Pregnant After Infertility: The first ultrasound

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Last week I had my first ultrasound just after 8 weeks. I was terrified. While I hadn’t had any cramping or bleeding, I simply couldn’t let myself off the hook. I mean, women have missed miscarriages right?!  Oh and if you are wondering, a missed miscarriage is when the baby stops growing but you don’t know it because you didn’t bleed or cramp. Since old habits die hard, I googled all the symptoms of missed miscarriages, like any good infertility patient.  Apparently, it might be a missed miscarriage if all of your pregnancy symptoms completely stop. Or you can still have all of your symptoms and still find out that you’ve had a missed miscarriage. Just lovely. My symptoms had decreased, but I guess it could happen either way.

So with trepidation, I went to my clinic and my husband met me there. I swear it was like I was approaching the stage for a big presentation or race. All eyes were on me. As I walked down the hall, every staff person stopped and smiled at me reassuringly, wishing me luck, but it almost looked like they were nervous too. My clinic is relatively small, I think, with only 2 RE’s and everyone discusses the cases together. Each nurse or tech has been involved with me multiple times over the past 5 rounds of IVF, 2 FETs, 3 ERAs, and lots of tests and procedures. They’ve all had a hand in my reproduction. Strange, but also oddly heart warming.

My RE did my ultrasound and right away he found one tiny baby. He quickly assured me that the baby was measuring right on time and had a heart beat. Relief flooded me. The nurse handed me tissue for my tears. Then my RE measured the heart rate and it was right on target at 155. More relief.

After we were done, each and every staff person, from my RE to the receptionist at the front desk, came and hugged me. There were cheers and tears. It had been a long road. And the caring support felt great.

So here we are. Pregnant with a singleton and off to a good start. But still I think about the worse case. Infertility seems to wire us to think this way, and it’s something I try to let go of. Still, I had heard from the grapevine that once you confirm a healthy heart beat in the ultrasound, the risk of miscarriage drops to 5%. I asked my RE to verify if that’s true. He said that at this point, 8 weeks, the risk drops to 10%, then once you still find that things are going well at 10 weeks the risk drops to 5%, then gets even lower at the end of the first trimester. So I guess I have a 90% comfort level right now. I was hoping to be 95% confident, and yes that extra 5% seems like a big deal.

When the anxiety comes up, I logically remind myself that my chances for a successful pregnancy are great. Sometimes I mindfully let the negative thoughts float past me. Acknowledging them, but simply letting them float by without judgment. Most of the time I can do this. My husband said he wished he could spray me with a “dumb spray”. I know it sounds bad, but his heart is in the right place. He wishes he could take the fear away and turn me into one of those blissfully naive women who don’t worry about early pregnancy and can enjoy it. He knows the toll infertility has had on me, and how hard it can be to let the fears go and celebrate the moment.

I think it gets a tiny bit easier each day. This time around I’m more prepared for how this works. I’m grateful to be pregnant after IVF and I’m trying my best to enjoy the moment. I still don’t feel particularly connected to this baby, as I have this lingering notion in my mind that my pregnancy isn’t secure until after the first trimester. I know that horrible losses occur after the first trimester, but I’m not allowing myself to go there.

bookI have a book called, “Spiritual Pregnancy” that interestingly was written by an couple who both happen to be OBGYNs. I find this book unique in that it is written from a spiritual perspective, but authored by MDs. Not to say that MDs can’t be spiritual, but it’s not often what you find in sterile, clinical settings. The book contains lots of meditative practices and journaling ideas for connecting with your growing baby, yoga poses to support the different stages of pregnancy, info on baby’s growth, as well as many other topics to support connection and a mindful pregnancy and birth. I think anyone who has a spiritual pull, regardless of religious affiliation or lack thereof, could enjoy this book. I started reading the beginning section for the first trimester, but I find myself not really engaging in reading much while I wait for the second trimester. I guess I’m still afraid to connect with the baby in case something goes wrong.  I suppose I have some reading to do.

What to do with a blog

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I’ve been reading a few blog posts lately about what to do with an infertility blog after one becomes pregnant. People feel different ways about this, and I’ve given it my though too. And, for me, what it comes down to is this: infertility will always be a part of me. I’m one of the lucky ones who has become pregnant after IVF. My IVF baby is a big girl now at 3.5 years old. If I’m lucky, my current IVF pregnancy will also end up with a baby in my arms. But that is still in the works, and I haven’t even begun to feel secure with the idea yet.

