What to expect when you’re not expecting: IVF baggage
OPINION: When you think about IVF, you don't tend to think about it in stages. IVF is the term we use when we talk about the process of getting a baby using science.
Oh, you did seven rounds of IVF but you have a baby now? Awesome! IVF success!
We don't think about the baggage that comes along it. We don't think about the time it takes between one failed cycle and the beginning of the next. How excruciatingly slow the days pass when you are waiting for whatever it is you are waiting for this time. We don't appreciate the feelings of inadequacy, of desperation, of loss. The needles. The drugs. The ultrasounds. The tests. The money. More waiting. The tears that don't stop. The fact that there are just as many, if not more, unhappy endings as there are happy ones.
What I failed to think about is how different the process is for everyone and just how easily things can fall apart, literally at any time on any day.
It didn't even cross my mind that we wouldn't see a cycle through to completion. Yet here we are, staring down the barrel of cycle number three, less than six months after starting cycle number one.
In IVF's simplest form, the owner of the eggs goes through a process of injecting a daily drug that increases follicle (and therefore egg) production, then a few days later introduces another daily injection to stop the ovaries from kicking the eggs out. When the timing is right, a third and final injection makes a one-off special appearance which lets the ovaries know it's time to prepare for ovulation.
At that point the eggs are harvested and introduced to their partners for a kind of coming-of-age party. If the party is successful, a newly formed embryo is cultivated in a lab for a few days before being transferred to its new home in the ladyparts, hopefully for the foreseeable future.
Because Dave and I look great on paper (thank you), the first treatment plan we received from our clinic was pretty mild. My eggs are in abundance, Dave's warm dudes are supercharged. Heck, I've even got two normal sized, fully functioning uteri to choose from. What a bounty!
Making the right decision based on the information at hand, our doctor prescribed a conservative daily dose of the stimulating drug Gonal F.
Eight days in to injections and after two ultrasounds, the cycle was cancelled because my ovaries didn't respond well enough to the medication. Or really, at all.
Leading up to cancellation day, I was so proud of myself for keeping a level head. I naively told my mum more than once that I was only focussing on what was in front of me and I wasn't getting too far ahead of myself. That I needed my energy to get through what I was doing today and that I would think about what happens next when it was happening.
Except I wasn't.
Not really anyway. Of course I was focussed on making sure I injected myself with the right dose of hormones at the right time of the day, but I was also thinking about what it would feel like to finally hold our baby in my arms.
I try not to dream about that day too much, because it hurts to.
Because we should have a baby by now. Our house should be noisy. We should be tripping over toys and not getting any sleep and all of our clothes should be covered in milk stains. We should be trading stories with our friends about what funny things our children did and what new things they are learning.
But while this happens all around us, our house is silent. We trip over our own mess and I get at least eight hours sleep every night and my clothes are depressingly clean.
I envy everyone with a family.
On cancellation day when the doctor told us that he thought the best step to take would be to abandon the cycle and try again with a slightly more aggressive protocol, I felt like the wind had been knocked out of me.
It wasn't working? How is that even possible? We were so full of promise and optimism and in an instant everything had changed.
Dave and I looked at each other and tried to mask our distress by asking intelligent questions. I don't remember what they were. All I really wanted was to get out of there so I didn't have to hold my tears in anymore. I needed to sob.
I held it together.
The doctor ushered us to the nurses station where I'm pretty sure one of them put their arms around me gently and said sorry.
We went home. We broke the news to our family and our friends. I cried. Dave wrote. A bird died. Beautiful friends rallied around us and brought us things. Food things. So we could eat our feelings.
It was a shock more than anything else. We just weren't prepared, even though we thought we were. Within a few days we were back up and feeling positive. All was not lost. We would try again with a higher dose of Gonal F and everything would be peachy.
Except it wasn't.
After giving my body a one full cycle break (which ended up being about seven weeks), we started again. The daily stimulation drug went from 150 units to 225 units.
The first ultrasound to check follicle growth wasn't amazing. We had made an adequate start with about four follicles. It was better than last time.
Two days later, the second ultrasound showed ten follicles. That's more like it! Here we go! We were on cloud nine. Dave started calling me Folli-Kim.
Two days later, the ultrasound showed three follicles. Everything crashed down around us. They increased my dose to 300 units. Dave stopped calling me Folli-Kim.
