Tag Archives: infertility

Get! Out! Mah! Belly!

IMG_0235
I’m 37 weeks pregnant here, visiting my choir friends in the church basement. My brother is clearly amazed at how big I am. Looking back, so am I.

This time last year, I was so remarkably uncomfortable. I was a massive 186 pounds on 5’2″ frame at exactly 38 weeks pregnant with the horrible itchy PUPPPs rash across my stomach and legs. I’d essentially lost my job for being pregnant but had quit on my own with Aug. 13, 2012, being the first day of my vacation before the end of my employment. That allowed the peace of mind to have insurance still covering delivery whenever it happened, though I knew it would be within the month.

With the threat of losing the babies and the journey through infertility to get to this point always in mind, I’d stayed ridiculously hydrated through a hot Chicago summer and only had two pre-term scares. The first, at nearly 32 weeks on a Sunday, watching “Sunday Best,” I had a series of contractions that also squeezed my head. Four an hour was bad; I’d had six, seven, eight and was on the phone with the hospital. I wasn’t in labor; apparently, that was the nature of being pregnant with twins. I sang with my church choir through my eighth month, finally giving up after a month of promoting our CD release. Two Sundays after a Saturday afternoon funeral and backing Aretha Franklin that night, I thought my water broke and left the choir loft mid-service. The embarrassment of people watching me tip out while the pastor was preparing to preach was enough for me have several seats for a while. Or maybe it was the shame of explaining that, no, my water didn’t break and that I’d most likely peed on myself.

I was at the hospital every Monday the last six weeks for a non-stress test, measuring the babies heart beats in response to my regular but normal contractions. And because my blood pressure rose a little higher each visit, a nurse would always say I might deliver that day. But every time, they’d send my uncomfortable big butt home to keep the babies cooking. The Monday a year ago, I felt guilty for wanting these babies out, mainly to be able to breathe normally, to see my feet, to stop hugging the Mr. only from the side and to stop that junky itch from the rash. My blood pressure was 190/89. Even though I was not pre-eclamptic (yet), I was admitted and scheduled to have the babies that day.

I’m hoping in finally recounting the last days of pregnancy, labor, delivery and ultimately motherhood, you’ll forgive my long delay in writing anything at all. The twins are great as they approach a year old tomorrow, and I’m feeling good and confident that I can keep them alive. It wasn’t always that way. I’ve got dark days to shed light on by retelling the story. And what a tale it is.

In short, it’s like the VH-1 “Diary” tag line: You think you know, but you have no idea. Stay tuned.

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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).

Dancing babies

Anybody remember the dancing baby from the "Ally McBeal" days? I've got two of 'em just a movin' and groovin' like no one is watching.

Despite fears to the contrary, the babies are still there.

The ghosts of infertility have a habit of popping into my mind, especially in the weeks between doctor visits. Since Februrary of last year, I’d been seeing my reproductive endocrinologist (and associated nurses) once every few days. That’s not an exaggeration.

Consider that one menstrual cycle lasts about a month and that each month, doctors are trying various methods of assisted reproductive technology, or ART, to get you pregnant. To get to this point, we had one attempt at interuterine insemination before another one that was canceled because I ovulated too soon. I then had two more unsuccessful attempts. With each cycle, there’s an initial ultrasound to be sure there are no lingering cysts. Then, there’s another to check the size of any resulting follicles produced from oral medications. (I took Clomid.) If the size isn’t large enough for an ovualation “trigger shot,” you go back to the doctor in a couple days for another ultrasound. If the sizes are right, you get the shot and then return a day or so later for the actual insemination. There’s a two week break in there — time before you can take a pregnancy test. When — as in my case — the test is negative, you go back and start the process over again.

And every time, you expect to be expecting. By the time we were moving ahead with the more invasive in-vitro fertilization, which I cried about having to do, my expectations weren’t as high. And it was a lot to endure for fear of failure yet again.

So now, with two and three weeks between visits, I’ll admit that I’ve been freaking out. What if I’m really just getting fat? What if we go back and there are no babies? What if I’ve done something (or not) to make the pregnancy go away?

It’s possible that those are normal pre-whale questions that everybody has. I’m sure it’s connected to the security I had in constant visits, especially between my third and eighth weeks. We’ve got microscopic and ultrasound pictures at three days before transfer, in utero but pre-implanation, and at four, seven and eight weeks. Internally, the last four weeks were murder until last week’s appointment.

(Because of my “advanced” maternal age of 35, the risk for chromosonal defects is higher. We agreed to recommended genetic testing for information purposes, not to “play God.” Just FYI. We learned a lot worth another educational post for another time. Feel free to ask questions, though …)

Though it was in the geneticist’s office for first trimester screening, we saw both babies active with Rufus face up and Reefus face down. It looked like they were dancing, and clearly, they thought no one was watching.

My Hannah Moment

As the story goes from I Samuel, Hannah couldn't have a child and "was in bitterness of soul, and prayed to the Lord, and wept sore." It hurt until she cried, and she cried until it hurt.

