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Infertility 102

  • Posted on October 7, 2010 at 6:16 pm

Once it was established that we would not have a family of our own unless we pursued IVF with ICSI, we decided to forgo buying a house and put all our efforts into starting a family.

This was no easy task.

In no time, I was met with a rather large box of drugs and had to start injecting myself with all sorts of hormones.  The color-coded calendar I had was rather intimidating, not to mention the first time I had to give myself a shot to stimulate my follicles.  I remember my hand shaking with the fear that the shot would really hurt.  I probably shouldn’t have looked at youtube videos about the kinds of shots women have to give themselves for IVF.  I remember one woman had bruises all over her belly from all the shots she had to give herself.

Thankfully, the follicle stimulation shot didn’t hurt… most of the time.  At one point, I had four different shots to take, all at very specific times of the day.  I even had to use a color-coded calendar to help me make sure I was taking the right drugs at the right time.  My husband also had to give me a shot in my hip every night after the transfer, all the way up to the day of the Beta blood test.

During the chaos of the first cycle, I had five ultrasounds in five days.  The fertility doctors had to monitor my follicles to the exact point where they’d be best for retrieval.  My follicles were responding so well to the drugs, one of the fertility doctors was very close to canceling my cycle because I had too many follicles.  Too many follicles can cause the follicles to not grow to the right size for egg retrieval.  Not only that, but my ovaries were maxed out and I was teetering on the edge of Ovarian Hyperstimulation Syndrome, which causes fluid to leak into the abdominal cavity and can be potentially dangerous.

When I look back on all of this, it seems so confusing and so overwhelming.  I really don’t know how I went through it all, other than to say that I had a one-track mind that was focused on nothing but doing what I needed to do to get pregnant.

Pregnant.  It seems like such an easy thing to do.  Egg and sperm meet, baby is conceived, nine months of joyous anticipation for the blessed birth.  This did not happen for us.  I had to shoot myself up with a ton of hormone drugs, have a wand shoved up my hoo ha more times than I could count, and I got very used to almost-strangers looking at my girl parts to the point where it didn’t bother me anymore.  I remember a time in my life that the mere thought of having a well-woman exam scared the crap out of me.  I had to deal with bloating and weight gain and my clothes not fitting me anymore.  But, worst of all, I had to deal with what seemed like EVERYONE around me getting pregnant and having cute, bouncy babies.  EVERYONE but me.

That first cycle seemed like such a surreal dream.  Here I was, standing on the precipice of something I had never experienced before in my life: having a baby grow inside me.  Even though my doctor was tempted to cancel my cycle because of my over-stimulated ovaries, he did not.  Apparently, my follicles grew enough to where they could be retrieved safely.  So, on with the cycle we went and I administered the shot that would ripen my follicles so they could be retrieved.  I went in on a Tuesday morning, my husband driving me to the clinic.  I remember feeling extremely bloated and uncomfortable, and well, nervous.  Who wouldn’t be?  We had just spent thousands of dollars on a procedure that wasn’t a 100% guarantee.

I was asked to undress and wear a hospital gown with the ties in the front.  I didn’t bring a pair of socks, which now that I think back on it, if I had known, I would have totally rocked a pair of cute socks.  I have a whole drawer full of cute, funky socks.  Instead, I went barefoot.  My legs were put into some sort of leg holders and strapped down and I was asked to scootch myself down to the very edge of the bed.  And then, the anesthesiologist put me to sleep.  When I woke up, my lower abdomen hurt and I was completely groggy and out of it.

The news was good, however.  I had produced 17 eggs.  SEVENTEEN!!!!  I couldn’t believe it at first, but then, looking at my swollen abdomen, I did believe it.

17 eggs retrieved, 15 of them were mature, and 14 fertilized.  That is an extremely high number.  Many women end up with maybe a couple of mature eggs and have to repeat the entire first cycle over again.  Two embryos were transferred and the rest were frozen, leaving us with ten embryos.

We were very lucky.

We went in for the embryo transfer.  It wasn’t a pleasant experience at all.  I thought one of the three fertility doctors I had been working with would be there for the transfer.  Instead, I got a doctor I didn’t know and he didn’t know my body very well because he couldn’t get into my cervix.  He had to place a SUTURE on my cervix to bring it up enough in alignment to where he could send the embryos on their way.  It was so painful, I tensed up and had tears rolling down the sides of my face, pooling in my hair.  After the procedure, and the two very best embryos (3-day blastocysts!) were placed through my cervix and allowed to float around in my uterus, I was told to lay there for 45 minutes and the table was placed at an angle where my feet were higher than my head.  I laid there in pain, the 45 minutes slowly ticking by.  Why is it that when you’re in pain and you’re forced to lay there, time moves excruciatingly slow?  My back was killing me because of the awkward angle I was in and all I wanted to do was go home.

