more IVF and a Loss….

First off let me start with a trigger warning because Loss is mentioned and I know that can be hard for a lot of women.

 

My RE was perplexed as to why I wasn’t getting pregnant.  He decided he would do  ERA testing.  This is where they take a scrape from your uterus and send it off to establish the ideal time for transferring an embryo.

At the time I did this, it was in early stages and my sample had to be sent to Spain for analysis!  I remember thinking it was very strange that now Spain was involved in my fertility.  It came back that we were doing everything right.

During this break I went to see an acupuncturist whom my Mother used to work for.  After an extensive list of questions she told me that she didn’t think that acupuncture would help my fertility.  She gave me the name of a woman that she thought would be able to make a difference to my story.  This woman practiced Maya Abdominal Massage.

I went to see her right away.  It was very emotional and quite strange.  Its a very gentle practice but you can definitely feel something happen.  It connects you mentally with your uterus which is something that I’d never even contemplated beforehand.  I left with exercises to do at home.

A couple of weeks later I had another embryo transfer and miracle of miracles… a positive pregnancy test!!

My betas were strong and they doubled, then doubled again.  I went for an ultrasound and immediately my heart sunk.  A perfect yolk sack but no fetal pole.   The embryo was measuring behind.  I had seen others go through this.  I knew what this meant.  They made another appointment for a week later and told me to be pessimistically optimistic.

What an awful week.  I couldn’t justify taking the whole week off from work to wallow so I carried on as if nothing was happening.  I went to work, I went to friends dinner parties.  I didn’t drink.  I faked it.

Sure enough a week later the worst was confirmed.  At nearly 7 weeks I had lost the pregnancy.  I had options on how to proceed but I knew I needed answers.  I chose to have a D & E so that they could analyze the embryo and hopefully discover why it had happened.

The day of the D & E was one of the worst days of my life.  I felt utterly hopeless.  I had told myself that I was done trying and that this would be my last attempt.  I cried all day long.

Then the results came back.  The embryo had not been compatible with life.  It had the most common genetic errors for miscarriage.  It was not due to my age.  It was nothing I had done wrong.  My RE told me that this is the same reason that 25 year olds miscarry and that in so far as it could be, this was a good thing.

I found such solace in knowing this.  Light started coming back into the edges of the dark corners of my mind.  I felt empowered by knowing that my Uterus wasn’t broken, that it could maybe nurture a life….

I needed to find a way to try one. last. time.

A Guide to Understanding IVF

While every protocol for IVF is different there are some steps that are pretty much the same for everyone.  If you’re just starting out here’s what you can expect;

  1. Initial consult with RE to discuss protocol
  2. Wait for start of period. You may already be taking estrogen/birth control pill.
  3. Vaginal Ultrasound to assess baseline
  4. Start injections
  5. Another Vaginal Ultrasound to see how you’re doing and to tweak meds if necessary
  6. More injections
  7. Another Ultrasound, maybe add in another shot to stop you ovulating.
  8. More injections until they finally tell you to do trigger shot.
  9. 36 hours after trigger shot you have your egg retrieval
  10. A day after egg retrieval you find out how many eggs fertilized
  11. Maybe a day 3 transfer, maybe a day 5 transfer.  You might choose to freeze all or have embryos tested.

Here’s my experience...

When I started on the journey to have a child I remember naively saying that I wanted as little intervention as possible.  I was against taking drugs.  I said I would never do IVF.

Health insurance back then did not cover fertility treatment for single women.  You had to be married.  I was paying for everything out of pocket and none of it was cheap!!

In order to boost my chances I tried a couple of rounds of clomid.  RE’s often like you to do a ‘clomid challenge’ to see how you respond to drugs.  What clomid does is it makes your body produce extra follicles, which is where the eggs grow and mature.  I responded well but didn’t achieve a pregnancy.

I threw out my no intervention and no drugs rule.  I took out a loan and moved to IVF.  I had found an RE that I liked.  I went to a consultation where I asked 5000 questions and then waited to start my cycle.  I remember being terrified but also confident that it would work.

IVF is not at all glamorous.  You’re constantly undressing and having vaginal ultrasounds.  It becomes so routine that when I was pregnant I once got undressed only to have the doctor tell me it wasn’t necessary anymore! (embarrassing!)

I had one last hurdle to overcome.  I was terrified of needles!  I wasn’t sure how I was going to find the courage to inject myself!  The sheer volume of meds and equipment was terrifying.

meds

I swear that first shot took me half an hour to prepare and inject.  To my surprise it didn’t hurt in the slightest.  I think the adrenaline and fear of doing it wrong  makes you not even notice the needle going in.

