Our Fresh Embryo Transfer (1.13)…baby making made easy????

I was so excited. I was expecting great news from our first-ever egg retrieval. Instead, I was told that only three of the eggs had fertilized, and of those three only two had survived. I had been counting on dozens of left over embryos to freeze for the future. Instead, we only had two. Although I was discouraged, I was also encouraged. Two embryos were all that we needed. I would take them!Two baby boys playing on bed

Several days later we headed to the hospital for our fresh embryo transfer. This is when embryos are placed through a tiny capillary catheter into the uterus. My personal infertility specialist was the one scheduled to perform the transfer rather than any of her partners, which gave me an immense sense of relief. Now that I was an “interesting” patient, with soaring estrodial levels and swollen ovaries…everyone knew me. I had broken records. I was off the chart! No longer one of many, I was distinct. It is strange how something bad like ovarian hyperstimulation can actually work in your favor. Being known made the process easier and meant that I received more time and dedicated attention from all of the doctors. In spite of this, I was still relieved that it would be my own doctor doing the transfer. She knew me the best, and I trusted her the most.

The transfer wasn’t supposed to be painful. It was a quick in and out. They actually said that I didn’t even have to stay laying on my back at all. I could get right up and head to work if I wanted to. I didn’t want to. Were they crazy?  I wanted to go home and put my feet over my head. I wanted those embryos to stick and stay!

We arrived to the procedure room early in the morning. My husband, Dave, was thankfully able to get the time off of work. We were making a baby…yes, the unromantic way, but we were still making a baby. As the nurse brought us back, she told me to undress from the waist down-yet again, and she handed Dave his baby-blue paper jump suit and surgical cap. As I was starting to strip down and Dave was starting to layer up, the nurse announced the sad news that we now only had one remaining embryo. The second one had not survived. I was heart-broken.Baby Fetus Newborn Over Isolated White Background. New Born Chil

One embryo decreased our chances of success by at least 50%, maybe even more. As it was, the chances of success had only been about 50%; now they were down into the 30’s. I gave myself a mental pep talk, but all the time I felt like someone had just punched me in the stomach. As my doctor prepared for the transfer, the nurse pressed the transabdominal ultrasound uncomfortably over my overly full bladder and hyperstimulated and swollen ovaries. I was fairly certain that I was going to start peeing right in my doctor’s face! I felt like I needed to warn her just in case I was about to embarrass myself and soak her. She reassured me that I wasn’t going to urinate. I remained skeptical and started cursing the darn ultrasound. It felt worse than the transvaginal. How was that even possible?

It took a little while longer than expected to get the catheter in place, but once in, the embryo was shot into my uterus. I was with child. A baby was inside of me. Now it was time to wait and see if it would attach and grow. There was nothing more that I could do other than wait.Questions, questions, questions... the Concept photo

Waiting. Waiting. Waiting is such a hard process. I prayed more than I ever have. I pleaded with God to let this work. I prayed that the baby would be healthy. I made promises to God that I probably couldn’t even possibly keep, but I wanted him to know that I meant business. I knew that he could make this happen. He could control the situation. Why he had put me in this situation in the first place I didn’t understand, but I knew that he could rectify it. I figured that I had already learned so much. I had grown so much. I realized my human fragility and my need for divine intervention. I waited, and I waited, and then…..I started spotting. And then, I started hemorrhaging with a full-out worst period of my life. My one little embryo had not survived. My womb was empty once again.Woman having a stomachache sitting on sofa at her home




Our Infertility Journey (1.3): My turn to be the patient!

Young beautiful woman with depressionI stared at the computer screen, overwhelmed, dazed, and mad that we had wasted time trying to fix something that was a long shot. I regretted waiting to meet with the Reproductive Endocrinologist. That should have been our first stop instead of our last-ditch effort. Paging through countless infertility clinic profiles online was getting me nowhere. I needed to make an appointment somewhere…and I needed to do it NOW. I wanted to be a mother more than anything! I didn’t have any time to waste. Each second-hand strike on the clock was another moment counting against me, my ovaries, and my sanity.

I picked up the phone and made the call. I was sitting in the middle of the hospital cafeteria, surrounded by coworkers and strangers. It was the only place that I could get good reception and the only time that I had during the day while the infertility office was open. Not ideal! I’m already known to speak softly, and since I didn’t want to announce to everyone eating lunch that I needed an infertility appointment, my voice (which I thought was booming) was probably a faint whisper. The secretary on the line couldn’t hear a word of what I was saying. I felt my face turn ten shades of red as I turned up my volume. “I need an infertility appointment…I can’t get pregnant! Sex doesn’t work!” Had I really just screamed that at the top of my lungs? I quickly looked around, expecting to see shocked stares. Instead…nothing. No one even met my glance. My secret was safe, but strangely that only made me feel more isolated.Young sad woman alone in a black stone beach.

