Practically Fertile: Our IVF Story.

One year ago today, we transferred a 6AA blastocyst, praying it would yield the beautiful baby she is today. See, we are one of the 1 in 8 couples who battled with infertility. Infertility is a hush-hush, often unfamiliar medical condition that deeply effects so many. For my husband and I, it was a 3 year ordeal and it sucked to not have anyone who really understood what we were going through. So we kept it mostly to ourselves as it threw our world upside down.

Sure you’ve heard of IVF, but unless you’ve gone through it you probably don’t really know what it entails. My hope in openly sharing our experience is that I can help educate those who aren’t familiar, provide comfort and hope for those going through it, and help and normalize the conversation… So ready to get personal? Warning: It’s a very long story with a whole lot of TMI!

When I was younger, my early-to-mid 20’s, I wasn’t sure if I wanted children. I was self centered and fully aware of it. I wanted love and a career first and foremost. It wasn’t until after marrying the love of my life, hitting career goals, and transitioning from twenty-something into thirty-something that my maternal instincts kicked in and the thought of procreating started tugging at my heartstrings.

With the idea of a child in the near future (so we thought), my husband and I did what people do. We bought a house in the burbs, with a big backyard, in a neighborhood with top schools. After spending some time turning it into our dream home (oh you know, just a few small projects like cabinet painting, a master closet overhaul and gel staining some ugly oak banisters…) we decided to start trying for a baby. “It will happen when it happens,” we naively thought.

After a few months of this casual approach, the lingerie came off and we began the more regimented approach of tracking my cycle and timing things just right. After nearly a year of collecting negative pregnancy tests, we got the feeling that something wasn’t right, so I made an appointment with my OBGYN. They ran some tests that came back all fine and good, which meant now my husband was up to bat with a visit to the Urologist. With a solid sperm count and a perfect ultrasound of his family jewels, he checked out just fine too. So what the heck was wrong? My doctor diagnosed me with “unexplained infertility” and the fun began.

The first method of treatment was the least invasive: timed intercourse with the help of “light” fertility medications. In short, I took a series of pills aligned with my cycle then peed on ovulation test sticks until they showed that I was at the peak of ovulation. Then we began some really sexy timed intercourse for a few days followed by two weeks of progesterone vaginal suppositories (yes they’re as much fun as they sound!) This part is called the two-week-wait, when you’re hoping that the sperm met the egg and a baby is growing. After the wait, I took a pregnancy test to see if it all worked… and it didn’t.

We did three rounds of that charade, before I was referred to a fertility specialist, also known as a Reproductive Endocrinologist (an RE for short). Did I say the fun had already began? It was really just getting started.

We had a lengthy consult (complete with transvaginal ultrasound and pelvic exam for me) followed by a whole lot of blood work for both the hubs and I. I had a HSG test where they fill your uterus and fallopian tubes with dye then take ultrasound images of your interior lady parts while the dye runs through (to ensure there’s no blockages, polyps, etc.) From testing hormone levels to genetic testing and beyond, all of the tests came back to reveal… absolutely nothing. We were still diagnosed as “unexplained infertility”.

Here’s the point where our RE explained there are two routes:

He explained that even after #1, we’ll find ourselves back at #2, so modern infertility treatments often skip #1 at first try.

So the next step was Super Ovulation with Inter Uterine Insemination (IUI). “Say what?” you ask. Super Ovulation basically takes over your cycle and does all the work for your body, helping to grow some nice mature follicles (eggs) and have them drop at just the right time. It’s a two week course of daily injectables that you learn to administer into your belly or upper thigh. The medicines change as your cycle progresses. The last injection is called “the trigger shot” which makes you ovulate. This bad boy requires a 1.5″ intramuscular needle that my husband needed to give me at a very specific time… in the butt.