About 10 days in I started feeling quite delicate.  I used to say that my lady balls were swollen.  I found myself being a little more cautious as I sat down and stood up.  Imagine your ovaries as a golf ball and usually they have a little marble or two in them each month.  Now imagine that you’ve put 6+ marbles in there.  That golf ball is turning into a tennis ball… or maybe even bigger.  That’s what I was feeling.. I couldn’t wait til retrieval day.

Once my follicles had reached their goal size I was brought in for my egg retrieval.   It was a little scary (isn’t any surgery?) but over quickly.  I felt a bit sore for a day or so after my first one but nothing major.

Then I waited to see how many had fertilized… then how many made it to day 3, then to day 5.  I was lucky and was about to transfer one and freeze the rest.  It didn’t take.  Nor did any of the frozen ones.

There’s a lot more research now that points to frozen transfers being more successful.  Taking a break gives your body a chance to get rid of all those nasty drugs and find its equilibrium.  In hindsight I wonder if taking a break between tries might have brought my child to me more quickly…. I was on the train, month after month and I wasn’t going to give up until I got my baby! (Or went bankrupt.)

I did a second round of IVF and got even more good looking day 5 embryos.  I did a fresh transfer which didn’t take.  I did more Frozen transfers that failed.. and then I took a much needed break.

to be continued.  

The Importance of Finding the Right Fertility Doc for you.

Once I had picked a donor, done a couple of IUI’s, had the HSG and had a couple more failed IUI’s I came to a realization;

I couldn’t stand my RE!!!

I had thought that all you had to do was find a Reproductive Endocrinologist and they would unlock the secret to getting you pregnant.  This was not the case.  I didn’t feel like I had an advocate in my RE.  I felt like I was walking through glue.  After 6 months of this I was ready to move to IVF and a new RE.

This time I did some research aka: I googled.  I called a couple of clinics and rejected the ones who would only accept applications via fax. (I’m supposed to have faith in your state of the art reproductive technology yet you won’t accept my emailed application?  No thanks… )

I loved my new RE.  He was a wealth of information.  He was encouraging.  He was never too busy for questions. He was up on the latest technology.  He never let me lose hope.

He eventually got me pregnant.

 

PUBLIC SERVICE ANNOUNCEMENT:

These days it’s much easier to choose an RE thanks to a great new website called Fertility IQ.  You can use this site to research the clinics and REs in your area.  These are verified reviews from people who have actually used the clinics/RE’s.  I have submitted my reviews and I urge others to do the same OR to use this resource when choosing their RE.  I’ve heard so many horror stories of bad RE’s – especially from single women.  Fertility IQ will help you avoid them.   Incidentally, I am not affiliated with them, merely think it’s a service that everyone should know about!

How to choose a donor again, and again and again…

Once I had decided that I was going to try to have a baby on my own it was time to start thinking about who was going to Father said child.  I considered all the options, some more than others…

  • One Night Stand?  Totally out of the question.  Gross/diseases/timing and of course morality.
  • Known Donor?  I considered this briefly after a ‘close male friend’ offered.  It has its pros and works for some people but I didn’t want the danger of ever having to fight for full custody of my child.  I also didn’t want to be tied to this person for the rest of my life.
  • Sperm Bank?  Overwhelming as there are so many.  For me this was the most logical way even though it was the most expensive.

Once the decision had been made there were a barrage of decisions behind it.  I decided against an anonymous donor immediately.  I am a very honest person and intended to be open with my child about how they came to be.  Choosing someone who had opted out of contact with their offspring seemed wrong to me.  I’d spent time reading up on donor offspring and felt that my child would be a lot less likely to resent me if I had at least afforded them the opportunity to speak to, or meet their donor one day.

So I decided I would choose an ID release or Open Donor, which means that the donor is anonymous until his offspring reach 18 years old.  They are then entitled to at least one contact with him.  This costs more, but in the great scheme of things is a paltry sum to perhaps offset a lifetime of genetic curiosity.

The Sperm Bank and actually choosing the donor.  It took me weeks to stop being overwhelmed by this and to settle on a sperm bank.  I went with one where you could see adult photos.. lets face it, you can be a cute baby but a creepy looking adult.  The bank I chose happened to also be the most expensive one but I reasoned with myself… ‘who wants cheap sperm?’  It didn’t feel like an area I should be saving money.

Choosing a donor is a lot like internet dating… you just have to delve a lot deeper before you can swipe left or right.  The bonus is that you get to read family health history and you know he doesn’t have a drug problem or any STD’s right off the bat.

Donor Number One

I agonized for days over more profiles that I can count.  I took notes.  I had a short-list.  I pored over family histories, interviews, profile pics.  I paid attention to their star sign.  I wondered if we met (and I were younger,) would I date this person?  When my child finally speaks to or meets this man will he understand my choice.  After days and days I finally had my future baby Daddy paid for and winging his way to my clinic.  I was so nervous but so relieved.  I bought Donor One in bulk so I would have enough for 2 kids… but even a bulk buy wouldn’t see me to the end of my journey and after 6 treatments I’d run out of stock.