Hearing the woman’s voice on the other end of the phone jolted me back to reality. Three months? That was the next available appointment? Four months to get in with the doctor I preferred? The secretary reassured me that if a cancellation came up they would let me know. “Right,” I said to myself… like I would be top of the call list. I knew how these things worked. The only call I would be getting would be to reschedule to a later date…and I was right!

Four and a half months later,  my infertility appointment finally arrived. I was nervous but excited to finally get some answers and come up with a “get pregnant” plan. Choosing which infertility specialist to see had been challenging. Word of mouth was how I finally decided on my physician. Knowing OB/GYN residents who had worked with the doctors in the reproductive endocrinology practice was the most helpful. They were able to give me the inside scoop on personality, bedside manner, procedure skill level, and expertise. I had chosen a female physician who came highly recommended. I was told that she was “to the point,” but she was great at what she did. I needed great. I wanted amazing bedside manner too, but if I had to choose between success at getting pregnant and feeling cozy without getting pregnant… I was 100% for success.

Choosing a female physician wasn’t coincidental. As a female physician, I tell my male patients who are uncomfortable with a woman examining them that since I see so many body parts all day long, nothing shocks or embarrasses me. Penis, vagina, testicles, breasts…it’s all part of the job. However, as a patient, I wanted a female physician. Somehow, I felt like it would be just a little less uncomfortable discussing my most intimate concerns with another woman.Honeymoon couple romantic in love at beach sunset. Newlywed happ

Although Dave was able to make it to our first appointment, I still felt slightly alone and uncomfortable. Anytime you are discussing infertility it just gets touchy. Trading in my white coat for a patient gown wasn’t my idea of fun either. At that point in my life, I wasn’t much of a crier. Yes, at home, I could have as good of a melt down as anyone, but never in public. I recounted our story feeling hopeful that the Reproductive Endocrinologist would simply say, “No, problem. We will get you pregnant in no time.” I knew that she would want to rule out any female factor contributing to our inability to get pregnant, but I was “pretty” sure nothing was wrong with me. My cycles were like clock work. I never missed. Deep down, I was hoping that there was nothing wrong with me. I am not sure why it made it easier, but it did make it just a little easier to know that I wasn’t the reason we were infertile. I wasn’t mad at Dave. It wasn’t his fault. But, somehow, it made me feel better to know that it really wasn’t my fault. Looking back, it is strange to think that it would make a difference; but, when you can’t get pregnant you get this feeling of shame…this ultimate sense of barrenness. It is hard to describe other than as a feeling of insufficiency and brokenness. Being able to say out loud or even say to yourself that,  “Nothing is wrong with me,” somehow makes being pregnantless a little less painful.

Our Reproductive Endocrinologist confirmed my thoughts on our next step. I would need a full work up, and Dave would need additional testing to see if there was any other reason for his low sperm count other than the varicocele. While sitting in the exam room, I noticed a fancy ultrasound sitting by the bedside. The vaginal probe was covered in blue medical gel and then carefully covered over with a condom. Very appealing indeed! Even more appealing, when she informed me that the probe and I would be making a very intimate acquaintance in a few moments. I was asked to undress from the waist down for the ultrasound. Feeling more than half-naked in my gown, socks and that paper-thin sheet, I dreaded what was to come next. It is funny how uncomfortable I initially felt about the ultrasound probe. 20-30 condom covered ultrasound probes down the road, vaginal ultrasounds felt as routine as brushing my teeth…okay, maybe not that normal!

With the ultrasound done, I was told to get dressed so that we could discuss results and options. If you don’t already know this, the one wipe and tiny tissue box the nurse leaves you to clean up the blue gel is pathetically insufficient. I actually discovered one reason to love the paper-thin sheet…extra large towelette! To my relief, I was told that the ultrasound looked great. Finally, some good news! I’m a bad news first kind of girl, so what came next threw me completely off guard.Worried woman looking at a pregnancy test in the bathroom.

I was expecting that we would start with intrauterine insemination. Dave would give a “sample.”  I would poke myself with a few shots…they would squirt the sample into me…we would get pregnant. To my dismay, this idea was quickly shot down. Because of Dave’s low counts the physician matter-of-factly told us that our best and only option was to go straight to IVF (in vitro fertilization), and not just IVF, but a more specialized type called ICSI (intra cytoplasmic sperm insemination).

As I mentioned, I am not a crier. Medicine teaches you to develop a thick skin. You can’t treat patients effectively if you cry with all of them. It teaches you to desensitize while at the same time to show sensitivity. Remove yourself one step away or you will become consumed and lose rationality and perspective. It teaches you these things, but when your heart is broken all in one moment for yourself, it is hard to keep from crying. I started swallowing so many tears that my nose began to run. All I could think of was IVF! Somehow, that felt like a punishment, a worst case scenario. IVF was a last resort, not the first step.

From The Mom in Me, MD