North of Hope

If I could put this post simply, I would say this: IVF is no joke.  It’s complicated, it’s painful, it’s emotional.  But it is also an absolute miracle from God, as it helps countless couples become parents who would have otherwise had no chance.

This post will be my longest, but I wanted to provide you with meaningful detail and understanding.  For those of you who do not know much about IVF, here is a brief run down…

Step 1. Ovarian stimulation
Your doctor prescribes a course of injectable medications for you to take to stimulate your ovaries into producing a high quantity of eggs.  During the stimulation phase, I typically give myself 3-5 shots per day.  Thankfully, the injections have never scared me and I am incredibly fortunate for that.

Step 2. Monitoring
In order to monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests, which for me, took place every other day for about 12-14 days.

Step 3. Egg retrieval
Egg retrieval is a surgical procedure which entails a light general anesthetic.  The doctor retrieves each and every egg using an ultrasound-guided technique.  On average, the surgery takes about 30 minutes, depending on the number of eggs the woman has.

Step 4. Fertilization
With visualization from a microscope, the embryologist injects each of the retrieved eggs with the male partner’s sperm and, if all goes well, the eggs fertilize and early embryo development begins.

Step 5. Embryo transfer
Two to five days after egg collection, your doctor places the planned number of embryos into your uterus (again using ultrasound guidance).

Step 6. Embryo freezing
If you have additional embryos suitable for use, they can be frozen and kept for future transfers.

Step 7.  The pregnancy test
Ten to fourteen days after embryo transfer, you have a blood test to find out whether the treatment worked.  As someone who does not have a whole lot of patience, this wait is consistently the most difficult part of the process. Our doctor has always told us to not take at home pregnancy tests prior to the blood test in the clinic, and so far, we have remained faithful to this.

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We began our IVF journey in June of 2018 with an initial consultation with our doctor, Dr. Jenson.  She is an energetic, glass-half-full kind of woman, which are qualities we knew we needed in a physician handling our fertility care.  I felt extreme optimism going into this process; my only hesitation was how the large amounts of hormones would affect me.  I had read stories of women who would cry unexpectedly, or irrationally yell at their husbands for no significant reason.  Fortunately, when I started my injectable medications, aside from some pretty severe daily headaches and a bloated tummy, my emotional and psychological well-being was unaffected.  I think Dave was/is pretty thankful for this, as well 🙂

With regard to the bloated stomach, picture this…  A woman’s ovaries are each normally the size of a walnut.  When given stimulation medications, each follicle (sac containing the egg) on the ovary swells to the size of a grape.  So, by egg retrieval, I had two sacks of grapes sitting inside my abdomen!  It’s as uncomfortable as it sounds.  And tough, because while I looked several months pregnant, and wanted to be more than anything, I was most definitely not.

Leading up to egg retrieval, I could not do any exercise aside from walking.  For those of you who know me, I’m a very active individual and enjoy the endorphins that working out provides.  So, cutting this activity was difficult for me. But my sidekick Nash and I had plenty of walks together by the lake, and luckily the summertime weather made them that much more enjoyable.  During these walks, I would often reflect on the fact that while our circumstances weren’t ideal, we were incredibly fortunate to be able to afford and pursue pregnancy via IVF.  Most insurances, including ours, do not cover fertility treatments, so they are 100% out of pocket expenses.  And while becoming parents was and still is worth every penny, going this route can be extremely stressful financially.  Being aware of this from the beginning, Dave and I vowed to speak to one another when we were feeling anxious, save as much as we could, and always have open communication.  For many couples the financial, physical, and emotional burdens of infertility can tear apart their marriage.  I can say wholeheartedly that this journey has brought Dave and I closer than ever.  God is to thank for that.

After twelve days of morning and evening injections, paired with other oral medications, we had finally reached the big day: egg retrieval (Thursday, July 19^th).  I arrived at the clinic, had an IV started, and spoke to the anesthesia team.  Before we knew it, I kissed Dave and was taken back to the operating room.  And not long after I saw Dr. Jenson come into the room, clearly smiling behind her mask, I was waking up in the recovery room asking Dave how many eggs were retrieved. And then I asked him again.  And again (darn anesthesia).  Dave wrote “10 EGGIES!” on a sheet of paper, turned it around, and set it on my stomach to serve as a reminder for when I would inevitably forget.  I closed my eyes and cried.  We did it!