Infertility is something near and dear to my heart. Gaining medical coverage for those who need infertility treatment is something I want to dedicate my time to. Advocating for reproductive rights and normalizing infertility by raising awareness is something I’m passionate about. I want to give back by supporting those struggling with infertility, just as I have received support from so many other infertility warriors. As  psychologist who devours research and has years of personal experience with infertility treatments, I think I still have much to contribute.

So I plan on continuing this blog. Some posts will be about pregnancy after infertility. As I began explaining in my last post, I believe that infertility has a significant impact on a woman’s experience of pregnancy that is distinctly different than what fertile women go through. This was something that I struggled with during my first IVF pregnancy, and from what I’ve seen in IVF support groups, it’s a pretty common experience. I want to give that experience a voice. In order to be mindful of those that might not be in a place where they want to read about pregnancy-related topics, I’m going to title each of those posts with, “Pregnant After Infertility…” for easy identification.

Otherwise, I’m going to continue blogging about infertility awareness, emotional coping, all the ups and downs, and the choices that we face while trying to conceive. I hope that some of my experiences and perspectives will continue to be informative and useful for those in the trenches. Oh, and I hope to throw in a dash of sarcasm and laughs, because we all need that.

The Liminal Space After A BFP

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It’s only been 3 weeks since finding out that my FET actually worked, but it feels like a lot longer. Since my initial HCG beta, I’ve had 2 more betas and each had doubled appropriately. Each beta brought temporary relief and renewed confidence. All in all, I’ve been maintaining a decent level of calm, right up until about 3 days ago. Since then I’ve been beating back that feeling that, I think, goes had in hand with pregnancy after infertility. It’s the feeling you get when you know just how fragile something is. When you know how easily it can be lost. And how frequently “bad things” happen. How I wish I could be blissfully naive.

When I see women posting pictures of positive pregnancy tests, as they announce to the world that they are having a baby, I cringe in silence and hope that they really do end up with that baby. Or I roll my eyes and spat out, “idiot!” You know, it depends on how my hormone cocktail is affecting my mood that day. The reality is that those of us who struggle with infertility have a deeper level of understanding about what all can go wrong. And that makes the early weeks, even months, of pregnancy after infertility a peculiar time.

I feel like I have to pause to state specifically how grateful I am to be pregnant at all after my FET. So let me be clear – I am grateful. I would rather be riding in this anxiety boat than preparing the ships for another turbulent round of IVF, no contest. We all work so hard to hopefully get here. But I do want to acknowledge the strange liminal space that comes after a big fat positive (BFP).

The psychological impact of infertility does not go away with a positive pregnancy test. Sometimes, it doesn’t even go away when you get the baby in your arms. Trauma, depression, sadness, anxiety, fear, anger, guilt – these emotions can be carried forward. Sometimes their faces changes, but in some ways they may go with you. At least for a while. This concept caught me completely off guard when I became pregnant after IVF 4 years ago. In fact, it wasn’t even until the second trimester that I even realized how numb and detached I felt. That’s never how I imagined I’d feel after trying so hard for so long to get pregnant. And I was too ashamed about that to tell anyone.

The problem was that no one talked about it. So that’s why I’m bringing it up, because I know my experience isn’t unique. The infertility community is a wonderful support resource. But it can be hard to share anxieties and fears with those who are still struggling to get their BFP. And rightly so – I get that. Assumptions of happiness also come from family and friends, sometimes from our partners too. But I think it’s important for women to know that it is normal to not feel ecstatic after a positive beta. You don’t have to feel guilty for that – we’ve felt guilty about enough crap, haven’t we?

So what can we do when we are standing at the threshold of pregnancy land but we still feel like an infertile imposter?

First and foremost, I think just knowing that these feeling can happen and are normal is a huge step. I was literally blindsided, and when I realized what was going on I wondered why no one talked about this. As a psychologist I’ve worked a lot with trauma survivors, and I realized that there’s an analogy there. When you take a person out of a traumatic situation, we all know that there is going to be carryover effects. For example, when a soldier comes home from war, we know that simply being home and no longer being shot at doesn’t make all of the symptoms of post-traumatic stress disorder (PTSD) go away. Not by a long shot. I’m not saying that all women who go through infertility have PTSD, although some may. But, we can’t simply remove a woman from infertility and expect that she is going to be all smiles and have no remnants of the pain that she went through. Yet, a lot of people kind of expect her to.

