Ready, set, …um?

Infertility is a mindf*ck. I could write a whole series of posts on how this process has changed me– little of it positive. Yeah, yeah… I know. Find silver linings and all that other bullshit, but I also believe in letting myself have all the feelings. Like even the bad ones.

Of the many side effects, I learned how to navigate the complexities of treatments. I learned to not have expectations on timelines or outcomes. Full throttle it armed with copious notes, spreadsheets, and injectibles, knowing that none of it was given. Expect to be let down, frustrated, disappointed, then go back to my well of resilience and hope there was still something left.

Oh, the arguments I had with my insurance. The test results that came back inconclusive, resulting in more tests that confirmed or denied nothing.

I learned that this is hard.

When I made the appointment with Dr. Petrel a few weeks ago, I was preparing myself to get back into the arena. I was suiting up– filling out forms, calling my insurance, going through my timeline to familiarize myself with the jargon I had willfully forgotten in the last two years.

Mr. O and I went in to see Dr. Petrel together with an agreement– we’ll try our one frostie, but only if it looks like it will survive thawing and be a good candidate for implantation. If not, fine. No more extreme measures.  

I went to my appointment yesterday ready to try to start, with the full expectation that I would walk out with a list of more questions. I brought a notebook so I could take notes because I remembered how easily my heart could make me numb in doctor’s appointments.

I also remembered how miserable waiting rooms are. How you look around at the other people in the room and wonder where they are– are they on their 3rd IVF cycle? Did they just learn they were pregnant? Are they like me or are they one of those “freaks” who gets pregnant without really trying?

But before I could start building their stories, Dr. Petrel appeared in the door and ushered Mr. O and I into her office. She was just as I remembered- kind, upbeat, but also no bullshit. She got right down to business.

Petrel called our embryologist. Our embryo is stellar. It Triple A bonded, or whatever grading system they use. She suspects it has a 95% chance of thawing. So what we need to determine is how my uterus is doing post pregnancy, though since my periods have been pretty regular in frequency and flow, she is optimistic. Still, I’ll need a sonohystogram to make sure, and a few blood tests to make sure my thyroid is behaving.

Then well, that’s it. A sonohystogram, a check on my hormones, then we can get this baby-making started. Depending on those results, I could even technically just introduce the embryo as part of my natural cycle. No (or I should say, fewer) drugs required. Theoretically, our cycle could start in November, almost exactly when the cycle that begat Chick began.

I walked out of the office in a haze. What? Isn’t this supposed to be harder? Isn’t this supposed to take longer?

More importantly, am I really ready for this? Then again, are we ever?

Heartbeats

Yesterday, Mr. O and I went in for our 6 week ultrasound. I’d been nearly convinced that I would get there, and they would tell me that there was, in fact, no baby inside. A Hot Wheels car? A Hershey’s Kiss? What about a Hermit crab?  All these things seemed much more plausible.

So imagine my genuine surprise when the ultrasound tech found a tiny lima bean hanging out in my uterus. A tiny lima bean with a tiny flickering heartbeat. Fluttering like a small hummingbird. It was awesome.

Afterwards, we met with Dr. Petrel. She was her usual peppy, matter-of-fact self. According to how my little hummingbird is progressing, we have a due date of August 13th. It now feels real.

Mr. O and I sat in her office a little gobsmacked. I completely lost control of my brain. All the smart questions I wanted to ask about potential complications, medications I should be taking, physical activities I should be avoiding… GONE. I just stared ahead at her file cabinet.

In the meantime, Dr. Petrel went over the results of our IVF (besides the obvious successful implantation.) As you all know, I started out with 13 oocytes, 10 fertilized, and then only 3 made it to Day 3. We implanted one, and we have one leftover. That embryo is in excellent condition, we are told. It has a very high grading- it is practically a valedictorian. So if we want to do this again sometime, we have one lovely embryo for FET.

I could feel the conversation winding down, my opportunity to ask all my questions being gently ushered out the door. It’s like that moment in A Christmas Story, when Ralphie is losing out on his one chance with Santa. I was blowing it! Blowing it!

