Some Version of Psychological Torture

Well, we're in ANOTHER waiting period for IVF. I swear this process feels like nothing but waiting. It's a true test of patience. Well...Let me back up a little. I'm writing these early blog posts after the fact to catch you up on how we arrived here before I just hit the ground running with where we are now....so forgive the bouncing around.

January 2023

My husband, Andrew and I started seeing a Reproductive Endocrinologist "RE" to help us get pregnant. I have stage 3 endometriosis and over the last 3 years have had two excision surgeries to remove as much endo as possible. My endometriosis is mostly around my colon and my ovaries. Causing stomach issues, bad cramping, and lovely ovulation pains. During both of my surgeries, my left ovary has either been fully encapsulated in scar tissue or fully stuck to my pelvic wall with adhesions. When we began to see our RE I learned I also have Diminished Ovarian Reserve "DOR". My DOR is likely due to my age (34 years old), and my endometriosis. My anti-mullerian hormone "AMH" is 0.28 ng/ml. For reference, with a quick Google search, you'll find that the low range for a 45-year-old woman (again, I'm 34) is 0.5 ng/ml, and under 0.40 ng/ml is considered severely low. AMH levels are thought to indicate the number of eggs that are left in a woman's ovaries. For those that don't know, women are born with all the eggs they will ever have so as we age that number decreases. It's very normal for your AMH levels to decrease as you age, but mine were severely low, so basically I'm running out of eggs. Yes, this news was pretty depressing to hear.

At this point, we learn that we have around a 1-3% chance of conceiving on our own. IUI with Clomid increased those odds to approximately 10% so I think at this point we started to assume IVF would be part of our journey to a family. But we knew that trying Clomid and IUI was the most logically sound decision because it is significantly less expensive AND it did increase our odds, although not by that much, it was worth a shot (haha, pun not intended). Not to mention it was a lot less physically demanding for me, however, I would argue that medicated IUI was harder mentally and emotionally than IVF has been for me. More on that below!

March 2023

We tried IUI with Clomid and an HCG trigger shot for 3 months/rounds. During these 3 rounds of Clomid, I really started to struggle mentally. I have always struggled with anxiety and some mild depression, but this process took it to a new level for me. At this point, we had been trying for over a year, and even during IUI we still only had a 10% chance of success. Between the price we were paying and the toll it was taking on my body and mind the next 3 months felt very bleak. The 10% chance of success just felt like we were wasting precious time, money, and precious eggs. That may be dramatic, but when you're in the thick of it a 7% increase in odds doesn't feel worth the cost or time you put into it. There are A LOT of women who are successful with medicated IUI, so please don't take this as it can't work. It was just harder on me mentally because I still hadn't seen good odds or stats for my diagnosis. Every month I would go in for a beta HCG test to find out if this was our month. Every month I would get a message on our online portal that would begin with something along the lines of "We're so sorry, but..." and the tears would flow. Every month. I can't begin to tell you how thankful I am for Andrew throughout this process. He's a rock and my voice of reason and LOGIC. He is naturally very low-stress and balances my tendency toward high stress-and high anxiety in these situations. All I wanted to do was google, google, google. I felt comfort in understanding my body and how it functioned. I felt comfort in statistics and reading other people's stories. If I'm being honest (which I've told you I intend to be through this blog) it became obsessive to the point that I would be embarrassed for any of you to see my search history. Haha! But anyways, back to Andrew, he supported me when I needed to rest, when I needed to cry, when I needed to move. He listened when I talked, he told me my feelings were valid and okay, and would only offer advice when I wanted it. Personally, I think that's the best way to be there for someone. Just listen, only offer advice if they request it, because sometimes we just want to be heard. That's definitely something I'm working on for myself. So, after 3 rounds of medicated IUI, we decided to start IVF.

June 2023

Alright, we've made it to June. You're almost caught up! In June my anxiety started to lift. There was FINALLY a light at the end of this tunnel. The odds of success with IVF are much higher than with IUI. With my specific diagnosis, we were told we had around a 70% chance of success within 3 transfers.

At this point, we had been trying to conceive (TTC) for 16 long months and I was finally starting to see some light, which really helped my mental health.

June 1

We began the IVF stim process. Due to my DOR, we were giving me 3 injections per day (and by we, I mean Andrew, because I can't seem to make myself do my own injections...eek) plus 5 different pills each day. It's a lot of drugs and a lot of planning. These medicines have to be kept in the fridge and also given at a specific time each day so managing that with plans outside the house can be a little tricky. We tried to avoid making very many plans during this 10-day period to make our lives a little easier, but the times we had plans we just packed a cooler of my drugs and some alcohol swabs.

There was one night that Andrew gave me my injections in a parking garage between dinner and a friend's rooftop celebration so we always found a way to make it work. See below for a picture of said rooftop celebration. Smiling after one injection in my thigh and one in my stomach, honestly, I was just happy to have made it to this stage!

During these next 10 days of stims, I had doctor's appointments almost every other day for lab work and transvaginal ultrasounds to check my follicles. Honestly, at this point, I was getting pretty used to mass amounts of lab work and ultrasounds, but over the next 10 days, I really started to feel like a pin cushion. I had bruises on my stomach and finding a fresh place for my injections each day was like some kind of weird game.