When women talk about the unique experience of pregnancy after infertility – and not just the side with rainbows and kittens – we create awareness, normalize the whole continuum of the experience of infertility, and foster honest support. I’ve found some Facebook groups specifically geared toward pregnancy after IVF, but honestly they were harder to find than the infertility groups. I think these groups can be valuable since it provides a space for opening up about these feelings to women who can likely relate, without being insensitive to those who are still in the IVF trenches.

Lastly, I just want to say that we need to be kind to ourselves. That is true no matter where we are in this process, and it doesn’t end with a BFP. And this is particularly relevant to me today as I sit here anxiously awaiting my first ultrasound tomorrow. I’ve reluctantly analyzed every symptom in a futile effort to determine whether this pregnancy is still progressing – whether we’ll find a baby with a heart beat in there tomorrow. It doesn’t feel real. I don’t feel connected to this baby. I’m scared to, because what if… But I know that right now this is out of my hands. My body will do what it intuitively knows to do, and if this embryo is healthy then it will still be growing. If not, I will find a way to cope. I hope I don’t have to, but I will. If infertility has taught me anything, it’s how strong I am.

An Unlikely Outcome to an Unlikely FET

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Yesterday was beta day. I didn’t even bother taking the day off of work because I was prepared for the outcome. I basically expected this to fail, again. After all, it was an unlikely FET. The fall seems a little less painful when you set your expectations so low. In fact, in the days leading up to beta day I really wasn’t even anxious. My husband was a nervous wreck, but he had high hopes. I’d just smile kindly at him and think to myself, “you poor, sweet fool.”

So I decided to go first thing in the morning for the blood draw, then do my PIO shot, and only after I got all of that out of the way, then I planned on taking a home pregnancy test (hpt). Women who take hpt’s and get negatives, but still have to go through all the motions until the confirmation beta must be made of steel.  I just can’t imagine going for a blood draw and taking meds if I already knew it was a bust. Still, by doing the hpt after all that, I at least save myself the dreaded all day wait for the nurse to call to deliver the results. Plus, as I learned from my last cycle, this method allows me to get the news on my own terms rather than from an awkward nurse who isn’t quite sure how to break it to me. I’ve had enough of those awkward nurse calls, thank you very much.  

It was a long 3 minutes waiting for that hpt. Seriously, how can 3 minutes take that long?! After waiting in another room for the seconds to crawl by like a dying snail in the sun, I went in to see the test. I couldn’t believe my eyes. For the first time ever, there were 2 lines. And they were nice dark lines. OMG!

My hands were shaking so bad as I picked up the test and tried to use my phone to tell my husband. I sent pictures of the miracle test to the people who are close to us that have been supporting us all along. These are the few people I would tell regardless of the outcome. I prefaced each text with, “don’t get to excited yet, but…”. Because I wanted people to stay calm and rational about this. No one did, of course, but I guess really I’m just trying to keep myself calm.

I waited 4.5 hours for the nurse to call with my beta results. It seemed like a whole day at least. And I finally got good news. My HCG was 365. A solid number. I had a moment of relief.

To my confusion, my clinic recently changed the way they do betas, so they weren’t planning on doing a second beta until a week from now. Honestly, I don’t get that since the doubling time is more important than one number. But I guess it’s because they are doing them later now, rather than earlier (mine was 12 days past a 5 day transfer, which is like 17 days past ovulation), so if you have a good HCG level at this point they are less worried about it, I guess. I’m not less worried though, so I asked the nurse for a sooner beta. She agreed and said I could do another on Friday, which is 4 days later. I’m sure I’ll hate myself for asking for this come Friday morning, but hopefully by the afternoon I’ll have a little more reassurance.

So here I sit, pregnant. I’m still in shock. The beautiful hpt is still sitting on my desk a day later. I don’t know what to do with it, but I can’t bring myself to throw it away. It was very hard won. It’s like gold. Maybe I’ll take it for a walk later or pet it. I never had one of these with my first IVF pregnancy because I was so traumatized by years of negative tests that I was simply too scared to take a hpt, even after my positive beta.

Despite the shock though, somewhere inside of me is a calm. It’s the same underlying calmness that I felt during my pregnancy with my first IVF baby 4 years ago. I had that calm despite 2 rather large bleeds that were reminiscent of crime scenes due to a nasty subchorionic hematoma early on in that pregnancy. It’s a calm that says, “everything is going to be okay,” despite the statistics that might suggest otherwise. If I let my analytical mind begin to stir, I start mulling over miscarriage statistics for my age, and panic starts to pound in my chest. So I’ve decided to simply be irrational and not think at all during these next weeks. Is that possible?