Because I had a moderate case of OHSS and the fluid in my abdomen was pushing on my organs to the point where I couldn’t eat more than two celery sticks cut in half with peanut butter, my 2-day bedrest was pure misery.  My poor husband also had to run up and down the stairs to fetch me my breakfast, lunch, and dinner, since the only thing I was allowed to do was go to the bathroom.  I had movies to watch and books to read while I lounged around in bed.  Except, I was in massive pain.  I couldn’t sleep because I had been laying in bed all day and my back hurt beyond all measure because I had been laying in bed all day.

Needless to say, the entire experience of the first cycle was miserable.  I went in for my blood test on July 24th, 2009 and waited on pins and needles for my Beta result.  When the nurse called to tell me I wasn’t pregnant, I completely lost it.

It just didn’t seem fair.  We had put so much hope and faith and so much of ourselves into what we hoped would be the start of our new family.  In retrospect, it was most definitely for the best that I didn’t get pregnant that first cycle, especially considering the OHSS I had to deal with.  A pregnancy would have exacerbated my condition to the point that I could have had my abdomen drained of fluid.  Who knows?  It still hurt to know that it didn’t work.

With the high number of embryos we had, we were lucky that we were able to continue IVF with ICSI without having to go through another egg retrieval.  I told my husband that I didn’t think I could go through that again.  And yet, there are women out there who have to do one for every cycle.  The amount of stress it caused was unbelievable.  The 11 days I had to wait for my results was mind-numbing.  And all the doubt!  When I found out the first cycle didn’t take, I kept thinking it was something I did wrong.  Did I lift something that was too heavy and cause the embroyos to shoot out of my uterus?  What about that time I had a piece of chocolate?  Or how about that coffee?  It had to have been something I did, right?  I mean, two perfectly good, top-quality embroyos were placed in my uterus, floating around in there.  Why didn’t they take?  I guess that’s just how the human body works.

For the second cycle, I had to go in for a practice transfer to make sure they wouldn’t have to resort to putting a SUTURE in my cervix to align it properly.  All this because the doctor who did the first transfer had such difficulty.  The practice transfer went swimmingly well and it was determined nothing was wrong.

The second transfer went fine.  In fact, I felt absolutely no pain and was surprised that I didn’t.  Everything felt so right: I didn’t have any pain, I wasn’t bloated from OHSS, and I knew the doctor doing the transfer.  I was positive the second transfer would be successful.  I would find out a few days after my birthday.  What better birthday present than to have the gift of starting a family of our own?  Instead, I found out my sister-in-law was pregnant with her second child.  The devastation hit me like a brick wall.  I felt so miserable.  I didn’t want to feel jealous, but I did.  I didn’t want to be angry, but I was.  My thoughts were right back to what I was thinking before we started the IVF:  why is it so easy for some women to get pregnant and others, not?  That was a dark time for me.  I felt really, really terrible for thinking the way I did.

I had a few more tests run on me to make sure there was nothing causing my infertility, like polyps or cysts in my ovaries.  I had a hystersonogram just to be sure because he thought it interesting that I said I had spotting for several days before my cycle started and my cramps were out of this world painful.  I told him I thought all women had spotting before their periods – how else would they know it’s coming?  Oh, but that wasn’t true at all.  Most women might have a little spotting a couple of hours before their cycle starts, but not for days before.  This was news to me.  The doctor told me that there might be polyps and/or cysts in my uterus, causing irritation and not allowing the embryos to take hold in the lining, which would also explain the spotting and the horrible cramping I had every month.  He couldn’t find any reason why the 2nd cycle was unsuccessful and wanted to make doubly sure there was nothing in my uterus causing trouble before we proceeded with the 3rd cycle.

He said that if there were no polyps and/or cysts, then it was most likely that I had what was called a dysfunctional cycle.  And, that’s what I have because my uterus was pristine and clear as a bell.

For the 3rd cycle, my fertility doctor felt it would be best if we took a more aggressive approach and transferred three embryos, rather than just two.  Obviously, two embryos didn’t work in the past and I wasn’t getting any younger.  And, with three being my favorite number, and it being our 3rd attempt at a pregnancy, we agreed to have three embryos transferred.

This time, the original doctor we had our consultation with, the one who perused my medical chart and noticed my hormone levels were not normal, was the one who would do the transfer.  I was relieved because I felt he was the best doctor and the most thorough.  This is not to say that the doctor who did our second transfer wasn’t good enough – she was.  I just felt that if Dr. R did our third transfer, maybe we’d have a better chance.