The recovery period was difficult physically.  I was extremely sore and bloated from my follicles swelling with fluid.  This is a common bodily response following egg retrieval and a woman must be extremely cautious during the recovery to avoid a serious condition called OHSS (Ovarian Hyperstimulation Syndrome).  I was fortunate to avoid this complication and each day after surgery got a bit easier… physically.  Emotionally?  I was a mess.  We knew that once we left the clinic on Thursday (our retrieval day), our eggs would be injected with Dave’s sperm and we would not hear from them until Saturday, when we would receive a phone call stating the date of our embryo transfer.  Panic and “what if” questions filled my head.  “What if none of our eggs are mature enough to survive?”  “What if none of them fertilize?”  But my forever optimist of a husband would always redirect my thoughts with positivity, and remind me to surrender those fears to God.  I’m so lucky to have such an incredibly supportive and loving husband.  This won’t be the last time I say this.  He is amazing and there is no way I could get through this without him.

On Saturday, we received the phone call that our embryo transfer would be on post-retrieval day 5 (Tuesday).  This means at least one embryo survived and fertilized!  I of course dug for a little more detail, and later that day the nurse kindly sent me an email to notify us of our little embryos’ status.  It read,

“Good evening, Emily.  Here is a little info on your embryos:  10 eggs were retrieved; 7 out of those 10 were mature; 6 of those 7 fertilized.  The embryologist will give you much more detailed info when you come in for your transfer.”

We were absolutely over the moon!  I continued to let my body heal and prepare for our fresh embryo transfer, and on Tuesday, we made our way back to our clinic.  When going in for an embryo transfer, the woman must have a full bladder in order to allow the doctor to best visualize the uterus.  The transfer itself is relatively painless.  The full bladder, however?  Not so fun :).  Once in the procedure room, the moment came for our embryologist to come in and notify us of the status of our embryo(s).  She presented us with a picture of our strongest embryo, that which would be implanted.  She then explained that our other five were of average quality, and they wanted to give them until the following day to determine if they were strong enough to be frozen for future transfers.  While this scared us tremendously, we wanted to focus all of our positive energy at that time on our baby being transferred in just a few minutes.  Dr. Jenson soon joined the room, and like a flash (or shooting star, as she put it), Dave and I watched her delicately place our sweet embryo in my uterus via ultrasound.  It was incredible.  Breathtaking.  It was all done in less than five minutes and, prior to leaving, Dr. Jenson touched my stomach and said with a smile, “Stick and Grow, Stick and Grow.”  What we would soon learn to be her tagline.  We were officially PUPO!!  “Pregnant until Proven Otherwise.”  And the wait began.

During our ten-day wait, we learned that three of our five remaining embryos grew enough to be frozen for future transfers!  This brought us so much comfort, thinking about the potential of future siblings for our child.  We kept busy during the waiting period by celebrating Dave’s birthday with friends, going out to dinners, going to movies (one of my favorite things to do!) and attending Eagle Brook Church.  We had so many prayers coming from friends, family, and our church community; it was truly incredible.  On day five I had quite the scare when I noticed I was bleeding, but the clinic had warned me this could occur as a sign of the embryo implanting.  So while I was fearful, I was also hopeful.  The time came on Friday, August 3^rd to receive the news.  We both went to work, and since we were told we would receive the call between 3-4pm, I left the office at 1:30pm to get home in time and compose myself.  Dave worked the last half of his day from home for the same reason.  Just as I was turning on to my street shortly after 2:00pm, my phone rang.  And as you can imagine, my stomach dropped and my foot pressed hard on the pedal so I could get home to take in the news with my husband.  As I pulled in to my garage on what was likely the final ring, I answered the call, and on the other line the woman said,

“Hi Emily, I am calling to give you the results of your pregnancy test.  Congratulations, we have a positive!”

I jumped out of my car (which I later realized I left running!) and ran up onto our deck where I could see Dave sitting at the kitchen table through the glass sliding door.  I threw out a thumbs up, jumped in the air, and he soon joined me on the deck to take in the rest of the news from the call.  Her instructions were a blur as we held each other and cried.  It worked!!! It really worked!!!  After we hung up the phone, Dave went in to our fridge and pulled out a bottle of sparkling cider for us to celebrate – this is another moment for me to comment on just how lucky I am to have him as my husband.  Dave’s attention to detail and enthusiasm for life, especially life’s celebrations, is something I have always loved about him.  With our bubbly in hand, we FaceTimed our parents and saw their eyes fill with tears, just as ours had.

