Cycles in my Life (IVF updates)

Hey there loyal audience....if you're still subscribed to my blog. Lol. There is so much to catch up on. Where do I even begin? I wanted to go through my most recent...well not so recent....fertility cycles with you all. Life has just been too nuts to even have a second to write up everything that has transpired this last year. I'm actually on hold with a third party pharmacy waiting for a specific out of pocket expense medication that I will need for my next cycle. What a fun "lunch break" no? Someone told me once that IVF was a full time job, I never doubted that comment, I just didn't realize the levels of commitment it took on a daily basis. Even when you're "off" cycle you're still making phone calls, verifying prescriptions, doing baseline bloodwork and ultrasounds, sending confirmation emails to office staff, organizing your medications, the list goes on.

Let's go back and recap what my fertility journey in specifics to IVF has looked like this last year. Pretty nuts that it's been over a year of me dealing with going through IVF stuff and a year prior to that of miscarriages and surgeries. Time sure does fly when you're miserable, sad, frustrated, alone, angry, and confused. There was a sarcastic undertone to that last statement. There were plenty days of joy and happiness, but most of my life unfortunately has been consumed by all this. There isn't a day that goes by where I don't replay all of this in my head over and over again and entertain the what ifs? Dangerous? Sure...unhealthy? Of course, but this is what happens when you go through something of this magnitude. Your mind takes over even when you redirect it to not.

So let's dig in.

January 2021

My husband and I were so excited! We fell pregnant naturally after our third miscarriage in 2020. We were not trying, I can assure you. It happened. We actually had a call with our first fertility clinic in January of 2021. I remember being on the zoom call with him (Covid so no in person visits) and being so excited to start this process. He went through what our game plan was and how the protocols would be set up. I was very overwhelmed because I was so new to this. He did mention that we would go right into IVF instead of IUI. The quick difference between the two, if you are not super familiar with the terminology is that an IUI (intrauterine insemination) is basically a medicated cycle but timed when you are ovulating. They are mediated, but it is less invasive. The percentage of successful IUIs according to most fertility studies is 15-20%. I only know one person who has had a successful IUI. Most try a few of those due to financial constraints and insurance coverage and move into IVF. IVF is invitro fertilization where they take out your eggs fertilize them and put them back in. This is much more complex procedure for obvious reasons and much more expensive as well. There are also a lot more doctor visits, medications, and hoops you have to jump through to get to this point. The fertility clinic I was talking to actually told me I had to go straight to IVF because of age and recurrent pregnancy loss. You have to have three in a row to be diagnosed for recurrent pregnancy loss. I was right there.

So we met with the doctor and I was confident in the plan. The month went by and I never got my period, so I tested and sure enough it was positive. Yah! Pregnant! Now we don't have to do IVF and spend thousands of dollars on a baby. This was another tough pill to swallow. I just assumed if and when we had to do it, it would work. Not exactly. Quite the opposite. So anyway, I was pregnant! Naturally! This had to be it right? The reason why it happened, so we wouldn't have to venture down the IVF path....not exactly. My husband and I decided to go away and with the help of my parents were able to go to Florida and relax during a pretty stressful time. We were buying and selling a home, working full-time, had a pretty rambunctious two year old...we were due for a break. So a break we took. I called my fertility doc and told him the news. He said congrats and we will see you hopefully never! My husband and I left. We enjoyed our "baby moon" and put life on hold. Of course if you know me you know I love me a pool and a cocktail. They go hand in hand. Florida is fun, but it's really enjoyable to be away with your spouse and have a few drinks ya know? I obviously didn't do that, but did sleep in and lounge by the pool. The few days passed quickly and we returned home to finish our closings and moved into our new house! It was such an exciting time. It was perfect actually. I remember thinking okay I endured all of this, the pain, the heartache, the misery for THIS chapter. I can finally breathe. We have our house our second baby on the way...life is good. Like so many people I know, I was living what I thought was the dream after even so much trauma and torture. Not too fast Nat...don't move so quick.

After our move once we were in our new home, I remember getting a really bad headache one day. I thought it was just the stress of the move. The next day I went for my 9 week ultrasound appointment and yet again, "Natalie I can't believe this is happening, but there's no heartbeat." What in the actual f%ck? You can't make this shit up if you tried. So I waited the doctor to come in and told him that I am just done. That I'm at a loss. He said well, I suggest you test the product after your D&C and go from there. Maybe go back to your fertility guy...I said for sure. Obviously we need help. This was a hard pill to swallow. The loss was one thing, but I felt like there was really something wrong with me. There still might be to this day, but I took his advice and called my RE (Reproductive Endocrinologist). I said, "What's up Doc" It's Natalie. So remember how I called you and said we were pregnant? Well turns out we're not. So after much waiting and begging and pleading, we got back into for a zoom call, eye roll here because God forbid you talk to the doctor face to face. Any who you can thank Covid for that, but we did have a follow up and I was told to come in for follow up blood work and ultrasounds. At this time were were still waiting for the product/tissue samples from my miscarriage/D&C.

