All The Details No One Talks About: My IVF Experience
12 february 2019
I really needed good news today.
My last few doctor’s appointments had me in face contortions attempting to hold back the flood of tears that puddled in my eyes. I made it through check-out & scheduling but as soon as I turned the doorknob out of the office the levee broke and the tears poured out. Days like those are hard. So when good days happen and happy news is received, celebration is mandatory.
I’ll back up a few days.
After my first unsuccessful IUI in January, we jumped right into the next cycle. I took Clomid (CD 3-7, 150mg) and my first ultrasound post meds revealed…nothing. Nada. No follicles, no eggs. So another round of Clomid (CD 7-11, 150mg, what my doctor called piggybacking). Cue night sweats, 3:30am wake-ups, back acne, sore gums & teeth (seriously?!). I had my ultrasound a few hours ago. 3 Follicles at 15mm. Uterine lining looks good. Thank you God.
It is mind blowing that when we are still in our mother’s womb we already contain all the eggs we will ever have. So from that perspective, we are born with our future children inside of us. I have my future baby in my body right now (even if only at a microscopic level). This is my life raft as I navigate these deep waters of baby making. While I waited my turn at check out I (over)heard a nurse speaking with a couple about upcoming IVF cycles and slots available/waiting lists. We decided (after our “talk”) that IVF was our Plan B. If this cycle of clomid/trigger/IUI did not put our baby in my body, then we were getting our ducks in a row to start IVF. There are more tests + paperwork + contracts + costs + schedules. Your ducks have to be very much be in a row. When I heard this tidbit I panicked a little because we hadn’t yet done all the things nor had we been confirmed in an upcoming cycle. So I wrote a deposit check, as a “hold my place in the next cycle in case,” and told the office manager I would email her the signed contract when I got home. I felt like I was signing up for a yoga workshop or renting a car. Here’s your contract, sign it, give me a check and off you go. Except the tangible gift of this experience was not immediate. Far from. As I kept my ears perked, the nurse told the couple that all the March slots had been filled. The next open cycle was in April. I immediately saw the calendar pages turning and I felt anxious and stressed. Like the mercury in a thermometer rising and rising. When you’ve got baby making going on in your life waiting and patience are essential but often depleted and in short supply.
14 february 2019
2 days later and I’m back in the office.
All of the sudden things are moving fast. My appointment this afternoon was with my Baby Making Boss, not a nurse. Lights off in the chilly room the ultrasound showed five mature follicles. She says we need to discuss what that means and options. She lays it out:
One: we can proceed with the process of IUI recognizing that there is an increased risk of multiples (due to the potential of 5 mature eggs that could all possibly fertilize), not just twins, but triplets or quads. This would create a very high risk pregnancy with low live birth rates. Obviously this is an option that is not really an option.
Two: We cancel the cycle. F*ck No. Again, obviously this is an option that is not really an option.
Three: We switch to an IVF cycle.
I didn’t even know it was possible to just switch to an IVF cycle. I ask what will give us the best chance at conceiving our baby in the healthiest, safest way possible. The million dollar question that has been the foundation of this process. But in my gut I knew the answer.
She says we will not know for sure the path until I come back in tomorrow morning for blood work, but based on the blood results (measuring progesterone, estrogen & LH, the hormone that supports your reproduction system) decisions will have to be made quickly. She wants husband and I to be prepared by discussing these options in advance.
I pray for guidance. And cry. I am so incredibly thankful. That kind where it literally takes your breath away.
I get home and we discuss all the things and we agree on moving forward with the IVF cycle. What that looks like: I’ll schedule an egg retrieval sometime in the next 3-5 days. This is a surgical procedure that removes the eggs from the follicles in my ovaries. It takes about 30 minutes and I’ll be out cold through intravenous anesthesia. The eggs go straight to the embryologist to determine maturity and quality. Eggs that make the cut are placed in a small petri dish in an incubator. Almost immediately the eggs are fertilized (thank you hubby) by placing the sperm in the dish and allowing sperm to enter the egg on its own. And then the wait and see begins. Are the cells dividing and maturing normally, how many are viable for transfer, will we do genetic testing, how many will we transfer, will we freeze the remaining embryos? It’s a lot. It all feels so big. We could have 5 viable embryos. Or none. I’m praying for that one, The One. An embryo transfer is scheduled 3-5 days after retrieval. The goal: embryo implants and hatches in the uterine lining within 1-2 days of transfer. 12 days later a blood pregnancy test. This is the science part. The physical/emotional/psychological/how do you deal with it all part - no one ever brings it up.
