Visiting friends in New York allowed my mind to veer away from that hovering in-vitro fertilization cloud — with the exception of the nightly shots. (Speaking of, it’s almost that time again.)
When we all lived in the same city, we often played the “What if …” game just as we did this weekend. What if I came home and the Mr. had a pet monkey? What if Mrs. Friend told her husband that her name was Ursula when they first met? What if one of us caught another of us cheating on the other of us? It gets deep and sometimes wild and crazy as driven by a double dose of vivid imagination. The possibilities stray so far out of anyone’s mind that it takes a while to decide on the most honest and likely answer. For example, I never thought about what food I’d eat if I could only eat that one thing the rest of my life with no consequences until I had to answer the question.
The same day we hung out, I aimlessly scrolled Twitter to find the following tweet: “No more treatments for me. Moving to childfree, kicking & screaming with a side of crying. #MovingOn” and then “For the twithearts that don’t know my story: 3IUIs, 3IVFs, 1DEIVF, 2FET: all BFN. I truly gave it my all. #MovingOn #Infertility.”
For those who don’t know the lingo, the woman I follow with the Twitter handle @IVFandme has endured:
three intrauterine inseminations,
three in-vitro fertilization attempts,
one in-vitro fertilization attempt using donated eggs and
two frozen embryo transfers
… all leading to a BFN, infamously known in infertility circles as a big fat negative pregnancy test result. That’s a whole pharmacy of drugs, a lot of little tubes going you know where and God knows how many, ahem, “private viewings” to go through without a baby to show for it. I wanted to kick something on her behalf, and I couldn’t help thinking: What if that were me?
I don’t think people understand that when you get to the point of fertility treatments, you’ve already tried everything you know to do and that everything else really is a crapshoot. It’s not a sure thing. So, although I look fine with the frequent transvaginal ultrasounds, multiple drugs, blood draws and injections that not only expose my belly fat to the Mr. but turn it red so he can see it better, know that I’m anxious, I’m nervous, I’m occasionally pessimistic and sometimes downright depressed. Fortunately, the worst of it never lingers. But like the darkside, it’s always there. When I explain that I’m “undergoing fertility treatments,” congratulations are not in order. This (group of attempts that may go on for years until I’m tired or bankrupt) feels like my last ditch effort, and I don’t want to jinx it by celebrating what could be a lost cause and maybe a waste of money. “We’ll see what happens” is about all I can politely muster with that weight behind every fertility-related move.
Sorry, Mr. and Mrs. Friend, I’m breaking the rules and sticking by my non-answer: I don’t know what I’d do if it were me.
As for @IVFandme, my thoughts are with you. With a remote understanding of your individual suckage, I know at least part of the road you traveled to this point and send virtual hugs your way. It ain’t much, but tonight’s shots are dedicated to you. Ouch and sugar honey iced tea.
If you consider that phrase an acrostic, you’ll understand what I almost yelled from my mother-in-law’s bedroom on Thanksgiving Day when the Mr. gave me the first injections. Three days out, I realize maybe it wasn’t THAT horrible, but it did hurt like the devil — especially when he removed each needle.
I’m on two medications administered with inch-and-a-half needles at the highest dosage allowed. One involves two vials of powder that have to be mixed via syringe with sodium chloride. The other requires refrigeration. Both necessitated stealth moves in a house full of folks who seemed joined at the hip Thanksgiving Day. It would’ve been a great time to inform my fairly new extended family that I was in the midst of fertility treatments; I just didn’t want to. It just seemed like a party killer. So rather than say anything, the Mr. and I eyed our watches for about an hour before an unrehearsed signal for a synchronized exit to the kitchen and upstairs. Essentially, he stood at the foot of the stairs over everybody tapping his watch. Real inventive, right?
He was the one who’d been paying the most attention to the nurse’s instructions. I was winging it, trying to teach him “aseptic techniques” that I learned from working one year at a hospital. That didn’t really help me with the specific instructions that I should’ve studied. Once again, I was the slacker and the Mr. saved the day — even if he did make me wanna punch him.
We’re still hanging with the in-laws, so there’ll be a couple more covert operations where photos will be near impossible. Stay tuned.
I got the go-ahead Wednesday to start my plethora of potions in the build-a-baby kit.