Two days after that, rinse, repeat.
Our doctor said he still wanted to proceed with egg collection. We were too far through and we could still get a few of them out. I pushed my negativity to the side and focussed on the good. We've got three follicles – that's three chances to get three eggs. Women have been successful with fewer.
The morning of harvest day, I was a bundle of nerves. I showered, got dressed and had nothing for breakfast (because surgery). I pulled on my special pair of bacon and egg socks that were given to me by my sock buddy.
Sock buddy. It's a thing in the world of IVF. My sock buddy is someone I met on a Facebook support group who was going through treatment at a similar time to me. The deal is, you each buy the other a pair of socks to wear at appointments (because you've always got your pants off) and you help each other through the good times and the bad. They are your cheerleader and your confidant. They are also usually a stranger. But they know what you are going through because they are going through it too and you feel bonded to them. I chose not to wear my socks until egg collection day, which meant they sat in my drawer for months before I put them on for the first time.
When I looked down at fried eggs on my legs, it started to feel real. This was actually happening. Without a doubt, the two parts that make a baby would be coming together. Today. It was the first time that we could be absolutely sure that it would happen, because someone was going to make it happen for us. It was conception day.
Except it wasn't.
The physical process of egg collection was a piece of cake. Some women really struggle with this part and it can be quite painful, but I was lucky enough to have a lot of drugs and a very talented clinician. While I was watching the giant needle pierce my ovaries on the ultrasound, I failed to recognise that this was even happening to me. It felt like I was watching a movie. When the embryologist announced they had collected five eggs, I started crying. My mum continued crying (she started when we entered the room) and my husband beamed. This was so much more than we were expecting. I had worked myself up to believe we were going to get one or two. But FIVE. Dave started calling me Folli-Kim again and everything was good with the world.
Except it wasn't.
The next day we got the phone call no-one wants. None of the five eggs fertilised. And just like that, like the flip of a switch, this round of IVF was over.
There are no words that can accurately describe the feelings that followed. It was like someone had died, but there was never anyone there to physically mourn in the first place. I was numb. The sense of failure returned. I was angry. I was sad. At one point I even felt relieved. Relieved because we had certainty, which is not something you get to experience a lot of when you are going through IVF.
I'll never forget the sound my mum made when we called her. She is in this just as much as we are and the pained cry that came down the phoneline was devastating. This was not the news she was expecting to hear. I didn't know what to say. Neither did she. I said sorry. I felt like I had let her down, even though I know that's not how she felt.
We wanted to get the news out there as quickly as possible, because the sooner it was, the quicker we would be able to process it. If you can't tell by now, talking about this is incredibly cathartic for both of us. Dave is infinitely better at it than I am though. I admire his ability to capture and communicate his feelings so quickly and accurately. I'm different in that I want people to know what's going on, but unless I'm face to face with someone, I'm not very good at putting it out there and asking for support. If someone asks me explicitly about it I'll talk about it for hours, but I struggle to proactively come out and say "this happened today and I'm sad about it".
So I withdrew.
Having artificial hormones surging through my body didn't help either. I was unreasonable. Or maybe I was reasonable. I couldn't tell. Dave struggled with his own demons. We talked about how I was probably in a better place than he was in terms of coping. And I probably was, at least on the outside. I had dealt with the sense of failure before, but this was the first time that he had felt it too. We muddled through. Dave surrounded himself with people and I surrounded myself with cats. I missed more important friend-life moments. I'm sorry.
We went back to the clinic five days later for a follow up appointment. This was the same day we should have been transferring an embryo back in, but instead we were talking about why things didn't work out and what we would change for next time.
Ugh. Next time. This road just keeps on winding. The only thing that keeps me going is the hope that we'll find a little family at the end of it. And if there's not… well… I don't even know.
Our doctor is still optimistic and you can't help but feel better about that. After a thorough discussion, we've got a new plan in place. In about a week I'm going to start taking an estrogen pill that will hopefully balance out my egg growth and encourage a better response. We've also changed my stimulation drug from Gonal F to something called Menopur. I'm starting at the highest dose. We are going to inject the sperm into any eggs we get (please let there be some eggs) and see how far that gets us. I hope it gets us as far as a baby. That would be nice.
This post was first published on The Ruminator and is re-posted with permission.