So I quickly spewed all my questions, in no particular order. And as always, Dr. Petrel gave me concise, articulate answers. Some highlights:

  1. We didn’t have a lot of embryos make it, which may have something to do with my egg quality. But it may not. In her eyes, getting pregnant is a little bit like the lottery. So many things have to go right, even if you’re starting off with quality ingredients.
  2. We basically got an entire years worth of trying out in one shot (12 months in a year, 13 oocytes.) Of those 13, 2 were viable. If we had waited another year of conceiving naturally (when I’d be 37) then egg quality would be of a bigger concern from her standpoint.
  3. I can exercise, but nothing crazy. Some light jogging is okay, and nothing that elevates my heart rate over 140. So no more half marathon training for me. The reason they want you to keep things light after IVF is because your ovaries are still very swollen, and there could be some twisting if you’re not careful. (Twisting ovaries. Ouch.)
  4. I can stop taking just about all my meds. My PCP before I moved to Dr. Finch had me on so many damn vitamins which I don’t need. (Given her lackadaisical attitude toward my care, I am not surprised.) I’m now just taking a prenatal vitamin and continued progesterone. No more estrogen patches, fish oil, or additional Folic Acid and vitamin D.
  5. We have another ultrasound in 2 weeks. At that point, we will be considered a “normal” pregnancy. Like this whole IVF thing never happened. I will part ways with my beloved Petrel and will need to find a regular ol’ OB/GYN.

Though still not elated (as I’ve expected myself to be this whole time,) I felt tons better after the appointment. I don’t want to count my ostriches before they hatch (HA!) but I started to feel like maybe this would work out. Maybe the hardest part would be over.

Remember: this is my life we’re talking about. There is no joy without pain, no sunshine without rain.

I get back to work, and actually work. Since I was not fixated on my fertility, I was able to get down to business. So many spreadsheets! There were even graphs and cogent conclusions based on said graphs! At around 4:45, I started to wind down when I got an email from my dad.

On Friday, my mom’s condition took a weird turn. Among a few complications, her heart has started to act “weird.” (Weird. It’s a medical term, I swear.) It will stop for a few seconds, then start up on its own. Her surgeon is recommending that we sign a DNR on her heart. And my dad wanted to talk about it with me and my siblings.

The sad poetry of all this isn’t lost on me. My mother’s heartbeat starts to give out on the day I learn I have two.

A Funny Thing Happened on the Way to Dying Barren and Alone

Hello, Ostrich. It is Nurse Lovely Pants from Dr. Petrel’s office. I’m calling with great news. Your pregnancy test today is positive. Your HcG levels are very reassuring.  We’d like you to continue with your medications for…

Friday’s HcG: 260

Today’s HcG: 668

After I got the message on Friday, I wandered around my home trying to find something to do. I’ve spent so much time thinking about how to get pregnant, but so little time thinking about actually being pregnant. I am entirely unprepared.

I’m still not sure what to do with all this. I’m not exactly happy as much as I am relieved. We now know this Ostrich is capable of getting pregnant (albeit with a lot of intervention.) That is certainly farther than I’ve got before. What I am not capable of is thinking beyond that. All I can say is that when I checked with the nurse 30 minutes ago, I was still pregnant.

What do non-infertile people do when they find out they are pregnant? Do they plan nurseries? Start researching daycare? Buy ironic onesies? I have no such urges. Mostly, I just keep thinking I haven’t gotten my period yet.

I wish I could feel that unbridled excitement I’ve witnessed in others so many times. I wish I could use multiple exclamation points about how I’m sooooo happpppy!!! Right now, I’m still just sooooo shocked!!!

If I’m being honest, I feel like a bad person. I know so many couples that would be over the moon right now. Tap dancing in the streets kind of shit. Some of you are probably a little angry with me, which I understand. But I can’t exhale. I can’t feel “happy.”

I do, however, feel grateful. So I’m going to start there.

The Countdown Begins

Two more days until I test. Which means two more days to desperately try to interpret my symptoms. An exercise in futility if ever there was one.