When I had my ultrasound and follow up the doctor was concerned about a fibroid that I had in my uterus and was wondering if that was the culprit of my miscarriages. Finally! An answer this is why! We can take it out and move on with life and get pregnant and live happily ever after! Not too fast Natalie....gosh if I had a dollar for every time this happened, I could retire like yesterday. We did discuss options and my doctor wanted it removed so I had to go back to my OBGYN and get it laparoscopically removed. This was in April 2021. He did tell me that we couldn't do anything IVF related until three months after the fibroid removal surgery. It is pretty intense and the uterus needs to heal. Fine. What's another three months at this point? So I scheduled the surgery got all my Covid tests done and I was ready to go. Well turns out between the time I scheduled my surgery and did all my testing, I actually got Covid. Wouldn't ya know...lucky gal huh? Well back on the phone and was told I couldn't have the procedure until I have negative clearance or a negative test. I freaked out because that could take weeks! I was so mad because this was just pushing back my IVF timeline. Another thing I learned is that you have to let go of timelines. THEY NEVER EVER EVER go according to plan in IVF world. So fast forward to after my birthday in April, fun birthday right? Covid and stuck at home. The year prior Covid just started so yeah stuck at home. That April 29th instead of surgery I was at home sick with a sick toddler. Good times. Anyway we all recovered after about 48 hours and went back to life as normal, well under quarantine of course. Then May came and I was finally able to have my procedure done. He removed some endometriosis and the asshole fibroid that was causing me to miscarry! Finally. I was on the way to recovery and closer to a baby!!!!!!!!!!! Not really. Oh and the product came back from my miscarriage and it was a boy with genetic abnormalities.

The summer came and went and I enjoyed as much of it as I could, but obviously in the back of my head I was always thinking about the fertility stuff. What it would have been like if we were still pregnant, etc. I mentally tried to check out, but it's really hard. People think you can just move on or get over it, but you never really do. Anyway we did have a trip in June and on our vacation I had my follow up zoom with my fertility guy. He said that if and when my uterus looked good at my next appointment and healed from my myomectomy then we can start moving forward with our first IVF cycle. This was good news! Kinda...still so many unknowns. We came back and were set up in July to start. I got clearance to start and we began the official IVF journey in July. I remember giving myself shots the last few weeks of my summer vacation. There was one night....this is funny...where I needed Ganarelix. If you know you know, but apparently this is a critical drug in regards to ovulation suppression. For some protocols, you need this drug to keep you from ovulating, so that come egg retrieval (harvest) time they are ready to go. If you prematurely ovulated then the cycle would be null and void. Well, anyway with lack of communication and not knowing on my end, I didn't have enough of those. I frantically realized that on day who knows of my cycle and asked anyone and everyone if they had one. I went to my trustworthy Facebook group, highly recommend, my friend told me about it and asked the girls there. Some random girl, angel in disguise had an extra one! The only stipulation was I had to drive out to Schaumburg from far away lol to get it and I had to do this before the time ran out. You have a window of time in the evenings where you have to give yourself the injections. SO I drove and I found her house. She gave me the meds and I remember distinctively using the alcohol swab on my tummy in the dark under a street light off a side street like a pure drug addict. If someone had their Ring watching me, they must have been terrified Haha But I gave myself the shot, drove back to my parents and tried to sleep, freaking out. Did I make it in time? Did I ovulate? I went to the doctor the next day they said I was fine. So retrieval was still on! We had the retrieval right before I came back to work in August and they got five eggs. I was not impressed with these numbers. Everyone told me it's quality vs. quantity and although this is true, hard to hear that number and remain hopeful. I'm a numbers gal. To me the more eggs you get the better chance you have. Statistically eighty percent fertilize and then half make it day five or day six and then twenty-five percent of that are PGS (chromosomally) normal. So wasn't looking good. Actually 4/5 fertilized which was normal or expected. Two out of the four made it to day five which was great and were high grade, which now means nothing to me. Now the next step. Send those babies off to test! So the longest two weeks of my life.

