Tag Archives: IVF

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

26 Wednesday Sep 2018

Posted by in Pregnancy After Infertility, Uncategorized

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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: Out with the guilt and on with the symptoms!

25 Monday Jun 2018

Posted by in Pregnancy After Infertility

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alone bed bedroom blur

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You know that guilt we carry around while going through infertility treatments? The part where we second guess each choice and worry that we’ve messed something up? I wrote about one of my guilt stricken moments a while back during who knows which round of IVF. That guilt doesn’t simply go away with a big fat positive (BFP), I think it just morphs into something new. Maybe even something similar to survivor guilt.

Let’s talk about that.

I can’t tell you how many times I’ve heard a woman who is pregnant after IVF express guilt over complaining about anything pregnancy related. Just the other day I was reading a post from a woman who was struggling with guilt because she felt bad over the fact that she wanted to complain about throwing up multiple times per day, everyday. Let me repeat that. This poor woman is vomiting her guts out repeatedly every freaking day, and she felt like she was being ungrateful if she let on that she wasn’t loving “puke fest 2018”. Wait, what?!

So I’m just going to say it. Just because we are pregnant after struggling long and hard with infertility, doesn’t mean that we should love pregnancy symptoms. And just because we don’t like nausea, vomiting, exhaustion, etc., does NOT mean that we are ungrateful to be pregnant. We are grateful. And we are so very sad and empathetic toward all the women continuing to fight the infertility battle.

But still, pregnancy symptoms are just as hard for us as they are for our fertile sisters. And they get to complain without the added guilt. In fact, they get sympathy for their symptoms. And so should we. Throwing up is not fun for anyone, regardless of how badly you wanted that baby or how long you tried.

It’s okay to not like this part. So let’s let the guilt go, ladies. You can be miserable during the first trimester, and any other part if it fits. You earned it. In fact, you went to hell and back to get here.

abdomen active activity belly button

Photo by freestocks.org on Pexels.com

We spend so much time, effort, and money chasing that BFP that we sometimes begin to idealize what it will finally be like when we become pregnant. We paint this pretty picture in our minds filled with rainbows in the sky, glitter raining down upon us, our baby bumps growing round while the rest of our body  glows like a magical earth goddesses, while we hold picture perfect yoga poses, and lovingly chuckle at our partners as they struggle to assemble the perfect crib. Oh and we’re craving nothing but veggies and fruit.

Yeah, that’s probably not going to happen.

So when early pregnancy isn’t quite what you imagined it would be during the years you were trying to conceive, please don’t beat yourself up over it. Let the guilt go! You have the right to be heard and to feel what you feel. Guilt free. Yes, you definitely earned it.

What to do with a blog

18 Monday Jun 2018

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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

11 Monday Jun 2018

Posted by in Pregnancy After Infertility

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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

22 Tuesday May 2018

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

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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.

Do you trust your RE?

15 Tuesday May 2018

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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

11 Friday May 2018

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

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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.

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.

 

 

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

02 Wednesday May 2018

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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.

An Unlikely FET

19 Thursday Apr 2018

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

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Well this should be an interesting cycle.

Yesterday I began the preparations for another frozen embryo transfer (FET). My baseline ultrasound went well – my lining is thin as it should be at the start and my ovaries are “quiet”. Glad there’s no party going on in there. My blood work came back normal and so I was given the green light for estradiol valerate injections. Somehow I managed to forget that this medication is an intramuscular (IM) injection. Who wouldn’t want to block that out?  Also I’ll be doing progesterone in oil  – the dreaded butt shot – later in the cycle. So with these two, I’m anticipating a sore back end. However, I recently realized that my husband had previously been doing my IM shots way too low, which probably accounts for much of the pain and bruising. Mind you, I used PIO for 10 weeks during my IVF pregnancy so you’d think we would have known better. In any event, I think (or hope) things will go smoother now that we know to aim higher.

What makes this cycle so interesting, though, is that we are using 2 embryos that have the odds highly stacked against them – my PGS “abnormal” embryo and my bonus embryo left over from last cycle. I wrote more about these embryos here. If this works I’ll be shocked.

This cycle feels pretty different from the rest. I feel calmer. I’m not stressing about every little thing, analyzing every option, and second guessing every choice. And you know, all of that mental effort is exhausting and time consuming! I’m taking a cue from my beloved ocean – going with the flow and riding the waves. I’m not fighting the current. There is strength in that. Of course I hope this goes well, but honestly I’m not expecting it. I’m not clinging onto the outcome. I’m just riding the wave and waiting to observe where I end up. This is my visualization, my mantra.