So far my boobs hurt, my skin is oily, and my endometriosis is “tickling” though not actually painful. This is more or less what happens before my period. The new addition is a low level headache, but after some hardcore Googling I know this is a side effect of the estrogen patch I’m on.

I waver between two extremes.

Misery! Because this means I’m not pregnant, and will die childless and alone.

or

Exhaustion! Because this means nothing at all, and I’m working myself up for no reason.

After a little hemming and hawing I decided not to POAS. It has never been in my repertoire, in part because I liked the idea that nature gave me a built-in pregnancy test (i.e. my period.) It helped me stay connected to my body, and honestly was starting to feel like the last “natural” part of this process. Of course, IVF really throws any illusion of “nature” out the window. Who am I kidding?

I’ve been having really strange dreams lately. The first one was just me getting my period. I could see the blood making beautiful and intricate designs in the toilet bowl. (TMI, but this is an infertility blog.) The second dream was actually a little funny. I was being chewed out by a nurse for having a miscarriage because I had an orgasm. (They make this big deal about how you’re not allowed any sexy fun time after IVF, so this isn’t completely out of left field.) Obviously, my unconscious is anxious.

Is it weird that I’m actually dreading my test a little bit? I’ve liked spending the last two-ish weeks dwelling in possibility. It was nice, even if it was unknown. But in just a few days, I’ll know what’s actually been going on done there.

Mr. O has decided to take the day off. At first I thought this was crazy, but I can imagine that he’ll be just as apprehensive as I am. And his isn’t the kind of job where you can run into the bathroom for a good cry. I’m going to work from home in the afternoon while I wait for the call. I think it will be good to be distracted by work for most of the day, but be in a safe place when I find out for sure.

We’ve decided to make reservations at a restaurant that night. Either we’ll be celebrating, or we’ll be consoling ourselves with excellent food. Even if this cycle doesn’t work out, I like the idea of having a plan and sticking to it. Life goes on, damnit. And that includes dinner reservations.

This is one angsty ostrich, signing off…

Happy T Day

As you may have guessed Saturday night was a full-on shit show for me. After freaking out that I only had 3 embryos remaining, I lay on my couch watching truly weird documentaries and convincing myself that I would never have children.

This may sound defeatist, but it had a calming effect. You see, I may not be able to control the outcome of this or any IVF cycle, but I do have some say in whatever happens next. If I can’t have kids, I’m pulling an Elizabeth Gilbert. (More on that at a later date.)

I got “the call” Sunday morning that we were going in for the transfer. My appointment was 12:00, with the transfer scheduled at 1:00. They make this whole deal about not wearing perfume and emptying your bladder before you go. So showered, peed, and commenced freaking out.

Ah, what would my first IVF cycle be without several waves of panic? The clinic I go to offers you Valium for the transfer. So I become preoccupied with taking it. Or not. or maybe yes. On one hand, I was clearly so worked up about my transfer that I was having trouble staying calm. On the other hand, I was so tired of all the chemicals coursing through my veins that I didn’t want to introduce more.

As corny as this sounds, I meditated on it. I went through one of my mindfulness exercises and realized I was more anxious about making the decision that the actual decision itself. So I got off the Valium train. I set a plan with Mr. O about how he could help keep me centered and parts throughout the visit when we would check in.

We were now off to the races.

The next several hours were tedious. There was a lot of water and a lot of waiting. Water, because a full bladder helps the ultrasound during transfer. Waiting because they were clearly behind schedule.

Oh, how I love the illusion created by moving you from one waiting room to the next. As I was moved from one, two, three waiting rooms, I was not fooled that we were 45 minutes behind. More to the point, my bladder was not fooled. Once I told the nurse that my eyes were literally watering in pain, she let me pee for 10 seconds. NOT ENOUGH, I TELL YOU.

Once we were ushered into Transfer Room B, I was waddling with my massive bladder. I told the ultrasound tech that I was pretty full, and she told me that was perfect. Until she scanned me and saw how full I was. Nothing like someone looking into your bladder and expressing shock. There is, apparently, too much pee for your own good.

