Tag Archives: in-vitro fertilization

Reflections of the Way Things Used to Be

Last year this time, I was in New York with a fresh needle wound from the first shot of my in-vitro fertilization cycle. I was trying to be thankful for a wonderful husband, a promising job that fit my talents and general happiness with life despite the ache of not yet being pregnant and having to endure IVF at all. That was a difficult balance. It was even worse to battle such inner turmoil while wearing the permanent smile-face of holidays with in-laws who didn’t know or necessarily understand anything about me or anything I might be feeling. Empathy from outside of the infertility circle is hard to come by even after the explanations of why and how.

But. I. Survived.

And I came out with a story to tell happily ending with a real live Rufus and Reefus, born exactly three months, two weeks and three days ago. Even as I listen to them sleep in their cribs (for only the third freaking day ever FINALLY), it’s unbelievable that they actually exist way beyond a couple groups of dividing cells, a collection of heartbeats captured in a whirlwind doctor’s visit or even the invisible sources of discomfort in the late hours of labor. Ready or not (with emphasis on the NOT), they’re here.

Their presence means:

– I’m up at 5:43 a.m., having just nursed the boy for the third time this hour with him now wanting to play. (Grrr, boy, go to sleep!)

– I contemplate daily cutting my hair to a low fade to avoid looking a hot mess. (My stylist’s feelings will be so hurt.)

– I haven’t slept more than four hours at a time since a week before I delivered. (I’m done with the “I’m tired” complaints of my childless friends, BTW.)

– I ate Thanksgiving dinner with a baby on my lap, having cooked a minimal spread with another on my hip.

– I’m incredibly isolated from the civilized world most days and evenings and often lonely because of my husband’s work hours.

– This is life as I now know it with no end in sight.

Yet this year, even with all of that, I’m not superficially thankful with a veneer over the potentially heavy burdens of new motherhood. Instead, I’m overwhelmingly humble for the greatest gifts since salvation and welcoming of the collective discomforts that my babies bring. I can’t say I don’t complain — I do because, well, this crap is hard — but the comfort of this new family is greater than the discomfort of feeling it would never happen. This is true every day all day with baby giggles, smiles and developmental skills that put icing on the cake (which I can eat worry-free with the calorie burning of nursing). And I’m nothing but thankful for that. I’m also thankful for the smallest hope that led me to this point, the prayers of the people around me, those who remain to share in our children’s lives and to God, who made it all possible.

Recognizing that things didn’t have to work out in my favor has made every day with the twins a day of thanksgiving, regardless of what the calendar says. To those whose struggle continues, try to know that my heart is with you. Happy Thanksgiving (give or take four or five days. Sue me; I’ve got twins).

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Birthday Card from God

Meet babies-to-be Rufus and Reefus, who officially have heartbeats. We saw the hearts beating like two fluttering hummingbirds two days before my birthday. Happy birthday, indeed.

I flew to Nashville on my birthday last Friday to cover the Stellar Awards, something like the Oscars of gospel music, for work. Months ago when I arranged the trip, I was only thinking of the fun of celebrating 35 years of life — not adjusting to carrying new life along with me. The Mr. was a very helpful travel companion, but still I was exhausted and couldn’t throw myself into all of the unoffical Stellar-related activites I’d hoped to attend.

But while resting and missing a free ASCAP breakfast Saturday morning, I started praying quietly then not at all. That’s when the words of this birthday card from God came to mind.

“As insignificant as you’ve felt in your short life, I’ve always seen you. As much as you’ve prayed — sometimes more than others — I’ve always heard you. As much as I’ve done to get to this point in your life, in some cases, I let you rest on your own laurels as if it was all you. We both know that you were aware of that fact more times than you’d say aloud.

That’s why you brought your conception struggles to me in the first place, even though you armed yourself with science. Though you believed that perhaps such a blessing was only for others who lived a less “colorful” life, this blessing was always yours — yours and your husband’s.

