Eggs, not so over-easy

These past five years have been some of the toughest years of my life. They have also taught me so much about myself, my strengths, my weaknesses, and my relationships.

I experienced the happiest day of my life when I married my perfect match. Six months later I experienced one of the worst days of my life when I lost my mom. The grief of losing her then compounded with the grief of negative pregnancy tests month after month for five years.

I lost half of my original family, and it seemed I couldn't even start my own.

I kept a journal like a map, as a way to navigate through the stress that surrounded me.

I wrote the poem below one year ago.

Pieces

Every time I've shattered

Into a million pieces on the floor,

I've slowly put them back together,

But you see each time this happens,

Some of those pieces are lost forever.

So now as I pick up the pieces

For the millionth time

I can't help but wonder

If there will come a time

When there will be no pieces left.

Along with seven fibroids and endometriosis, I have what is called an arcuate uterus (pictured on the right.) Mine is a bit more severe than this drawing but you get the gist. Some doctors who looked at it seemed to be more concerned than others. The ones who were concerned said it could cause a late term miscarriage. 

My former gynecologist, Dr. Locher, who I started seeing when I was 34, was the only doctor to ever listen to my concerns. After lots of testing, he recommended laparoscopic surgery to get a better look at my issues. The surgery confirmed my endometriosis, which I had suspected for years due to the pain I endured each month. He decided to leave the fibroids and arcuate alone because in his opinion, they weren't severe enough and could've caused more damage than good had he messed with them. While viewing the pictures with Dr. Locher after the surgery, I said something like "Ew, gross" to which he replied, "Yeah, your uterus isn't going to win any beauty pageants, but should be okay to carry a baby." His sense of humor is one of the reasons I liked him so much. (Unfortunately for me, he is too advanced in his career now and no longer delivers babies.)

After years of dragging my feet and never once seeing that second pink line on a pregnancy test, we decided to seek out fertility treatment. I called and made an appointment with Dr. Raprisarda, a Reproductive Endocrinologist (RE) with Fertility Centers of Illinois. We did tons of tests, and started with trying an IUI first. This is, in short, a medicated cycle where the clinic turkey basters the sperm inside of you in hopes nature does the rest. We did this three times (all failures) before moving onto IVF.

I will give you a "quick" rundown on what my IVF cycle entailed. I say “my” cycle because there are different protocols that are specific to the individual person/couple.

Transvaginal ultrasound machine.
I had far too many dates with this guy.

The stimulation phase: I had to stimulate my ovaries to produce as many follicles as possible to have the best chance at producing as many eggs as possible, which would then hopefully be fertilized and become viable embryos. During the stimulation phase, I went to the clinic every other day in the beginning and then everyday towards the end for ultrasound and blood work. These are called monitoring appointments. They checked how many follicles I had growing and measured the size. During this phase I could actually feel my ovaries growing and by the end I was bloated and uncomfortable. There is no sexual or physical activity allowed because your ovaries are huge and it could be very harmful. During this extremely stressful time, there isn’t much you can do in the way of stress management. Over time, I started doing meditation which seemed to help with stress a bit. Once the doctor decided my follicles were mature enough, he told me when to administer the “trigger shot," an injection taken 36 hours before the Egg Retrieval is then scheduled. This means, you cannot tell your job you need a few days off until a few days before. This is why I broke down and told my boss what I was going through, because it became too hard to think of excuses for all the needed time off, being late from all the monitoring appointments, etc.

Stimulation meds for egg retrieval prep.

I got over my fear of needles and learned to give myself the shots. To ease my anxiety, I would chose a theme each night and play music while doing these shots. 90's Hip-Hop was one of my favorite themes.

Mad Scientist

Egg retrieval day. This is what years of hoping looks like.

