Tag Archives: Infertility

Pregnant After Infertility: On shame and infertility

23 Tuesday Oct 2018

Posted by in Pregnancy After Infertility, Uncategorized

≈ 15 Comments

Tags

, , ,

asdrubal-luna-485688-unsplashI want to talk about body shame and infertility. One of the most common sentiments that I’ve come across among women dealing with infertility is the idea that their body is somehow broken. Like their body has failed them. After all, we are women with all these reproductive parts, and we spend a lot of time dealing with periods, pains, and “lady stuff” – you would think we’d be able to get the pay out from all this bodily hassle.

Now, to be clear, infertility is not always related to a woman’s body. In fact, about one third of the time infertility is related to issues with the woman’s body, another third of the time it is due to male factors, and the last third is a combo of male and female issues or unexplained (www.asrm.org). I can’t speak from the male’s perspective, but when it comes to women, we tend to carry a lot of shame that our bodies aren’t doing what they are “supposed to be doing”.

Here’s my confession: I never felt this shame.  The truth is, I don’t think there’s any place for body shame in infertility. As a psychologist, I’ve spent many an hour sitting with people who blame themselves and carry crushing shame for all sorts of things that are in no way their fault. I’ve seen this with victims of sexual abuse and domestic violence, as well as among those struggling with PTSD, addiction, eating disorders, and the list goes on. Sometimes it’s even common everyday occurrences for which people carry an unreasonable weight. I see this, and I know it’s not their fault. I also see that self-blame and shame makes their difficult situation that much worse. It’s easy for me to see as an objective viewer, and I try to help them see it too so they can get out from under it.

And I see this so much with women who are carrying the burden of infertility – blaming their bodies and being ashamed to even talk about it.

But here’s the thing – this isn’t your fault. Fault implies that you did something wrong. And you didn’t. Infertility is a medical condition. It’s not a character deficit. Medical conditions happen – we are all dealt different things in life. We got infertility. Lucky us. But it’s nothing that happened because we did something wrong. So there’s really no place for shame in this.

I think the fact that infertility is largely a silent disease contributes, at least in part, to the experience of shame. Few people are talking about infertility. I’ve never seen a “run for infertility” in my community. I’ve never seen people walking around in public with infertility awareness ribbons pinned to their chest. Do these things exist for infertility? I know there are some public events, marches, and awareness events. But these are few and far between. The only reason I even know about them is because I’ve spent a lot of time deep in the trenches of infertility. But I don’t have to be a cancer survivor to know what a pink ribbon means or know about many of the events going on related to breast cancer awareness and support. Infertility doesn’t have much of a media presence.  We aren’t anywhere near the same scale that you see for other medical conditions, conditions that have shed their outdated skins of shame.

As long as people are either not talking about infertility, or at best whispering about it, then women (and men) will continue to internalize this disease and morph it into personal shame.

I understand that it’s not easy to be vocal about infertility. There is so much misunderstanding and people can be too quick to share their (often ignorant and sometimes downright hurtful) opinions. We are carrying such a heavy load when we trudge through infertility. Sometimes sharing our stories is simply too much  to add on to an already maxed out, stressful situation. At some point though, the scales must tip in the direction of disclosure and healthy discussions so that we can confront ignorance and raise awareness.

For my part, I’m going to keep talking about infertility – like it’s normal. Because, unfortunately, it is. When infertility affects 1 in 8 (and the numbers are rising), it’s something people should be talking about. Some may think it’s odd, but I bring infertility and IVF into many conversations about my daughter and my current pregnancy. When people I don’t really know say, “Congratulations!” – I say, “Thanks! We’re really grateful.  We had to go through so many rounds of IVF to get pregnant!” That response probably takes a lot of people by surprise. And to my surprise, I’ve never gotten a negative comment back (I’ve been waiting for one and I’m ready…just try me). What has happened more times than I can count, is this has led to conversations with strangers and acquaintances about their own struggles to conceive, the struggles of their loved ones, or questions about what my experiences have been. I’m happy to engage in all of these conversations.