So what you saw yesterday on the ultrasound screen is what you asked for, and because I really am able to do things that exceed abundantly above all you ask or think, including your prayer for a child, I answered as specifically as your heart desired.

You wanted twins; you got twins. Happy birthday.”

It is no secret what God can do …

We're breaking out the sparkling grape bubbly with wine glasses from past tastings at Williamsburg Winery, where it all began for the Mr. and I.

Because we spent all of 2011 praying and fasted twice for 21 days at a time in hopes of a baby, I’d be remiss for not actually saying that the lines we saw nearly two weeks ago showed I’m officially knocked up, preggers (even though the Mr. hates that word), with child, expecting, in the family way, or finally, pregnant.

No, I’m not beyond the first trimester, but I’ve told a close and close-casual handful of people what I know to be true based on a four-week ultrasound (way too early — the nurse’s fault, not mine) and the double-line positive pregnancy test. Further, the way I’ve felt the last several days serves as additional evidence, but I didn’t count it as definitive given all the “symptoms” prior to in-vitro fertilization that were likely imagined.

The early morning “chest cymbals” were a clue. But now I’m beyond tired especially after I find something I feel like eating. This is no -itis; this is it. (For you “Karate Kid II” fans: “This no tournament; this for real.”)

It’s official: I’m pregnant. Feel free to applaud while I close my eyes — just for a second.

Conventional wisdom and practice says to keep early pregnancy a secret at least until you’re through the first three months. I don’t think it ever occurred to me to be that clandestine about it. I mean, we’ve been trying, it’s been a struggle, I’ve enlisted support from anyone who could offer it. I’ve had people earnestly praying for us. They — I’d — want to know that God answered and what that answer was.

It would just be rude to go silent; though, I’m sure some imagined that as the reason for my most recent lulls. Nope; I was just tired. That, and I had to call a few people first. (Actually, I didn’t want people from my hometown startling my matriarchal aunt with the news when I hadn’t talked to her since before Thanksgiving.) But outside of that, I’ve been operating, breathing, sleeping (and passing gas) as a pregnant woman. As you can tell, I’m even using the p-word. (Pregnant, pregnant, pregnant. Per-regggg-nant!)

Even as I say that — and know it — fears remain that this could end at any moment. Not only does that quiet paranoia have me avoiding all fish, caffeine even chocolate, cold cuts and mushrooms (though I’ve forgotten why about the mushrooms); it also has me claiming every minute of the mini-me in the making. So even if it’s for a shorter time than I expect, I feel confident in saying that if God can do what He’s done at this point having made it so, He’ll do it again. Thus, I don’t feel compelled to hide my pregnancy until it’s “safe.”

Also, in not knowing the future — for example, what tomorrow’s latest ultrasound will bring beyond the awaited fetal heartbeat — I decided to claim every victory in this quest to have my own children. Thus, as the song says, “It is no secret what God can do” nor what He has done.

Sparkling grape juice for everybody!

Read between the lines

He wanted to know, so after I did the pregnancy test honors -- bright and early at 4 a.m. -- I woke up the Mr. to show him the results.

How long has it been? A week? I apologize for the delay, but the past several days have been one long waiting game: waiting to find a new place, waiting to get to the hotel lobby for free Internet, waiting for our approved apartment application, then waiting for movers and this week waiting for the cable guy. My computer felt completely useless without a wireless connection to the outside world.

Though I’m connected again (and free to online window shop about the world), my return to normal life is taking several twists. Not only is it a new year in a new apartment; it’s also new duties at work that essentially mean my problem child is no longer my problem.

And, apparently, I’ve gained this new habit of actually doing what my husband says.

With a small amount of arm twisting, I took the blankety-blank test, the pregnancy test that had been lingering in the bathroom cabinet of our old apartment. The Mr. knew exactly where it was in our packed waiting-to-go-on-a-truck luggage and dug it out to wave it in my face. That took away my argument that pregnancy tests are too expensive to buy one for peace of mind. And yes, this was after months of $14.95 times two or three per cycle that I wasted on tests that I knew would most likely be negative. Most of those he never knew about. Either way, I had no case except the one I’d made here.