During the course of injections, I was closely monitored by my RE. Every 2nd or 3rd day was a 6:45am appointment where I would get blood work and a transvaginal ultrasound… all before commuting into work. Two days after the trigger shot, I had an IUI. The IUI started with a sperm sample from the hubs that got washed and counted. (Not sure who’s job it is to count them, but a good sample is tens of millions of sperm…) Then I had the pleasure of getting a catheter shoved up my vagina, through my cervix and into my uterus. Through the catheter went millions of sperm in hopes that between the meds stimulating my cycle and the sperm’s shortcut, a baby would be made. During my two-week-wait I again used progesterone vaginal suppositories daily. When the wait was up I took a blood work pregnancy test (also called a beta.) According to my RE, this whole process only yields a 20% success rate…

And of course we fell into the other 80%, so the doctor ordered one more round. Same process, the only difference was this time, the IUI happened to be scheduled on my birthday. Lucky, right? We were convinced it was a sign and it was going to happen. But unfortunately, it didn’t.

Emotional Sidenote: At this point, I started to feel a bit alone in this process. I guess the people around me are super fertile. I knew NO ONE who had fertility issues. When I tried to open up and share my story with a select few, I found myself faced with comments that hurt. People would say things like “Are you open to adoption?” or “Maybe you just need to relax?” or “Have you considered using someone else’s eggs?”. They just assumed my baby maker was broken and these were the right things to say. But they weren’t, these words are those of someone who simply has no idea about infertility and the process. I had two failed IUI’s and suddenly I need to give up and consider adoption? I’ve been using fertility medications for months now and I just need to relax to get pregnant? These naive and unintentionally hurtful comments showed me that I needed to find people in similar situations to connect with. People who understood infertility from a first hand perspective. So I began to search around to try and find stories and experiences from other women. That’s when I found an incredible, supportive, open community on, don’t laugh, Instagram. I created a private account to document the journey from this point on. It gave me a place to connect with amazing women who are going through, have gone through, are about to go through all different stages of infertility treatments. Having this community as a sounding board, advice panel, and confidants helped normalize the situation and prepared and supported me for the next step in our journey. Since I’m an open book now, feel free to follow me @TheFertilityFiles. Now back to the story…

So IVF begins with a similar 2 week regiment of injections like Super Ovulation, only at higher doses and with more hardcore medications. The monitoring is similar with bright and early AM blood work and intra-vaginal ultrasounds every other day. The difference in IVF is that after the trigger shot, you have a surgical Egg Retrieval rather than an insemination, so they can create the embryo(s) outside the body. Egg Retrieval is exactly what it sounds like… they knock you out, take a HUGE needle and extract mature eggs from your ovaries. The goal is to get as many mature eggs as possible without hyperstimulating you, which is a common issue that thankfully I did not have to deal with. I remember coming out of the anesthesia and the first thing I overheard was the doctor giving the egg count to the woman in the recovery room next to me. 50. They got 50 eggs. A few minutes later I was told my count, 7. They got 7 freakin’ eggs. I was devastated, but still had my husband grab me McDonalds fries on the way home (IVF inside joke).

I quickly learned that it’s quality over quantity. While I recovered from my Egg Retrieval, my 7 eggs were introduced to my husbands sperm in a warm incubator underneath a microscope in an effort to fertilize them. This is done by an Embryologist, who is essentially our child’s first babysitter. After 5-6 days the Embryologist checks on them to see what has been fertilized and has grown into a blastocyst, which is the typically the size embryo that they implant (though some doctors implant 3-4 day embryos). When the nurse called with our fertilization report, I was terribly nervous. To our surprise 5 out of the 7 had fertilized which is statistically great.

At this point you can choose to do a Fresh Transfer, where with the help of some more meds your body is prepped to implant the freshly grown embryo immediately, or you can have them frozen and opt to do a Frozen Embryo Transfer (FET) at a later date. We had opted for the latter as we decided to do genetic testing on the 5 embryos. Before freezing they biopsied our potential future baby microscopic cell clusters and sent them out to a laboratory that determines which are genetically sound (to a certain extent.) This is called PGS testing. The advantage of doing PGS is to rule out embryos that may be destined to fail (not properly implant or miscarry) due to genetic issues. There’s some controversy around the genetic testing of embryos as it’s not fool proof, and it’s quite pricy. After doing our research and under the guidance of our RE we chose to move forward with it to give ourselves the best chance of success possible.

