Leap

Status update.

Sometimes science works.

Science for me is working for now. I'm 15 weeks 2 days pregnant from my first round of ivf and as of my last scan 1.5 weeks ago I have a thing with a beating heart in a place inside of me that was empty for several years. First trimester was easy, now clothes are starting to get snug and I'm buying things like "nipple cream" and a "pregnancy pillow" and Matt and I are having conversations about "names" etc. I'm not "connected" to this thing but that's common in regular pregnancies as well as in pregnancies conceived via ivf after years of infertility and loss. I can't summon up any "excitement" about this but I do feel thankful and I do not believe how stupid lucky I am that one go at ivf is so far working, first birth control pill in September and pregnancy confirmed in December, I don't know how that happened, well yes I know how that happened but I don't know how that and this happened to US.

I'm terrified that this won't stick, at my first ultrasound at 6 weeks I couldn't breathe and at each subsequent ultrasound I go numb about an hour before and can't form a sentence until I see the heartbeat but I think that's common too.

For now I'm pregnant though, and there are lots and lots of complicated fucking emotions rolling around but this is my reality for now and it seems pretty damn similar to other realities and that, for now, for me, is ok.

IVFlipping Out

I've been absent, and this is long.

We got 2 normal embryos. omg. 

I started my transfer cycle. Birth control, estrogen pills, and two types of progesterone therapy: The first, a needle that I fill with Progesterone In Oil (PIO), and the other a tampon-like insert containing a gel that I push into myself each night. If I get pregnant, I will continue to take the progesterone(s) until well into the first trimester, when the placenta takes over and begins to produce the hormone on its own. 

1.5 inches of pure happiness

A few days ago I went in for my Frozen Embryo (Blastocyst) Transfer. It's goddamn sorcery: a doctor inserts the recently thawed, beautiful, perfect blast directly into the uterus, where it has a chance to hatch (if not hatched already) and implant. Implantation is the big big deal here, it's the main attraction, it's what means you're pregnant and what starts producing hcg (which turns that second line pink).

I transferred a week ago. Tomorrow I take a blood test to find out whether it took, and whether I'm pregnant. 

And my right now is unlike any reality or dream I've ever experienced.

Over the years, this is what I've done to get pregnant:

1. Every single morning, I've taken my basal body temperature and a (pee) test that tells a woman whether she's gearing up to ovulate. I've monitored and analyzed the consistency of my cervical fluid, and for a couple years, I checked the position and texture (firm? soft? medium?) of my cervix.

2. Lost weight, gained weight, maintained weight. I've increased and decreased physical activity. I've added soy, cut out soy, eaten pineapple core, drunk pomegranate juice, tried Atkins, tried Keto, tried Whole 30, cut out drinking, drunk excessively, cut out gluten, stopped eating sugar, gone vegan, gone vegetarian, gone raw, gone high protein. 

3. Taken Chinese herbs, Pregnitude, baby aspirin, CoQ10, Ubiquinol, 5 or 6 different types of prenatals, and then the heavy hitters: letrozole, estrogen tablets, progesterone suppositories, and the trigger shot. I've had one miscarriage, one ectopic, six chemicals, 2 IUI's. I've had hundreds of blood draws, dozens of ultrasounds, weekly monitoring and daily monitoring. 

4. Seen five to seven different obgyn's: some of them good, some of them bad, some of them irresponsible hacks

5. Been to acupuncture, a psychic, and a shaman. I did reiki once. 

6. Insisted on mandated timed intercourse, every month, for years, which is, if you can't imagine, one of the least romantic and intimate acts a couple can engage in.

7. Looked into adoption (SO DON'T ASK), surrogacy (DO NOT ASK), egg donation, sperm donation (don't ask don't ask PLEASE don't ask). 

8. Stayed home from baby showers and bridal showers, I've left early from plays and parties and events, I've become better friends with The Real Housewives than any human person, all because I am a drag right now. I am such an incredible drag. And I don't want to subject the people around me to my misery. And I can't handle abundant happiness right now, and I haven't been able to for years. 