One of my very best friends — I call her my “stick girl” among many things — gave the best motivational speech to shake me from my fear of knowing. In a random text message, she said, “You know I love you, and I usually refrain from commenting on bodily functions.You give a compelling no pee argument. But pee on the damn stick, friend.”

You have to understand that she is the Yang to my yin, i.e., the Christina to my Meredith, my person, the only person who can say crap like that and make it so endearing.

Hours after our exchange, sometime around 4 a.m. Thursday, I woke up and stumbled to the loo, did the potty dance back out to find the test in the dark and sprinkled on myself before successfully peeing on the doggone stick. It wasn’t graceful, but it was effective.

I know what the stick said, but now, I’m waiting to see what the doctor says next week.

Pee-er Pressure (in the Mr.’s own words)

I'm comfortable with this scenario, but the Mr. needs something more.

I’m giving up my normal rant space to the Mr., who really wants — nay, needs — me to take a home pregnancy test. His offering is largely unedited — aside from those dreaded double spaces after each sentence. (Who still does that?) Nevertheless, despite promising ultrasounds and no evidence suggesting that there isn’t p-word outside of our cautious uncertainty, he wants to see a positive home test. Here’s why:  

About three and a half years ago, I had a question I really, really wanted to ask the woman I loved. Just a few simple words, but it was a monumental question. The big question. You know the one. It was the biggest question I’d ever asked her. Eventually, after a princely sum on a ring and tickets to a dinner whose taste I still can’t remember, I got my answer.

It was the answer I’d expected, hoped for, prayed for and was relieved to get. I’d seen the signs after all: She told me she loved me, moved halfway across the country for me, she laughed at my lame jokes and allowed me to experiment on her with my cooking. And rare was the day we hadn’t spent thinking of and talking about a future together. So, yeah, the signs were there. But it was the most real when she had that ring on her finger, that word of affirmation ringing in my ear. She later teased me about my nervousness, even while admitting that she wasn’t always sure that moment would ever come. Bottom line, we didn’t know till we knew.

So here we are again, where there’s a question to be answered. This time it’s not about matrimony. It’s about maternity. It isn’t about whether she’ll take my hand. It’s about whether we’ll form a band. There’re no musicians singing in the background, and instead of a diamond ring in my hand, I’ve got a cheap piece of plastic. Ain’t nothing sexy about where this stick goes and she probably won’t walk around with it on her finger (although that would make one heck of a mood ring).

(Now that I’ve conflated my proposal and a pregnancy test, my head is filled with images of how so many other questions would be more simply resolved if it could be settled with a little pee. Does she love me? Is she laughing at me or with me? Is she really mad I ate all of the cookies? Two lines for yes, one line for no.)

So, call it peer pressure. or pee-er pressure. Or just one more time where a guy’s gotta know. Sure it might be beside the point. Even a little bit anti-climactic. But, remember that Kay’s Jewelers jingle: “Every kiss begins with Kay”? Well, every pregnancy begins with pee.

Babe, all I’m saying is give pee a chance.

To pee or not to pee …


OK, so the question wasn't "to pee or not to pee." However, the real query did consider the value of seeking resolution once and for all. Aside from that, Mel Gibson's portrayal of "Hamlet" is my favorite. That other dude with the white hair creeps me out.

That is the question:
Whether ’tis nobler in the mind to suffer
the fears and uncertainty behind only seeing two tiny open-air blips via ultrasound
or to take arms against a sea of doubt
and by peeing on a stick end them.

Given that this post marks the third random Shakespearean reference (the second to “Hamlet,” my second-favorite tragedy), I opted for a little creativity. Besides I’m still trying to make light of spending the holidays in the hotel because of my landlord’s poor judgment over the gas line. This was really the last straw of the property manager’s continual missteps, so rather than be indefinitely displaced, we terminated our lease and suddenly found ourselves moving — days before Christmas. It’s not that I dislike the posh concession in living arrangements; I’ve just found it hard to obsess about the validity of the p-word and whether what we saw last Tuesday really meant what the doctor said it did.