You’ll have to pardon my irreverence. In addition to my normal last-minute packing, I also had to prepare and pack all my drugs for the next several days to get me through Thanksgiving weekend. Making sure I had the right amount of needles, vials, ice packs for the refrigerated stuff and necessary alcohol wipes and gauzes added an hour to my ritual. I’m exhausted, but sitting under this hooded hair dryer is the first time I’ve sat still since I left work. And I have to stop my mind from reeling; it’s been on 90 mph since my ultrasound and blood work this morning.
The point was to make sure my reproductive system responded well to the birth control pills by essentially taking a nap. I didn’t know I was worried about the possibility of the cycle being canceled until worry came up during our workplace Bible study. Boo, hiss. I hate when God calls me out like that. I relaxed a bit after that, but my relief was only temporary even after the nurse called to say the meds were a go. It was like I was suddenly eligible to take a test I hadn’t studied for. I really did mean to brush up on the shot and medicine-mixing lessons from the first in-vitro appointment last week. Just like college, there was so much information that I’d resigned myself to figuring it out on my own time. Tick, tock, tick, tock — lo and behold, the test is tomorrow!
Instead of worrying, though, I’ll sing this song until my iPod changes to Thanksgiving songs:
“It’s only a test you’re going through.
It’s gonna be over real soon.
Keep the faith; don’t give up
For it’s only a test!”
The fact that I’m actually doing this in-vitro fertilization thing is really sinking in. I don’t know how I feel about that. Let me think about it — that is try to mediatate on the words that match my feelings, whatever they are … Meanwhile, I know you’ve still got questions. I’ve got answers:
11) How worried are you about the side effects — death, stroke, losing an ovary?
I’ve been well versed in all the risk factors and surprised at the same time. I’m not worried, though. I don’t know why. I’m just not.
12) How much does it cost? Is it expensive?
Expense is relative based on what you value. Eight dollars for a gallon of gas is expensive unless your tank is on “E,” and there’s just one station nearby. Also, not to get religious on you, we tithe at our church, so by God, we tend to have everything we need to keep the lights on and eat well though we likely make less money than you’d think.
13) Will you be another Octomom?
It’s highly unlikely. There’s a reason that the doctor for Nadya Suleman (her NAME, people) lost his license. The American Society for Reproductive Medicine recommends implanting no more than two embryos – fertilized eggs – in women 35 and younger and no more than five for women older than 40. Her doctor implanted 12, and eight survived. As I get deeper into this process, I totally get how the doctor is the most at fault.
In some cases, implanted embryos split and two may become three. It happens, but it’s rare. For me to sprout octuplets, the fertilized eggs that will be returned to sender would have to miraculously split several times over and beyond that. Don’t hold your breath for it to happen. And if it does, like NeNe from the Real Housewives of Atlanta, I’ll be verrrry rich.
Also, on the Octomom thing, jokes about this get old very quickly. Tread carefully.
14) Does infertility run in your family?
I’m one of four, the youngest actually. My maternal grandmother had four children; my paternal grandmother had eight with several losses in between. From that, I’d say no. But then, when I consider that of all my aunts, only two bore their own children, it’s a possibility. Reproductive system issues were rampant, and although my mother was perhaps the most fertile of everybody, she died in 2007 of ovarian cancer.
15) Why you putting all your business out there?
I have several answers for this. You remember when people wouldn’t say “cancer” out loud? It was mysterious, and people thought it was contagious. Now that it’s an everyday word, there are rallies and research and resources for its less affluent sufferers. Do you remember how conversations about AIDS started that way? See where I’m going?
Black people have a tendency to be quiet about the wrong things. Infertility is not a white woman’s condition, and treating it is not a luxury reserved for rich people. We would know that and perhaps encourage women struggling with infertility to reach out for support if it weren’t such a secret. And maybe that support would become universally offered, expected and funded.
That’s the activist in me talking. She can only go on for so long before it gets personal.
I carried this “secret” of struggling to conceive for a long time, especially in the face of well-meaning comments of it being “time to start a family.” I struggled through Mother’s Day and seemingly a million friends showing off 3-D ultrasounds and pictures of new babies. Quite often, I wanted to, like, snap out and just let some folks have it – not quite the Christian approach. I’d told a couple people in an informational kinda way, but really, I was starting to need something more than what even the saint-like Mr. could contain. Honestly, given my own beliefs, I needed some people praying for me.