Of course at this point, I have exactly no pants on. But I’ve been cleared for 20 seconds of peeing before the Doc comes in for the transfer and modesty can screw itself. I wrap a sheet around me and waddle out to the bathroom. I’m not usually one to wander around offices without my underware on, so this felt really weird. Not to mention that I ended up getting ultrasound jelly everywhere in the process. But yay for sweet relief!

Back in Transfer Room B, things are heating up. Lots of people come in and ask me my name and date of birth repeatedly. The Doc comes in, and the transfer process gets started in earnest.

The way this office is configured, it looks like the transfer rooms surround the lab. Each transfer room as two doors- one for the patients and staff to access, another for the lab and embryologists. Once I was deemed ready, one of the nurses opened the lab-side door and yells “Ready for transfer in room B.” The embryologist confirms “Ready for transfer in room B.” My little bundle of cells is escorted in, the actual transfer begins.

It felt a little bit like putting an order in a diner. Yes, Chef! Order up!

Throughout this process, I was focusing on staying relaxed. Or at least as relaxed as possible when your legs are in stirrups and your vagina is exposed to three relative strangers. The ultrasound tech pointed me to the screen (which I had been intentionally avoiding for fear it would send me into hyperventilation) and explained to me that I could watch the transfer. In seconds, what looked like one tiny air bubble appeared on the screen.

I’ve never been so freaking amazed by science in my life. Holy shit. Even if this doesn’t turn into a pregnancy, I was in awe. At that exact moment, there was the tiniest combination of mine and Mr. O’s cells hanging out in my uterus. This is a first.

And just like that, we were done. For the record, transferring is fine. Because my HSG and sonohysterogram were distinctly uncomfortable, I thought transfer would be the same or worse. Not the case. It may seem incredibly obvious, but with those other procedures you’re forcing quantities of fluid into your uterus. The transfer is just a wee bundle of cells. By comparison, it is practically delightful.

As we drove home, I looked at the small picture they gave us of the embryo currently nesting in my uterus. It’s so small. I can count the number of cells. For a split second, I found myself thinking “I wish you were bigger. I wish there were more of you. I wish…” And I stopped myself.

I haven’t thought about parenting in a while. After over 2 years of trying, it seemed so far outside my purview. But if I am going to be a parent, I refuse to start by putting my own outlandish expectations first, by wishing my child to be anything other than he or she is. My job now is to harbor that little mass of cells, to offer it shelter and safety. But that’s it.

So now we wait. My official pregnancy test is scheduled for Friday December 5th, and a whole new debate begins.

To preemptively pee on a stick or not to preemptively pee on a stick. That is the question.

And then there were 3

From 13 to 3.

Unless I hear otherwise, I’m going in tomorrow for a day 3 transfer. According to the nurse, I have 3 embryos that look like they are in good shape.

Wait… What? 3? I did all that for 3 little turds?! (Yes, I did just potentially call my future child a turd. But…. RAGE.)

I recognize that this sounds like extreme complaining, but as previous explored, I don’t always have the most realistic set of expectations.

I will now publicly admit that I had “a plan.” Anyone who has experienced infertility will recognize this as an exercise in futility. And yet… I couldn’t help myself.

After I abandoned the “plan” of having babies like a normal person, I fast-forwarded to IVF. For some reason, I just didn’t think other methods were going to work. So I underwent the Great Clomid Experiment with little faith in the outcomes. Yes, yes… I did try in earnest, but I didn’t see that as the solution. So getting to IVF seemed like I was finally in the Reproductive Technology Big Leagues– and right where I belonged.

Much like my irrational fixation on getting 30 follicles, I really wanted 5 embryos. 1 to implant, 4 to freeze. You know… a “rainy day” stash. This is who I am. I make responsible decisions! I plan out my meals for the entire week! I have savings and a 401K, goddamnit! How could I not have some freaking embryos left over, just in case?!

BAH! ALL THE EXCLAMATION POINTS!!!!

Now that my righteous indignation has passed, I can see this for what it is. It’s the Four Horsemen of the IF Apocalypse. And will come as no surprise to any of you, I am sure.