One thing I do know for a fact is that worrying will not change the outcome, it will only make me miserable in the process. So I’m making the conscious decision to trust that calm wave that’s flowing through me right now. Maybe it’s my intuition telling me that everything really will work out. Maybe it’s hope sneaking in. Maybe it’s completely irrational. Whatever it is, I’m going to go with it. Otherwise I’m not sure how I’d survive the next 4 days.

Of course, this may be easier said then done. Must. Stop. Thinking.

The Problem with Manifestation

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It seems that where ever I go I find commentary about how we create our own realities. In spiritual circles the notion of manifestation, or the Law of Attraction, is everywhere. In essence, it’s the idea that by utilizing the power of the mind to focus on your desired outcome, and taking some action toward that outcome, your desire will become your reality. It’s like sending all of your positive thoughts and intentions out into the Universe, and being rewarded with your heart’s desires. And I admit, I’ve done my best to sing to the manifestation tune. I’ve visualized, I’ve sent intentions out to the Universe, I’ve been confident in an outcome, I’ve done my part. But can it ever really be that simple?

As a psychologist, you find countless examples of the power of the mind to “manifest”. What psychologist hasn’t knowingly smiled and thought, “yes, of course that’s what’s happened – it was a self-fulfilling prophecy”? Trust me, we say things like that.  A self-fulfilling prophecy is when one’s deeply held beliefs and expectations subconsciously effect our behavior and ultimately lead to an outcome consistent with our beliefs. One example of this is the placebo effect, which is when you expect something to happen and then it does. Take medications for example. In medical research, patients may think they are taking a certain medication, but really they are given a sham pill. Nevertheless, the outcomes look the same as it does for the patients taking the real medication. But since the people taking the sham pill, or placebo, believed it was a real medication, it ended up having the same effect. The placebo effect is actually a pretty common occurrence in scientific studies, thus illustrating the power of the mind. And then there’s the research on the perception of pain that shows that one’s thoughts about pain can actually impact their sensitivity to pain. Or how about ulcers? It is well known that ulcers can be caused by stress. Read: the brain can manifest physical illness.

It’s easy to start wondering what role manifestation might have in infertility and getting pregnant. Am I the reason I’m not getting pregnant? Am I not willing it hard enough?

These ideas get reinforced in the world of infertility in various ways. There are fertility meditations and visualizations designed specifically for conception, IVF, FET, and healthy  pregnancies. Don’t get me wrong, I love meditations. I’m a big fan of Circle and Bloom’s IVF and FET series, and have used them during multiple cycles. I think they are beautifully healthy ways to cope with the stress that goes hand in hand with infertility treatments. And that is hugely important. But is there another message being conveyed here? Is there a subtle pressure telling us that if we just visualize that embryo implanting strong enough…

The mantra said to women going through infertility treatment is, “Think positive!” When I was an IVF virgin, I was all on board the “just think positive” train. I tried my best to manifest like a goddess. Baby dust sparkled out of my vagina when I walked. (And if you don’t know what “baby dust” is, then you really are new here). As time passed, and I accumulated more infertility treatment experience than I ever thought I would, I found myself hanging off the back of that positivity train, kind of bouncing off the ground. I was feeling beat up by it. Then I simply let go and sat on the ground as I watched the train fade into the distance. I’m still not entirely sure what I think of it all.

But there are a few things I know for sure.

When it comes to infertility, and possibly other things in life, this idea of manifestation via the Law of Attraction has a really dangerous underbelly. It’s the underlying message that the reason I didn’t get pregnant is because I didn’t try hard enough. Because I didn’t think positively enough. I didn’t will it enough. I am to blame. I caused this.

That’s self-blaming, guilt provoking, and shaming. And complete bullshit. I did not cause this infertility.

People say, “Think positive!” in an effort to encourage us. To support us. We even say it to each other. Sometimes it’s said because the speaker is uncomfortable with our pain and doesn’t know what else to say. Sometimes we don’t want to tell the truth. Sometimes it’s all we have to hold on to. But those words can so easily be turned upside down when they’re received. Those words can become fears and anxieties: “Could this fail because I wasn’t positive enough? Did I ruin this?” It’s an insidious game that gets played in our minds. All too often infertility is marred by blame and shame.