And, we did.  Not only was I pregnant, but I was pregnant with fraternal twins – two of the embryos took.

Oh, I remember the joy.  But, I also remember the anxiety.  Looking back on my pregnancy, I really wish I could have enjoyed it more, but I was too scared I would lose the pregnancy and we would have to start all over again.

Infertility 101

  • Posted on September 30, 2010 at 10:37 pm

My husband and I tried for two years to start a family.  I tracked my cycle for months, peed on sticks ten to twenty days a month, used a fertility monitor (which became just a very expensive cycle tracker), took my basal body temperature for that tell-tale sign of a temperature spike at the ungodly hour of 4:00 AM, and peed on countless pregnancy tests, crying into a towel in the bathroom to hide my sorrow and frustration when none of them said “PREGNANT.” Sometimes, as a cruel joke, my body would wake up at 2:00 AM to alert me that I had to go to the bathroom, but I couldn’t go until at the earliest 3:00 AM.  There is nothing worse than knowing you have to pee, but not being able to for fear of messing up your basal body temperature.

I was told by my OB/GYN that I had to try for a year before we would even be considered for a referral to an infertility doctor.  I knew something was wrong, even before I met my husband.  But, I couldn’t have any testing done until after that coveted year.  I fudged it (we didn’t wait the coveted year), and, even though my doctor knew I did, went ahead and referred us to a fertility clinic.  I had a battery of tests done, as well as my husband, and even though my OB/GYN said my hormone levels were “Normal!,” I still knew something was WRONG.

The fertility clinic we were referred to was nice enough, but we couldn’t escape the feeling that they wanted our money right then and there.  We felt we were being pressured to start the first cycle right away and they were preying on our desperation to have a family.  I didn’t like the feeling of being pressured to start, not even giving us time to research the clinic or the procedures that would be done on me.  The doctor called some number while we sat in his office and spoke in a fast dialogue about the two of us.  It was all rather weird and strange and not something we really felt any comfort with starting.

I went home and researched the clinic we were referred to, as well as other fertility clinics in the area.  It became obvious after I was able to compare fertility clinics that the one we were referred to was not the clinic we would want to use.  Despite all the pictures of happy babies from happy clients decorating the lobby, the fertility clinic we went to had the lowest success rate for a woman my age (35 when we started) compared to other clinics in the area.

After looking over the data available, we decided to go with the clinic that had the highest success rate, with several offices smattered around southern California.  I called to make an appointment and because of my wacky coaching schedule, managed to finally squeeze in a consultation appointment for $250.00.  That’s right… despite having the best insurance coverage I’ve ever had in my life, to the point where I could add my husband onto my plan for free, it did NOT cover the cost of infertility.  My family doctor, bless his beautiful, old soul, managed to get expensive tests done on me that I only had to pay the co-pay for.  If he hadn’t written up the hysterosalpingogram as a necessary test to see why my cycles were so severe, I would have had to pay for the test myself, and that would have just added to the exorbitant amounts of money we would ultimately have to pay.

I brought all my test results, the hysterosalpingogram (normal), my progesterone levels (my OB/GYN said it was normal!), and my husband’s lab results to our consultation.  The fertility doctor looked everything over and said, very succinctly, “Your progesterone levels are NOT normal.  You are producing progesterone, but not enough to maintain a pregnancy.  Your husband’s results are not enough for us to determine whether you’ll need to do an IUI or IVF.”  So, my poor husband had to go and have more tests done.

It was determined that we both had nasty fertility issues, me with low progesterone, and my husband with a Kroger count of 1% (the normal range is 5-6%).  The only available option for us was IVF with ICSI.

Stay tuned… Part 2 in a few days.

And, we’re off….

  • Posted on September 28, 2010 at 5:56 pm

After many years of wanting my own website, I finally created one.  I have been blogging for years and before that, I wrote journals.  I love writing.  I love journals to the point that I have several blank ones, waiting to be filled.  But, my writing stopped on March 23, 2010.  That day, I found out I would lose my son.  I’m using my blog and my new website as an outlet of sorts, to sort through all the heartache, the anger, and the sadness of these past several months.  I also want to write about my IVF experiences and how that changed my views of pregnancy.

I’ve been wanting to also move some of my journal entries from my livejournal account to here so I have an archive that stretches back to 2002, but not sure if I want to even deal with it.  A fresh start might be just what I need and anyone who stumbles upon this site can have that fresh start right along with me.

Time to go… my daughter is squirming for more food.