IVF and the game of red light, green light: my infertility story part 3

April 19 to 25 is RESOLVE National Infertility Awareness Week. In keeping with this year’s theme, “You Are Not Alone” this week I will feature posts about infertility and my story. Read about part 1 and part 2 here. 

Moving on to the next ride meant riding the IVF roller coaster. It’s twice as long as the IUI roller coaster since at my clinic each IVF cycle was really two months long. The first month mainly consisted of taking pills a few times every day. Since there were only 1 or 2 blood tests during this time, my bruised arms got a rest too.

The second month was the real IVF deal. The first two weeks is medication and monitoring, then ovulation is triggered before the eggs are retrieved and embryos are created in the lab.  A few days after that, if there are any embryos, viable ones are implanted, then the two week wait before the pregnancy test. As if waiting weren’t enough torture, I was on the receiving end of a progesterone shot daily during this period. Nothing says “I Love You” more than injecting a wide gauge needle full of hormones into the butt of your loved one.

In reality, it’s not like an IVF patient moves effortlessly through the cycle from step to step. No, what actually happens is it’s more like a traffic light. I could move on the next step only after I received a green light from a nurse. For example, I couldn’t even start injecting meds unless I started my period and the day 2 bloodwork on a litany of hormones came back at acceptable levels.  Also, there was no guarantee once I started meds that I would get to egg retrieval. If I didn’t respond to the meds, the clinic could cancel my cycle at any time. I was always conscious of this and this was definitely an anxiety trigger, like I needed another.

I got the green light to start meds in mid September so I basically became a human pin cushion. I was injecting myself 3 to 4 times a day. Fortunately, I could do these all myself. I believe there were some oral meds as well. Of course, there was the daily bloodwork so I looked like an IV drug user once again. I thought of my diabetic stepbrother. At least after 2 weeks I could stop, he couldn’t.

Now, while I was pumped up on hormones, physically, I felt fine. Mentally, I was a wreck. I think the reason why is I realized I had to cede all control to the clinic. Part of why IVF works, I think, is because the clinic and the lab were medically controlling every possible aspect of the cycle. That kind of trust was really hard for a finance micro manager like myself to give.

Still, all was progressing. I had a cohort of 6 or so follicles that were growing, my lining was thick and “fluffy” as the nurses used to say, and one day, my doctor determined that it was time for the “big shot” as they called it. It was a shot of a hormone that would trigger ovulation. The trick with this was it had to be timed exactly right. The eggs had to be retrieved exactly 36 hours later or all was lost. Talk about a big red light.

The retrieval was scheduled for a Saturday morning which was nice since I didn’t have to take the day off work.  As a result, there was absolutely nothing to do that Friday night. I couldn’t eat, I couldn’t drink. At least there were no shots. Maybe it was all the hormones, maybe it was because I finally had time to reflect on the loss of control, but it was then I broke down. The girl who didn’t cry in movies was all of a sudden shivering and sobbing relentlessly in the middle of my hallway.

“None of this is okay, ” I cried.

It might not have been okay but for us this was the way.

I had to be at the clinic at 7 the next morning for an 8 AM procedure since I needed anesthesia. They kept me waiting, waiting, and waiting some more. The anxiety grew by the minute. I just kept panicking, 36 hours, 36 hours, 36 hours. There better be eggs! I think it was 8:45 AM before they knocked me out. It felt like I was asleep forever but not even 20 minutes passed before I woke up. “We got 5 eggs,” my doctor told me at my bedside.  I went home and parked my crampy self on the couch, bottle of Extra Strength Tylenol at my side.

For the next few days I pretty much was at the mercy of the embryologist, who gave me a wake-up call at 6 AM each morning. It was my daily news bulletin on the state of my embryos. “Good morning MBA Mom, we retrieved 5 eggs, there are 4 embryos and they are still dividing,” was the message I got every morning. More green lights.

My embryo transfer was that Tuesday. Before the procedure they sat me and MBA Dad in a lounge and the doctor came in to talk to us. His recommendation was straightforward: transfer 2 embryos and freeze the other 2. We got a sheet a paper with the pictures of the ones we were transferring. They looked like perfect little spheres.