I’m really behind on the updates. I’ve just been so incredibly sleepy. Some time has gone by since then, but I did have my weeping Hannah moment in church. Ironically, though, it had nothing to do with me or anything I could’ve predicted.

Call it a divine revelation or or a alignment of coincidental thoughts — not that I don’t believe either is possible — but given that this site has been up and circulated, I might call it something different. Whatever it was led to an altar call for “a couple struggling to conceive.” I only recently posted positive pregnancy results, but I knew at time that I was and had told the people most proximate to me on a day-to-day basis. But it wasn’t widely known, particularly not by the person led to invite “a couple struggling to conceive” to the altar.

Don’t misunderstand; I fully believe in inspiration of the Holy Spirit to move a person to say or do something in a way that isn’t based on any prior knowledge. In many ways, I try to live my life with that kind of direction. But to have prior knowledge and to suggest it was revealed by God feels kind of like a carnival show gimmick. Already pregnant and fully aware of it, I didn’t go to the altar, but three women did.

At the moment, I realized that my struggle has not been for me nor has the blessing up to this point. It has been to tell the story of prayer for undeserved favor in an impossible situation, the unrelenting downright stupid-looking faith, and a glimpse of the promise (which is where I feel I am now) to somebod(ies) who feel even more hopeless that I have in the midst of all of that. That was my revelation that night.

I was skeptical of the way it went down, but I thought it was cool that the church, a black church in particular, devoted prayer time to infertility. Rather than let the method of how we got there permanently divert my attention, I directed my energy toward praying for them and just worshiping in general.

And I cried and cried some more, praying that God would show himself strong for those ladies as He has for me.

I’d wondered — with the postive pregnancy test and the ultrasound photos — whether I could still be considered part of the infertility struggle. I know how I felt when I’d read that someone had a successful interuterine insemination or in-vitro fertilization cycle: abandoned and even more like a failure. But my Hannah moment reminded me that the struggle to this point binds me to every woman on the same road.
Not to get too churchy on you, but it was one of my pastor’s sermons that kept me holding on to the idea that God would allow us to become parents. I don’t remember the title (and this tired mama is too lazy to go find her journal), but I do remember the scripture and its context — 2 Kings 3:18. After you prepare, which you’re already doing, you pray and you try to be patient, it’s a simple matter in the sight of the LORD. That’s the New King James Version. The Message translation reads: “This is easy for God to do.”

As hard as the infertility road is, rest with that idea in mind.

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.

Another reason infertility kicks rocks

This doesn't even begin to show what nine kinds of ticked off looks like. I was here -- and for good doggone reason.

I mentioned that part of my stress during the last several weeks involved work. Aside from the initial problem that had me sitting in human resources, I got wind of the fact that my “medical condition” had come up in discussions toward the need for some type of resolution. Actually, the comment — which I received through a super-reliable source — essentially alluded to my “oversensitivity, likely a result of (my) medical condition.”

I’m a lot of things, but sensitive probably isn’t at the top of the list. Incorrect characteristic aside, I was nine kinds of ticked off. Yes, nine.

I was outraged at the lack of understanding, at the blanket application of what “undergoing infertility treatments” means. I was livid at the seeming sexism that drove the conversation. The belittling of a legitimate work concern because of my “medical condition” had me seeing red.

Post-rage — even though I’m still on the same drugs progesterone and estradiol, mind you (told you it wasn’t the drugs) — I remember that anger tends to be a secondary emotion. I’m ready to admit now that more than anything, my feelings were hurt.

Understanding the value of personal authenticity to myself and others, I try to live a fairly transparent life. Despite what my writings suggest, I’m not an open book. I’m more like a library offering. Through conversation and revelation of the type of person you are, in a way you can’t explain with words, you’re filling out an application for a library card. The way you fill out the paperwork gives me insight into what version of the book you can check out. Regardless of whether you get “Goodnight, Moon,” “Charlotte’s Web,” “Are You There, God? It’s Me Margaret,” “Fight Club” or “The Sun Also Rises,” you’re still getting the real me with all my quirks.

I was a small child for my age and would get questioning looks when I’d attempt to check out library books that looked well beyond my literary capacity. Eventually, though, some librarian would decide it was OK for a 12-year-old to read John Jakes’ “North and South” and let me have the book.

That’s how I felt when I said in a meeting that the work situation needed to be in the hands of someone with the authority to deal with it. Not only was that kind of power above my pay grade, I have other things I’m focused on, I said. “For example, my husband and I are undergoing fertility treatments.” At that point, injections and ultrasounds were normal to me. I said “undergoing fertility treatments” like people say, “We’re moving” or “Our car broke down.” It is a condition of life, a normal condition of life like anything else that sucks and requires a coming to terms. After you reach the terms, it is what it is: life. And I decided the person I’d spoken to was in a position to handle that. I was wrong.

Having my life used against me felt like a sucker punch to the gut. The irony was that such a twist of words never would’ve been used to describe a woman battling her way through cancer. What is it about infertility that makes that kind of marginalization OK?