I’m not telling anyone to not think positively if that’s helping them cope. What I am saying is that it will not change the outcome. IVF will either work or it won’t. And the determining factor won’t be how positive you were. So if you aren’t feeling particularly positive, don’t beat yourself up over it! Feel what you need to feel. And if you’re feeling extra positive, that’s great too. Just watch where you sprinkle that shit.

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Do you trust your RE?

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When you become involved in the online infertility community, you learn a lot about what happens with other women during treatment cycles. You quickly find that different doctors subscribe to different beliefs, strategies, and practices. Not all doctors or clinics are created equally. And sometimes the differences seem to teeter on negligence.

Just recently, in fact, I heard from one woman that her RE is recommending that she cancel or convert her IVF cycle to an IUI because her lead follicle grew too much and is “overripe”. She has several other eggs that are prime size for retrieval, but her RE subscribes to the idea that the healthiest eggs (that is, the ones most likely to become a baby) are the ones that respond first to stimulation meds, so if you miss your lead follicle(s) you may blow your whole cycle. Compare this to RE’s who purposely “sacrifice” lead follicles to allow smaller ones to catch up in hope of gaining a bigger harvest. Their belief is that with more eggs retrieved, you have a better chance of getting the baby. Two very different approaches, with potentially very different outcomes. This woman is stressed and torn about whether to forfeit this cycle or proceed.

Another women is fuming because for the second cycle in a row, her RE wasn’t able to retrieve all of her eggs due to issues with the dose and timing of the trigger. So her mature eggs are stuck in her ovaries. The RE should have known better and made adjustments after the first cycle.

Then there are the tests that should have been done, but never were. Protocols that weren’t individualized for women, who were treated like numbers instead. The examples can go on and on.

Some of this discrepancy is no doubt due to limitations in the research. Some things just aren’t fully known yet when it comes to assisted reproduction (or reproduction in general for that matter – the birds and the bees was clearly too simplistic). But a big part of that discrepancy also falls on the shoulders of the RE. They simply are not all built the same. And the most disturbing part for me, as someone in the health profession, is that not all RE’s stay up on the current research or are even qualified to understand the research (it takes training in research methodology and statistics to really understand the studies that are published. Just because it’s published doesn’t mean that the research design and/or statistical analyses fully support the conclusions drawn in the study). So some RE’s unfortunately aren’t up on the current findings, and some really don’t understand the findings that they read. I don’t mean to pick on RE’s – it’s like this in any discipline that attempts to bridge the gap between research and practice.  And then there’s the RE’s personal experiences, which can influence how they practice.

I often joke that I should be awarded an honorary degree in reproductive medicine after everything I’ve been through and all the studying I’ve done. Seriously, I know more about reproduction than my OBGYN. But all joking aside, I’m not an RE. I rely on my RE to advise me, make the best decisions for my individual case, be knowledgeable about current research, and care about making this work for me. And I do. I trust and respect my RE. I actually think he’s awesome for so many reasons.

And that gives me a sense of peace. I know that if this doesn’t end in a baby, it’s not because my RE wasn’t skilled enough or should have done something differently. That isn’t to say that I wish we wouldn’t have done some things differently, but I do believe that we did the best we could at each step with the information we had. And when we got new information, we changed things up accordingly.

Going through IVF is easier when you trust and believe in your RE.

It really is. In life we often have to advocate for ourselves, and I want to encourage women to speak up during infertility treatment. Ask questions – as many as you need to until you feel satisfied with the answers. Don’t be shy. And if you don’t feel comfortable with your RE – if you don’t believe in their skill and trust them – consider finding a new one. I know that’s not always an option. You may be restricted by insurance, geography, or other factors. But if you have the option, exercise it. If you don’t have the option,  it makes this difficult process that much harder.

FET, Emotions, and Control

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Another frozen embryo transfer is complete. We transferred my 2 remaining blastocysts on Wednesday the 9th. One is the surprise embryo left over from my last fresh transfer, and the other was PGS tested and labeled “abnormal”. I know how that sounds, but you can read more about how my RE and I came to the decision to transfer these two here.  The transfer went well. Both embryos were thawed about 5 hours before the transfer and immediately began showing great growth. One was almost completely hatched. The procedure was easy and lots of laughs were shared among the RE, nurse, my husband, and I, as usual because my clinic is awesome. I did pre- and post-acupuncture, then relaxed.