9. Missed out on my friend's and my family's major life events because I am reminded, constantly, of my child-less state and it destroys me, friends. It destroys me.

10. Broken down because of diapers, pictures of ultrasounds (oh god), a baby's cry, pregnancy photos, women complaining about morning sickness (or insomnia/swollen ankles/hormones/etc)...Hanukkah, Christmas, Thanksgiving...social media can suck it, too. 

And then I did IVF. Which you know all about. I've been sick since I started my transfer cycle, in one way or another, and I can't lay or sleep on my side and I have uncomfortable gunk coming out of me all day. 

Infertility, especially prolonged infertility, is not a once-a-month thing. It's not a something I think about every so often. It is every second of every day. My infertility has become my identity, and before you tell me that I just need to alter my mindset, please spend a couple of years losing pregnancies and drugging yourself with mind and mood-altering hormones. 

This is why I get bristly when people tell me to relax or think positively or "hope for the best" (thoughts and prayers are worthless everywhere and here). It's why I cannot stand, CANNOT STAND, when people make recommendations to "improve my chances." It's why I prefer a strictly science-based approach, and it's why I've resorted to the most sophisticated biological process that currently exists to get me pregnant. I am obsessed with my infertility and obsessed with overcoming my infertility, and if you recommend a new study or treatment, at this point in my process, I'm likely to lose my everloving shit. 

I'm a mess, folks.

Tomorrow, she's almost here.

And here we go. 

IVWTF

Today I found out: Of my 14 eggs retrieved, 8 were fertilized, and one…just one…made it to freeze and genetic testing. Which is to say, I had bonkers bang up amazing results for the first step and the second step, and today some very real fears were confirmed. We'll find out tomorrow if any other embryos catch up and make it to freeze, it’s certainly happened before, but I'm not banking on it. 

And here, right here, is the quiet steady torture of IVF. This is why I need to exist constantly, always, just shy of cautiously optimistic. No, I don’t like sticking myself with needles and I don’t like all of my bruises and it’s not nice to be roughly 1.5 times my normal size and hobbling around with two bowling ball-sized ovaries, and my clothes don’t really fit and I’ve had to wear stretch pants for three weeks straight. That’s not FUN. But the real pain lies in its many nuances:

• 8 transvaginal ultrasounds in 12 days that got increasingly uncomfortable as at least 23 follicles popped up and grew 
• 9 blood draws in 12 days that resulted in my veins collapsing and a mad rush to find a portal for the anesthesia needle at retrieval
• a kerfuffle with the specialty pharmacy on day 12 that almost cost me my cycle and resulted in a near-breakdown
• 10 nights of almost no sleep at all (first from the estrogen, then nerves for retrieval, then anxiety over whether any of my embryos will “make it”). I will not sleep tonight, I'm sure of that.
• the waiting: wait in the doctor's office. wait to hear about med increases. wait for the refills to arrive on time. wait to hear how many follicles I have. wait for the estrogen results. wait to see if the trigger worked. Or if it worked too well. Waiting to see whether I'd develop OHSS (I didn't, thank goodness). Waiting, and waiting, and waiting until day 5 and then day 6, then waiting for the pgs results if we even elect to go that route instead of trying another stim cycle. 
• The looking at myself in the mirror every morning and night, taking a deep breath, pushing the needles in, and knowing that this could result in a baby...or not. 

Last night of stims: Lupron (trigger), Follistim, Menopur, and my trusty sharps container (aka my bff's)

IVF is isolating. It is traumatic. It’s all I talk about on social media and really in-person, and it’s caused me to voluntarily cut myself off from so many of my friends and family, to spare them the redundancy of just a constant steady stream of bad news. It’s why I don’t smile for real and can’t let myself get excited about much at all. I’m constantly steadying my hand, managing my expectations. This little embryo that could might be my take-home baby and might be another dud, and I might have to repeat this process again, and I have to hold all of the possible scenarios with equal care and consideration. IVF took my fertility woes and catapulted them through the stratosphere, where crashing back down to earth gets progressively more and more and more damaging. So I have to keep balance as best I can.

