Thursday, September 15, 2016

The Thoughts of My Heart: IVF Round 2.5


My heart keeps urging me to write this post, even though the other part of me has been resisting. This post is not meant to inspire pity but to inspire faith. We finished our 2.5 round of IVF a couple of weeks ago. I realized this past week that I have never explained the medical process of IVF, and it may be easier for people to know what happened if they understand how it works. If medical stuff weirds you out, skip this next section.

Summary of IVF (Skip If You Don't Like Medical Stuff!)
  1. You usually start by getting your cycle in sync with all of the doctor's other IVF patients by taking birth control or estrogen. The estrogen totally messed up our first cycle--part of the reason why we cancelled and have 0.5 of a round. So for the next two rounds, we had to do it off our natural cycle as opposed to syncing up with the doctor's regular batch, which made it kind of tricky.
  2. Stimulation meds (via injections): you take these to grow your follicles. Your follicles are the houses for your eggs. You want to grow as many as possible and to get them to the perfect size. This causes your ovaries, which house the follicles, to grow from the normal size of almonds to the size of oranges. This makes your lower abdomen very tender, bloated and uncomfortable after a few days. Give anyone you know going through IVF a "gentle" hug! 
  3. After about a week of taking stimulation meds, you add on the antagonist, another injection (a hilarious name coming from an English major's perspective). The antagonist stops you from normally ovulating so that you can get those egg follicles (houses) as big as possible before retrieval.
  4. Then it's the trigger shot! This shot has to be given at an exact time, 35 hours before retrieval, and triggers ovulation. This shot must be done correctly, or all the shots and medication will have been for nought and IVF will not work!
  5. Egg Retrieval: they put you out for this, but this is where they remove the eggs and give you your total egg count. Up to this point, you've been to the doctor pretty much every day to every other day getting ultrasounds. Because of this, you have a general idea of how many eggs you will get, but you don't find out the egg quality or maturity until retrieval.
  6. Embryo Transfer: once embryos form, they call you to give you a report on how your embryos are looking. On transfer day, they give you an egg quality grade and then transfer your embryo through a procedure, a super uncomfortable procedure, but it's so exciting to think you have a little embryo inside of you.
  7. Then it's time to start taking daily progesterone to encourage the embryo to stick to your uterus. Mistakingly, many people think that when the embryo is transferred that the doctor can implant it. Not possible. The doctor can get it close to the best spot for implantation, but that embryo has to decide to stick. 
  8. After that, it's two painful weeks of taking progesterone and waiting and waiting and waiting and waiting. You are told not to do too much at this point, hoping that the embryo will attach and be kept safe. 
There are so many complexities, but that is IVF in a nutshell.

IVF 2.5

This IVF was our 2.5 time. We technically had one more IVF try if we paid a small amount (in infertility dollars). Our plan was to pay it, if this one didn't work, and try IVF one last time.

This IVF round started great! Our doctor was optimistic about my first couple of ultrasounds. They did extremely high dosages of stimulation meds this time to see if they could get more eggs than the six from last time (six is a very low number for IVF. Most women would a lot more than that.)--much, much higher dosages than last time.

The stimulation shots weren't as painful this time, but I had a pretty bad reaction to the antagonist every time I received it. The injection site would swell into a welt, and it would feel like it was burning for about an hour. Oh well! The trigger shot also caused a similar reaction. Despite that, this IVF was going pretty much according to schedule, and I was starting to get pretty excited. This could be it! The real deal! Third time's the charm, right?!

Ben had a meeting at the bank that he had to be at on the day of retrieval so he took me over, stayed with me for an hour, and then, making sure I was really okay with him leaving, left. My dear, sweet mom stayed with me to see me through. We had a different doctor do my retrieval this time since it wasn't our normal doctor's batch (remember, I am a non-batcher). We were expecting to get 6-8 eggs after the multiple ultrasounds we had already had. I was feeling calm and peaceful beforehand, just terrified that I would have another weird dream like I did last time and that I would tell all the nurses about after the procedure, haha. I remember waking up and just not feeling as well as I had last time right after retrieval.

