We sat in the waiting room of the IVF center waiting to meet Dr. Chet. Smooth jazz played overhead, a spread of celebrity magazines were fanned out on a coffee table in front of us. A large stone statue of a pregnant woman stood stoic in the corner. It was 9:00am on a Monday last summer.
Neither of us were entirely convinced we needed to be there. We were young and healthy. Surely the last 3 years had just been a rough patch of bad luck. Had it really come to this?
The nurse called my name and lead us back to Dr. Chet’s office. We walked in and were greeted by an older man with patchy gray hair sitting behind an old wooden desk. Degrees from Yale and other prestigious institutions flanked him on the wall above. In the corner of the room his computer screensaver played a photo collage of all the babies he had helped bring into the world on loop. We told him our history – that we met young, had been together for a long time and wanted to have kids. We said we had been trying for close to 3 years with ovulation predictor kits, Clomid and IUI procedures, but nothing had worked. I had no history of any endometriosis, ovarian cysts, or ovulation dysfunction that we knew of. Trey’s sperm (cue Magic Mike music) had been tested and were normal. I just wasn’t getting pregnant and we had no clue why.
They took my blood to measure my hormone levels and did an ultrasound to look at my ovaries. Not the cute belly ultrasounds. These are the ones where they stick a wand up your vagina. He sent me to a radiologist to get an HSG (hysterosalpingogram) done, which is an X-ray test where they inject a dye into your uterus and fallopian tubes via a thin catheter to see if there are any structural abnormalities. All in all, everything came back normal with the exception of my hormones being a little off. He talked to us about our options. Given the 3 years we had tried with ovulation predictor kits on our own, and the months on Clomid + IUIs we had already done, he put our chances at conceiving on our own as being pretty low. It was something we needed to hear. He was right and we knew it even if we didn’t want to believe it right then. Neither of us wanted to keep going down the road we were going on.
He told us we could spend months doing lesser-invasive treatments like injectable stimulation medications that may or may not work. Or, we could do IVF where the probability of me getting pregnant was more likely. IVF (In Vitro Fertilization) is when an egg is fertilized by sperm outside of the body. Medications are used to stimulate the ovaries into producing lots of eggs, which are then surgically retrieved, fertilized using sperm, and then transferred into the uterus (or frozen and transferred later).
He told us the costs for both options. We sat with the numbers for a while and told him we’d get back to him about where we wanted to go from there. We went home and tried for two more months on our own and got nowhere.
It was the beginning of September 2016 when we scheduled the appointment to tell Dr. Chet we wanted to go through IVF. Given that months on Clomid (a stimulation medication) + IUIs didn’t work in the past, we decided we didn’t want to waste our time trying the injectable stimulation medications and wanted to proceed directly to IVF. Dr. Chet gave me a prescription for an oral birth control medication to take that would balance my hormones and put them in a good place to start the IVF medications. The nurse worked with us to find a pharmacy that gave us an amazing deal on the medications through manufacturers coupons, insurance, and some publicly-available fertility medication discounts programs. A big cost in IVF are the medications, so we were really fortunate to be able to find affordable solutions.
A couple weeks later the medications arrived on our doorstep in a over-nighted refrigerated Fed-Ex box. I took the medications and spread them out on the kitchen counter. Small gauged needles, larger gauged needles, syringes, vials of thick fluids. Trey and I couldn’t believe the amount of medication that was involved.
IVF is done in 3 stages: Stimulation, Egg retrieval, and Embryo Transfer.
For this first stage, the stimulation phase, I would be using medications that would stimulate my ovaries into producing lots of follicles, which would house eggs to be retrieved. The medications were self-administered injections in the abdomen every morning and night. The medications used were identical vials containing hCG #1 (to be taken daily) and hCG #2 (to be used only on the last day of stimulation), Gonal-F, Cetrotide, and an oral medication, Medrol. My blood was tested every other day for the 12-14 day stimulation period and I had daily ultrasounds to measure the follicles in my ovaries. When the follicles reached a size that would likely yield mature eggs, I was instructed to inject the “trigger shot”, hCG #2, which would tell my body to stop stimulating the follicles in my ovaries for preparation for ovulation (release of eggs), and egg retrieval in my case.
Everything went smoothly. The injections weren’t that bad. The needles were relatively small and thinly gauged and if I pinched my belly fat and injected on those parts I could barely even feel them. Sometimes the needle wouldn’t go in easy and it would leave a bruise, or bleed….but for the most part they were okay if I got a clean stick. Trey and I got into a good routine. He would set out the syringes, vials, alcohol wipes, etc in the morning and I would then come and measure out the medications before self-administering the injections. Then we would leave to go to the IVF center for blood work and ultrasound. It ended up being around 50-60 injections and sticks for the stimulation phase including the blood draws. The medications made me feel oddly good physically at first. I think I was feeling good because of the hormones, but mostly it was excitement that this might actually be happening for us soon (!).