Donor Number Two

It was when I was 5 days into belly injections for my second round of IVF that I received a call from my clinic to ask when my specimen would arrive.  I was, at that time picking flowers to sell at a local farmers market.  I was gob smacked to discover that they had used up my last two vials during my previous round of IVF but had failed to let me know.

I couldn’t get home fast enough.  I made a call to the sperm bank who informed me that my original donor was sold out.  They kindly let me look at full profiles for free for 3 days.  Of course I didn’t have 3 days.  I had 3 hours to choose my potential kids potential biological other half.  I hurriedly absorbed as many as I could and favorited a handful as I narrowed them down.  At the end of the 3 hours I had picked a donor who seemed even more wonderful than Number One.  I figured maybe it was a sign.  Maybe Number One and I just weren’t compatible but Number Two… now he really seemed like he would have what it took.

Donor Number Three

I was jaded.  Another failed round of IVF behind me.  I had spent more money than I make in a year chasing my dream.  I had had a miscarriage.  I had decided to give it one last try.  I didn’t believe it would work.  I called the sperm bank and tried to get a free trial again to no avail.  I didn’t have money to spend looking at multiple donors.  Then I remembered my favorites.  Fifteen minutes later I had picked the most handsome one.  He had an amazing jawline and good family health history.  That’s all that I cared about.  Besides it was never going to work anyways.

And that is how I picked the best donor.  The donor who would (with a lot of help from Science) make me a mother.  And I couldn’t believe that after all the agonizing he was the one I had spent the least time worrying about.

I have since heard it a lot from women who fight infertility.  That the donor selection becomes less and less important as you go on.  As your hope wanes.  You just want a baby, any baby and it really doesn’t matter where that baby comes from in the end.  You’ve already fallen in love with a couple (or a few) donors along the way and the only person you have energy left to be disappointed with is yourself.

I’m also happy to report that I have now read up on Donor Don (affectionate nickname.) I now know more than his family health history and exquisite jawline.  I even know his star sign.  And if my younger self were to meet him in a bar she would most definitely try to talk to him.

Why you shouldn’t wait to get your fertility checked out…

One of the many things I wish I had known way before I did was that you can be proactive about your fertility.  You can go to your OB or find an RE and get your ‘fertility work up’.  What this means is having bloodwork done on day 3 of your cycle and then getting back a load of words and numbers that you spend 3 hours googling even though your RE has already explained what they mean to you.

This info; your FSH, AMH, E2 give an approximate idea of what might be going on with your eggs.  Mine came back pretty good but with low AMH (which a lot of RE’s don’t pay much attention to anyways.)  I decided to go ahead with a couple of unmedicated IUI’s before going through the more aggressive tests.  An IUI is where they use a catheter to bypass your cervix and place the sperm directly in there.  It’s painless and has a higher success rate than ICI (think turkey baster method.)

After a couple of IUI’s didn’t work I got an HSG which is where they shoot dye into your fallopian tubes to ensure they aren’t blocked.  Cue one of the most painful mornings of my life with a very unpleasant Doctor.  They are not always this painful but they are never enjoyable!

It was discovered that I am the proud owner of a Unicornuate Uterus (so called as it is the rarest of all the uterus abnormalities.)  I only have half a uterus which means that only one of my ovaries is attached.  When you google it it’s pretty terrifying.

uterus

Had I known about all of these tests I would have done them years before.  Why don’t they teach this stuff in school along with periods, wet dreams and sex?  So my friends, if you are thinking that one day you might want to have a little person, I highly recommend that you make a doctors appointment and get an idea of what’s going on in your invisible parts.

You’ll be glad you did.

He is here.

My son is nearly 18 months old and yet not a day has gone by where I haven’t mentally stopped time for just a moment and marveled that he is here.  I am still in awe of the woman who let go of her dreams of a traditional family and built one on her own.

At age 38 I had finally accepted my reality;  I was not going to meet Prince Charming.  He was not lurking in the corners of Tinder or OKcupid.  He was not behind me in the checkout line at the Supermarket and he most certainly was not taking up a seat at my bar, sipping on Bourbon.

It had been a year and a half since the end of a significant relationship.  I had done the embarrassing rebound thing with someone entirely inappropriate and been on a handful of blah dates.  I was happy in my skin and felt more than capable of parenting on my own.

It was time. I did a lot of research and asked a lot of questions of women who had walked this path before me.  I then visited my doctor, got some tests and booked a date with a local RE. (Reproductive Endocrinologist)

I lacked health coverage for fertility treatments (back then only married women qualified) but I had savings in the bank.  I felt so sure that a baby was less than a year away from my arms… I figured I’d spend maybe $5000 on getting pregnant and still have money in the bank for when baby arrived.

Mother nature had other plans.