So, randomly, over breakfast with my beloved fellow singers, I spoke up. Immediately, something lifted. It was clear that all of this is safer for me spoken out loud than trapped in my head. And now I’m writing it because I just can’t talk THAT much.
In the last two months, I’ve taken more license in speaking about why I have yet another doctor’s appointment and why it’s on Sunday morning. Each disapproving look or dumb comment has prepared me for the next one. So, negative ninnies, bring it on.
16) What does your family say about it?
My sister has taken the Malcolm X approach: by any means necessary. I told a brother that we were having trouble, and he said, “The Lord will make it happen when He decides. You can’t do nothing but wait.” Ironically, this is similar to something my estranged father said when my 6-year-old self asked where babies came from. Alas. I haven’t discussed my infertility with any other members of my family.
17) Do you think God is punishing you for something you did?
18) What are your church’s or pastor’s views on all of this?
It hasn’t really come up in church. And as for my pastor, I didn’t think to ask him what he thought. I did, however, slip his wife a note to pray for us and the in-vitro fertilization process.
19) How much does your health insurance cover?
Fortunately, we do have insurance coverage; a lot of women do not or one cycle wipes out their entire benefit. For us, most procedures are covered at 80 percent. The diagnostic hysterosalpingogram, or HSG, was our wakeup call that this process could get pricey. Insurance coverage for that still cost about $500 out of pocket. For the intrauterine inseminations, we paid about $22 out of pocket, but the accompanying drugs carried $75 and $10 copays. Multiply all of that times three, and that’s about the out-of-pocket cost of the drug protocols for one month of in-vitro fertilization. This one cycle will complete my lifetime maximum for my current insurance. Limitations like that fuel the temptation to implant as many embryos as possible, by the way. Decisions on what to do with the remaining embryos raises other issues as well.
20) How do you deal with the dumb things people say when they find out you’re undergoing infertility treatments?
I involuntarily cut my eyes at them before I politely nod and take it as my cue to shut up. Mentally, I acknowledge that it is ignorance and not necessarily malice. I also try to choose people I open up to carefully. I don’t yet have canned responses for the innocent but painful questions about when we’ll have kids. I’ve tried not to take my frustration out on the unsuspecting — even when they deserve it.
(Sigh) If you made it this far down, you’re a trooper. Thanks for sticking around. FWIW, these answers don’t negate my willingness to share other things you may be curious about. Feel free to post a question in the comments section, or e-mail me at email@example.com. I look forward to hearing from you. — MBE
They arrived. That’s a month of in-vitro fertilization drugs.
It occurred to me once I decided to go public with my infertility struggles that people would have a lot of questions. I’ve found that when I open up in a quest for comfort, I instead do more educating than emoting. To remedy that and to avoid repeating myself, I present the most common questions I encounter and answers as they stand right now. That’s my disclaimer for if or when my answers change.
1) Why can’t you have kids?
I don’t actually know that I can’t. I just know that I haven’t. I have a diagnosis of diminished ovarian reserve, meaning I don’t have as many eggs as expected for my age. (I’m in my early to mid-thirties.) Therein lies the challenge and why we – the Mr. and I – are trying everything available to make it happen.
2) What’s that like?
Well, in short, it sucks. It’s annoying. It feels unfair. And I wish it wasn’t so. I get down about it sometimes, and maybe I wanna complain. It just doesn’t make me feel any better. So, I refocus. I write. I pray. I take my prenatal vitamins as an act of faith.
3) Did you pray about it?
Yes, for Christ’s sake, AND in His name with fasting. Intercessors welcome.
I get very tempted on Sundays to throw myself on the altar at church Hannah-style, but I’m pretty sure security would take me down and carry me out before I can say, “Amen.”
4) Are you having enough sex to get pregnant?
(People do ask.) Yep.
5) How long have you been trying?
I’d say not long enough for infertility street cred. Things have moved really quickly, but when I count back, the path to this point feels like a long road. I ditched the Nuvaring the last week of January 2010. I can’t believe it’s almost 2012.
