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, part 2, and part 3 here.
After my son was born we still had 2 frozen embryos from his IVF cycle in storage. I never thought “frozen embryo storage” would be a line item in our budget every year.
The winter after he turned 2 I was back at the doctor’s office. She wanted to check my thyroid but then asked about our family continuation plans and added an FSH test to the order to look at the state of my ovaries. They weren’t in great shape. The test came back at 11.7; she wanted to see it lower than 10 which mine was before we started fertility treatment 4 years prior. She told me the biological clock would soon stop ticking for me. At the time I was the ripe old age of 36.
So I went back to the fertility clinic. While we still had embryos in storage given the whole biological clock thing the clinic recommended we do a fresh IVF cycle. Here we go again. One morning in February I dropped my son off at preschool and drove to the clinic to start the crazy cycle of bloodwork, ultrasounds and shots. They used the same medication protocol as the successful IVF for my son. Why mess with something that works, right?
Except it wasn’t working. After almost 2 weeks of injections, I had maybe 3 follicles growing, that’s it. Not good. Instead of cancelling the cycle, the doctor recommended I could move onto retrieval but that we should thaw the 2 frozen embryos in storage and also use those. Only two eggs were retrieved that time; one did not fertilize and the other one was immature. Through the miracle that is modern science, the embryologist was able to mature the egg in the lab and fertilize it. Amazing. Only one of the thawed embryos survived so a few days later two embryos were transferred.
The miracle of modern embryology was not enough to overcome the desert which was my uterus. Two weeks later I had another negative pregnancy test.
Standard practice at the clinic was to have a follow-up call after a failed IVF cycle. The doctor told me the problem most likely was the embryos and I could do one of two things. I could try another fresh IVF cycle but do it sooner rather than later. Or, I could try using donor eggs.
It just so happened the clinic was sponsoring a reception on donor eggs and the nurse encouraged me to attend since they hosted those maybe once a year. I sat in a hotel banquet room and listened to the story of one woman who suffered from ovarian failure and was able to have 2 children on her own using donor eggs. She spoke about reading the profiles of the donors and finding a connection, in her case, it was a favorite book, “To Kill A Mockingbird” and she named her child Scout as a result. Wow, this could work, I thought.
I had a consultation with the woman who ran third party reproduction at the clinic and she sent me some profiles that MBA Dad and I read. However, we learned something else at the consultation. They ran a review of our insurance coverage and while our insurance did not cover donor egg cycles (most don’t), we still had room for 2 more IVF cycles. We decided to do the cycles first, than revisit the donor egg option.
So, now it was summertime and I was back for another round of IVF torture. Based on the awful egg yield from the last cycle, the doctor decided to try a more aggressive medical protocol. This time I responded and I had follicles here, there everywhere, and they were all growing. That was the good news.
The bad news happened the second week of my injections. One night we got a call from one of MBA Dad’s stepbrothers. His dad was sick, very sick. He was home on hospice care and was going to die, soon. We rushed to his home in Pennsylvania to visit with him one last time. I was sure to bring my meds, extra empty water bottles and ice packs on that 95 degree day. They weren’t close growing up which made it harder I think. How do you cram over 40 years into one day? You can’t, but still, he waited for his son. He died the next day after our visit.
The funeral was the day of my egg retrieval. MBA Dad traveled back home and I stayed behind for the procedure. I went home alone not knowing how many eggs were retrieved. I forgot to ask.
Early the next morning I got a wake-up call from the embryologist. “You have 8 embryos and they are all dividing.” I asked how many eggs I had. “Oh, they didn’t tell you?” It turns out I had 8 eggs. That was a even better crop than the cycle that resulted in my son. Ultimately 6 embryos made it and the doctor wanted to transfer 3 and freeze 3 at -196 degrees Celsius, the temperature at which biological processes are suspended.
Sadly, it didn’t matter. Another two weeks, another failed pregnancy test.
September brought another cycle, same exact medication. This was the last fresh cycle insurance would pay for. Everything seemed to be going well again. This time the doctor retrieved 6 eggs and all were fertilized. Again, 3 embryos were transferred and another 3 went into the freezer. At least this time instead of a funeral I had a wedding to look forward to as my cousin was getting married in California. The morning of my flight I checked into the clinic for the pregnancy test.
My phone rang as I was walking into the JetBlue terminal at JFK. “Your test was negative,” the nurse told me.
“I want to do a frozen cycle next.” I told her. “After that, we are done, with everything.” She agreed that made sense.
As it turned out, a frozen cycle was much easier and less invasive than a fresh IVF cycle. I took pills for a few weeks and had a few blood tests and ultrasounds. When the doctor decided it was time, the lab thawed the embryos and set a time for the embryo transfer procedure. That was it. No needles, no anesthesia.
