My IVF Challenge: Mostly Physical, Hardly Emotional!

Challenge can mean many things. As a verb, it can mean to confront something, face up to it. It can mean a dare, or to question. As a noun, it can mean a test, or experiment. Which of these can I relate to the most? ALL.

I don’t pretend to know how other women have felt when they went through this process. But as much as I have read about their experiences to try to connect, to understand, to have that bond with this community of kick a** women, I find myself more disconnected than ever. I sit and wonder why. I strum my fingers along the keyboard trying to find the words. I squint as if that’ll help any. I take a much-needed break.

Okay, I’m back…. So, it’s not that I don’t have the words, heck, anyone that truly knows me will say that I am never at a loss for words. To be honest, this is one of those moments, one of those topics that I tread lightly due to the high likelihood of being judged. Judged by all those kick a** women. Like I mentioned in my blog intro, I like to consider myself part Vulcan, hoping that logic will trump emotion. Don’t get me wrong though, I am a woman, I am human, I am a mother and a wife, which only means I get emotional… a lot. But I guess this was not one of those moments.

It’s never been easy for me to get pregnant. I’m not very fertile. Actually, it runs in my very small family. My only sister is 20 years my senior; her only 2 kids are 17 years apart. Then it was my turn. Married twice and we needed “help” getting pregnant, regardless of my DH (dear husband). I won’t bore you with my other experiences, but this time around, due to my genetic predisposition, my aging eggs and my 40+ bracket, IVF (in vitro) was my OB/GYN’s recommendation instead of the old college try. We were actually relieved that they weren’t going to put us on some weird intercourse schedule; we had done plenty of “that” without much success. We were actually psyched at the new experience, always up for an adventure, if you can call it that.

By way of the doctor’s recommendation we go with RMA NY for our IVF  treatments. From the get go something seemed odd, out-of-place, as if I was an oblivious character in the Twilight Zone. I couldn’t quite put my finger on it at the moment. But what did I know? This was new to us. I guess our expectations were a little different. My expectations? I guess I thought that due to the common denominator of why we were all there, this would create somewhat of a sisterhood, a kindness in the air, a slight smile, a nod, a look of understanding that we all belonged to the same club. And if not from the other hopeful mothers to be, then at least from a staff trained to interact with patients of this nature. But it was the epitome of clinical. No hand-holding, no amicable small talk, not even a smile. Everyone in that waiting room got called by their last name, next!, in you went, got your blood work done and out. Next. Next. Next. With each visit, I felt like….dare I say it….like cattle. I didn’t look forward to each new phase. Don’t get me wrong, they did their job, plus I hear they have a high success rate. But shouldn’t this experience come with a little extra something? Was I expecting too much? Did I want this to be more fun, more enjoyable, more personal? Heck yeah!!!

I met our doctor, Dr. Lawrence Grunfeld for all but 5 minutes, who directed us to our coordinator, another 5 minutes and then dealt with our nurse. I received my schedule with my list of medications. I started taking the GnRH antagonist, Lupron, to put my little ovaries to “sleep”. Then afterwards, of course to trigger ovulation, I was given a cocktail of Clomid,  Gonal-F and Menopur. I measured, I kept time, and I injected. All the while my belly and thigh sites being the testaments of my persistence. I didn’t think much about it except that it was a chore, like doing my dreaded dishes or folding the laundry. Things I must do. Except that these injections had a hopeful outcome at the end. Not like those stupid dishes and clothes getting dirty all over again. By now the follicles, or follies are developing, estradiol (estrogen) levels are being monitored and oocytes (egg cells) are hopefully growing. The trigger shot Ovidrel (hCG) is now introduced and it needed to be timed just right, a onetime deal. Geez, I could feel the pressure, the concern, we were a step closer to egg retrieval. But despite my detached feeling with RMA NY, we were excited. My body seemed to be responding to the medications, plus I felt no side effects. A total plus.

Retrieval day and we anticipated the moment as if we were already giving birth. I get prepped, and a visit from the anesthesiologist, and I’m out. They retrieve a whopping 23 oocytes. What? And I couldn’t ovulate one of those eggies all on my own?  But I smiled because those are all hopeful signs and hopeful odds. I may be wrong, but I think DH (dear husband) and I high-fived at that moment. Let’s not forget, my DH had his moment of solitude to contribute his little swimmers while I underwent this process. Oh, the simple lives of men. We were then advised that 15 had fertilized, 8 had developed well and a 5 day transfer would occur. In the interim, back home I now encountered the dreaded Progesterone Intramuscular injection. Okay, NOW I’ll give it up to emotion. THIS scared the crap out of me. That thing was huge. DH was ever so willing to step up to the plate and administer it as his “contribution”, other than those little swimmers. I’d cringe with each passing shot. I bet DH was smiling with his role as Doctor O. (That’s his first initial, in case you were thinking otherwise).

Transfer day and again total excitement. Okay, that’s another emotion, right? You see, I’m not made of ice if that’s what you were thinking. There were 5 embryos, we opted to transfer 3. And unlike the retrieval, I got to watch the whole process. Now here was the best part. I got a photo of my 3 cute embryos for the baby book journal. Awesomely crazy.

Now came the 2WW (2 week wait). Keeping busy with everyday life, time passed. All this leading up to a BFN! (That means a Big Fat Negative as my pregnancy result). Definitely cried and disappointed. WTH!!! Did I do something wrong? No, I didn’t do anything wrong. I followed everything to the T. We knew statistics showed that it usually fails on a person’s first try. We weren’t oblivious to that when we started this whole process. If it failed for other couples, it could just as likely happen to us.