We went in for the procedure. It wasn’t exactly the way I always imagined conception: me, my husband, and my reproductive endocrinologist. In this case, three is not a crowd.

The post transferral instructions included an order for 48 hour modified bed rest. One of the cable stations was hosting a “Dallas” marathon that day so I had Bobby, JR, Pam and Sue Ellen to keep me company. The next day though I went back to work. I just couldn’t see taking another day off to lay around and do nothing. It didn’t seem right.

After that, there was really nothing to do but wait for two weeks. Thankfully, my college roommate provided me with the ultimate distraction during this time: her wedding. I was a bridesmaid and the venue was a few hours away in New Hampshire so a long Columbus Day weekend road trip it was. This time I was sure to pack my injectible progesterone and extra needles. A good travel tip: an empty spring water bottle can be repurposed as a receptacle for used needles in lieu of a sharps container.

I had so much fun I almost forgot the set the alarm a little early the morning after we came back home. It was Tuesday, October 9, the day before my wedding anniversary, the day before my one year service anniversary at my new company. It was also the day of my pregnancy test at the clinic.

As I was walking out to the cafeteria for lunch my phone rang. “Well, I have some good news for you, ” said the nurse, “You’re pregnant.”

“Really?” I asked. I couldn’t believe it and the disbelief came through in my voice.

“You’re not feeling any symptoms?” The nurse asked. “No, I am a little bloated but I thought it was the shots.” I really didn’t consider that to be a symptom. One of the many defense mechanisms I used to get through all of my two week waits was not allowing myself to believe any changes in my body were attributable to a pregnancy. It’s all about bracing yourself for the negative test. If you don’t get your hopes up, they can’t be crushed, right?

“Oh, that’s definitely a symptom.” The nurse continued, “And your numbers look good. Your hCG is 326, which is a good level.” hCG is the hormone pregnant women start to secrete once an embryo successfully implants. In early pregnancy, they told me ideally the number is supposed to double every few days.

While I was incredibly excited, in reality I was still in red light-green light mode. The nurse told me to come back for more bloodwork to test hCG and a couple of other hormones in a week. I was all too aware of all that could go wrong in early pregnancy. So, the following Tuesday I went back and hormone levels were still fine. Green light.

There were just a couple of more lights at the clinic. The following week was more bloodwork and the first pregnancy ultrasound. MBA Dad came with me.  The doctor came in this time; usually the nurses handle the ultrasounds. He walked us through what we saw on the screen, “You can see there is a single sac, the embryo is there. That flicker is the heartbeat which right now is about 140 so very strong. The placement looks good. Congratulations.”

It was nothing short of amazing. We did it! Green light, green light, green light!

Over the next two weeks I had 2 more ultrasounds at the clinic and at 8 weeks, I graduated from the clinic and went back to my ob/gyn who ultimately delivered our son the following June.

Since this is an infertility story not a pregnancy story, I won’t give the play-by-play on the pregnancy but I will say the entire infertility experience definitely clouded it. I was extremely fortunate in that I had a complication-free pregnancy and didn’t even have morning sickness but looking back now I wish I appreciated that more. I was so worried it could all be gone at any moment. Even the lack of morning sickness worried me.  I mean, my infertility had to be caused by something; we just didn’t know what it was. What if it manifested itself during pregnancy? That’s how infertility warped my thinking.

Because of that fear I didn’t tell anyone at work until I was 18 weeks and I only did it then because a couple of my co-workers approached me. One actually had the audacity to come over to my desk, point to my stomach and congratulate me on the little one! I have no idea how they knew. I wasn’t throwing up, I wore the same clothes, and I never, ever talked about it or took a call from the doctor’s office in our around the office. Still, I didn’t want to lie about it.

Apparently I had a short memory because four years later we decided to go through this torture again for another child. As emotionally exhausting this IVF cycle was, eventually I discovered this cycle was as good as it gets. Stay tuned.

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