6) What’s the effect on your marriage?
There’s been no negative effect. It was already the two of us against the world. Now, it’s the two of us against infertility. Beyond that, my husband amazes me every day just by being his funny, supportive and thoughtful self.
7) How many kids do you want?
For most of my life, I wanted five. Before we got married, we decided on three. There’s a song from my hometown that’s now my song: “Any way you bless me, Lord, I’ll be satisfied.”
8 ) Why not just adopt?
Oh, why not get a bike instead buying a car? It’s transportation, right? Sorry, that darn humanity. Um, adoption could be considered a “fix” for childlessness perhaps, but not infertility.
9) So you’ll be doing that artificial insemination stuff?
Kinda. Nobody calls it that anymore. For one, there’s not much artificial about it – sperm and eggs are still required. What used to be called “artificial insemination” is modernly known as intrauterine insemination, or IUI. Sperm cells, which usually “walk” to meet a single egg, instead get a bath before taking an express train via a thin catheter guided in most cases by a nurse. The actual procedure takes about a half hour, including time just laying there. I’ve done that three times. No dice. That’s why I’m at the in-vitro fertilization stage. The fur is similar, but it’s an entirely different animal. We’ll be experiencing it together.
10) What do they have to do?
Essentially, with drugs, they’ll suppress my reproductive system, jump-start it with more drugs to make my body produce multiple follicles, which house eggs. Doctors will then go get the eggs, pair them with sperm from the Mr. in a lab, offer them wine and hope they hit it off. Once matches are made in heaven, the doctor will let me hold one or two of them for safe keeping, and I’ll eventually look like I ate a watermelon seed. I’m oversimplifying to explain the procedure without the gory details that – again – I’ll experience when it all happens with you along for the ride.
Even though I was born before that, I’m a child of the ’80s who took the “Just Say No to Drugs” campaign very seriously. I wouldn’t even eat cough drops as candy. I made it through adolescence as a “clean teen,” and as an adult, I avoid pain medicine as much as possible.
Now, I’m awaiting a call from my drug dealer. The drugs are legal, depending on how you use them, but they’re drugs nonetheless — a whole lot of drugs. That’s one side of in-vitro fertilization I forgot to think about. I was prepared for the injections; I just didn’t realize I’d have my own pharmacy of tablets, powders, vials, inserts and syringes. In the next 30 days, I will have taken multiple doses of eight medications through multiple methods, rooter to tooter. That doesn’t include a prenatal vitamin and the hazily wonderful hospital drugs to come.
Like any fiend, I’m anxious to talk to my pusher to work out the drop and how much these high-end, high-copay pharmaceuticals will cost me.
So even as I struggle to wrap my mind around it all, Nancy will just have to understand.
So these aren’t really mine, but you get the idea.
Here’s a little introductory trivia question, an icebreaker, considering I don’t know you and you don’t know me:
What’s the difference between brown eggs and white eggs? Not much.
The difference lies in the color of the hen that laid the eggs. Brown eggs tend to come from red-feathered chickens, and white eggs come from white-frocked birds. Nutritionally, they’re pretty much the same — just like the chickens. It just doesn’t come up in your everyday conversation.
Neither does infertility among black women. The same problems that white women have with conception and problematic ovaries and wayward eggs are same that black women have. As a group, we just don’t talk about it. Discussing it every day might be overkill, but the silence of it all and resulting isolation is enough to kill the spirit of every woman of color who carries the universal desire to bear her own children.
Wow. That sounded really profound, well beyond what I was going for.
I’m just a brown girl who inherited the genetic reproductive misfortune from the Brown family and finds herself staring in-vitro fertilization in the face. Journalism saved my life once; I figured the foundation of it — writing — might ease the stress of bringing about new life in the form of a round-faced baby or two. Or three. Or eight.
I’m also giving myself and the universe permission to say “black woman” and “infertility” in the same sentence. Part of that will include sharing what I learn about cycles, procedures and shots (oh, my!). There will be flashbacks, observations and blatant use of anonymity to protect the ignorant. You can trust that every raw tale will be true and reflect my most authentic thoughts and feelings about unscrambling my Brown eggs to finally get pregnant.
It’s what all the inquiring mouths are waiting for, after all. So, this is also to shut them up.