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Hatching day-5 blast, early blast day-6

And so there it is, I have two tiny embryos doing their thing in my uterus. And by day 2 after transfer, I completely lost it. Typically, the panic and worry doesn’t set in until much closer to beta day. Normally, I’m in a happy “pregnant until proven otherwise” state, with my hand on my belly sending good energy to my embryos. I envision it working and the good news I’m soon to get. I put all my intention, prayer, and determination into a positive outcome.

But not this time. This time, I feel scared to touch my belly and think of these embryos. I feel scared of being hopeful. Maybe I’ve simply gotten bad news one too many times.

Here’s where it gets tricky though. My mind has started playing games with me. I know a big factor influencing this is the estrogen and progesterone I’m injecting, which makes me not feel quite like myself anymore. Despite rational thought to the contrary, I’m scared that if I don’t set my intentions and focus on these embryos that maybe it will fail because I didn’t want it bad enough – because I didn’t try hard enough. You see, I’m a person who believes in both rational science and the magic of the universe and power of the mind. Sometimes I feel conflicted because these two sides of me don’t seem to mesh, while other times I have no problem seeing how beautifully they dance together.

The truth is I want to protect my heart. I don’t want to get my hopes up. I don’t want to spend this next week connecting to a baby in my womb just to find out that the embryos were dead all along.  It’s a set up for a big fall. But I’m scared that in allowing myself that distance, I’m somehow sabotaging the outcome. Like a self-fulfilling prophecy. Logically I know that can’t be true. My very first IVF, the one that brought me my daughter, I was absolutely convinced by beta day that it failed. Earlier in the wait I was more positive though. Then, years later when I transferred my PGS normal girl, I was certain it worked. And it didn’t. Last cycle I spent the whole time sending energy to my embryos, connecting with them, and sending my intention out to the Universe to be heard, yet none implanted.

My logical mind tells me that it doesn’t really matter what I do. At this point, whether my embryo implants and grows or not only depends on the strength and make up of that embryo. Inside my uterus, where my lining is perfect, there is silence, safety, and opportunity. I’ve done my part, and now it’s up to the embryos. But my emotional mind, and possibly my spiritual self, struggle to surrender to that.

At the beginning of this cycle I told myself that I wasn’t going to try to control or influence the outcome, which may only be a perception of control anyway.  Of course, I follow protocol instructions, take good physical care of myself, and all that. But I decided not to stress, over think, over analyze. I decided not to pray every night, light candles, or visualize. The Divine knows my desire, I’ve not been shy about it. So I let this one go. I surrendered to the Universe. I’ve been able to maintain that less anxious attitude all the way up until yesterday, when all the fear crept back in. When I started to second guess myself and whether I’ve done or am doing enough to make it work.

As though I can control it.

Maybe that’s the lesson here. To learn to truly let go.

 

 

How to Plan a Pregnancy IVF Style

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I came across a lovely article recently in Fertility Road Magazine titled How to Plan a Pregnancy. It had lots of helpful information about health, lifestyle choices, and tests that you can do to optimize your body and chances for successful conception. I’m glad that this information is out there, and I agree that these are all important issues to think about and plan for before getting it on. But for whatever reason, maybe it’s the hormones I’m currently injecting, I found myself chuckling about what I might say to someone about how to plan a pregnancy IVF style. So here goes, but reader beware, the sarcasm is strong with this one.

Step 1: Check with your insurance to see if they cover infertility treatments.

Read all the fine print to see how many procedures and medications are not actually covered. Oh wait, your insurance doesn’t cover infertility? Yeah, probably not. Move on to step 2.

Step 2: Find money.

Check your bank account to see how much money you have saved. You should also revisit your budget to see if there’s any money you can set aside to fund your treatments. This might include making decisions about necessities versus luxuries. Do you really need cable TV? How about those dinners out? Can you ride a bicycle to work to save on gas? Do you really need soap? Yeah, you’ll be stinky and bored if it means getting a baby. Don’t forget to check under the couch cushions for change. It adds up.

Step 3: Check your schedule to make sure that you have time for infertility treatments.

Do you have a work trip coming up? A family obligation? Planning a vacation? Wait – vacation? You can’t afford that anymore. You basically need to cancel your whole life for the next few months. You’re going to busy with lab draws, ultrasound appointments, and googling how to make PIO shots less painful. You won’t have time for anything else.

Step 4: Call your RE to make an appointment.