Normally, I insist on knowing the reality of a situation — straight, no chaser. But with all the work drama and then the home front catastrophe, I’ve comfortably waded in plausible deniability. I have ultrasound pictures to prove what the doctor said, no evidence of a periodic relative, and I still awake daily with the feeling of clanging of chest cymbals but nothing else to prove p-word status. Thus, I decided that this is what a little bit p-word feels like. I’ve been OK with that, figuring that in a few more days, I’ll have another ultrasound and maybe that’s when I can get excited.

It’s sad — I feel sad thinking about the fact — that infertility can be so deflating month after month of doing what they say will work, could work, or worked for someone else that if signs show that it worked for you, you doubt it still to avoid getting your hopes up. And even though it’s fun to be deliberately obtuse about whether I am or I’m not the p-word, the real reason for it is really the fear that something will go wrong. Isn’t that why people don’t say they are until they’re 12 weeks or more along?

I think I’ve secretly accepted that I am. I even believe God’s confirmation through my relationship with Him. Perhaps I’m even at a place where I can accept whatever happens even if it’s the very worst that will hurt and kick rocks all at the same time. Where I am is further than I’ve ever gotten in this process, and I don’t take it for granted. I actually count this as a blessing in itself, well in advance of the one I seek. I’ve even told a decent handful of people, in part to make it real and then to have witnesses that I was at least here in case things change. And in believing all of that, I see no need to confirm it through an at-home urine pregnancy test. A negative test would end the mild uncertainty, but it would also end the fantasy. With that risk, I’m content to wait for a fetal heartbeat.

I could do that if this were just about me. Ah, but no possibly p-word wife is an island unto herself (John Donne reference!), and the king of this island, the Mr. himself, has spoken: “You’re taking a test.”

Ay, there’s the rub.

Double, double toil and trouble …

Despite good news, I'm still wary of the other shoe dropping. And given my reaction to a series of poop storms, I should also be watching for houses.

With infertility, silence sometimes means the worst has the happened. Fortunately, that isn’t the case, but as it always happens with every two-week wait and the optimism of each cycle, struggling to conceive means waiting for the other shoe to stomp all over your baby-building parade.

Under the invisible dangling shoe that has kept me quiet for the past few days, my human chorionic gonadotropin (hcg) levels doubled and then some, according to my latest blood test. Sunday, it was 148. Tuesday, it hit 552. It took a grueling hour to find that out.

I’d stepped away from my desk to pray with the rest of the company for the family of a recently deceased coworker, and the nurse called. A little shaken from the solemn office gathering and nervous about the call, I locked myself out of my voice mail. While waiting for the systems guy to reset my password, I tried calling the doctor’s office back. Every transfer to a live person went something like this:

“Name?” My name. S-P-E-L-L-E-D O-U-T. “Date of birth?” My birthdate and year. “Who’s your doctor?” My doctor. Then silence. “Let me transfer you to the IVF nurse.”

This was all too reminiscent of my low-ovarian reserve diagnosis. No one would tell me what the number was for my anti-mullerian hormone (AMH) test. I’d ask, and then they’d refer me to someone else. Essentially, this test can help determine the number of quality eggs a person has as well as determine gauge what the response might be to in-vitro fertilization. My test results suggested that my ovarian fertility potential hovered in the low- to very-low category. My doctor mentioned the use of donor eggs very early in this infertility process. I feared he was right and coped with the possibility by ignoring him.

That’s why is so unbelievable to me that, according to today’s doctor visit, he actually used what my husband called “the p word.” Here I was thinking the Mr. was being vulgar; instead he was marveling that the doctor kept casually referring to me being pregnant. I’d had moments of wanting to jump around like Doc Brown in “Back to the Future,” yelling, “It worked; 1.21 gigowatts!” but that still seemed a little premature. Short of that temptation, I’ve held out on using the p word and instead described my blood test results in strictly clinical terms.