When the PGS results came back, it was determined that 3 of the 5 were considered viable and were very highly graded. Strangely, the testing can actually tell you the genders of the blastocysts. At this point, we were kind of tired of the unknown and wanted to know. The 3 little blasts were all ladies! Regardless of gender, the order we were always going to implant them was based on grading (highest graded first).

So the next step was to wait for aunt flow to come to town, then schedule my frozen transfer and start medications up. Different from the previous procedures, the sole goal of Frozen Embryo Transfer medication is to prepare the lining of your uterus to accept the blastocyst. They’re not trying to make follicles here because the embryo was already created outside the body.

So more daily injections and more pills it was. Toward the end of the FET prep protocol, about 5 days before the transfer, I started a new shot called PIO – Progesterone In Oil. This is an intramuscular shot that required a thicker gauge 1.5″ needle, injected in the upper butt cheek. It’s done everyday, and if you become pregnant, you do it everyday for 12 weeks. Because of the location, my husband was contracted to do this daily injection. The first injection I thought was fine, but later that evening I began to limp and had a throbbing side. The next day, we switched sides and same thing happened. Now I was walking a bit funny because both side were throbbing. Finally, I called the doctor who thought we may have hit a nerve or gotten too close to bone. We tried switching up the injection site, but it only got worse. By day 3 of these shots I could hardly walk. Even lying down was painful. I was also running low grade fevers each night. But my RE needed me to continue in order to do the transfer, so I did.

Our transfer date arrived and we were quite nervous and excited all at once. The transfer goes a little something like this:

You get prepped in a gown and a hairnet, then ushered into a sterile room with an inversion table. Feet in stirrups, the embryologist confirms your identity and matches it to the embryo’s identity. They show you a super magnified image your little microscopic babe (and they give you a picture to take home), then they load it into a catheter. The catheter is passed to a nurse, who passes it to the RE who is all up in your lady business with a speculum and a cervix pincher. The catheter is then inserted way up into the uterus and they release the embryo into the fluffy lining so it can hatch and attach. You thank the doc for knocking you up, and retire to a recovery area where you can relax for a few before heading home.

After the transfer my RE didn’t recommend bedrest (some RE’s insist), but he wanted me to take it ridiculously easy the first 5 days. No lifting, housework, exercise… I continued with the PIO shots every day, and they only got worse. I was supposed to go back to work, but was actually unable to walk or sit enough to do so. I was in a lot of pain and still running low grade fevers in the evening. My RE wasn’t concerned about the fevers as they were very low and are a side effect of the PIO, but he couldn’t figure out exactly why I was in so much pain. He asked me to continue at least through my betas (which are a blood work pregnancy tests) and then I could switch back to progesterone suppositories.

Now in the two-week-wait, you can use a home pregnancy test, but you may just be driving yourself crazy with false negatives for testing too soon. I refrained from testing until 5 days past my transfer. I finally grabbed a cheapy dip stick from Amazon (when you’re infertile you quickly learn that buying regular pharmacy brand pregnancy tests at $15+ a pop is unaffordable month after month) and tested. Negative. Immediately I got myself down – it didn’t work. All this for nothing. The next day I tested again. I looked at the test and there was a very faint pink line. “OMG!”, I thought. Everyday up until the beta I tested. The line got darker and darker each day.

At 14 days past the transfer date, my first beta day arrived. We went in the early morning for my blood to be drawn, then anxiously waited for the nurse to call. When the phone rang, my stomach dropped. I picked up and was greeted by a cheery for that said “Congratulations!” I had a great number and I was pregnant! After all we went through, we were thrilled and excited.