The thought of IVF has really scared me. I just didn’t know if I had it in me to go through the whole process of birth control pills to calm and regulate my reproductive organs, ovarian hyper-stimulation with daily injections and drugs, the side effects, the retrieval, the recovery, the transfer, waiting day-by-day to receive updates on how many follicles/eggs/embryos, genetic testing, implantation, more needles + drugs + blood + poking. I didn’t know how I was going to go through it all and still have energy in the tank to be Mom and Wife and Human. This experience has been double life for me. I’m one person out in the world and another in my real life. All of this has been happening mostly behind closed doors. I dump it all out here. In words. And I go way deep down the google rabbit hole where women who are a thousand times braver than I share every detail of their story. They are my heroes.
so…..when my doctor said we could pivot into an egg retrieval/transfer, it was an answer to my prayers. I was already halfway there. And I didn't’t even have to do all the things I was so scared about. So typical. I convince myself not to do something based on ideas I have about what might happen. And then those things never happen. I was already doing/had done all the things I was afraid of. We can do hard things. And when we do them we open the door for magical things to happen.
We went to dinner. Caesar salad + short ribs + red velvet cake. It was Valentine’s Day, after all. When I crawled into bed and closed my eyes I felt a deep sense of calm and peace. I knew the next several days were going to be huge. I was ready.
15 february 2019
Today starts the long holiday weekend and our little beach town has swelled with people escaping the polar vortex. My family and good friends are in town and they want to drink, eat, shop and play. They are responsibility free and on vacation. And they want me to be that way, too. I want to be that way. I am trying to be in the I’ll be on vacation even though I live here game as well as the Baby Making game. We’ve got lunch, dinner, shopping and relaxing plans for the next 3 days. I also have to do 2 a-days at my doctor’s office for bloodwork, final paperwork and big decision making. And tonights my trigger shot at precisely 8:30pm. Right in the middle of dinner. I knew that it was not going to be possible to sneak into the bathroom, shoot myself up with HCG and return to the table for casual conversation and sushi. First: you have to set up a mini-lab to get the syringe ready: sterilizing, mixing water + powder, switching out needles. It is a thing. And you can’t give yourself the shot, it’s a 2 person operation. So dinner turned into drinks (Perrier please) at the bar and we slipped out early, speed walking home so we could make the injection curfew and go to bed. Lately I’ve had the sensation of a pinball, bouncing and crashing around in my world with flashing lights and sounds and high scores and lost balls. It can be fun and exciting, but it can bang you up a little, too.
17 february 2019: egg retrieval day
I didn’t get much sleep last night. Drug side effects + stress + anticipation + hope kept me wide eyed. I was happy when 5am rolled around and I could finally get out of bed. This past week has moved quickly and for that I am extremely grateful. Over the course of only a few days we had lots of action steps. Decisions, appointments, getting and taking medications, injections. Not a lot of time to *think* too much about things or go down the Google rabbit hole. This gave me a (false) sense of control. But I liked it and needed it so my mind wouldn’t run away on me. Doing makes me feel productive and responsible and in charge. Even if I know I’m really not. Especially then.
When we pulled away from our house that morning I felt relaxed and excited. I had to fast (no food or water) before my procedure. Only a few sips of water to take the valium my doctor prescribed. One pill an hour before the procedure, two more pills 30 minutes prior.
We arrived at 7:45am, the office was quiet and cold in temperature but warm in the energy and anticipation of what was about to happen. I kissed my love and held it longer than a usual goodbye for now kiss.
After stepping on the scale (every.single.visit this is the first thing you do. I never look at the number) and blood pressure, I head to the procedure room. It is like a mini-operating room with a stirrup chair on steroids. A fancy one with comfy leg and feet rests that are covered in cushiony fabric (not cold metal). I undressed from the waist down and put on my fuzzy socks. I grabbed the book I tossed into my purse before leaving the house.
I sat down in the procedure chair.