  1. Disappointment. I had set my hopes on 5. 3 is not 5, no matter how you cut it.
  2. Sadness. I worked hard for those 13 damn oocytes. I’m a little sad to see them go.
  3. Fear. Shit. What if this cycle doesn’t work?
  4. Shame. And what meltdown would be complete without a dash of shame? My best efforts have not yielded my best results.

I just don’t want to do this again. The injections, the egg retrieval, the general shittiness I feel since I started on the hormones… I haven’t felt well enough to run in over a week, which makes me a miserable human. (And likely compounding all the aforementioned.)

I don’t want to be on this emotional fucking roller coaster anymore.

So please, can we just get a baby out of this one and call it a day?

Lucky 13?

On Tuesday afternoon, I got “the call.” The one telling me my follicles were ripe for the plucking. After a thoroughly cryptic conversation with the nurse in my company cafeteria, I pieced together the triggering instructions. Then popped back into a meeting like it was NBD.

300 units of Gonal-F at 8:30. Novarel trigger at 9:30. At this point, I feel like one huge injection site. Ah, well… thems the breaks for the infertiles.

My retrieval was scheduled for Thursday morning. So nothing to do on Wednesday but wait. I’m used to waiting- that’s what the TTC game is all about, right? Mr. O, it seems, was late to that party. Because he had what is his equivalent to a freak out.  It happens infrequently, but when it does… Boyo, there is no talking him out of it.

It is worth noting that a “Mr. O Freak Out” looks a lot like my baseline for existence. He tends to latch on to something small then just perseverates on it for about 30 minutes. His obsession of choice today was how many embryos to implant. Like a dog with a bone, he would not let this go. “If we get one, obviously we’ll implant it and be done. But what if we get 3? Do we implant 2, then save the other one for later? What if we get 5?” And so on and so forth.

My feeling is that I will do whatever it takes to have a healthy pregnancy. If Dr. Petrel thinks that means implanting one, one it is. If she thinks that means two (and we have two viable ones), then we’ll go for two. Of all the things that have preoccupied my mind over our first IVF cycle, how many to implant has not been one of them.

Thursday morning, we show up for our retrieval. I don’t know how to explain this, but it was one of the saddest experiences I’ve had so far. Every couple that came in was “like me.” We’re all experiencing some kind of heartbreak. Perhaps I’m projecting, but everyone looked kind of sad and weathered.

When one couple walked in, the nurse said “I think I know you. Have you been here before?” They had been here in July. Like a dagger to my heart, friends.

Hooked up to my IVs, I sat and waited my turn. About 15 minutes before I was scheduled to go in, a nurse took Mr. O to the porn room. (Oh, come on… We’re all adults here, and THAT’S what it is!) I watched him walk out, and I just kept thinking “I didn’t want this for you.” I was just so deeply sad to be at this point. And so I sat there alone, trying not to weep openly.

When I woke up from the procedure, I had no idea where I was. I started crying, I babbled, I asked if it was Christmas*. It took about 5 minutes for Mr. O to calm me down, and for me to remember why I was there in the first place. Another 20 minutes later, we went home.

For the record, egg retrieval is fine. For me, it was a lot easier than the hysteroscopy. But don’t let anyone fool you- this isn’t like getting your teeth cleaned. I spent most of yesterday in bed, chugging Gatorade and eating a lot of meat because this is supposed to help my ovaries recover. (Who knew ovaries had so much in common with 15 year old boys?)

They were able to retrieve 13 in total. I’ll get a call today to let me know how they are progressing, then we could go in on Saturday to implant them. Does this seem early to anyone? I thought they’d need time to percolate or something…

Anyway, it feels like the hard part is over. Okay, the second hardest part… because this TWW will be one for the books.

Prepare yourself for more truly neurotic posts.

*This may seem random, but it isn’t. My mom went in for an endoscopy in November of last year, and experienced a whole mess of complications which have left her in the hospital for over a year. She went in November 1, and didn’t wake up until Christmas day.