The Egg Retrieval: We arrived at the clinic and Nate was called to do his one and only job. As he got up, I gave him a pat on the butt, wished him luck and tell him to think of me. Upon his return to the waiting room he tells me how “weird and creepy” it was, to which I would pull out my tiny violin. We then went back to the prep room where I changed into a hospital gown and waited for the nurse to come in to start my IV line. I then left Nate to go into the procedure room, put my legs up in the stirrups and waited for the drugs to kick in and put me under. The doctor then inserted a giant needle up through my uterus and into my ovaries to extract as many eggs as they could.

Waiting patiently to be taken to the procedure room.

When I woke up, they told me how many eggs they’d retrieved. This is the number of tributes I was sending into the Hunger games, what the Infertility community calls the days following the egg retrieval. My first IVF cycle went as follows:

Day of egg retrieval: 15 eggs retrieved

Day after: 11 Eggs fertilized

Day 3 report: All 11 still growing and starting to divide! Yay!

Day 5 report: Down to 6 tributes fighting

Day 6: Fresh transfer day. We made our way into the clinic with our hopes high that the saga of trying to get pregnant would now be coming to an end. We have 6 embryos so even if this one fails, we will have more chances, right? Wrong. We find out at the clinic only 2 have made it.

But still, felt super lucky to end up with any at all. There are women who end up with none.

Before my fresh embryo transfer. Full of hope this time would be it.

The Two Week Wait: Now on to the next part in the torture waiting game. This is where you pretend your pregnant. No alcohol, no caffeine, no sushi. I am now pumping progesterone and estrogen into myself. Here’s the best part of these hormones. They give the same symptoms of being pregnant. Yet another form of torture, in case everything else wasn’t enough. Cool.

Meet Enodmetrin, a progesterone suppository.
It is inserted in your vagina. I had to do
 this 3 times a day for months on top of all the shots.
No one ever talks about these. These SUCK. But at
least these came with an applicator. I also had to
launch estrogen pills up there as well, but free hand.
Super glamorous.

The big guns. This intramuscular shot gets
injected into my upper butt/hip area. I never could muster up the courage to give myself these. And look at Nate's face. Who am I to deprive him of the joy he gets from giving these to me??

The wait was over: The doctor called with the results: Big Fat Negative. 

I hang up, completely gutted. I didn’t care that it was only 3 p.m., I poured myself a giant glass of bourbon, grabbed my phone and journal and headed to sit on the bathroom floor. I called Nate and gave him the news. I hit play on my playlist titled “Bathroom Floor” and proceeded to break into a million pieces once again. Nate joined me here once he got home where we once again would lean on each other.

Fertility treatment is the hardest thing I have ever been through. There is no normalcy when you have no control over your emotions or body. Trying to plan every aspect, big or small, in your life around it, is hell. The mood swings are by far the worst part of the process. Let’s just say that I’m surprised everything in our house isn't smashed.

Once we recovered from this loss, we regrouped and decided to do another egg retrieval. We decided this time to do everything we could to make our chances better. This included PGS (prenatal genetic screening) and an ERA (Endometrial Receptivity Analysis). Neither of these extras is covered by our insurance, but to us, it was well worth the cost. Also, neither of these things guarantees success, but just another tick on the “did everything we possibly could” checklist.

PGS testing happens after the Hunger Games. Thus, extending that part of the torture.

2^nd Round for us went like this:

Egg retrieval #2: 12 eggs retrieved. Seven eggs fertilized. 7 going strong on day 5. 6 made it to be biopsied and sent into the lab for PGS testing. The embryos don’t survive past day 6 on the outside, so once they were biopsied, they were frozen.

More waiting…. a couple of weeks later I get a call that three came back normal!! I was so thrilled. I had set my hopes super low and was hoping for one, so I was over the moon. But of course, this didn’t mean I had any guarantees. Still, I held onto hope. PGS just ruled out embryos that would’ve unquestionably ended in miscarriage.

I then prepped for my ERA cycle. This is where I do everything exactly as I would for a frozen transfer. I start the meds, including Lupron injections, Progesterone (PIO) injections, estrogen pills and patches and progesterone suppositories. 