On to the next stage in our lives. Challenge cycle #2. I realized I didn’t want to do this again with the staff of RMA NY. The first time I trusted the recommendation of my doctor. This time we’d choose for ourselves. After much research, we went with NYU and met the amazing Dr. David Keefe. Now here’s a man who knows how to treat his patients. During our consultation, Dr. Keefe asked us regarding our last experience, along with personal questions. The type of questions you ask someone when you want to get to know them as a friend. The man even took notes. And in turn we got to know him a bit. He loved his trip to Puerto Rico and even learned how to dance Salsa. And when it came down to the medical basics, he explained everything; his reasons for the customized schedule for our scenario in comparison to what I had before, and even explained why he didn’t believe in having Progesterone administered in injection form. Dr. Keefe mentioned it would be best to go with vaginal gel this time around. I cheered and gave an obvious sigh of relief. Even the staff at NYU Langone Medical Center, down to the receptionist were all cordial, happy, they got along with one another, they interacted, said hello in passing. A practice that knew how to deal with people. Imagine that! I don’t even care if they were all faking it. But if they understood this is what their patients needed to feel comfortable, to want to keep coming back, then in essence, they did their job.

My new cocktail consisted of the same medications as before, just in different dosages. Follicle and oocyte results were similar. We transferred again 3 embryos. We wait… we wait… and afterwards a BFP!!! (This one means Big Fat Positive!!!). Could that have happened with RMA NY on my second cycle? Sure, it could have. But I wanted it to be more fun this time around. I just wanted nice people surrounding us during a time of hopeful thoughts. I wanted the staff to believe this was going to happen, and celebrate each step. And that’s what we got at NYU Langone Medical Center.

So what am I concerned with being judged on? That sure, it’s sad when you get a negative result, and heck I can even understand wanting more out of the experience itself. But I forget the details of this so-called experience, I don’t remember my retrieval or transfer dates. I don’t remember the names of the medications I was given. (I had to refer back to my paperwork). I don’t care to remember the beta levels and most definitely the whole list of abbreviations below just annoyed the heck out of me. Yes, I used some in my rant above just to show how annoying it can be. (Please feel free to print out the cheat sheet below to help you understand most of the forums on this topic). This wasn’t a spiritual “journey” for me, it was just a means to an end. It was just another amazing medical option. And could I have allowed the first BFN depress me, bring me down? Sure, but what good would have that done to the quality of my life, to my relationship with my husband, with my other goals in life? Is this an indication that it meant less to me? With each forum I entered, I almost felt like it meant more to all the women there than it did to me. But deep down, I knew that wasn’t true. I yearned for my son just as much as every other woman does for the children they do have or hope to have.

So, for those women out there just looking to find a nice practice, just want to get through the shots, the stupid progesterone, the constant blood work and visits to your endocrinology clinic; and don’t truly care to understand the science behind the process, those who refuse to remember all the little details, give very little concern to any possible side effects or don’t have much time to join a support group; I’m with you.

***And to ALL the women going through this process, journey or not, may every one eventually have a BFPositive!!!!

Elke

(If you’re as oblivious as I was to all these abbreviations, save these to your phone):

2WW Two week wait
16dp3dt 16 days past 3 day transfer
ACA Anticardiolipin Antibodies
AF Aunt Flo = period arriving / bleeding starting
AH Assisted Hatching
AHR Assisted Human Reproduction
ANA Antinuclear Antibodies
ART Assisted Reproductive Technologies
BBT Basal Body Temperature
BCP Birth Control Pill
Beta hCG level blood test
BFP/BFN Big Fat Positive/Negative
BMI Body Mass Index
COH Controlled Ovarian Hyperstimulation
CD Cycle Day
DH/DW/DS/DD Dear Husband/Wife/Son/Daughter
Dx Diagnosis
ED Egg Donor
EDD Estimated Due Date
ER/ET Embryo Retrieval/Transfer
FSH Follical Stimulating Hormone
FET Frozen Embryo Transfer
GIFT Gamete intra-fallopian tube transfer
GS Gestational Surrogate
hCG Human Chorionic Gonadfotropin
HPT Home Pregnancy Test
ICSI Intra-Cytoplasmic Sperm Injection
IP Intended Parent
IUI Intra-Uterine Insemination
IVF In Vitro Fertilization
IVIg Intra-venous immunoglobulin therapy
IVM In Vitro Maturation
LAP Laproscopy
LMP Last Menstrual Period
LH Luteinizing Hormone
LP Luteal Phase
LPD Luteal Phase Defect
MF Male Factor
NK (Cells) Natural Killer Cells
OHSS Ovarian Hyperstimulation Syndrome
PCO Polycystic Ovarian Disease
PCOS Polycystic Ovarian Syndrome
PCP Primary Care Physician
PGD Preimplantation Genetic Diagnosis
PID Pelvic Inflammatory Disease
POAS Pee on a stick – home pregnancy test
POF Premature Ovarian Failure
PUPO Pregnant Until Proven Otherwise
RE Reproductive Endocrinologist
Rx Prescription
SM Surrogate Mom
TCM Traditional Chinese Medicine
TDI Therapeutic Donor Insemination
TET Tubal Embryo Transfer
TR Tubal Reversal
TS Traditional Surrogate
TSH Thyroid Stimulating Hormone
TTC Trying To Conceive
UR Urologist
ZIFT Zygote intra-fallopian tube transfer
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