF! The Good, the Bad and the Ugly

After what seemed like an eternity, I FINALLY started and completed an IVF cycle. If you thought TTC itself is a roller coaster, IVF feels like all of that condensed into one month. I have a lot of commentary on IVF, so I will break it down by category:

The Meds

This part was not that bad for me. I am by no means minimizing the fact that it can be very hard to deal with multiple daily injections! What helped me was that I kept telling myself these medicines will hopefully help me achieve my dream of parenthood, so what’s a pinch here and there for a few days? I also had a relatively simple medication regimen, which helped. For about 9 days I took Follistim daily. The needle was small and thin, and injections were easy. Then, I took ganirelix for the last 3 days. A warning about ganirelix- the needle does not go in easily! So this was not particularly fun. Also, after injecting, I would get a pink rash which would go away in an hour. Annoying, but I’ve handled worse. I did not end up taking Menopur this time around because my body made enough LH on its own. Then there was the trigger shot- an intramuscular injection in the butt. This was the most daunting for me, A) because the needle was quite long, and B) because my dear husband faints at the sight of blood and needles, so I was somehow supposed to inject this myself! I was pretty nervous about this one. I was able to get the needle in, but I couldn’t hold it and inject at the same time, the angle was off. My husband mustered up some courage and was able to help me inject! He then pretended to faint after which was not funny.

The Retrieval

The retrieval was not so bad and also very bad at the same time! I was put under conscious sedation for this, so I was awake. But I felt almost everything! I’m not going to lie, it was painful. The pain was bearable, but having to be in pain for 20 minutes straight starts to become unbearable. My advice- ask for general anesthesia. The clinic I go to performs the retrievals in the office and so general wasn’t an option for me, but boy I wish it was. I will say that there are ladies out there that had their retrieval under conscious sedation like me and didn’t feel any pain at all. But I will also say that I was talking to a colleague of mine who also had her retrieval under conscious sedation, and it was painful for her too. After the retrieval, I did have some pelvic pain, but was able to keep it at bay with some motrin. I wish I didn’t have to do this again, but I do (see “The Numbers”). If I know that this will get me what I want, it will be worth it.

The Numbers

This is tricky. On the one hand, more is better, because the more follicles are mature, the more eggs are collected, the more embryos are made. But on the other hand, “all you need is one.” Not all eggs are necessarily “good” eggs (Ugh I hate using terms like good and bad). As you go on with each phase of the IVF process, the numbers go down and down. Here are mine for example: I had like 23 follicles the day I triggered. Great right? Granted they were different sizes, so not all will be retrievable, I get that. On retrieval day, they were only able to collect 8 eggs (not all my follicles had eggs in them). Of the 8, only 4 were mature. Of the 4, 3 fertilized properly. Of the 3, 1 made it to blastocyst phase.  So of course I am so happy that I have something, but sad that I don’t have more in case this one God forbid does not work out. So before doing the transfer, I will be doing another round of IVF (stim + retrieval) which will hopefully yield more blastocysts.

The Emotions

This is by far the hardest part for me, not just during IVF but throughout my whole TTC journey. No amount of physical pain can match the heartache that I have been going through. That being said, the beginning part of IVF was great! I was feeling very hopeful, and things were going very smoothly. I downloaded a meditation app and meditated each night for some extra calmness. I was eating well, sleeping well and feeling well.  Then the retrieval. I was excited and nervous. After the retrieval, happy that eggs were retrieved, disappointed that more weren’t retrieved, and anxious about how many would make it to the blastocyst phase. Then the negative emotions returned. Can something finally work for me please? How much longer do I have to go through this? WHY do I have to go through this? What did I do to deserve this? I’m still roller coastering through these emotions. I have my good days and bad days, but the best thing to do is to find your supports, turn to them, and remain hopeful.

Can I start IVF already?

Ah IVF. I hoped I wouldn’t need you. But now that I know I need you, I need you NOW. Why are there so many things getting in the way of our love, when we are clearly meant to be together? One thing I wish I knew about IVF- not only is IVF itself a process, but the checklist prior to starting is a process too! I have been ready since September 2018!!  Here are the things that got in my way:

-To my biggest surprise, I got pregnant in September- no complaints there! But then I miscarried in November. I lost a potential child and also months off my TTC timeline. It was (and still is) a VERY dark time for me.

-My hcg needed to drop from the thousands, to <2. And it took months for it to get there.

-Next, I needed a sonohysterogram. That didn’t take long at all, but I couldn’t even schedule it until my hcg was low, which, see above, took months.  I totally understand the reason why, but still, more waiting.  Side note- I got some pretty bad cramps from the SHG! Despite taking motrin before!

-Next I needed to wait for authorization approval, attend an IVF class and pick up my meds. All done, but boy did I make sure to move this along.

-Next, I needed to take estrace before my IVF cycle. And guess what- it messed up my periods. My periods were FINALLY occurring every 28-30 days for the past few months. And now on day 34, still no period in sight. No I’m not pregnant again. I now need to take provera to induce a bleed, so here goes another few weeks or so of having to wait.

So can I start IVF already? I’ll let you know when I know.

Frustrated With Your Fertility Clinic? Comment Please!

Hi all, happy new year. I was going to post something sappy about reflecting over last year and my hopes for this year, but no.  A lot of bad things happened to me last year including a miscarriage at the end of the year, so I’m not in the best place to be sappy.

I’ve been going to my fertility clinic for over a year now. The more time goes on, the harder the burden of infertility weighs on me, and I am trying not to let that tarnish my view of the fertility clinic that is supposed to be helping me.

But I am pretty frustrated with my clinic, and I want to know if this is a systemic issue across all/most clinics, or if I just have bad luck.  Like most clinics, bloodwork and ultrasound monitoring  is done in the morning. When I get my monitoring done, I usually get a call or email from one of the nurses to relay results and plan. This is fine. My problem is getting in touch with my doctor. If I want to talk to him, I have to go through the nursing line. I leave a message with the nurse, she talks to my doctor, he answers her, and the nurse relays the message back to me.  I trust the nurses, but when you pass along a message, who knows if things get lost or misinterpreted. This is not my doctor being a jerk– at least, I hope not!– this is how my clinic works. All doctors in my clinic communicate with their patients via the nurses. But getting a message relayed to you is not the same as having an actual conversation with the doctor! If I have any follow-up questions, the whole thing becomes a back-and-forth nightmare. And I am tired of it. Is it that hard for a doctor to get on the phone? I am lucky to be in a clinic that has a respectable name. And when I have an actual appointment with my doctor after a failed treatment, he does spend a lot of time with me. But if he orders tests and results come back after the appointment, I do not hear them from him. When I had the miscarriage, and they were unable to perform genetic testing on the products of conception, I did not hear this from my doctor. Not even a courtesy call to apologize or explain why.

Am I being unreasonable? Am I just losing my faith? Also, is your fertility clinic like this? What do you like/dislike? I think it’s good we know about the options available to us.