Today, the Mr. and I had a brief moment of acceptance of a positive outcome. Then life kicked in and my focus returned to the poop storm spinning over work and now where we live. The latter is a horrific mess that would turn anybody into a Scrooge, or in my case, the B. on a Broomstick. That’s the bad news. The good news, in addition to the news I have yet to accept, is that trouble don’t last always. Praise God, it still will be a merry Christmas and a maybe even a very special one.

Meanwhile, I’ll be on the lookout for falling shoes — and houses.

 

Here’s to the numbers game

The "butterfly" part goes into a vein, and a blood collection tube attaches to the "vacuum." I gotta do this again in a couple days. It used to be fine, but now these little suckers are starting to hurt.

I made it to my first beta test without giving in to pressure to buy a home pregnancy test. I kinda floated through the last several days, having some symptoms of something but blaming everything on the drugs — not just my bad moods.

For example: In the lighter sleep of early morning, I tend to have a blanket tug of war with the Mr. That fight involves turning to one side with a death grip on the covers. After nearly three years, I can literally do this in my sleep. But for the past week, that sleeping turn has come with the equivalent of what feels like someone clanging cymbals on the girls. Mmhm, those girls. I wake up abruptly — mad — then stay awake for another hour or so until about five minutes before my alarm sounds. I blame this for my constant need for a nap before bed. And the vicious cycle continues.

Then, there are the slight pains in my side that go away as soon as I try to identify them. It’s like I’m leaning over to stretch, except I’m sitting still. In that case, I didn’t necessarily blame the drugs. I thought, as usual, it was something I ate from the dairy case. (Infer what you will.)

The whole point of the mind games was to downplay anything that could be unnecessarily attributed to a pregnancy that had not been confirmed. Instead of wishful thinking, it was careful thinking.

The game changer was the quick phone call from the nurse about an hour an a half after my blood test, 10 days post transfer. “I’m calling with good news that your beta level is positive at 148. You’ll keep taking your meds and come back Tuesday. Then, it should double to about 320.”

She didn’t say pregnant and I didn’t hear pregnant nor say pregnant to the Mr. But we all know 148 is a good sign. Still, I know not to get too excited — at least not yet. Here’s why: While anything above 25 milli-international units per milliliter (mIU/ml) equals a positive pregnancy test, the real proof is in how much the numbers increase in 48-72 hours. Even then, it’s only through ultrasound, somewhere between 1,000 and 2,000 mIU/ml, that we can get more accurate information about the pregnancy. That includes whether we’re carrying one or two babies.

I could come up with a multitude of Doomsday scenarios, but the possibility of them is enough to keep me grounded even despite the silly grin that the Mr.’s probably worn all day. It’s cute, and it reminds me that there’s hope. Don’t get me wrong: I am tickled chocolate brown and a little bit relieved, but I remain super cautious. I’m thankful to God because I consider this an answered prayer even though there are others to come. With all of that in mind, I’ll quietly celebrate 148 mIU/ml for what it is with a glass of water, more drugs and gummy prenatal vitamins. In the meantime, we’ll see what happens

Here’s to the numbers game. Cheers, big ears.

Alas, poor embryos. I knew them …

My quest for motherhood is like looking for red Skittles, i.e., good-quality eggs, in a bag of many colors. They're there; we just have to find them.

With the number of steps involved in the in-vitro process, I was bound to forget at least one. This would be the call from the andrologist on the status of the remaining five embryos.

I first Googled the phone number as I always do with unprogrammed calls and saw that it came from the hospital’s lab, my hospital. Neither the Mr. nor I could figure out why they were calling. Then, the message on “the status of your embryos” freaked me out even further. I figured it’d be about cost or storage options or how long we thought we wait before tapping into the frozen reserve. I called back immediately to find that neither assumption was true.

It was about the status of our embryos.