Except for attending his dad’s funeral, MBA Dad was usually there for the IVF egg retrieval and embryo transfer procedures. Not this time. The transfer was scheduled on the day he had to be in court testifying as an expert witness. I dropped MBA Son off at school and went to the clinic.
The doctor met with me in the lounge as he had many times before. They thawed all 6 and 5 survived. He recommended we transfer all 5.
My jaw dropped.
Yes, that was the recommendation. Based on my history and the fact that 1 of the 5 didn’t look viable, yes, we should go big or go home. This really was our last chance.
I couldn’t even talk about this with my husband. He was in court, and cell phones had to be turned off. For all I knew he was on the stand at that moment. So, what to do? I told the doctor to go ahead. they were already thawed and it’s not like you can re-freeze embryos.
Normally the wait is two weeks but since that was Thanksgiving Day, the clinic scheduled my pregnancy test for the day before Thanksgiving. Around noon that day I got the call from the clinic, “You’re pregnant! Congratulations!”
“You have the wrong patient.” I said. “Really, I don’t feel anything.” I told her. That was true. Unlike with my son, I wasn’t even bloated this time.
I asked, “So, what is my hCG number?” The nurse told me it was one thousand something. I stopped listening after the one thousand part. You see, the number with my son, a successful singleton pregnancy, was 326. A much higher number implied multiples. I was thrilled and thankful but also scared. What did we do?
That night I went to the drugstore and bought a home pregnancy test. I still didn’t believe the clinic. The test was very, very positive.
We celebrated Thanksgiving and still I felt very not pregnant. The following Tuesday MBA Dad and I were catching up on shows we recorded on the DVR when something just didn’t feel right. I went to the bathroom. There was blood everywhere.
I called the on-call nurse at the clinic. She tried to calm me down. “You are scheduled to come in tomorrow morning for bloodwork anyway so we’ll see what’s going on then.”
When I got to the clinic the next morning the nurse also wanted to do an ultrasound. She told me at 5 weeks it would be too soon to see a heartbeat but it might help give them more information about the bleeding. The image came up on the screen. “You haven’t lost the pregnancy. The bleeding is coming from another spot, away from the sac.”
There was something else. “There are 2 sacs. We expected that based on your pregnancy test.” Then the lights went out. Yes, there was a power outage, in the middle of a vaginal ultrasound while I was alone, without my husband, right after finding out I was carrying twins. Another nurse knocked on the door and asked if we were okay. I said yes but I was lying. Thankfully the generator kicked on a few minutes later.
One week later I went back for the first ultrasound. By this time I was having morning sickness morning, afternoon and night. Just as before, the doctor came in for this ultrasound. “I cannot believe this, ” he said smiling. However, there was a very good reason not to smile. Yes, there were 2 sacs and 2 heartbeats. Now, granted, I never made it past Biology 101 from freshman year of college but just in looking at one of the sacs, I knew something was wrong. The heartbeat on one was slower and the sac was much, much smaller. My doctor gave me the name of a maternal-fetal specialist in New York City. “She’s the best, ” he said.
I got an appointment with the maternal-fetal specialist so one morning right after Christmas I threw up and got on a train to the city for the consult. Meanwhile I was 9 weeks and both embryos were still with me. The ultrasound started. We saw two sacs, one heartbeat. The technician ran out of the room and hunted the doctor down. She came in and tried and tried to see a heartbeat but couldn’t get it.
So that was that. She told me losing the twin should help with the constant nausea. It didn’t. At least I finally got a due date. I never got one before because the one we lost, Baby B or Baby A depending on the doctor, was measuring 1 to 2 weeks behind the healthy one.
Still, even with one, she recommended a chorionic villus sampling, or CVS due to my age. Two weeks later we went for the procedure and a battery of tests were conducted assessing the state of my 11-week old fetus. In the meantime, thanks to the bloodwork ordered by my new ob-gyn (mine had stopped performing deliveries), I found out I am a carrier for spinal muscular atrophy, or SMA so that was added to the list of tests from the CVS.
One week after the CVS the geneticist phoned me late on a Friday afternoon. “I’m in a cab but I grabbed your file before I left because your results just came back. The fetus has 46 chromosomes, so good news. Also, the SMA test came back negative. Do you have any questions.”
“Yes, can I find out the gender.” I heard some ruffling of papers in the car.
“Are you sure you want to find out?”
“It’s a girl.”
She sure is a girl! All 98.6 degrees of her arrived late that July. I cannot believe this vibrant, dynamic feisty miracle of mine was once frozen and I have modern science to thank for that. I also am eternally grateful to the mini army of doctors, nurses, phlebotomists, ultrasound technicians, embryologists, lab technicians and everyone else along the way. We have all heard the phrase, “it takes a village to raise a child”. In our case, it took a village to create a child.
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