I am strong, I really believe that, and I also believe that I will fight until I get what I want. I'm not going to stop and I'm letting Hope rear its beautiful dangerous head because I am lucky to get just one embryo. But I'm constantly trying to play catch up here, and the things that I was worried about before I actually started seem so trite now. I feel like I'm in the battle of my life. The inside of my head would make a great movie.

I'm fixated, I'm hurt, I'm terrified, I'm obsessed, I'm on the verge...but I'm doing this and I guess I've proven that I'm determined enough to clumsily find my way through it. Thanks in no small part to my universe of support, I'm gonna find my way through it. 

Retrieval day, on no sleep, looking forward to a sweeeeet medicated nap

Until tomorrow, babes. 

Race ya

Here's what this feels like to me (on my bad days, which is sometimes every day):

You break your toes. All of your toes, your big toe and little toe and the ones that went to market and the ones that stayed home, and you break them randomly, cruelly, really painfully, and you're just dumbfounded. You can't understand why you keep on breaking toes, you look where you're going and step so carefully, you spend thousands on good shoes with ankle support and you read every last book on toe-break prevention, but you can't help it, the toes just snap no matter what you do. You get tiny little toe casts which give you momentary relief, but as soon as one of them comes off the toe breaks again, and I don't have to tell you that it hurts more the second time around. 

And then just when you can't take it anymore a magic genie doctor appears and tells you about a potion that he promises will make your feet "good as new," but it's halfway across the world and you have to walk miles and miles to get this stuff and there aren't any buses or trains that will take you even a block or two and this is the only thing you can take to heal (ha), this is the only way. 

So you start walking. I mean, what choice do you have. 

As you hobble towards your salvation, people are just sprinting past you. Running circles around your dilapidated depleted self, slapping you on the back and yelling "you can do it!" "just think good things!" "at least you're still alive!!" into the wind as they pass you up one, two, three times and without any effort. 

You're walking by the most gorgeous scenery in the world, these perfect idyllic towns, but you don't pay attention because you can't stop focusing on your stupid ugly feet and then you realize that you're focusing only on your stupid ugly feet and feel even worse about yourself because you can't even smell the flowers or feel the sunshine.

And months or years later, when you're almost there, almost to the finish line, you learn that this potion will probably help but oops, magic doc forgot to tell you that it isn't actually a guarantee, just a possibility, and sometimes people who take this medication develop bizarre side effects like maybe they grow an extra arm or can't ever blink again. And you've forgotten where you live and who you know and who you are, you can probably remember your name but everything else you just left on the long long road you've been walking on forever towards this one measly possible chance at comfort. And you're not looking good, you're gross and sweaty and hoarse, and eeeeeveryone can see you. Everyone. And they're all wearing sandals and their pedicures are perfect. 

This metaphor is completely on the nose (or the toes), I realize. I thought it was clever at first but now I'm not so sure. 

ivf ftw

The psychologist at my RE's office told me that if my transfer fails, it will be awful...but she's more worried about me if it's a success.

She talked about our baby making it to 6 weeks, heartbeat, then 8 weeks, then 9 weeks when I can stop the PIO shots, then 12 weeks when I'll be returned to the care of my OB, then 20 weeks, then 24...and so on and so on and I couldn't stop crying, and eventually I said, "I just can't imagine ever getting that far." And she said, "I know."

Three years of trying, two of absolutely perfect timing, 8 months of letrozole/trigger, and 2 IUI's resulting in: one miscarriage, one ectopic and removal of right tube, and five chemicals...and I'm ready to admit that something's not working. There's a thing that's wrong with me or there's a thing that's wrong with our embryos but there's a thing that's wrong. We have killer insurance and I'm at my wits' end and broken from the inside out and well, it's time to give it our all and our best shot so we're doing in vitro fucking fertilization. Starting in October.