Then our doctor came in and told us, "I am so sorry. We only got one egg. All the other follicles were empty. This (the follicles not containing eggs) only happens about once a year and typically only to someone in their forties." With a mix of heartfelt emotion coupled with a heavy dose of anesthesia, I started crying and crying. It felt so dire. I knew what this probably would ultimately mean. And then one of the sweetest acts in my life took place: the woman who was recovering on the other side of the curtain who had also just come out of retrieval said so sweetly, "I don't know you, but I'll be praying for you." It touched me so much that right after her procedure, she had enough love and compassion to give to me. But then I really couldn't stop crying. The odds of that one egg making it to an embryo were so, so slim, especially since I have such poor egg quality as it is.

I told Ben the news at work, and he texted some sweet words of faith. After retrieval I was pretty skeptical about the egg making it to an embryo because so many eggs after retrieval don't make it to the embryo stage. The next day I got the call. An embryo had been miraculously made! I was elated and surprised!

A couple of days later, our "real" doctor called and had a heart-to-heart with me. He told me that based on my previous responses to the medication, my poor egg quality and my diminished ovarian reserve (hardly any eggs), that if this IVF did not work, he did not recommend further treatment. It just isn't worth doing IVF if you may only get one egg. The odds are just so low. It was SO hard to hear that this little embryo inside of me may be our last chance (excluding miracles). But I was glad he told me so I could mentally prepare myself that IVF 2.5 was definitely our last IVF.

A few days went by and I wanted to hope for our embryo so badly, but I just didn't seem to have the same symptoms as last time, and that concerned me. I think Heavenly Father was preparing me. I started feeling the worst cramps of my life and then I knew. This was it. This is over. The embryo didn't make it, and we were counseled not to pursue further treatment. The implications of this were so heavy--I may never be pregnant and get to nurse my baby, never feel a baby kick inside nor see the features of a child created by us and identify the ones that came from Ben. It's a lot to take in. Of course, there's the possibility that we may randomly get pregnant, but the odds are not in our favor. At our follow-up, the doctor said he gives us a 5% chance of getting pregnant on our own but not to count on it; he told us he recommended adoption in our case.

Because there are so many quotes about motherhood being the highest calling a woman can have, I have sometimes felt down the last few years about not doing something meaningful with my life right now and have occasionally felt a lack of true purpose. The only thing I ever wanted to be when I grew up was a mother. I have loved dreaming about it all my life, and I am still dreaming. I know it would be SO hard, but it would be SO worth it. A few months ago, I read a quote from Elder Oaks saying that a single sister also felt a lack of purpose because she wasn't a mother and then he said something so profound: our main mission in life is to be a disciple of Christ! If you're a mother, then that's the BEST way you can be doing that, but if you're not, be a disciple of Christ in the best way you can: that is what matters. That really hushed a lot of the insecurities that Satan loves to whisper to those who struggle with infertility.

The story of infertility and the journey to motherhood doesn't begin when we got married or even when we decided to increase our family the first week of April in 2012. It begins when I was a little girl--when I carried around dolls and played "mommy." It continued as a teenager when I started a list of "Things I Want To Do When I Am a Mom," and I added to it when I saw/heard about great ideas from other moms and things I saw my own mom do that I loved. It carried on as a newly married couple when we picked out a color for a room that would be the "nursery" that never got used, and it journeys to the spot right now where we're at, where we have found out we may never have biological children. But what I am learning is this journey does not end here. This is not the end all. Heavenly Father has a plan, and it will unfold--when one door closes, another opens.

Now, a couple of weeks later, I am still processing, still grieving and trying to put a plan into action of what's next. It's weird not to have future infertility appointments lined up when we have been living and breathing them for a year, but we know our time will fill with the next steps of a different path.

Heavenly Father is a patient God, a loving God. He has us here to grow and to learn. We all have different trials--some seen and some unseen. But the truth is...He is there! He has been here all along. He does not forsake us. I have felt Him in so many ways: sweet, uplifting text messages from friends, a package from one of my oldest and dearest friends in CA who I rarely get to see, dinner brought over from my kind sister-in-law, a sweet gift from our next door neighbor, inspired scriptures sent by my dad, a mom who weeps with me, hugs from loved ones and Ben's mom bringing over ice-cream and chatting. I have also found His love in unexpected places, like from a woman on the other side of the curtain after retrieval. I have felt so much support and so much love from you all--thank you. I cannot express how much it means.

D&C 123:17 "Therefore, dearly beloved brethren, let us cheerfully do all things that lie in our power; and then may we stand still, with the upmost assurance, to see the salvation of God, and for his arm to be revealed."