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.

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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.

Coping with the Winter Holidays

The holidays have always been a tough time for me while I was struggling with infertility, but this year was especially hard, as I had a miscarriage right at the start of holiday season.

What I find so hard about the holidays is the emotional burden. Yes, holidays are supposed to be a happy time, however it is quite difficult to be happy just because you are “supposed” to be. I can’t be happy on demand. Not when I am still mourning my previous loss and not while I am unsure of what the future will bring.

What we do on the holidays is up to us. Sometimes, being with family/loved ones is a nice distraction from our problems. But sometimes it can make us feel worse. Thinking of all the traditions you loved as a child, and being unable to share it with yours. Seeing other family members with children of their own. It’s emotionally taxing! To that I say- do what is best for you.  I received news of my fetal loss the week of Thanksgiving.  I cried to my family over the phone but there was no way I could attend my large family gathering and put on a happy face, even for a few hours. I needed time with my husband to mourn, to reflect.

I’m not advising you to skip on holiday traditions, but rather do what will bring comfort the most.

As the new year is approaching, I’ve been doing a lot of reflecting (more on that later, probably). Stay strong and wishing you all brighter 2019.

Infertility, Miscarriage and Grief

I will start this post the same way I ended my last one, by stating that there is no right or wrong way to grieve.  My recent miscarriage made me reflect on my fertility journey and I realized that I was grieving throughout the entire process, but in different ways. I’d like to share the different ways I grieved with you. Maybe you have felt the same. Maybe you have felt completely different. But if you are reading this my guess is you have gone through some sort of loss or heartbreak and I hope that sharing my experience can somehow provide you comfort.

1. The first time I grieved was after my first miscarriage. This also happened to be my first pregnancy. I was heartbroken,  I cried a lot, and took off work, but I was able to get “back on my feet” relatively quickly, with the help of rationalization. This was an early first trimester miscarriage. The baby would not have been healthy. This was nature’s way of doing things “for the best.” Also, so many women have miscarriages and go on to have healthy babies– at least that’s what doctors and non-doctors kept telling me. I’ll just keep on trying. I was sad but I had hope.

2.  Over the next 2 years, my hope was completely destroyed. Not a single pregnancy after trying on our own or with the help from our reproductive endocrinology friends. During this period, I grieved much more frequently, but on a smaller scale.  I was able to go to work, but sometimes I would cry on my commute to and from. I could get out of bed and function on a day-to-day basis, but if I checked social media and read about a new pregnancy, I’d be in a bad mood for most of the day. I found myself declining invites to baby showers and other baby related events. I was slowly withdrawing. During this period, I wasn’t grieving over a loss per se, but over the same endpoint- nothingness. I felt hopeless and helpless. The lack of control over my situation tormented me.

3. A second pregnancy, with a heartbeat detected, followed by a miscarriage (actually I’m still waiting for that to happen. That’s another story). This one hit me hard. I still cry daily. I couldn’t go to work for a while. I could barely get out of bed. I could barely eat. I did not want to see anybody or talk to anybody except for my husband. I was sad, devastated and angry. I strongly questioned my faith. I was in a state where absolutely nothing could make me feel better. I am still in this state and I don’t think I will ever fully recover. But one thing that helped a little is the passage of time. It made me realize that there are things I cannot change. I am in the midst of another loss, and I cannot reverse this. It will always be heartbreaking and devastating. I feel what I feel. But I have to move on. See my doctor, come up with new plans, take care of myself, go back to work and get things “back to normal.”

I  will end with this: if you are going through something, ANYTHING, that is getting you down, tell someone. A loved one, a friend, a co-worker, a therapist, a counselor– anyone. You might be surprised how supportive they can be. Support is so important during a time when you are most vulnerable.

From the Highest of Highs to the Lowest of Lows

I don’t normally like to share medical updates, but I think I have gone through every human emotion imaginable over the past few months that I wanted to share.

So remember when I told you that I needed IVF? (see Putting the I in IVF) I asked to take September “off” because I would be out of the country for 2 weeks for a conference and I didn’t want to miss any of the monitoring or have my trip interfere with scheduling the retrieval.  My doc told me “Sure, we’ll begin after your next period.” Well…

My next period never came.

WHAT?! No way. Iv’e been seeing my reproductive endocrinologist for over a year and I was not able to get pregnant AT ALL despite using all different types of medications for ovulation induction, trigger shots and even IUI. And now, I go on a completely UNMEDICATED cycle, and I conceive???? This is unreal. The last time I was pregnant was over two years ago. This is huge! Maybe I don’t need IVF after all! What a story!

Although my husband and I were over the moon with happiness, we were also cautious about our expectations, because the last time I was pregnant, it ended with a first trimester miscarriage. But so far, things were going well. I was going in for hcg checks every few days and the levels were appropriately rising. Good sign.

Then I went for my first ultrasound. They found the gestational sac and yolk sac, but no fetal pole. This worried me a bit, because during my last pregnancy, the ultrasound was not lining up with the expected dates. But my RE told me “don’t worry, you probably just ovulated late. Come back in a week, we should be able to see the heartbeat by then.”

