I expected things to feel differently. I knew that my ovaries would be working overtime with all of the hormones, so I brushed off the full feeling in my pelvis as “normal.” But as soon as my feet hit the floor on the second week of my IVF cycle I knew something wasn’t quite right. I jumped up and down a little bit beside the bed just to confirm my discomfort. Taking my dog, Bentley, for a short walk around the block confirmed my fears. Every step felt like a jab into my lower abdomen. I could feel each footstep as though it was kicking me in the belly. I had peritoneal signs.
Most people wouldn’t be familiar with this term, but I had routinely ruled this symptom in and out in belly pain patients presenting to my office and the emergency room. Peritoneal signs meant that I now had free-floating fluid sloshing around in my abdomen and pelvis. In my case, this fluid was coming from my ovaries. I was hyperstimualting! This may not sound like a big deal…but it can be. Not only does ovarian hyperstimulation cause discomfort, it can be very dangerous. Ovaries can get so large that they twist on themselves, cutting off their blood supply and ultimately dying if not surgically corrected quickly enough. Body fluids can spill into the abdominal cavity and fluid can pour into the lungs compromising breathing and even leading to electrolyte disturbances (potassium and salt imbalances). If severe enough, ovarian hyperstimulation syndrome can lead to kidney failure, blood clots, and even death.
My risks were low. I wasn’t too old. I wasn’t too young. I wasn’t too skinny, and I wasn’t to heavy. I didn’t have polycystic ovary syndrome. I was a model patient for IVF. This couldn’t be happening! But, it was. My estrodiol levels were off the charts and climbing! Just stopping the medications wouldn’t necessarily stop the hyperstimulation right away. These medications would continue to work for hours and even days before they would no longer have an effect on my ovaries. Moving forward with the IVF cycle would only make things worse and compromise my health and safety. It was over. The only option now was to cancel the cycle and wait for my ovaries to calm down. Wait…Wait…Wait…
What now? That was my big question. Over a week of shots, thousands of dollars spent, and nothing to show for it except for a medical complication….what now? I needed a plan. I needed an answer. I needed to know that we could move forward. If IVF wasn’t an option, then what was?
Although my infertility specialist had used tiny doses of the stimulating medication on me since I was considered fertile (funny for someone undergoing infertility treatments!), my body’s response to the small doses was like a rocket launching for the moon. The next time around I was told that we would simply use even smaller doses of the medications. I was ready. “Sign me up. When can we get started?” Those were my most pressing questions. In medicine, this mentality is referred to as a “gunner”-someone who is dug into the trenches ready to give it their all no matter the cost. I was an infertility gunner.
I had been gunning for things for years-medical school, residency, Hopkins admission-this wasn’t any different…other than that it matter so much more. Motherhood mattered more to me than any degree or job ever could. I longed for a baby more than I had longed for anything. As soon as my ovaries calmed down, I gladly grabbed my injections ready to get started again. IVF was my ticket to motherhood, and I was going to make it work. I had to…what other option did I have? Guns blazing was going to be my style. I warned Angelina Jolie to watch out; I was about to steal her role for Mr. and Mrs. Smith II. The baby making scenes weren’t going to be quite as sexy…but we WERE going to make a baby!