I stopped using my home pregnancy tests, as I was scheduled for a second beta two days later. This time, when the nurse called with the results, her tone wasn’t the same as it was for beta #1. She said my numbers should have doubled, but unfortunately they dropped and I was likely having an early miscarriage or that the pregnancy could be ectopic. I needed to have a third beta done two days later to confirm that either way, I was losing the pregnancy. We prayed for a bounce back, for the second beta to have been a misread, a mistake. But beta 3 confirmed an early miscarriage, my numbers had completely tanked. My RE called me later that day. He said based on my first beta numbers, he would have bet his house on my pregnancy. He wanted me to stop all meds and for my husband and I to come in for a talk about how to move forward before transferring another embryo. In the infertility world this is what they call “A WTF Appointment.”

We were completely heartbroken. We had taken our families along for the ride, and now we had tell them the bad news. I had to be open with my job about things in order to get the flexibility I needed, and now I had to let them know this. It was hard for us to process, but it was even harder having to tell everyone that the transfer failed, that I was miscarrying, and that yet another fertility treatment – the most invasive one – didn’t work. Now what?

At the “WTF Appointment” we spoke with my RE for over an hour. He fine-tooth combed my records, my husbands records, test results, PGS testing results… there was no explanation of why it didn’t work, so we needed to dig deeper.

First, he suggested doing exploratory laparoscopic surgery and a hysteroscopy of the uterus. He had previously considered that I could have low-stage endometriosis, but often that can be overwhelmed by fertility medications. It can truly only be diagnosed and treated via surgery. Second, we decided for the next transfer to change the needle size for my PIO. Though he didn’t feel that my reaction to the PIO injections effected the pregnancy, he knew I couldn’t be completely debilitated and unable to walk next time around. So I would use a 1″ needle and if that didn’t do it, we would change the PIO to a different oil suspension. Finally, I asked him to run additional bloodwork on me. My father suddenly passed away a few years back from bi-lateral pulmonary embolisms (blood clots that traveled to his lungs.) He agreed to order the blood work to leave no stone unturned, but was also not convinced that findings would be reason for my infertility.

I had the blood work done, 15 vials at once (thank goodness for Gatorade.) The results came back that I tested positive for MTHFR and PAI-1 (one mutation of each.) Again, another debatable topic depending on what doctor you’re talking to, but basically I have two genetic blood clotting and folate absorption issues. My doctor stressed how only having one mutation and not two means these are very low risk, but wanted me on different prenatals with extra Methelayted Folate and a daily baby aspirin that I would start immediately and continue with until 36 weeks of pregnancy. Though we uncovered these, these were not reason for what had happened.

I agreed to do the surgery. I was scared, I didn’t want to do it, but I knew I had to. I couldn’t keep putting embryos in and having my body reject them. We needed answers and wanted to get pregnant. So I had the surgery. I awoke shaking like crazy from the anesthesia. They covered me with lots of blankets and put a warmer under my sheets until I stopped shaking. Strangely my shoulders hurt. I was later told that they pump air in you during the surgery and though they try to get most of it out, some can remain and get trapped up by your shoulders causing pain for up to a week. I had two small incisions one on my upper bikini line and one in my belly button. My RE explained to a very groggy me that he did find stage 2/3 endometriosis on my uterus and my ovary and that he lasered it off. He then explained this in further detail with pictures to my nervous husband in the waiting room.

After the surgery I needed to fully heal and get two normal periods before my RE could schedule a transfer and I would be able to start another round of meds to prep for the transfer. It was a waiting game. During this time my husband and I decided a few things:

First, that the infertility schedule and my work schedule were a bit much. I needed more flexibility to work from home then my job allowed. I had never expected to do this, but we needed to make our next transfer our #1 priority, so together we decided it would be best if I left my job.

Second, that we would keep this next transfer to ourselves. Simply put, there was just a general lack of understanding and this was just such an emotional process for the both of us, we just didn’t feel like sharing.