Regardless of whether you are in a position to openly discuss infertility with others or if you are simply trying to make it through each day without crying, know that you have nothing to be ashamed of. All bodies work differently and none of them are perfect. That fertile myrtle you know might end up with cancer or a heart attack at the age of 60. Hey, I’m not wishing illness on fertile people, I’m just saying you never know what your genes have lined up for you. Infertility is part of our story. It’s in the cards we were dealt. There’s no shame in that.

Instead of blaming our bodies for what they aren’t doing, what if we take a moment and appreciate them for all they are doing? Think about it. When we go through infertility treatments, we are asking our bodies to do so much. We are asking our bodies to take in and tolerate massive about of hormones and medications, we are poking and prodding ourselves with needles and ultrasound wands, doing tests after tests, repeated blood draws. We are bruising our bodies and pushing them to their limits. All the while asking them to keep performing all their other duties necessary to sustain our lives. Instead of criticizing our bodies, what if we said, “thank you”? Thank you for trying, thank you for continuing to carry me, thank you for tolerating all I’m putting you through.

Be kind to yourself. Be kind to your body. There’s no place in infertility for shame.

vana-ash-696163-unsplash

Pregnant After Infertility: Reflections on the things people say during IVF

26 Wednesday Sep 2018

Posted by in Pregnancy After Infertility, Uncategorized

≈ 3 Comments

Tags

, , ,

I’ll never forget the day I had my first ultrasound for this pregnancy. The fear and anxiety going in – just hoping that we would find a baby in there with a strong heart beat. All of the warm congratulations from the nurses, my RE, and other staff at my clinic. It was amazing.

But there was one comment made by one of the nurses that stood out at the time and has remained with me. She said, “You did it! You never gave up! And it paid off.” But what she didn’t know was that I kinda had given up.

Now that I’m obviously sporting a baby bump and it “looks” like I’m out of the danger zone, I’ve had others comment on the same thing. People who know how much infertility treatment I went through to get here seem to be saying, “you never gave up” in one form or another. I suppose it’s meant to be an affirmation or validation of some sort. It’s with good intentions, I know, but it always rubs me the wrong way.

What does “giving up” mean in the context of infertility treatment? Does anyone ever casually say, “Ummm, I think I’m good now. I don’t really want that baby. You can keep the medications. I’m done. Thanks.” No one casually throws in the towel when it comes to infertility. Maybe the term “give up” irritates me so much because it sounds a lot like failure or resignation. Simply quitting. It sounds like someone was too weak to continue.

But there is nothing weak about the women (and men) who go through infertility.

Honestly, I can think of few harder decisions that require more strength of mind than making the decision to stop infertility treatments. To choose to embrace the life before you, one that is not what you had planned or preferred, but can make something beautiful out of, rather than continuing down a dark and possibly quite unhealthy path.

And that’s assuming you even have a choice. For so many women and couples, the decision to end infertility treatment is made for you against your will. By insurance companies, lack of insurance, finances, medical conditions, age, and other factors out of one’s control. That lack of control can be traumatic. And being told to never give up when you don’t really even get to make the choice, can leave women feeling ashamed, confused, angry, or guilty. We don’t all have the luxury of “never giving up”.

In an environment that sings to the tune of “never give up,” discontinuing treatments, whether by choice or not, can leave a person feeling like they are doing something wrong. In the infertility community this starts to look like some form of peer pressure. Well-meaning women in IVF support groups readily tell other to “never give up” after any set back or negative test result. Sometimes I feel like shouting it’s not giving up! Sometimes stopping treatments, if the decision is up to you, is a healthy thing to do. Sometimes it’s healthy to choose the life you have rather than constantly hoping for or living for a “maybe” while the rest of your life passes you by.