We got to day 12 of the stimulation phase and were in a bit of a rush getting out of the door. Our routine was off that day and I had to get the syringes and vials prepared myself, then measure out the meds to be injected. We got to the appointment and after the ultrasound Dr. Chet told me the follicles were large enough in my ovaries to likely yield a lot of eggs. So he told me in the next day he would call to tell me the time (everything in this process is done on a timed schedule) to inject the trigger shot, hCG #2.
It was then when I realized my mistake. In our rush that morning, I had injected the wrong hCG medication. I had already given myself the trigger shot (hCG #2) unknowingly and my body was now preparing to ovulate. I had grabbed the wrong identical looking hCG vial from the refrigerator. Dr. Chet and the nurse told us that that meant I wouldn’t be able to go through the egg retrieval surgery this go around, but instead we would need to try to save this cycle by going home and having lots of intercourse over the next 24-48 hours. Intercourse. Because that’s what it was. Shirts on, scheduled, intercourse.
At the time I felt like a massive failure. On top of my body already failing me, I had just unknowingly sabotaged our IVF efforts. I was really hard on myself. We had gone all the way through the stimulation phase, I had injected up to 4 medications into my abdomen a day, and at the very last moment accidentally triggered my body to ovulate too soon. I was mad. I don’t make mistakes like this. I’m the girl who worked in genetics labs all throughout college and grad school and knew the precautions necessary to minimize errors. But I did make the mistake. The difference this time being it was with my own body and I was the experiment. There would be no egg retrieval, not this time. I did what any self-loathing person would do – went to Taco Bell drive-thru and screamed into a plate of Nachos Bel Grande in my car in the parking lot with the windows up. Trey was there, he screamed too (not at me, at the nachos).
In the end, like a lot of errors, it turned out to not be that big of a deal. One of our nurses put it in perspective for us – we ended up doing what a lot of couples do, which is try the stimulation meds first to see if that alone would work. If it did, we would save thousands of dollars on medications and procedures and not have to go through the IVF process. So we did what the doctor told us to do and went home to, in the words of Marvin Gaye, get it on.
At each stage of treatment for infertility, you think you’re getting closer to actually getting pregnant, so naturally you get kinda excited. I remember the first few times I used an ovulation predictor kit I thought “alright, it’s really going to happen”. Then with Clomid, I thought “this is going to work!”. Then with the months combining Clomid + IUIs I kept thinking “this time it’ll happen”. And now with the injectable stimulation drugs and knowing my body had the perfect mix of medications to put my hormones levels in the perfect place, I found myself again thinking – “oh man, soon!”.
But then the pregnancy test came back negative two weeks later. It was a big blow. In some ways it was good affirmation that IVF was the route we needed to be going down, but it was also a set back because I was again – not pregnant. After 30+ months of negative pregnancy tests over the course of close to 3 years, that excitement I felt finally went away. I didn’t want it to, but it was like I didn’t have a choice in the matter anymore. I couldn’t bring myself to get my spirits up again because I didn’t want another monumental crash afterwards. In it’s place came a dark, callousness. I felt a big part of me change in the months that followed.
Dr. Chet told us my body needed time to rest and let things go back to normal before we could try again with the stimulation drugs. If you use stimulation drugs too frequently, it can lead to cysts and excess fluid in your abdomen. Coming down off the drugs was hard, worse than Clomid. I had headaches and mood swings. I had put work on hold at this point and found it hard to find the motivation to get out of bed. I wasn’t feeling much like myself. I told Dr. Chet how I was feeling and he referred me to a therapist who had been through IVF herself. I started meeting with her once a week. I was emotionally exhausted in a way I had never been before. I stopped going out and doing things with friends. I’ve always been introverted, but this took it to a new level. I wasn’t leaving the house or talking to anyone. I’ve never been the type to look to others for help. I’ve talked about my childhood here before some, and… self-reliance was something I learned from a young age. I didn’t know how to seek support from others because I had never really been in a situation where I felt like I couldn’t handle it on my own. I always dealt with things myself or with Trey. I didn’t know how to write about it here. I definitely didn’t want it to look like I was writing about it for the wrong reasons. So, I took some time to devote to therapy and swimming and getting myself in a better place to start over with treatment.
When it came time to decide whether or not we were going to try again with IVF this year (2016), I had mixed emotions. We had come so far in the past few years, and it felt like we were getting closer, but I didn’t want to go through another let down if it didn’t work out. It was early November, 2016. The therapy had helped some, I was feeling better physically, and was starting to feel like I was getting back to being myself. I had told myself I had one last treatment in me for this year and then I was going to take a break and travel if it didn’t work out. I imagined laying on a beach somewhere, or renting a loft in Mexico City to write for a few weeks.
Trey asked what I wanted to do. He told me it was my body and there was no pressure. Trey is the best partner on the planet for me. Throughout all of this, and everything to come, he would never miss an appointment, blood draw, or ultrasound. He also is really funny and knows how to make any situation lighter, like making origami cranes for me while I’m getting my blood drawn.
I thought about it for a little while, then looked over at him and said confidently, “Yes. Let’s try this again”.