As I was starting stims I was so worried about how these medicines would make me feel. Would they make me feel crazy? Angry? Sad? Overly emotional? Bloated? Tired? Honestly, they affected me less than I expected. And the ways they affected me were not what I was expecting. Emotionally I felt pretty stable. In the first few days of stims, I had an unusual amount of energy. I basically cleaned our entire house top to bottom and did a ton of yard work. Unfortunately, this side effect wore off and didn't last more than a couple of days. Physically, I felt uncomfortable, but not as much pain as I was expecting but I was extremely bloated. And at this point was living in leggings and loose dresses because jeans wouldn't quite button.

I think my years of endo pain helped to prepare me for the abdominal discomfort of so many follicles on my ovaries. I felt my ovaries. There's really no other way to explain that other than just that you're very aware of where they are and they ache. I couldn't do any type of higher-intensity exercise, I couldn't do any type of extreme rotations. For example, I had be the audience for a night of top golf during this time period (bummer). While going through stims you are at a greater risk of ovarian torsion so you have to be cautious with those precious ovaries and follicles. I struggled with some insomnia. But honestly, the very worst part of this for me was the migraines. I have hormone-induced migraines anyways and have for years. I typically get migraines right before my period. Well with the mass amounts of hormones and the crazy high estrogen levels I had my migraines hit me pretty hard. I had almost daily migraines. During IVF you're very limited on what medication you can take so my normal migraine medicines were off-limits for me during this time. Soo.. Tylenol and ice packs it is. Unfortunately, those mostly didn't touch my migraines so I was living in a near-constant state of dim rooms and sleeping with ice pack

By the end of the 10 days I had at least 5 mature follicles that could be seen on the ultrasound and some others that could mature by the time of my retrieval. We scheduled my retrieval for June 13. We're getting closer!

June 13

We went to Chattanooga for our egg retrieval. I got to wear my "IVF GOT POSITIVE VIBES" shirt. This was overall an easier process than I expected.

Thankfully they use anesthesia so it was a quick and painless procedure. We learned when I came out of the procedure that they retrieved 6 eggs. For someone with DOR that seems to be a pretty good result from what I can tell so we tried to be pleased with that. You hear of a lot of people getting 10-15+ eggs during their retrieval so, of course, I hoped for that, BUT I'm a realist so knew it was unlikely. Now we had to wait for 6 more days to find out of those 6 how many make it to the next step.

June 19

We learned that of the 6 eggs, 3 of those fertilized normally, but only 1 of those made it to a day 5 blastocyst that could be biopsied for testing and frozen for a later transfer.

So at this point, we potentially have ONE embryo that we can transfer. Next up, more waiting. Waiting for the genetic testing "PGT" to come back. Genetic testing will tell us if this is a genetically normal embryo. You can transfer embryos without this step, but this step helps to increase our odds of successful implantation and a lower risk of miscarriage so it felt worth it to us. They told us this wait could be 15 business days. That wait felt like a lifetime. Torture, absolute torture.

July

July 6

CELEBRATE!! We had one embryo getting genetically tested so it felt like wishful thinking to think this one embryo would come back genetically healthy. But, drum roll please........we have one GENETICALLY HEALTHY embryo!!! I cannot describe the level of relief and excitement we felt at this news. I told Andrew that I truly needed this little nugget of positive news. This journey has felt utterly exhausting and at each step, it always felt like we really weren't getting great news. But this time, this time we got great news! Really great news.

So now back to the psychological torture and waiting game that is IVF. Today is July 12 and I have no idea when we get to transfer our little nugget. The amount of patience it takes to wait for the next steps from our clinic during this process is unexplainable. Our little embryo is frozen in a lab in Chattanooga waiting for our transfer. I wish they had some type of camera set up where we could just peek in and check on him/her. Does that make me a little crazy? Maybe, haha! But it sure would be cool. Speaking of him/her, with IVF you can know the sex of the embryo prior to transfer. We are choosing not to do that. We plan to wait to find out the sex of our future baby when they are born. Every single bit of this process has felt so planned and scheduled through infertility treatment. We want some part of this to be a surprise! Did anyone else wait to find out the sex of their little one? I’d love to hear about some of your experiences!

It looks like our transfer could take place anywhere in the next 4-8 weeks. That's a total of around 3 months for ONE full cycle of IVF. It's a long process so if you're heading towards this path, I recommend buckling up for a lot of waiting and what I like to call psychological torture. And for those that don't know, in the US infertility coverage is rarely covered under health insurance. We have a good full coverage health insurance policy, but our insurance hasn't paid any portion of our infertility treatment. At this point, we have spent over 30k on infertility treatment since the beginning of this year and we don't really know how much more to expect.

Thank you for joining me on my blog! This post was meant to be my catch-up post so I can begin bringing you along with me on the next steps. I hope you'll reach out if you're in a similar boat or just want to ask any questions. I truly love discussing women's health, infertility, periods, endo, exercise, etc...