infertility

It’s the end National Infertility Awareness Week. So in the spirit of that, here’s the personal experience of someone who knows what it’s like.

My husband and I have been married almost fifteen years.  Shortly after getting married, we started trying to have kids.  We knew we wanted to have children in our twenties. We wanted to have energy to do things with our kids.  I told my OB-GYN our plans and he gave us a book about pregnancy (think What to Expect When You’re Expecting but from a medical journal perspective). I eagerly read through it, naturally skipping the chapters about infertility.  We wouldn’t need to read them!

After a couple years, we started trying all the different suggestions. Pillows under hips, eating certain foods, taking prenatal vitamins and folic acid, charting cycles including basal temperatures (right before you ovulate, your temperature when you first wake up will dip and then a couple days later will rise).  If there was an old wives’ tale trick that worked like a charm, we tried it.

A few years after that we stopped actively trying (although still didn’t use protection). We were in denial.  We couldn’t possibly be infertile. No way, no how.

Month after month, I would feel the slightest twinge in my abdomen, or feel slightly sick for a week before my period was supposed to come I would rush out and buy a pregnancy test. I would set the timer on my phone and stare at the stick as the liquid moved across the window to reveal the control line and nothing else. My heart would sink. I would wait the full three minutes of torture, picking up the test and holding it from multiple angles. Certainly there must be a second line! There never was. The disappointment was intense. I would cry sometimes. My husband would be disappointed too. He was right there with me, hoping that the cursed second line would appear.

At our ten year anniversary, it sunk in. We were not going to get lucky and have a miracle pregnancy. I went to see our OB-GYN and admit defeat. I ran into an old friend in the waiting room. She asked me why I was there; choking back tears, I said because I am infertile. I asked her why she was there, and she said for check-up. Several months later, I found out she was sparing my feelings. She was there for a pregnancy check-up.

It took us more years still to get any tests run. Not being a religious person, I still felt spited. Why was God/the Universe/Karma doing this to us?  Why were we not good enough to be parents? What had we done in a past life to deserve this kind of torture?

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The first doctor we saw had a very fancy office. It was so uncomfortable waiting there with four other couples for our appointment. The doctor who saw us was very optimistic. Since we had limited money and infertility isn’t really covered under insurance, they suggested an IUI (intra-uterine insemination – they take the sperm, clean it, and insert a catheter through your cervix and release the sperm closer to the fallopian tubes).  They had me give myself a shot to trigger ovulation. I have never been so nervous in my life. I hate needles and shots, and here they were asking me to give one to myself!

It took me a good ten minutes to work up the nerve. I pinched my tummy, shoved the needle in, and pushed the plunger down all while shaking. Once I finished pushing the plunger down, I pulled the needle back out and released my tummy. I had done it.

The next day we went in to do the procedure. As I laid awkwardly with my legs in stirrups with my hunny by my side, the nurse came in with the catheter. She asked my husband some questions about being injured recently. He answered he hasn’t. Then she drops the bomb: his sperm count is 1% of what it should be, with low motility (movement). The doctor came in to do the procedure and they have me lay there with my legs up for 10 more minutes. Now the shock has worn off and I realized that we just paid money and went through all of this to find out it wasn’t going to work. I had been daydreaming about the due date, announcing it to our family, and imagining myself being pregnant.

To have it all come crashing down in a casual, calm voice.

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I went back for my beta two weeks later (beta is a hormone they are looking for in a blood test for pregnancy). Insult to injury they couldn’t draw blood (I have tricky veins). I sat there in their blood chair, which is in a hallway, crying while they keep trying to find a vein with the needle. After four tries they told me to go buy an over the counter test and call them with the results. I know what the results will be, but I do it anyway. Negative, again.

A year later we decided to get a second opinion. We got to a different doctor and at this point our insurance covers fertility testing so we do a full run of tests. Even with insurance we paid $1,200 for all the tests.  Turns out I do not ovulate in a timely fashion (luteal phase defect), plus I have low AMH (egg reserve), and hubby has very few and very lazy swimmers. Ouch. We get the worst diagnosis I can fathom, we need IVF (in-vitro fertilization).  We got a price quote for one “fresh” cycle (they do not freeze the embryos before transferring them into your uterus) and it was ten thousand bucks, but let’s not forget the medications required to harvest those eggs. Another $4500. So fifteen thousand. For a 50/50 shot, per attempt. Oh, plus you need to pay for that upfront.

Then a glimmer of hope. My job decide to add infertility treatment coverage, with a 10k max for procedures and 10k separate max for medications. I was so excited I could barely contain myself. We would have to pay the deductible, but that was only 3k. Surely we could afford that! We started saving up.

Less than two weeks after the good news, they pulled my team into a conference room. Our team is being outsourced and we will all be laid off at the end of March. I panicked. After talking to the hubs, we decided to get as much out of the insurance as we can. I called the clinic to let them know of the insurance change and get a cycle scheduled for January.  Then I called my last job and liquidate my old 401k.