Be prepared to find out that the clinic’s timeline for when you can start IVF does not in any way match up with your anticipated schedule as outlined in Step 3. You can begin to rearrange your life now. Again.

Step 5: Surprise!

You need one more test. It will take one month to get the results, so your start date will be delayed. Rearrange your life again.

Step 6: Order your IVF medications

This is going to cost an inordinate amount of money. Good luck with that.

Step 7: Wait for your period.

For those of you who have a regular cycle that starts exactly on the same day every month (what? they exist), this will be the first time in your life that your period is late. Get excited because you just might be pregnant while waiting to start IVF! Just kidding. Your period will start the day after you get excited. For those of you who have never had a regular, predictable period, this will be the longest cycle of your life. You may need to get a shot or take pills for 5 days to jump start your period. These pills turn you into a raging bitch.

Step 8: Your period finally arrives.

For the first time ever, you’re thrilled to bleed all over your new Victoria’s Secret panties. Time to call the clinic and go in for your baseline ultrasound and lab work.

Step 9: Inject yourself daily with your prescribed cocktail of medications.

This step also involves crying because you saw a Facebook photo of a cute puppy sleeping with a baby, yelling at your significant other because he/she left the cap off of the toothpaste, crying some more for no actual reason, gaining ten pounds, then injecting yourself some more. Try to avoid the bruises while injecting.

Step 10: Shave your legs and lady bits so you’re prepared for multiple vaginal ultrasounds weekly.

Note that your partner will get excited in the beginning when you shave because they’ll think they’re getting lucky later that night. But they won’t be. You have been cut off from having sex anymore. So lay back and enjoy the ultrasound my dear, because that’s the only action you’ll be getting any time soon. But don’t get too excited, this wand doesn’t vibrate.

Step 11: Egg retrieval day.

Kick back and relax, you’ll be getting a nice cocktail of anesthesia in your arm. It will be the best sleep you’ve gotten since you started infertility treatments. When you wake up you’ll either get wonderful news about the bounty of perfect eggs that were retrieved and you’ll feel elated that all your effort has been rewarded, or your heart will be ripped out as you’re told that they got 1/10th of the number of eggs you expected. It will be one or the other. Oh and your male partner, if you’re using one, will need to jack off at some point during this day. Gee, he has it rough.

Step 12: Wait.

Wait to see how many eggs fertilized, wait to see how many make it to blastocysts, wait to hear PGS results, make up shit to wait on. It doesn’t matter. This step will take the longest. No, I lied. Step 14 will take the longest so read on, but this is a close second.

Step 13: Embryo transfer.

On this day you’ll get the first precious picture of your “maybe baby”. It will look like a blob of nothing, but you will cry with joy anyway as you picture this blob in a bonnet. You and your partner will stare intently at the ultrasound screen to watch as this tiny embryo is inserted through a long catheter into your uterus. Your RE will point out the spot in your uterus where the embryo is placed. You will swell with emotion and love, but you won’t actually be able to see anything where the RE is pointing (although you’ll both pretend you do). This is normal. Note that if you have gone through this step multiple times in the past, you will realize that the best part of this day is the valium.

Step 14: Engage in the dreaded two week wait (TWW).

Over-analyze every twinge, change, fluid, swell, burp, craving, and sneeze. Compare these “symptoms” to every list of early pregnancy signs that you can find on the internet. Make sure you use multiple search engines to maximize the number of lists retrieved. Each time you pee you will need to have good lighting in the bathroom so you can adequately scrutinize the toilet paper after you wipe to look for any sign of implantation bleeding. Squeeze your boobs several times a day to determine if they feel sore, until they become sore. You’ll find yourself shifting from elation and optimism that this cycle has finally worked and you are pregnant, to absolute certainty that it has failed. This will be the longest two weeks of your life. By beta day you’ll be a blubbering shadow of your former self.

Step 15: Beta day

This will either be the best day or worst day. If it’s the best day and you get a positive result, you will proceed to an entirely new list of paranoias and procedures. Congratulations! If you get a negative, you may find yourself back at Step 1. But look at the bright side: you’ve done it before so the next time will be easier! Right? RIGHT???!!! (Ha ha ha you poor fool.) Good luck.

Hope you enjoyed this, but if you didn’t it was probably the hormones.