For me, making the decision to stop began as a mindset not yet in sync with my actions. I had agreed with my RE to transfer my two unlikely embryos that I did not expect to take, and planned to do one last retrieval and fresh transfer afterwards. And then I decided that enough was enough at that point. I felt like I found the tipping point where maximizing my chances for success was going to become outweighed by the toll infertility treatments was taking on my mind, body, spirit, and relationships. Identifying that stopping point felt oddly liberating. Like a weight had been lifted from my shoulders. I began accepting what life would look like when IVF didn’t work, and I managed to see a light at the end of the tunnel (that wasn’t a train).

I realize that my road would have gotten rockier had my FET and last planned IVF hadn’t worked. I’m not naïve enough to think that I would have sailed through the finality of that loss without a huge crash, but I did have a support plan lined up for that outcome. Seeing a psychologist was a big factor in helping me come to terms with my stopping point, and although I ended my therapy while preparing for my FET – the ending was agreed upon and planned based on my progress – we agreed that if the final courses of treatment didn’t work, I would return to therapy to process my feelings and reactions to ending treatment and moving forward. Steps toward closure.

I’m not sure if this post is going to come off as negative or inspiring. I simply hope that it will help to open up the doors to acknowledging some of the difficult decisions that women face during infertility, provide a bit of insight into why “never give up” isn’t always helpful, and work to remove some of the shame and guilt that so often comes with infertility and treatment outcomes.

Pregnant After Infertility: IVF reflections and the needle shot

17 Monday Sep 2018

Posted by in Pregnancy After Infertility, Uncategorized

≈ 13 Comments

Tags

, , ,

PicsArt_09-17-02.02.50I saved my IVF needles. All of them. That’s a total of 6 egg retrievals, 2 fresh transfers, 2 frozen transfers, and 2 mock cycles. Some people, including probably everyone who has never gone through IVF, would think I’m a bit nuts for holding on to all these needles. But it’s oddly hard to part with something that you’ve put so much of yourself into. Something that symbolizes an experience, or maybe a part of you.

I even have my needles from my very first IVF cycle over 4 years ago – the one that brought me my feisty daughter. At that time I think it was just feeling a bit overwhelmed that kept me from taking the time to bring them back to my RE’s office for disposal. I didn’t have any grand plans for them. But this second time around, I did. I kept the needles from each cycle in a separate sharps container. I envisioned making one of those IVF baby announcements one day when it finally worked. You know, the cute pictures where all the needles are arranged in the shape of a heart with care, surrounding baby’s first ultrasound picture. Maybe a onsie or booties, too. I was so hopeful back then, and it made me smile every time I saw one of those pictures.

But as my failed cycles piled up, so did my needles. The idea that once symbolized optimism and success, morphed into something quite different. Now I have a giant pile of needles. I’m actually missing about 80 percent of my Gonal F pens because my nurse would discard them when I’d bring them in for her to combine the tails to get me an extra dose or 2 of meds. My pile began to feel chaotic as one cycle blurred into the next. The FET that finally worked consisted of 2 embryos from 2 different egg retrievals; I lost track of which sharps containers led to which of these embryos.

I’m left with a big pile of needles and no desire to shape them into something pretty.

Why did I keep these needles? Because when I look at this pile on my table I see my pain and strength. I see determination and perseverance. Countless hours spent crying in the arms of my loved ones, and even more spent crying alone in the bathroom when no one knew. Friendships fading away, while unexpected ones blossomed when I needed them most. Miracles. I see isolation and connection. The highs and lows that no one really understands unless you’ve walked in my shoes. Failure and success. Baddassery (especially when I self administered my first PIO shot). Luck – sometimes good, sometimes bad. I see hours of research and hard decisions made. Coping skills executed and eventually exhausted. Asking for help, and helping myself. Enduring more than I thought I could, and then a little bit more. Making a healthy decision of when to stop and finding peace with that. The emotional, spiritual, and physical tolls. Pride in myself. Somewhere along the way, infertility became a part of who I am. It is not all of who I am, but it has challenged and changed me in ways I never anticipated. And I’m different now. Oddly, I wouldn’t change that.

PicsArt_09-17-02.04.08

Me and my almost 4 year old IVF baby and 17 weeks pregnant with my second IVF girl.