I was pretty nervous. I kept thinking back to my last pregnancy where the heartbeat was never detected. I went for my return ultrasound. I told them I was nervous. They said “Why? Look, there is your baby and there is the heartbeat.” They found it almost instantaneously. Oh my God. This is really happening! Finding the heartbeat is such a reassuring sign! Again, the fetus measured to be younger than expected since my last period, but again, “I ovulated late.” They wanted me to come back in a week.

So I went back, this time without the hubby. Everyone was overly cheerful. The receptionist asked “is this your last visit with us?” My doc saw me and said with a smile, “still nervous?” He proceeds with the ultrasound. He stops talking. He shows me the fetus and the cardiac activity.  He tells me that the fetus was very small and did not grow appropriately. He then proceeds to measure the heart rate. It’s 90 beats per minute, which is slow.  You know things are bad when you can hear your doctor say “shit” under his breath. He told me that things didn’t look good. The fetus was still alive, so there was nothing we could actively do, but he wanted me to come back by the end of the week. That would either confirm the worst, or maybe a miracle would happen and everything would be fine.

Since then I couldn’t even bring myself to go to work. My husband and I were devastated. We let our families know, and they were devastated as well. They cried with us, and the grieved with us. I went back for my repeat ultrasound, and our worst fears were confirmed. I will be having a miscarriage. Again. They sent me for a slew of bloodwork and they gave me collection cups so they can study the products of conception. So now, I wait for this dreaded thing to happen. A piece of my heart has left and will never be replaced.

What went from an amazing 2 months changed to the worst week of my life in an instant. I’ll come back and write about the coping and grieving process, but in short, there is no wrong way to grieve.

 

 

Royal Pains

I have 2 work deadlines this week so what better way to work on them than to procrastinate?

I want to talk about the Royal Family for a bit, namely, the leading ladies. I’ve been getting so tired of hearing about them in the news all the time. Kate is pregnant! Again! And again! Meghan wants to have babies soon! Meghan is pregnant! Just like she wanted! At first I was like “how dare you ladies have no problems with fertility while a commoner such as myself is agonizing over it.” But I obviously have no hard feelings towards them. They’re not tormenting me on purpose.

It’s the media coverage I have problems with. The media doesn’t just report about celebrity pregnancies (suspected or confirmed), they SENSATIONALIZE it. It can get pretty annoying for anyone who doesn’t “care” about celebrity news, but for someone with infertility who is trying to take her mind off everyone around her getting pregnant, hearing about all these pregnant celebs does not make it easier! After Meghan Markle’s pregnancy announcement, for example, my Instagram explore page exploded with pictures of her and suspected baby bumps. I don’t want to see this! I don’t need reminders.

Do I need to flee to a deserted island to free myself of all this? Maybe I just need to visit Buckingham Palace for some fertility luck, since there seems to be an overabundance there.

Be Positive is more than just a blood type

I started this blog as an outlet to talk about my infertility and to give others going through similar experiences something to relate to.  And I realize that most of my posts here have been pretty negative lately and that’s no fun.  Yes, infertility feels like the worst thing in the world right now, but I can’t let it ruin me. I used to be such an optimistic person and the longer I remain childless, the more pessimistic I have become.  So I have been trying to put  myself back into a positive frame of mind., starting with the little things.  I’m excited for the fall weather. I’m excited to go shopping for fall clothes.  Motivated to eat better and exercise more. Happy that I am at a more healthy weight, and also happy that I can still have that Dunkin Donuts frozen coffee with hazelnut swirl from time to time. Thankful for my overall health, for being part of such a wonderful and loving close knit family, and for connecting with such a strong group of women (and men!) sharing a common goal.

Sometimes, just pausing to think of the good things can turn a bad mood into a not-such-a-bad-mood. It’s not foolproof, but it’s a start.

Putting the I in IVF

Well folks, it’s official. I’ll be starting IVF soon.

I know I did not reveal much about where I am in the treatment process, except for the fact that I was making no progress.

So I decided I will share a little more. During my fertility workup, I was diagnosed with PCOS. I will never forget the words of my RE, he said “That is easy, you just need help ovulating and we can help you!”

Easy. And yet here we are.

I’m trying my absolute hardest to be optimistic, but I’m also terrified that I’m reaching the “end of the road” so to speak. I will do whatever it takes to have a child, I just hope it will work.

Fingers crossed.

Deja Vu

So, I’ve complained before about how difficult it is to deal with those around me getting pregnant as I struggle with infertility. It can get quite taxing to be happy for someone and feel bad for yourself at the same time!  Along with a string of other negative emotions!

Well, I’ve been noticing a new trend. The SAME people that were getting  pregnant and having kids and making me feel bad about myself are now getting pregnant AGAIN!!! I know I’ve been dealing with fertility issues for quite some time, but to see people get pregnant (not literally lol), have their baby 9 months later, wait some time, and then get pregnant again—really puts things in perspective. It also amplifies the fact that all this time I was “trying,” I could have had  who knows how many kids by now.

Just wanted to vent. I’ll keep this post short and [bitter]sweet.