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They put me on birth control for five weeks leading up to the IVF cycle. Seems counter-intuitive, I know. They need to control when you start your cycle and keep your ovaries calm before they force them into overdrive. Birth control, if you have never had the pleasure, is quite frankly the devil. It made me so sick. I lived off ginger ale for weeks. I ordered my fertility medications, which had to be overnighted in a cooler because one of them needed to be refrigerated. Looking at the table full of strange drugs and all the side effects, I started to feel overwhelmed and nervous. What if I put myself, my hubby and my body through all of this for nothing?

I decided to force myself to be optimistic; we bought a couple infant items. A cute onesie, some pacifiers, etc. I put them on the kitchen table while I was gearing up to do more shots. Did I forget to mention that for the fertility medications, they were all shots in the tummy? The first few days of stims (stimulating drugs) were two shots to force the ovaries into overdrive. A few days in they add a third shot (isn’t that nice of them) to prevent ovulation.

Did I mention how fun your ovaries feel all full with liquid? No? Well, you are banned from any exercise except walking because your ovaries are giant and heavy and they don’t want them to twist and fall inside your body, resulting in needing surgery. I felt like I was walking around with 2 giant water balloons in my body. I could feel the liquid splashing around when I walked. It was so odd. Felt like if I bent over they might fall out or something.

They have you come in for ultrasounds towards the end of stims, to see how many follicles (sacs of fluid in your ovaries that should contain a mature egg) you are growing and measure them.  It is a wand ultrasound and I was not aware of that my first appointment. Yeah, basically a long vibrator-shaped item they stick up your vagina. The really fun part is when they have to twist and turn the wand at uncomfortable angles to see your ovaries and measure each and every follicle.  My right ovary was lazy and had less follicles then lefty. After ten days of shots, I was told to trigger. They have you trigger 36 hours before you are going in for your egg retrieval.  For the egg retrieval they put you under (if you are lucky, I have heard of clinics NOT doing that, which I would basically say ‘F you!’ and walk out LOL), with your legs in stirrups and they stick a giant needle through the sidewall of your vagina to reach your ovaries (guided by an ultrasound on top of your tummy) and suck the juice out of each follicle. They put the juice in a Petri dish and then once you wake up, you know how many eggs you actually had and how many are mature enough to be fertilized.
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Egg retrievals. Man, those hurt. The biggest concern for women with PCOS (polycystic ovarian syndrome) is developing OHSS (ovarian hyper stimulation syndrome), which could have your ovaries make you very sick and, if not treated, could destroy your ovaries. Luckily I don’t have PCOS. But they still tell you to drink a mountain of water. Which makes you have to pee. So you lie on a couch all day with a heating pad and Tylenol, then had to get up to pee all damn day. Basically torture.

Because I have low AMH (egg reserve) I was on a high dosage of fertility meds to receive far less eggs than other women my age.  Each morning they are supposed to call you with the results.  That first day, I was so nervous I couldn’t sit still. I felt sick to my stomach, jittery, my heart was beating so hard. What if none of them fertilized (where the sperm and egg make an embryo by reacting with each other)? What if they did, but died before the transfer? (It is normal for about 25% of fertilized embryos to survive from day one to transfer on day three or day five, or to freeze, which would be day six.).

The phone rang early, about 9 am. They told me of our 8 good eggs, only 2 fertilized (really bad rates – should be 75%). I broke into tears. With only two, the odds of making to a transfer were slim. They wanted to do a third day transfer, but would call me each morning to tell me how many were surviving and the cell count each day (they are supposed to double each day).

Each day was this awful waiting game. Holding my breath until they said both embryos were dividing correctly and doing okay.

ivfimplantdiagramIVF embryonic insertion diagram – credit: IVFConnections.com

Day 3.
Transfer day.

I bought special socks for the event. You’re probably thinking, special socks? Well, when so much is out of your control, the only thing you can do is buy yourself some warm, comfy socks and hold onto your hat! They made you drink a ton of water to do a tummy ultrasound so they can see where the catheter is dropping off your little embryos. But before the actual transfer, they show you a photo of your little embabies, tell you their grade (they rate them based on cell division, size, etc), and ask how many to transfer. Now for my age, they would normally recommend one (per SART.org) but since we only had two and they most likely wouldn’t live to freeze, they did both.

They had you get on the table, legs up, and bring in the embryos in a catheter. They use the ultrasound on your belly, pressing down really hard, which is terrible when you have to pee, insert the catheter and deposit your little ones. They can see them leave the tube so they snap a photo of your uterus, with the little spot of white showing you they dropped them off. Then they made you lay there for ten minutes, having to pee. After that you can go to the bathroom and go home. Thus begins the beloved two week wait (total sarcasm).

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© Christina Pate

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