The actual ERA is performed at the time you would do the actual transfer. This test is to see if your body’s conditions are right for transfer. The doctor inserts a catheter into your uterus and then collects a sample of your uterus lining to test. The nurse grabbed my hand before we started, and I thought to myself “oh please, I’m used to this kind of pain” and then as he started, I squeezed her hand, nearly crushing it. This was by far the most painful procedure I have ever been through. Luckily, it only lasted about 10 seconds. Bad news is I had to come back 2 days later to do the exact same thing a second time. I apologized to the doctor and nurse for the string of curse words I yelled out, and said see you in a few days. GULP.

Turned out that the torture wasn’t for nothing, and that I needed additional time on progesterone before transferring.

Full bladder is required, so right here I'm focusing
on not pissing in the doc's face

I then began prepping for the actual frozen transfer. So same as I did for the ERA cycle, the injections, the patches, the suppositories, the pills. Our transfer happened during the polar vortex, and it was nice to hole up for the next few days while hoping the embryo would stick. Ten (long) days later we get the call that it worked. Luckily, Nate was home with me this time when they called, so we got the good news together.

The little embryo that could. I mean, have you ever seen a cuter embryo??

We are some of the lucky ones whose insurance has fertility coverage, although there were tests and procedures it didn't cover. It only covers four IVF cycles for a lifetime, and the insurance company gets to decide what is considered a "cycle."

Every phone call with the insurance company went like this: 

Agent: I don’t know.

Me: Here is a lesson on the different stages of IVF.

Transfer.

New Agent: I don’t know.

Me: Here is lesson on the different stages of IVF.

Transfer.

New Agent: I don’t know.

Repeat.

Repeat.

Illinois is one of only eight states that has mandatory fertility coverage and even in those states there are rules and stipulations that make it difficult. Still, I know we are lucky to have any coverage at all.

I'm grateful to the doctors, nurses, phlebotomists, embryologists, and the magical science of IVF for making this possible for us. A special thanks to my online infertility community who gave me the support that no one in real life could possibly give, and also to my in real life friends who didn't have any experience with what I was going through, but still had the empathy to be there to listen and comfort me. And most of all to my husband and rock, Nate. It was not an easy road for us and our marriage, and at times it just about broke us, but when things got really rough, we clung to each other and it only made us stronger. It was not easy for Nate to take on the role of "caretaker." He had some pretty big shoes to fill in the absence of my mom, who of course was the one I always wanted to run to. But towards the end he got the hang of what I needed. He was the calmness I needed, he was the steady hand that kept me going. And most importantly, he always gives the best hugs, the best medicine for a broken heart.

The reason I am sharing my story with you is because there is so much false information surrounding getting pregnant, infertility and IVF. IVF does NOT guarantee a baby. It also is physically, mentally and emotionally draining. Not to mention, for so many, financially draining. I don't know how many well-meaning people told me that I just need to relax or a variety of other dismissive comments. That is NOT how it works. Stress does NOT cause infertility, but infertility DOES cause stress. I was appalled at how many women who I've opened up to about our struggles have launched right into how easy it was to have all of their children. That is like someone telling you their kidneys are failing and your response is, "Oh, my kidneys are perfect." It seems that somehow a woman's reproductive organs are not thought of as organs, when actually they are just that. They may not function properly just like any other one of your organs. You would never tell someone who has kidney failure that they need to "just relax" or better yet "just stop trying" and think that their kidneys will magically just start working again.

Also I want to add some people don't
want to have children which is
their RIGHT and NOT your business!

Also, if you have the audacity to ask someone if they have any children and they say "no," that should be the end of it. It is none of your business why they don't have children. And if they do tell you about their struggles, just listen. There is no need to say things like "just adopt." Adoption is not a new concept, not an easy fix and not for everyone. And it most certainly isn't only for people who can't get pregnant.  Before saying "It'll happen when it's supposed to" think about how there are women giving birth to their babies in prison, or little girls giving birth because they have no other choice.