In Other Words: Day #3 of a 3-day quote challenge

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Rounding to a close, today is the last day of my 3-day quote challenge. It’s been fun to share my some of my favorites because, let’s face it, during this infertility journey we all need a little inspiration and perspective. So before moving on to my last quote, a reminder of the rules:

    1. Thank the person who nominated you. One last thanks to CW from Almost Pregnant for tagging me. Be sure to go check out her blog if you haven’t yet. You’ll find great stuff there.
    2. Post a quote for 3 consecutive days and explain why it appeals to you.
    3. Nominate bloggers to participate in the challenge each day. My final tags are Silently Screaming and Serenity. Be sure to check out their blogs.

Today’s quote is a reminder of just how badass we all are – especially us infertility warriors.

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Photo: Pinterest

It’s simple but packs a big punch. During infertility treatments it’s easy to forget how tough we are when we focus so much on what is going wrong – with our bodies, our plans, our relationships, our eggs. But think about all the things we do in the pursuit of our dreams. We sacrifice. We endure pain. We get poked and prodded. We fall, and then we rise and do it all over again. We really are badass. And we shouldn’t forget it.

In total I’ve gone through 6 IVF cycles. I’ve always given myself the subcutaneous belly injections during the stimulation phase. Those were easy. Well, as “easy” as any of this ever gets. But I’ve always had my husband give me the intramuscular shots (IM). You know, the ones with the giant needles that go in the rear. Now, I’ve got plenty of booty, but still I always feared that if I stuck myself with that tree-sized needle I just might go too far and hit bone. The needle looks that big to me. I’ve had to do both progesterone in oil (PIO) and estradiol valerate intramuscularly. These shots have to be given at certain times. I have literally driven to my husband’s work site to have him give me an injection. (Umm, awkward much?) I’ve panicked when I thought he wasn’t going to be home in time to give me the shot. He’s turned down overtime to be home at the right time to administer my shot. It’s ridiculous.

This cycle I said fuck that. I decided to do the IM shots myself. I’m tired of waiting and worrying. I’m tired of being afraid.

So last night, while my husband was driving home late from work, I prepped my gigantic needle and gave myself the shot in my ass like an IVF boss. And then I smiled. Because I’m tough like that.        

If you missed Day 1 or Day 2, please check them out.

In Other Words: Day #2 of a 3-day quote challenge

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As the quotes continue to roll in the blogging world, I’m back for day #2 of the 3-day quote challenge. But first, a reminder of the rules:

  1. Thank the person who nominated you. Thanks again go out to CW from Almost Pregnant for thinking of me. If you haven’t checked out her blog you really should. It’s smart, informative, and witty.
  2. Post a quote for 3 consecutive days and explain why it appeals to you.
  3. Nominate bloggers to participate in the challenge each day. Today I’m tagging bloggers Dani of The Great Pudding Club Hunt and Allison of My Journey Creating Life. Another set of great blogs worth checking out.

Selecting a quote for today was easy. This is one is from Viktor E. Frankl who significantly shaped the face of psychology and my training. He was a neurologist, psychiatrist, and survivor of Nazi concentration camps. Through his unique lens as a psychiatrist, he observed and experienced both the darkest and brightest of the human condition during his imprisonment. His famous book Man’s Search For Meaning is harrowing and inspirational. The first half of the book is a must read for anyone who has ever had to endure and overcome. The second half of the book dives deeper into his conceptualization of psychotherapy and theory called logotherapy, which was heavily influenced by his personal insights into struggle, pain, and finding one’s meaning in life. While the theoretical half of the book is more academic, the first part of the book certainly stands on it’s own. While obviously a tragic subject, his insights are profound, easy to connect with, and apply to anyone struggling to move past pain.

Now for the quote…

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

~ Viktor E. Frankl

I’m come back to this quote many times in my life. And I’ve seen the truth in it in every person I’ve worked with. There are things that happen to us in our life that we have no control over – circumstances, the actions of others, abuses. We can live like victims, feeling helpless to our pain and circumstance. And there is a place for sitting with and honoring that pain in us. But that is not the whole picture.

If you put 20 people in the same situation, you will find that although there will likely be some similarities, ultimately you will have 20 different responses. And that is because each individual gets to choose how they think and ultimately how they will react. We all have a unique back-story that influences how we perceive things. But in the end, no matter where we’ve come from, the choice moving forward is up to us.

I choose to not let infertility beat me. And that doesn’t necessarily mean that I will get the baby that I’m after. That part I really don’t have control over. But I do get to choose how I will respond at the end. And that will shape the person I become.

If you missed the quote from Day #1, you can read the post here.