Even though I researched this I didn't know what it entails, and what it entails is this, best-case scenario: self-administered shots to the abdomen for several days to plump up your ovaries and produce lots and lots of beautiful follicles, most of which hopefully contain a perfect maturing egg. You give yourself another shot that triggers your ovaries to release all of those eggies, then roughly 34-36 hours later it's to the doctor's office for Egg Retrieval Day, where they make a little incision and suck out the eggs and fertilize them in a lab using technology that I am grateful for and which makes my head spin, then they age the "embabies" (I am fond of this term) to three days, then to five, then they freeze them and biopsy them and send them for genetic testing. I get a little rest. THEN I start taking estrogen pills and injecting myself with a truly terrifying needle, right in my butt, which is all supposed to prime my body for Transfer Day, where they put the thing back in me and hopefully it implants and bam, I'm pregnant. Scary butt shots until 9 weeks but I'm pregnant so I do not fucking care.

Best case scenario.

Worst case scenario is that I don't respond to the medication and if I do respond maybe I ovulate too early and the whole thing is a bust, and maybe I ovulate on time but they aren't able to retrieve any mature eggs and maybe none of our embryos make it to three days or five days and maybe none of them test genetically "normal" and maybe they don't survive the freeze or maybe they don't survive the thaw or maybe somebody sneezes in the petri dish or maybe I get OHSS and have to stay in bed for five weeks or maybe I get pregnant and it's another chemical or maybe I get pregnant and miscarry in my second or third trimester or maybe the birth hurts or kills me and maybe I never get to take a baby, MY baby, home from the hospital and I don't ever have children and don't ever recover from the trauma of these last several years but most specifically from the trauma of my failed ivf cycles.

I am completely overwhelmed, I am so excited, and I am beyond terrified. I have isolated myself to an astonishing extent and I mostly speak to my husband, my mother and sister, and a few friends who persist in contacting me for some reason.

I'm going to write all about my ivf experience. Some who read might not agree with this crazy science (I am open to discussion but not to ignorance), some might gain insight, some might stop after the first paragraph because it's just too boring, but I'm documenting all of it here because this process affects so many of us and it is kept silent and the lead-up to this is the worst hardest most inexplicable thing I've ever been through. Maybe this starts or continues a conversation or something, maybe it's purely gratuitous self-indulgence but at this point and in this pain and with this renewed hope I do not care.

Been on birth control pills for a couple of weeks, hysteroscopy last Friday, slated for baseline ultrasound and bloodwork on October 2nd and will start injections (stimming) on October 4th.

Here we go.

The month that is

I came up with the name for this post when I thought that I was "just" having another miscarriage. We had been advised to take some "time off" after our fifth loss in one year. My reproductive endocrinologist wanted to do an hysteroscopy to see if there was something in my uterus preventing full implantation -- some reason why all of these little fertilized eggs fail to "stick." So he suggested we take a month off and I started crying in his office. It was embarrassing. but he's seen it before and reacted kindly.

At 5 weeks, hcg had dropped but a week later shot up, and that's a problem. I went to the ER where they confirmed ectopic and removed my right tube.

That's the short story.

The longer story is that I was coming off of another chemical cycle, then got pregnant. hcg started very low and rose very slowly, but I diligently went for my blood draws every other day even though I knew this wasn't going to be viable.

My arm after following betas down from the chemical and up for the "pregnancy" -- a rich hue of shit-colored with an afterthought of purple

I didn't feel right, and I know my body too well to ignore that.  I didn't *feel* right. So I was not entirely surprised that my nurse called and told me that hcg rose swiftly a week after it started dropping or when the ER team confirmed that the little embryo had attached itself in or right next to my right Fallopian tube, missing my uterus by essentially the equivalent of a football field.