That’s not to say this will be easy, or that another negative outcome won’t hurt. But I know I can weather that pain. I know the storm will calm and there will be sunshine again. So let’s see what happens…

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My happy place

 

Next Up: FET (again)

10 Tuesday Apr 2018

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

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My follow-up consultation with my RE yesterday was packed full of good information and even a surprise. So first the surprise: we have one frozen blast left over from my last cycle! Sure I’m ignoring the fact that it’s been a month since my egg retrieval and fresh transfer and no one mentioned to me until yesterday that I have a frostie. Seriously, why did the nurse not call me with that update?! Anyway, I’m going to ignore that slip up and focus on the fact that I have a surprise bonus embryo that I wasn’t counting on. Of course it’s not tested and it’s an early blast graded “BC,” which isn’t the prettiest embryo but still has a 90% chance of surviving the thaw. I asked if BC embryos still make babies and my RE said, “yes”. In fact, just for fun, he looked back to my cycle 4 years ago – the one that resulted in the birth of my daughter – and we discovered that she was also an early blast graded BC. Maybe my crappy looking embryos fair better than my high quality ones. Okay, I’m grasping at straws here. I was 36 back then and I’m 40 now, so the chance that this little BC is healthy is lower. But still – it’s a chance.

My RE recommended using what we have and doing a frozen embryo transfer (FET). Using what we have includes a little frozen PGS “abnormal” girl too. Yes, you heard that right. My RE is recommending that I transfer a PGS abnormal embryo. But first a few points to clarify. We did not do Next Generation Sequencing (NGS) so the results are either normal or abnormal – all mosaics are labeled as abnormal. Knowing what I know now, I would have tested using NGS so that the results would have specified whether the embryo was mosaic and the percentage of mosaicism. But I digress. In any event, I have a lot of respect for my RE (and his knowledge base) because he isn’t quick to dismiss all abnormal embryos. He took a close look at the details of the results and saw that this particular “abnormal” embryo only has a tiny segment of duplication on the short arm of chromosome 17. He said that a small percentage of the population may be walking around with similar minor abnormalities  and no one knows it because we never tested for that sort of thing before. This particular partial duplication will not lead to the birth of a child with an abnormality. Maybe my embryo will even have a superpower. Okay, that’s probably not true but I’d like to think so. The embryo may not implant or might be an early miscarriage (no different than what happens with so many pregnancies both IVF and unassisted) or the embryo could develop into a healthy baby. Both of these embryos are long shots simply due to my age-related quality issues, but it’s a chance. So the plan is to transfer both for my upcoming FET.

Going into this consultation I was prepared for the FET recommendation. I was also prepared to call it quits afterward if the FET fails. Over these last several weeks I’ve come to a place where I’m at peace with not having another child. I never thought I’d say that. And I’ll write specifically about how I shifted to that mindset in a later post. For now though, my RE convinced me to try one more egg retrieval and fresh transfer if this FET ends in another negative beta. My husband and daughter are both strongly rooting for another child, and my husband was also hoping to do one more fresh transfer.

My RE told me about some studies that followed women over the course of up to 12 (gasp) complete IVF egg retrieval and transfer cycles. The studies found that the chance for success increased over the course of 3 cycles, but plateaued after that. Meaning that after 3 complete cycles, the results don’t often change much. It should be noted that multiple FETs with eggs collected during the same retrieval only count once – that is, you can do several FETs and that doesn’t count against the 3 cycle benchmark. Of course there are exceptions to this rule, but when weighing the pros and cons of when I want to stop, I’m not going to keep doing this forever in the hopes of breaking the odds. Taking all of my cycles together and the particulars of my results, my RE said that if it were he and his wife, he would do one more IVF and fresh transfer after the FET. He said if we do that and still it fails, then I can feel confident that I didn’t leave anything on the table. No looking back and wondering. No regrets.

I like the sound of that. It makes sense. I think with the “break” of doing a FET first – since there’s so much less prep work for a FET – I can muster up the strength for one more IVF cycle. I don’t want to look back one day and wonder, “what if”. This plan seems like it will satisfactorily exhaust our options with my eggs. And if the journey ends there, I’m okay with that.

On a side note, I want to mention that I mustered up the courage to ask the scary question I had been avoiding. The “does repeated rounds of IVF cause cancer” question. My RE gave me a confident “no” and explained that the hormones used for this are naturally occurring in the body so the body knows how to process them. It doesn’t cause cancer. When I asked specifically about estrogen-sensitive cancers, he explained that again the answer is that IVF will not cause them. Prolonged estrogen can cause estrogen-sensitive cancers to grow (get bigger) but will not cause them. But he specified that it really does have to be prolonged exposure – the short bursts we use for IVF isn’t considered prolonged even when we do it multiple times. So I’m putting that fear to bed and thankfully moving on.