It’s a new week and since I didn’t write last week, I guess I’ll explain by saying I’m making room in my new life for grace. Last week felt like a real “maternity leave” week. The truth is, things were chaotic at our house. While the week before had been smooth sailing, last week things exploded. The house got messier each day, both girls needed lots of love and attention, and everything else in life had to slide to the back burner to give them every ounce of energy (and patience) I could muster. I decided since we had just become a family of four a little more than 3 weeks earlier, I should cut myself a little slack.
Thankfully, this week is starting much more smoothly. So, as promised, I’m sharing our IVF story.
I want to preface this story with these words.
In the last several months, while contemplating restarting my blog, I thought long and hard about whether I wanted to share our infertility story, at least so publicly. I’ve had talks with people who asked if I would be quiet about our struggles. Not because IVF is a shameful thing, but because our “fertility baby” might read this someday. And then she’ll know. Know she was conceived differently, and know that she might have the same issues her mom did. Or that our second daughter might feel less wanted because she was conceived naturally. But honestly, these are exactly some of the reasons I want to share our story.
Both of our daughters should know how badly their mom and dad wanted to be their mom and dad. How badly we wanted to be parents and to what lengths we were willing to go to, to have our children. And how grateful we are to have each of them regardless of how they were conceived.
Perhaps even more important, both our daughters will know the struggles we faced because as women, they should feel informed (and empowered) about their own fertility if they choose to have children of their own. And I promise this blog post won’t be how Isla or Josie learns about their family history.
So, here it goes. Brace yourself: it’s a long one.
In August 2015, Chris and I started IVF. Multiple boxes of medications arrived via mail. Lots of synthetic hormones, loads of needles, alcohol swabs and bright red containers to dispose of all the supplies we would go through. I went to the clinic to get specific instructions, a time line for medication administration, and did some blood work. We were finally cleared to begin.
By no means is this a medical account of IVF. If you or a loved one is really interested in that, I encourage you to do more research or to meet with your own medical professional. But here is my bare bones explanation of IVF.
Step 1: Control ovarian stimulation. This is where you start the process of ovulation without actually allowing for it.
Step 2: Step one allows for step two, follicle stimulation. In a regular monthly cycle, we ovulate one or maybe two eggs, but in IVF you are looking to generate a high number of eggs to be retrieved. Egg retrieval results in about 15 eggs on average.
Step 3: At a precise time, you use a “trigger drug” to prepare for egg retrieval. This is administered exactly 36 hours before your procedure will take place.
Step 4: Egg retrieval occurs. In the 36 hours after the trigger is administered, the eggs come to the surface and are easier to extract.
Step 5: Fertilization. Once the eggs are retrieved, they are fertilized. We chose to utilize a process called ICSI (Intracytoplasmic Sperm Injection) for the fertilization of our eggs. In typical IVF, the eggs and sperm are allowed to fertilize “naturally” in a dish. In ICSI, the best looking/healthiest eggs and sperm are selected and fertilized manually. We opted to do ICSI after our multiple losses. The idea is that genetic problems caused the miscarriages and that perhaps selecting the best looking eggs and sperm would help prevent another loss.
Step 6: Embryo transfer. Once the embryos are old enough (at either day 3 or 5 after fertilization, TBD by your doctor), the embryo(s) that are of high enough quality are either transferred or frozen.
Looking back at IVF, there are of course some specific moments that stand out. Here are my cliff notes following the timeline of our experiences.
I’ll never forget the first time I had to stab myself in the stomach. There is at least one injection per day, and for us injections lasted until we were 10 weeks pregnant with Isla. The first time I needed to stab myself I was a mess. I remember saying to Chris through tears, hands shaking, “How is this our life?” Before our foray into infertility, I HATED needles. I certainly won’t ever say I like them, but I guess after all the stomach injections, blood work, and countless progesterone shots, I came to tolerate them. The next several nights I injected myself were easier and easier. And yes, even the progesterone shots I did while pregnant, known to be notoriously awful, got easier.
Each morning following the hormone injections, I had to visit the clinic to have blood drawn. At one point, I had blood drawn for 10 consecutive days, with many more draws during the month too. I remember hiding my bruised arms with long sleeves as much as I could at work, even though it was still summer.
Another hiccup related to work that I recall: I couldn’t exercise while doing IVF. Yeah, I’m a personal trainer so that’s kind of an issue. Follicle stimulation can be dangerous when coupled with high intensity exercise. As you prepare your body to “ovulate” so many eggs, your ovaries grow unusually large and high impact exercise can cause an ovary to twist, which could complicate the whole process. I didn’t want to miss work because I didn’t want to tell people I was doing IVF. So I adapted everything I did as quietly as possible. I instructed more low impact exercises and talked my clients through the high impact ones (normally I love to demonstrate everything).
The day we went for our egg retrieval, while setting my IV, the anesthesiologist punctured through the valve in my arm and blood shot across the room. It was a great way to start the procedure. Then, when I was laying spread eagle on the operating table, the performing doctor who walked in was none other than the one Chris and I chose not to work with the year before. Thankfully I trusted his capabilities and simply didn’t prefer his bedside manner, but a propofol blackout is just as fun as an alcohol black out. NOT FUN AT ALL. I apparently talked for 10 minutes before they could start the egg retrieval. And I’ll never know what I said in those 10 minutes (though my nurse assured me I was nice). Cue the eye roll.