Instead of saying these types of dismissive comments, and giving your unsolicited advice, just listen to what someone is going through. It is perfectly acceptable to say I don't know what to say, but I'm here for you in whatever way you need me to be. In fact, those words can be used in ANY situation when someone is confiding in you with something they are going through. People need to be met with empathy when opening up about their struggles, not judgement.

This video sums empathy up so nicely:

And this series of drawings perfectly sums up the struggle of infertility. 

It is so hard to try and put into words how broken I’ve felt while going through all of this. There is so much self-loathing and bitterness. The worst part being I felt I deserved this somehow, that I was a bad person and this was my punishment. I have always been so hard on myself, and this was no different. For a long time, I even felt responsible for my mom’s death. If I still lived with her this wouldn’t have happened. Or if I would’ve let her know how much I still needed her; she wouldn’t have left. It took years to let myself off the hook for that one, but I think part of me still wonders “what if.”

Infertility has been no different. The blame I have put on myself was very real and nearly destroyed me. Looking at Nate and his perfectly healthy sperm made me feel so inadequate. I constantly thought if he were with someone else, he wouldn’t have to go through all of this. Of course, he never made me feel this way, I just did. Whenever I would say I was infertile, he would correct me and say WE are infertile. He also made sure I knew if at any point in the treatment I decided I was done, that I'd had enough, he would support my decision. He knew that it was my body going through it, and that is was my choice. 

They say infertility is a form of grieving and they are absolutely right. The only difference being there isn’t a casket, or a funeral when you suffer infertility. There is the constant push from hope that next month will be different and pull from grief when it isn’t.  Over and Over and Over. There is no bereavement at work. Month after month, year after year, your life must just go on. Trying to be normal, trying not to cry when you see happy families all around you everywhere you go. Trying to make Christmas special with the loss of your parents and the loss of the family you should’ve had by now. And then there is the double-edged sword of Mother’s Day.

Mother's Day tip: Don’t wish women a happy Mother’s Day unless you see that she has children. Strangers wishing me a Happy Mother’s Day was an unnecessary reminder of all that I lacked. No one is going to leave the Jewel and say “The cashier didn’t wish me a Happy Mother’s Day, what a bitch” but some women may leave with tears in her eyes while throwing her groceries in her car because she did.

Infertility all but kills your love life. Even before we started treatment, timing intercourse pretty much kills the romance. It becomes a chore. Starting treatment actually was a sort of relief in that aspect: It takes sex out of the equation. With IVF you have restrictions on when you can even have sex, by that point we were pretty much over it anyhow. I have had a beautiful realization about intimacy, that it goes way beyond intercourse. Intimacy turned into slow dancing in the bathroom while Nate massaged my butt with a heating pad, after giving me a progesterone shot, or holding me as I uncontrollably cried after getting negative results. 

The most surprising thing I’ve found is infertility doesn’t just end when you get a positive pregnancy test. It has shaped me and has become a part of me. I still dislike baby showers (tbh, I’ve never really cared for them, the traditional kind anyway), and don’t even want to have one of my own. I still get bothered when someone gets pregnant “on accident” or talks about how fertile they are. The first trimester was really rough, knowing how many of my friends from my infertility community have had miscarriages. I still have so far to go, and I sometimes have to fight with myself to get the dark thoughts of losing this baby out of my head, but this is just a part of me now. And I roll with it, the way I have with every other hardship in my life. And the fact is, no matter how negative or positive your outlook is, it will not change the outcome. I am doing the best I can to stay positive and keeping my body and mind strong and most of all loving this baby with all of myself. I can definitely say that even though sharing this with all of you, albeit terrifying, it is also extremely therapeutic. There are things that were too hard for me to write about, so I didn’t. There were other things that were too hard for me to write about, but I did anyway. Whether or not I shared them with you, I know the hard things will always be there. I know the good things will be, too.