I don't remember much. We tried to stay busy, but of course you're wondering and analyzing everything during your "down time." I was hoping at least one was good for a potential transfer! I remember getting the portal message at work. Zero. None. Nada. So five grand later we had nothing to show for it. Now what? Well back to the drawing board, only with fertility guys you have to wait for them. So again after much begging and some bribing I got back in a lot more quickly than anticipated and we did our re-consult. I asked my doctor if he was going to change anything for this next protocol and he said no. I scratched my head, but hey he's the pro right? As I'm learning through this journey you have to find a doctor that will a) explain things b) be open to change. Not all doctors are. They think it's the luck of the draw and you just have to keep trying until you get one. Although, there might be some Science behind that, that just doesn't make sense to me. If it's not working why keep trying it right? I think of diets....why keep doing keto or vegan or weight watchers if you're not finding success? Anyway so we had another protocol and cycle ready to go for the following month. I make it sound so easy. Like oh it's ready to go. I failed to mention all the phone-calls and appointments you have to do in between those actual cycle dates. The approvals and authorizations you must obtain to even start a cycle is a headache and a half. I'm getting stressed just thinking about it.

Well the time came and we started up that second cycle with the same clinic. I was much more prepared this time around. I knew what to expect. I remember walking into the office super confident because hey, I've done this once. I am smirking as I'm typing this because it was literally just one cycle. You're certainly not a pro by any means. Little did I know that one wouldn't be successful and we would have to do more. It was just nice having that comfort of what to potentially anticipate. Still many curve balls were headed my way. Like my doctor wouldn't be doing the retrieval, I wouldn't be doing the trigger shot when I thought, etc. We wound up getting five eggs...again. I was devastated, but remembered that little voice, "it just takes one." Well couldn't even get to that point because none of them fertilized. I was just beyond myself. Talk about defeated. What was happening? I wasn't being selfish or greedy. I literally just want one more baby. A sibling for my daughter. Something that is soooooooooooo easy for most. Yes, I recognize a lot of women have fertltiy struggles, but a lot don't. Some have three, four, five children and it's no big deal. I just wanted one more selflessly for my kid. To have someone besides the dog and neighbor kids to run around with. Not an unrealistic request.

The next step....

We had a tough decision to make. I trusted my gut. My doctor wasn't giving me much and wasn't super responsive to my requests to change protocols. So guess what bruh...you don't change, I change. I went with my intuition and sought out another clinic. A specific doctor who was very well versed in recurrent loss and patients older in age. Yes, I am a grandma in the reproductive endocrinology world. My friend who went through her own struggles recommended this doctor in Naperville. I decided to bite the bullet, pull our funds from the former clinic, and jump ship. I was taking a chance, but hey they weren't cutting it and we're paying them no?

After many desperate phone calls singing my sad story to many receptionists, I finally got lucky and got in early with this very well-known and talented doctor. We were set to meet with him in October and in my mind could be pregnant by Christmas! Oh was I poorly mistaken. Yet again. Our initial consult was very productive. He told me, "Natalie, it's not a YOU issue, it's a protocol issue." He assured me he was going to get me where I needed to be. I was hopeful for the first time in a long time. We moved forward with all the necessary steps, checklist and were set to start our cycle in November. The contingency being that all my bloodwork and ultrasounds go okay. I had to do multiple tests and visits with him to just get to this point. Being at the doctor was my home away from home. When November came I remember being at birthday party and getting the portal message saying, you are ready to start your stimulation cycle! I was overjoyed. There was a point in this last cycle where I didn't know if it would be cancelled, so much to my surprise we were good to go! What a relief. That next day we started our new injections/shots and were tentatively good to go for another retrieval/procedure in December. With finals exams approaching for work and just everyday stressors I was very busy and overwhelmed, but powered through. We were set to have our retrieval the week before Christmas and everything looked good. I remember going in that day without my husband, shocking, another appointment without your spouse because of Covid, and being somewhat calm. I had a good feeling. I came out of anesthesia alone and the nurse came in to tell me they got 17 eggs! Holy shit! That was more than three times the amount from our pervious cycles. I was beyond elated. Drugged up, but ecstatic. I went home and waited for the phone-call the next day to see how many fertilized. We were told out of the seventeen, twelve were mature. Nine out of twelve fertilized and we then had to wait for our day six update. That was torturous, but I tried to distract myself and do life. With a crazy toddler who wakes up at six everyday and doesn't go to sleep until eight-thirty or nine, this wasn't too m much of an issue. On day six I got the call and remember crying so hard. They said six made it to blast stage! Meaning it's officially an embryo. We don't know if they are chromosomally normal, but we had six embryos to test! How exciting and right before the holidays too! I was like for sure at least two will be good. We could transfer one and freeze one. We sent them off to testing and enjoyed life....for a bit. Because of the holidays it was a longer wait to get our results back, but we eventually did. I think around three weeks time.