As I look back on this moment I can’t help but laugh at myself. Did I really think I was going to dive into Bird by Bird right now? After 3 tabs of valium, half naked and sitting in what sort of looks like a medieval torture device designed specifically for women? I was trying to make this another casual appointment. The stress was so heavy that normalizing the very-not-normal-moment was my coping mechanism.
My doctor came in with her reliable, sunny disposition. I was feeling good.
I remember the nurse being there and the Embryologist. They confirmed my name, date of birth and procedure.
And then black.
The next thing I remember, I opened my eyes and looked around and saw husband sitting in a chair beside me. I said, “oh, hi, honey. When are they going to get started with this its been awhile.” With a smile he responded, “honey, it’s already over”. My pants were back on and the blue hospital gown and scrubs hat had been removed.
Holy Narcotics.
I barely recall speaking with my doctor. But I do remember her smile and excitement at the 4 eggs that were now safely in petri dishes in the lab on the other side of the room.
During the retrieval hubby did his part so the eggs could be fertilized almost immediately.
Somehow we left the office and got in the car. I had a few sips of water and then fell asleep for the 30 minute ride home. I moved from car to bed and instantly feel into a deep, long sleep. It was around 11:30am when we got home (I learned later) and I remember waking up around 3:30pm. I did not have any pain, bleeding or cramping. I didn’t stay awake long enough to feel it if I did. I called my mom. I don’t remember a word of our conversation. It was 7pm when I got out of bed. I was still very fuzzy. I took a shower and we had dinner.
The whole experience felt out-of-body. Like I was watching it all happen to someone else.
I looked at my post-retrieval care instructions. I was to call the voicemail system the next morning to get a report from the Embryologist: how many eggs were retrieved, how many fertilized and how many are experiencing regular cell division. I had to check on my babies.
21 february 2019
When I emerged from the fog of my day on drugs/egg retrieval my first, almost primal instinct was to check on those embryos. I called the voicemail system religiously every morning at 9:30am. Each time I found a quiet spot where I could be alone. It was incredibly nerve racking. My breath would shorten, palms sweaty. When I pressed 1 to play messages, my hands would literally shake and I would pace like a mad woman.
My retrieval was on Sunday. Monday was Day One.
Monday, Day One: 4 mature eggs retrieved, 4 eggs naturally fertilized
Tuesday, Day Two: 4 embryos dividing normally
Wednesday, Day Three: 2 embryos stopped growing but will continue to be monitored for another 24hrs, 2 embryos continue to divide & grow normally
Thursday, Day Four: 2 embryos considered non-viable/discarded, 2 embryos continue to divide & grow normally
Friday, Day 5: Transfer Day. One 5-day blastocyst ready for transfer, not yet determined if remaining blastocyst viable for freezing.
This was not an easy week. It was torture. With every voicemail I could have received news that sent me right back to Square One. I’ve had so many “starts” I didn’t know if I could handle another one. To get to Day Five/Transfer Day with a thriving blastocyst (my baby!) was an enormous win. I let myself soften and celebrate (a little) and couldn’t wait to get that precious new life back into my body.
Once Transfer Day was confirmed, it seemed only logical to do everything I could to increase my chances of success during the 2WW. I approached it just like anything else I desired to be successful at. I researched, gathered info and then got busy doing. This doing (again) was my coping mechanism. My doctor did not recommend any of these things. Who knows if it makes a difference. It’s more that having something to do will save my sanity. It will get me through this part of the journey. I try to keep my blinders on and move from A to B. It is the only way I can manage. Small, actionable steps.
I scheduled acupuncture sessions for the day before, the day of and the day after my transfer. I stocked up on bone broth, fresh pineapple, green juice and fuzzy warm socks. I hate the busy badge as it is the ultimate form of distraction (for me) but in this case, I indulged it. I needed it. I busy bodied myself all day.
I get why my doctor recommends 3mg of melatonin an hour before bed as part of my supplement program. The emotions that go along with this process are No Joke and if you can’t fall asleep when your exhausted head hits the pillow at the end of the day there is no way you will survive it. Sleep is your best friend. The night before my transfer I slept like a baby. I also had acupuncture the day before to help prepare my body and it always helps me sleep well and deep.