Matt was able to leave work and meet me at Northwestern, and after just a couple of hours we got a room. Spent the next 8? 9? hours laying down and trying not to breathe because, as scary as this was, it would be worse if the pregnancy ruptured and destroyed my tube, ovary, worse...and Matt watched and waited, watched and waited: watched them take blood from my hand with a big needle and watched them give me 2, 3, or 4 pelvic exams and waited through the longest ultrasound ever and watched me break down when talking to the ob on-call and then watched me on hardcore valium and then waited for the surgery to be over at 12:30, then 1, then 1:30am all alone in the room where we got the first unofficial diagnosis of Dad's GBM.

And then the fucking badass team of women at Northwestern laparoscopically removed my right tube and I came back to the room sore but alive, and then I peed and came home and we ate leftover pizza and thai at 5:30 in the morning. And then I couldn't really move for a couple of days was very sore but then the incisions healed nicely, and today I got my dressings taken off.

But the REAL long story is that my sister and two friends came over to watch our dog while we were in the hospital. And my sister and my mom came over every day that weekend to watch me while Matt went to work. That two beautiful friends, who I was supposed to sing karaoke with the same night I had surgery, instead came over and listened to me and sat by me and held me. That I was able to take 2 days off of work to recover and still get paid. That my best friends, who have very big things happening in their lives right now, showed me incredible grace when I whined and cried about my crummy lot and gave me strength and gave me hope and sent us flowers. That my guardian angel advised me through it, from beginning to end. That the internet support group I've come to be closer to than many real-life people followed the whole thing, whispering gentle encouragements and allowing me to wallow, wallow, wallow in the stink of it all.

That my sweet puppy continues to save me without even knowing it.

That my husband still wants to be married to me...after this:

Acne from months of hormones plus valium = sexpot

That is the long story and this has been the longest story of my life.

Long story short, though:

My luck is terrible and my people are the best.

And, also, fuck this stupid-ass shit.

Loss

I'm writing this because I'm desperate. I'm writing this because I've alienated myself from so many of you, because you've been able to do something that I've been trying to do for years and years...and I'm lost, and I'm lonely, and I'm terrified.

I had a miscarriage that lasted from May-July 2017. I had two more early losses, one in Sept. 2017 and one in November 2017.

Also in 2017:

• We started renovations on our house. Big-time renovations that will make our space beautiful and bright and more of our own.
• We got the most incredible dog who lives through everything with us. He's real cute, too.
• I got an insane promotion at work. Living my career dream, quite literally.
• We ate really well, drank really well, and continued to be married which I think deserves a fucking medal in and of itself because when you're trying to conceive and you're not able to...holy FUCK the toll it takes.

But none of that matters to me. Not really. Because I'm empty and I continue to be empty, and this isn't a something that comes up every so often, no no no, this has consumed me and inhabits me and takes the place of any growing life inside of me. It's bigger than I am and bigger than life is and I never expected this, never, ever, ever, ever, ever.

Women should build each other up. Women should support each other and give to each other and be there for each other because the world isn't there for us. I believe this so completely...but when the women in my life (all of the women in my world, it seems) started to get pregnant, right after my loss, I felt betrayed and abandoned and angry. I felt jealous, for the first time in my life, of my friends...and I continue to be jealous of my friends, and I continue to hurt and it is *excruciating*. Because I don't want to feel this. I want to be there with my women, in their joy and fear and overwhelmed and excitement...but instead, I'm anxious about my next cycle, wigging out on hormones to try and get me to a place where I'm even able to attempt to conceive a child, seemingly ignoring the needs of my husband, my family, my friends (those that I have left)...I'm there with myself, alone, and I've put myself there, and it's ugly and it's tragic. I've been through some shit...but this is Fucking. Tragic.

I wanted to wait until I was pregnant again to write something, but I'm not pregnant, and so many others are, and I keep on blocking people on social media and cutting people out of my life who have any association with anyone I know who is pregnant, and I avoid speaking with women who could potentially possibly even remotely be trying to get pregnant, and the word pregnant sends white-hot searing pain down my spine, but it keeps on going through my head. Over, over, over again. And I'm desperate.

And I'm sorry.