Retrospectively, it felt like what would happen in the hospital when a nurse would call family members about their loved ones. They never say, “Mrs. K died.” Instead, they talk about the status of Mrs. K’s condition and how the family should come in. If you’ve ever experienced the activity surrounding someone’s else death in a hospital bed, you can always tell what you’re in for just based on the cryptic language used when they call you. But this was no nurse; the woman is an andrologist. She was compassionately matter-of-fact but obviously not a patient-care practitioner. I don’t hold that against her. I appreciated the information and her willingness to repeat it until I was sure I understood.

Essentially, there are no longer five embryos. Before the transfer, there were seven. The best two of those — the ones dividing evenly with proper cell shape and most likely to implant — were transferred last week, three days after fertilization.

Three more simply didn’t reach the blastocyst stage, meaning they “failed to progress” to Day 5. (Blastocysts are more likely to survive the freezing and thawing process for a another transfer than “younger” embryos.) Another embryo became a blastocyst but then began dividing unevenly and soon “arrested” as well. These are the types of fertilized eggs that never would’ve implanted in the first place. Yet, it’s still feels a little bit a little bit depressing that they didn’t make it and that there aren’t more additional mini-me possibilities.

Yet there is room for rejoicing because one survived to the cyropreservation (freezing) stage and is expected to be there when we need it. Also, in perspective, the loss of three embryos makes sense. Embryo survival is closely linked to egg quality, and my unexplained infertility is blamed on a diminished ovarian reserve. That means that of all the eggs I have, I only have a few that are of good quality. The majority of them probably aren’t as likely to undergo fertilization and endure a full term. The in-vitro route makes the existence of those eggs more apparent.

Imagine it this way: you have a bag of Skittles, and only the red ones count. You could blindly stick your hand in the bag for one at a time, hoping for a red one. However, the more efficient way would be to grab a handful and pick out the red ones while avoiding the rest, which would likely be the majority of the bag. In-vitro fertilization is my efficient handful into motherhood.

The quest feels a little more daunting right about now with just one backup, but I’m trying not to let it shake me. I will not buy a home pregnancy test to try to get an early result. I will not obsess about any twinges or odd feelings. I’m just gon’ ride it out and pray for two more days.

It’s the %@*$# drugs

We're done with the injectables, but these two seem to pack a more emotional punch. The Mr. finds it funny; he's allowed. Everyone else, look out.

It’s the drugs. It’s the drugs. It’s the drugs.

At least, that’s what I’ve been telling myself as a result of reaching the highest levels of pissivity. (That’s an original derivative of a word I hate to use and wouldn’t, well, if not for the drugs.) I was warned of the side effects of estradiol and progesterone, but I wasn’t expecting the same work-related poop storm from a few weeks ago to keep spinning. I don’t have the time, the patience nor the willingness to address it, but here it is, and here I am, nine kinds of ticked off.

Soooo, maybe it’s not the drugs.

However, the fear and resulting paranoia that pressure from this clusterfox will hurt my chances of housing the Wonder Twins long term might be drug manufactured. It would make sense to think that every significant upset would have a negative effect, but honestly, it doesn’t. Medically anyway, no one thinks so.

In addition to preparing me for mood swings, fatigue, and general haziness, the RE-mandated psychologist addressed stress and how I’d deal with it. Her focus was specifically now, the time between the transfer and the first blood test determing whether the in-vitro cycle was successful. Even though she encouraged a coping strategy — because, obviously alcohol is out of the question — she insisted that everyday wanna-throw-a-shoe, to-Hades-with-everybody, dare-you-to-walk-in-front-of my-car varieties wouldn’t be enough to derail pregnancy. What would have an effect is stress related to fear for my life, of being evicted and otherwise homeless or of not having food. Anything less than that would be implantation gravy.

I was relieved to leave aside the pressure of always trying to relax. In trying for so long to conceive, I’ve heard “Just relax” enough times to consider the phrase profane. And telling me that never works anyway. So rather than “Keep Calm and Carry On” like the book says, I’m doing just fine aligning myself with its companion piece, “Screw Calm and Get Angry.”

And if you don’t like me when I’m angry, well, let’s go with that idea that it’s the blankety-blank drugs.