Third, that our bathroom was super ugly and needed a DIY facelift.

Finally, that we would only transfer one embryo. My RE was not a proponent of transferring multiple embryos for a number of reasons. Though he did give us the option for this transfer, as it increases your chances of getting pregnant greatly. We only had two left and if this didn’t work we would need to go back and do another round of IVF, something I really did not want to have to do.

So we set the plan in motion. I left my job on March 17th, 2017. I immediately jumped into the DIY bathroom project to keep myself busy while I was waiting to start the injectables for my next FET. In April we got the okay and scheduled Frozen Embryo Transfer #2 for May 18th.

This time around the PIO shots still sucked, but were MUCH better. The smaller needle didn’t debilitate me as the longer ones had. I also did not develop fevers, things were looking better than last time. When the day of the transfer arrived we went in excited and hopeful, but also apprehensive. Having gone through this once before only to end up disappointed was unfortunately on our minds and in our hearts.

After the transfer, despite my doctor not requiring it, I put myself on bedrest for 5 days. I hardly did a thing. I was afraid to stand up, as if the embyro was going to fall out (which it could never…) Until my beta I tried to keep my mind busy and not do as they say “symptom-spot”. I also tried to refrain from testing, but that only lasted until day 6. Again I pulled out my trusty Amazon cheapies and tested. There was a faint line. I didn’t trust it. I kept testing everyday and again, the line got darker…

Finally beta day arrived, but what was my number? And would my second beta rise? The nurse called, “Congratulations!” but due to a holiday weekend, my next beta was 4 days later this time. It was a painful 4 days. I continued using my cheapy tests. There was still a line, but was it getting darker? Was I still pregnant? I was trying not to go crazy. After my second beta test, I was dreading the call. The phone rang, I picked up, the nurse spoke, I hung up. My numbers were right on. Two days later I had my third beta, and sure enough my numbers were continuing to rise.

At this point they schedule you for a 6 week ultrasound, no more betas. If I thought the wait for the betas was bad, this was worse. I kept testing like a lunatic because I was so nervous. This is what infertility does to you. Rather than enjoying the moment, I was terribly anxious expecting the worst to come at any minute. At 6 weeks and 1 day, I hopped up onto the table at my RE’s office pants off, feet in the holsters, intra-vaginal ultrasound wand all up in me for what would be the last time. There on the ultrasound was this little nugget with a tiny flickering heartbeat. Holy crap, this was more than just beta numbers and lines on a stick, I was actually pregnant.

My RE released me to my OB. I had a minor panic attack, as for the past year, he’s been the guy taking care of my fertility. He said to me, “From here on in you’re going to be a regular boring pregnancy.” I didn’t believe him. I wanted to switch to a high risk doctor. I already wanted to deliver in a hospital with a level 3 NICU. Again, this is what infertility does to you.

I was on vaginal progesterone suppositories until 8 weeks and PIO shots until 12 weeks. It wasn’t fun, but it was required. I would show you a picture of my very bruised, very swollen, and very red butt, but it’s pretty disturbing so I’ll spare you.

I spent the first half of my pregnancy pretty paranoid. We didn’t tell our family until 10 weeks, and didn’t tell most of our friends until 20 weeks. As happy as I was to be pregnant, I feel like our battle with infertility robbed me of some of the joys of pregnancy. But my RE was right, and I wound up having a pretty great, normal, boring pregnancy. With the exception of failing my first glucose test then having to do the 3 hour test. That was pretty terrible, but a story for another time…

Then on February 9th 2018, everything we went through was instantly worth it. Over 200+ injections, surgeries, countless doctors appointments, the loss, the tears, the worries, the fears all became distant memories when our tiny miracle came into this world.

Miss Abigail Jaclyn filled our hearts in ways I can’t even begin to describe.

This precious little girl was totally worth the wait and is the reason that we can finally say that we beat infertility.