I was well rested, a huge advantage going into anything, especially something like creating life. The 4 days between retrieval + transfer I spent doing things that greatly reduced my stress and made me happy. It was spirit week at my daughter’s school so every day was a theme. Pj’s, sports jerseys and school colors, it was fun. Light. I enjoyed the process of food shopping and preparing meals. I baked. I went to bed early. It’s Not Supposed To Be This Way by Lysa Terkeurst lived on my nightstand and I read at least a few pages every night before I closed my eyes. I was in a very peaceful, calm and grateful place.
22 february 2019: transfer day
My eyes popped open like clockwork at 5:30am. Excited doesn’t even come close to describing it. It was our baby’s first homecoming, back to Me, where she would continue to grow + thrive + become part of our family. We could feel the BIGness of the day. I chose to go to the appointment alone. There has been so much basically all of it that has been different about creating life this time around. It is always magical and miraculous. And for me, this moment was something I had to do alone. With our baby. No matter how it happens, how the path unfolds for each of us, it is both of those things. I have been coming to my doctor’s office for just over a year now and this time, when I entered the building, it felt different, I felt different. The knowledge that my babies were right here and I was close to them immediately triggered my momma bear instinct. I felt drawn to them.
I walked in. I had to go to the bathroom but of course couldn’t. Having a full bladder was a requirement for the procedure. They took me right away, weight & blood pressure as usual, then I went into the Transfer Room. This was my first time in this different room. It was connected to the Embryology Lab through a door, sort of like connecting rooms in a hotel. It had the classic bed + stirrups combo with an ultrasound machine. It was small and cozy. I was chilly and sweating at the same time. The nurse explained that the Embryologist would be in to review the embryos with me. She came in carrying a photo of our perfect 5-day blastocyst. Tears started to stream down my face. Feelings of gratitude poured over me. THANK YOU GOD. I cannot put into words what this moment was like. I am covered in pins and needles and crying as I type.
The nurse came in to check my bladder (not full enough) so I chugged more water. 10 minutes later we were ready to go. I was on my back, feet in stirrups and my doctor, the embryologist and nurse were all in the room.
The energy was high and happy. The overhead lights were off. I closed my eyes and took deep, full breaths and visualized our baby safely returning to my body and connecting itself to me where it would stay for the next 9 months. Tears streamed down my face.
When the nurse pressed on my abdomen with the ultrasound wand it was uncomfortable because it pressed right on my bladder, but otherwise the procedure was painless. Via the ultrasound screen my doctor and embryologist agreed on the perfect spot to release the embryo. She did a 3-2-1 countdown, and in she came. Everyone in the room could see the screen except for me (I didn’t want to, my eyes were closed) and there was a gasp from each of the women in the room. My doctor explained that sometimes you see a flash on the screen the moment the transfer happens. In science speak it is the fluid you see that is used to flush the embryo into the uterus. But I could tell from their gasps it was more than that.
It is also something else. It is the magic.
No matter how much science may be involved nothing trumps the miraculousness of creating life. The stuff only God can know and do.
The embryologist took the tubing used for the transfer into the lab to examine it. She gave a thumbs up. I could feel the room fully relax. Like when a rocket launches. Once it gets past the initial few minutes of blast off, it enters the sweet spot. Of safety, calm, celebration.
A few moments later I sat up and saw the big smiles on everyone in the room. I was smiling and crying and elated. And I reeeeaaalllly had to go to the bathroom. Which was important to do first thing so the uterus did not experience contractions (the last thing you want). When I returned my doctor rubbed my belly and gave me post procedure instructions: lay low for the weekend, put on your pj’s and watch funny movies, continue to take all my medications (progesterone + estrogen suppositories) and supplements. She explained that now that the embryo is in my uterus the lining acts like two pieces of velvet rubbing together, trapping the embryo exactly where it is supposed to be. And then the endometriosis creates a web over that, locking that baby in place. There is no more doing. Just being and receiving and allowing.
Even though I intellectually knew this, it was very comforting to hear her say it.
Come Monday I could go about my life as usual. My next appointment is Monday, March 4 when I will have my pregnancy test via blood draw. They will check progesterone + estrogen levels in addition to HCG.
That date felt lifetimes away.
Cue Two Week Wait. Actually 9 days 18 hours and 27 minutes. But who’s counting.