The retrieval took 45 minutes, a full 20 minutes longer than normal. 10 of these minutes were clearly due to my babbling on about Lord knows what, but another 10 were because they retrieved so many eggs. 28 eggs. Again, the average is 15. We still feel so grateful for this number, and days later we felt even more grateful when they told us they had been able to successfully fertilize 9 eggs. This is huge, and it’s something I often think about and feel guilty about. I know many women who were not so lucky. Some who get none, or just one. Or have to do loads of rounds of IVF. It’s like what I imagine survivor’s guilt feels like.
Transfer day came. They showed us a photo of our embryo and then I was yet again on that operating table in a compromising position. The nurse held my hand and as they injected the embryo I anxiously watched the ultrasound screen. The nurse described it as a shooting star and I felt a few silent tears fall. I was very close with my maternal grandmother and one of her favorite songs was, “When You Wish Upon a Star.” In this pivotal moment, I thought of her, simultaneously wishing this this little baby would stick and become the child we had been dreaming of for so long.
Two long weeks passed then finally we did the blood work we were anxiously anticipating. And finally, the call we were anticipating even more. We were pregnant. After more than a year, we were pregnant again. IVF had worked. We told our families and closest friends who knew what we had been up to. Two days later you’re required to recheck the HCG numbers with more blood work, to make sure you’re still pregnant. And it was with this blood test that our joy turned to sorrow once more. I was miscarrying and just didn’t know it yet. I was instructed to stop all medication and let my body take its course.
A couple days later I did start to miscarry, and yet again as the year before, my body wouldn’t stop bleeding. Fearful I had experienced an ectopic (or tubular) pregnancy, they brought me in for an endometrial biopsy. This would be like a mini D&C (dilation & curettage), a procedure often done under anesthesia when a woman is miscarrying. However, unlike with a d&c, the biopsy would take a sample of cells and see if any surviving cells from the embryo were present. We wanted them to find these cells. Thankfully they found them. Now they knew I hadn’t experienced an ectopic pregnancy (ectopic would have meant we couldn’t try to get pregnant for several more months since they would administer a drug that would be dangerous to a developing fetus).
After the procedure, I literally got the hardest news of my life. Visibly upset by the biopsy, and just emotionally exhausted by the whole previous month and change, the doctor sat me down and delivered the blow I had feared. While asking me how Chris and I would like to proceed, he gently told me, “This might not ever work.” He had to be a doctor, honest about our new statistics. Women who miscarry 3 or more times clearly have a higher risk of continuing to miscarry and a lower risk of maintaining a pregnancy. But despite the science behind our new statistical reality, these words crushed me. It was like a door was shutting on a part of my life I wanted so badly, but would never have. I can’t even begin to describe how devastated I felt. I remember sobbing with my doctor (Chris was at work when all of this happened). My doctor encouraged me to go home and discuss things with Chris.
The biopsy helped me finish miscarrying our IVF baby. And a couple weeks later we were back at our doctor’s office. We had decided to do a frozen transfer, but we had also decided we were done “trying” after this procedure if things didn’t work. We were just a couple months away from the start of a new year. If I didn’t get pregnant (and stay pregnant), this time I was going to start counseling. We were going to move forward childless. We were going to try to stop thinking about babies. Our doctor was compassionate and advised us to transfer two embryos. We agreed.
Shortly after this appointment we prepared for the frozen transfer. This is a different process for everyone and I won’t get into the details, but basically you either stimulate or allow for natural ovulation, then transfer the embryos at exactly right time and then support the pregnancy with hormones until a pregnancy is or isn’t confirmed.
We had our two embryos transferred with a lot less fanfare and celebration than immediately after our IVF cycle. Two weeks later, after I had started bleeding on Halloween and was sure I wasn’t pregnant, we got another positive pregnancy test call. And this time the numbers elevated in our blood work two days later. They continued to elevate with each new check.
However, I wouldn’t let myself celebrate. We told hardly anyone about this frozen cycle, or about the positive test. Not even our parents knew. We were tired. We were broken. Yet we had to fight one more time. We had to know we had done all we could that year. So, with this pregnancy, we barely believed it ourselves, though I was starting to feel sick. Something was different.
Finally, the last step with the fertility clinic. We went for an ultrasound to really confirm our pregnancy. Was this a viable pregnancy? And if so, was it twins? The ultrasound screen clicked on and there, for the first time ever we saw what we had been hoping, dreaming, and wishing for. One heartbeat, so strong and beautiful. I’ll admit, I was sad there weren’t two babies, but I was more overjoyed for that one little life. Our baby had survived the freezer, and we had weathered the hardest storm of our lives.
Our pregnancy continued with a whole mixture of emotions and anxiety, but 9 months later, that heartbeat emerged from my belly, still beating so strong and inside one of the sweetest people I had ever met: our daughter, Isla. Placed on my chest, I immediately knew she was worth it all. This little person was worth everything we went through; every ounce of sorrow, every tear, every injection, every vial of blood, every procedure, every loss. Our baby was finally here and when she was born, a new part of us was too. We became parents and our lives are forever changed, in the best way.