I still haven’t figured that out; I did however address what I’d heard. Despite broad deliverance from tearing people down with my words, I had not forgotten how to border on intimidating. I’m a little person; it takes a little of that sometimes. But really, it was the use of the words “illegal, if not, then unethical,” a reference to the employee handbook and prayers that began with “God, go before me …” that seemed to have an impact.

The abundance of ignorance regarding infertility perpetuates the embarrassment that many of us feel in the need to utilize advanced reproductive technology. It keeps us silent and hidden and unnecessarily distant from the support we need. To break that cycle, we’ve got one option (and I stole this from Jeff Bridges in “The Contender”). It’s simple: Don’t be embarrassed.

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.

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.

Send in the Embryos

This is a copy of the screen-grab image from the ultrasound at the moment of the embryo transfer.

It wasn’t on purpose, but I’ve been silent for a few days reveling in Thursday’s embryo transfer. It was nothing short of fascinating. It felt sacred and holy, an unexpectedly spiritual few minutes.

And that’s in spite of the intimate experience with an unfamiliar but funny doctor and his clueless intern. Bless her heart, I knew she bordered on inept because of preoccupation with the internal ultrasound probe that wasn’t part of this particular procedure. As instructed, I showed up with a full bladder. That meant an external ultrasound, but she’d missed the memo. (And sadly, she’d worked at the same hospital I had in the exact same position but on a different floor. I knew she should’ve known better.) When the doctor kindly corrected her, she pretended her gooped-up probe didn’t exist. To be nice, so did I. I even took shallow breaths so she wouldn’t lose her place with the external probe on my abdomen. I can’t take full credit for my behavior, though. My super-nice Mr. sat on a stool to my right, and his influence mellows me. Also, I didn’t have the benefit of the privacy sheet normally granted with exposure of the goods, and it’s hard to be critical with your hoo-hah on display. Fortunately, my monkey socks provided a nice diversion until the show started.

Just prior to the procedure, Dr. Funny Man passed the Mr. a good luck greeting card from the entire RE office. “Beautiful,” he said, “a family photo.” It was an image of the two embryos set aside for the transfer. And yeah, they were the most beautiful set of eight- and nine-cell embryos that ever existed. OK, it sounds weird, but the idea that these little babies could turn into real babies was just amazing to me. I think I’ve stared at that photo every day and several times a day since. I made it portable by taking a picture with my phone, and I look at that even more.

That picture might have been all I needed to see, but my excitement — while trying not to breathe too much for the Dr. Bailey intern reject — grew when the doctor pointed out everything on the screen. Amid the plumbing was his needle aimed at the ideal place. “Do you see me? Are you ready? Are you sure?” He yelled something to invisible people through talking through a hole in the wall and told us, “Bombs away. One, two. There they are.”

Two small somethings on the screen came through the needle and just sat tucked away right where they were placed. I cried a little staring at the movement I saw. I couldn’t look at the Mr. because it would’ve become a full-on Oprah ugly cry. And even though I felt it, crying just seemed a bit premature. I was fully aware, though, that whatever life that would come from this process would spring from something greater than a few doctors practicing medicine.

Regardless of the criticism surrounding infertility treatments, what I saw represented the presence of God in all things, including in what has been called “gravely evil.” Science only takes us so far; the rest really is up to God. And there ain’t nothin’ evil about that. Jerks.

Fentanyl is your friend

This is a 2-cell embryo on Day 2.
So much for “conscious sedation.” I was out almost as soon as the nurse injected it into my IV. (We won’t talk about the collateral damage done to both arms to get the IV going in the first place.) Right before then, I’m told I started singing “Nowadays” from the musical “Chicago.”

“… You can live the life you like. You can even marry Harry but mess around with Ike. Good, isn’t it grand …” I vaguely remember that. And I can recall turning on my side for the rump shot of progesterone. Sade’s greatest hits played in the recovery room. I remember hearing it, but I don’t remember singing along. A nurse said she wanted my autograph, so I must’ve done a decent job. I was hazy but soon awake enough to walk. At home, I slept the rest of the day — the whole day.

I think I’m done with the abrupt sleepiness from the fentanyl, but the Mr. keeps reminding me that it hasn’t been 24 hours since the procedure (it’s 8 a.m.). That’s the recommended time before I can operate heavy machinery. I didn’t think of it like that, but I guess it is a good idea that I’m working from home today editing printouts from last week. Even with uncomfortable bloating and a literal pain in the behind, I find it hard not to be celebratory.

My doctor extracted 15 eggs. Based on today’s call from the embryologist (how do you even become one of those?), seven of the 15 were mature and all seven were fertilized. Now, it’s a matter of days before the transfer of two embryos and yet another dreaded two-week wait. I’m done with injectable medications. Instead, I’m taking antibiotics twice a day, estradiol twice a day and progesterone inserts three times a day. One is to ward off infection from the procedure and the other two held prepare my body for implantation, the next hurdle.