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 ūüėČ

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 ūüėČ 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!

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 counselorРanyone. 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.

 

 

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.

 

 

Get Low

Ever have one of those days? Or weeks?

I want to take a break from social media. The amount of people I have snoozed or blocked for posting all things pregnancy/baby related is getting out of hand.  I can think of at least 3 people who have announced they are pregnant within the past month alone.

Fun fact: I realized something about myself . Not all parenthood-related posts trigger me (ie, make me feel sad and depressed and helpless). Only the ones related to the state of being pregnant- like pregnancy announcements, ultrasound pictures, baby bumps, gender reveals, baby showers- do. But pictures of babies and kids don’t make me feel as bad. Huh.

Anyway, I follow this one person on social media who is dealing with an issue of her own. The majority of her posts are filled with optimism, with the occasional “it’s okay to be not okay” message. And you know what, she’s right.

I don’t hide my feelings from my family and friends, but I do put on a happy face more often than not. I go to work every day and my coworkers would never guess what I am going through (except for the ones who know). Even my own family, who gives me ¬†such amazing support, doesn’t fully get it that when I see my baby cousins, as much as I love playing with them, it’s still a painful reminder of the family I do not yet have.

So you know what? I’ve been more down lately. Things aren’t going as smoothly as I would like. I’m not going to repress my feelings.

Because this sucks.

And it’s okay.