If all goes well, I will be a mom to 2 daughters. Yet in my mind, I will always be infertile. Despite the failures, I got the outcome that we all hope for. I am so very blessed. And, well, really I think I’m just lucky.

Pregnant After Infertility: The anatomy scan

05 Wednesday Sep 2018

Posted by in Pregnancy After Infertility

≈ 2 Comments

Tags

, , ,

close up of pink baby booties

I had my anatomy scan last week. As the day approached, I had my usual influx of paranoia that my baby had stopped growing. In other words, I was afraid my baby had died. There I said it – the “D” word. I’m always afraid to type that word. As though saying it out loud, or in this case typing it out loud, could make it come true. But that’s the fact of my feelings – oddly I’m not afraid that my baby has any disease or growth abnormality. I’m afraid of finding a silent heartbeat.

As soon as the scan began and the heartbeat was present, I was able to relax. Then my Maternal-Fetal Medicine (MFM) specialist proceeded through the lengthy process of measuring and calculating every detail of my growing baby. Reclined on a comfy table, I watched in awe and enjoyed every moment. I loved having my scan with a highly experienced MFM, who also happens to be a geneticist. He was able to explain everything we saw, not only the structures but also assumptions about functioning, with precision backed by extensive experience and knowledge. It really is amazing how much they can tell based on these pictures. For example, when they see fluid in the baby’s stomach, they can make assumptions about how the brain is functioning because apparently swallowing is a much more complicated series of behaviors than you would think, which relies on a well developed brain.

And every bit and part checked out perfectly. Could there by something wrong with my baby that they cannot see? Well sure, I suppose. But the chances of that are very unlikely. So unlikely that I’m not going to worry about it anymore. I know my baby is healthy.  I will, of course, continue to worry about my healthy baby dying before every appointment, even though that doesn’t make any logical sense. I mean, why would that even happen? It wouldn’t be due to some fetal disease or deficit, but sometimes things go wrong in pregnancy for other reasons. I guess my IVF stress has to go somewhere.

One slightly annoying thing we found out was that I have an anterior placenta. On the plus side, this means that my placenta did grow away from my cervix, as my OB thought it would. That’s great news and I’m thankful. But, seriously – how do you freak out an IVF mama-to-be? Give her an anterior placenta so she can’t feel the baby moving as often as she “thinks” she should. It’s a rabbit hole I’m trying to not go down. How am I doing with that? Well let’s just say that the other day my hubby walked in on me Googling “haven’t felt the baby move in 3 days with anterior placenta” and he simply said, “stop it.” I’m trying to stop it, really I am. I haven’t Googled anything today.

And last, but certainly not least. We found out the gender! With IVF baby #1 we didn’t find out until birth and that was pretty amazing, but this time around we decided to do it differently. We saw the telltale three parallel lines, clearly showing that we’re expecting a girl. So my daughter gets her wish – a little sister. I get all teary just thinking about it. I really thought she would never get to be a big sister and I am so grateful. Of course now all of a sudden she says she wants the baby to be a brother – but 3 year-olds are fickle little ones.

What to do with a blog

18 Monday Jun 2018

Posted by in Uncategorized

≈ 3 Comments

Tags

, ,

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.

An Unlikely Outcome to an Unlikely FET

22 Tuesday May 2018

Posted by in FET #2 (after IVF #6)

≈ 12 Comments

Tags

, , , ,

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

18 Friday May 2018

Posted by in Uncategorized

≈ 6 Comments

Tags

, , , ,

colourful capsules

Photo by rawpixel.com on Pexels.com

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.

81686

Do you trust your RE?

15 Tuesday May 2018

Posted by in Uncategorized

≈ 2 Comments

Tags

, , , ,

pexels-photo-1038727.jpeg

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

11 Friday May 2018

Posted by in FET #2 (after IVF #6)

≈ 7 Comments

Tags

, , ,

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.

FET blasts

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

07 Monday May 2018

Posted by in Uncategorized

≈ 7 Comments

Tags

,

thought-catalog-217861-unsplash

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.