I was in class, well in a colleague's class subbing because hey extra money to pay for testing right? That shit adds up and is an out of pocket expense I wish I never had to pay for. I was in her class and they called. It went to voicemail and I frantically checked it as the kids left when the bell rang. The nurse said, "Natalie I have your results. Please call us back" I was trying to evaluate her tone, was it good news? Bad? I called her back immediately. No answer. I tried for three hours to call her back and nothing. I figured she left for the day and I was sick to my stomach. How could I wait until the next day to find out what is our future? Our life? In desperation I reached out to my head nurse who lives in Florida. I emailed her saying you all have my results, but I don't know what they are. I hopped in the shower and kept my phone close. She called as I was in the shower, I rushed out and said, "Hello". She calmly said I have your results and I'm so sorry but zero out of six were chromosomally normal. My jaw dropped to the floor. I was in complete disbelief. How was this happening? I talked to her for thirty minutes in a towel in my closet when my husband came in and just held up zero with my hand. He walked out.

What most don't realize is that this affects everything. Your mood, your trust, your marriage, your relationships. You are not the same person you once were. You can't have fun making a baby or share in good news together. Seems like my husband and I keep getting hit and hard too. It's hard for both of us for different reasons. We try and go out occasionally just us, but have to get back to a toddler and jobs and fertltiy life. It's not the same and the time spent together is different now. Sometimes were just too tired to be Natalie and Tom because of everything. Breaks are needed, but are hard. The help isn't as prevalent and it's hard to take time away. You feel bad asking others to watch your kid so you can just have a quiet peaceful moment with your husband after all the stress and trauma. Plus people have their own shit going on.

Things I've heard that I wish I didn't:

- people have it worse

- you will have a baby someday

- at least you didn't _____________(fill in with so many options)

- well my friend's neighbor's sister....

- this is just a hard time right now

- it will get better

- you should be thankful that ____________

- at least you have Maddie

- be thankful for the blessings you do have

- one day it will happen

- stop worrying so much

- be strong and move forward

I could go on and while all these comments are fine and good, they don't really address the current state I'm in. That is the constant roller coaster of emotions that I'm on. Not to mention the extra hormones that are in and linger in my system for weeks. It's like an out of body experience looking at myself. I'm like I was happy once, but not so much any more. I find joy in things sure, am I thankful of course! Shit who wouldn't be....but I don't like or appreciate the "oh well" attitude that I get from some. This shit is fucking hard and it fucking sucks and it's been a struggle for way too long. Sometimes I just want those around me to acknowledge that.

Here are some things you could say to someone struggling with fertility issues:

- This must be really hard

- This fucking sucks

- How are you feeling about all this?

- How did you feel when you at your last visit?

- How did you feel when you miscarried?

- Do you think about those babies you lost?

- How were those appointments without your husband?

- Can I bring you some food?

- Can I take you to dinner?

- Can I watch Maddie for you so you can go out with your husband?

- Can I help in anyway?

- What will make you happy today?

- How can I be a better listener?

- You're a bad ass chick and I respect the fuck out of you

I say this with conviction...you don't know what a woman who has gone through this feels until you have gone through it with the same severity. You just wont. That's no ones' fault, but instead being a helping hand or ear can do more than you could ever imagine.

Moving forward we are set up to try another cycle with our current fertltiy clinic here in March. All the feels came back when they delivered my medication. All the doubts and worries and concerns came back into my mind. How could they not? For two years we have been knocked on our assess several times. Although we get back up, we still have that residual feeling of what if this isn't it? What if this doesn't work? What if this is it?

If and I hope and pray this cycle is a successful one and get some embabies on ice, there are still the hurdles of more testing. ALICE/EMMA/ERA are three that I will have to do. I can explain those tests as well. One thing to note those are not covered either. At that point you hope you can transfer and it's a successful one. Many women transfer perfectly healthy PGS tested embryos and still miscarry. There are so many moving parts that I wish I never knew about. I guess the only silver lining is maybe I'm helping some woman out there who is struggling herself. Maybe she has gone through loss and is embarking on this path. You certainty don't want someone to have it worse than you, but maybe "get it" or recognize the struggle if you know their story.

I will keep you updated on what's to come with this next round and in the meantime thank you for your loyalty and compassion. It's a tough world out there. We can be tough most days, but we also need to be humans with real feelings and raw emotions. Be well.

#fertility #secondaryinfertility #miscarriage #pregnancyloss #fertilitywarriors #help #healing #hope #support