We spent the weekend in awe of our little miracle growing inside of me.  We were at Dave’s family reunion in Iowa, and while surrounded by family, I would look across the room and see Dave smiling at me from afar.  He would kiss my belly every night and tell me how excited he was to be a daddy.  We were overjoyed.  Physically, I felt an extreme amount of fatigue, and was actually taking daily naps, which is extremely rare for me as many of you know.  My boobs were also so sore – sorry for the detailed information, but that’s what you will get in this blog :).

Our next appointment was a follow up blood draw on Monday morning, August 6^th.  Once a positive pregnancy test is confirmed in the clinic, every IVF patient must go in for a confirmatory blood draw 48-72 hours later to ensure that the woman’s HCG (pregnancy hormone) levels are rising appropriately.  According to our clinic, the HCG level should double every 48 hours.  Our initial result on Friday was 52, and on Monday, it had risen to 107.3.  Although the level technically doubled, our doctor requested one additional blood draw to be done on Wednesday, just to be sure everything was progressing.  I should note that while going through the journey of infertility, I’ve constantly felt like something is wrong with me.  Like I’m not enough.  I’ve felt as if I’m not worthy of having a child, and perhaps I am being punished for something.  So when our HCG levels weren’t rising at the rate our clinic had hoped, I yet again felt as if I was climbing a mountain too high for me to conquer.  But on Wednesday afternoon, our lab result was 247.9, and on the following Monday, 1,198.  Our pregnancy was official!  We were told our due date would be April 11^th, 2019, and our first ultrasound would be at 5 weeks, 5 days.  That five-week ultrasound showed a beautiful gestational sac, and while we were told it was a bit too early to see the baby or the heartbeat, we could not wait for our next ultrasound in just over a week.

On Tuesday, August 21^st, Dave and I got to the clinic early, hopeful and eager to see our little baby growing.  We were brought back to the ultrasound room and everything went as it normally did.  But when our tech placed the probe to view my uterus, the empty sac was all to be seen.  And her face told the rest of the story.  I gripped Dave’s hand tightly, waiting to hear confirmation of what I already knew to be true.  We had lost our pregnancy.  She stated how she was so sorry, but there was no fetal development.  It appeared that our pregnancy had stopped progressing, and she stepped out to give us the time we needed.  I laid on the table with my hands over my eyes, sobbing uncontrollably.  For the first time, Dave was not jumping up to immediately comfort me with positivity.  He was by my side, with his own hands over his eyes, also crying.  Eventually he helped guide me off the table and held my body as I wept.  And he continued to do the same.  We met with the clinic staff member to discuss what our next steps would be – we could either wait to miscarry naturally, or I could have a surgical procedure called a Dilation and Curettage (better known as a D&C) to remove the contents of the pregnancy.  The surgical option would allow us to complete genetic testing and help determine why this loss took place.  We chose that option, and fortunately, my OB was able to get me in the following day.  Those next 24 hours were honestly a blur to me.  I went into work, because I didn’t know what else to do.  But I’m fairly certain that while I was present physically, I was emotionally vacant and completely disconnected.  The D&C was a relatively simple procedure from a recovery standpoint, but it took weeks for me to feel even remotely close to myself again.  I decided to share with my coworkers, and several other people close to me, so I did not have to slap on a happy face when all I felt was heartbreak.  I felt a great degree of healing once I became open with the individuals who I spend a large portion of my life with.  The flood of messages, prayers, and most surprisingly, people who shared their own similar journey, made me feel not quite so alone.  Our genetic test revealed that our baby had a chromosomal abnormality called Trisomy 16.  As difficult as it was to hear this, it provided a reason for the loss, and helped me to know that I didn’t do anything wrong.

As the days continued to pass, I felt myself becoming stronger physically and emotionally, and ready to look into our next steps.  After all, we had three frozen embryos remaining and there was hope and glory in that.  The loss of our sweet baby brought Dave and I closer to each other, and closer to God, than ever before because we realized that we truly have no control in our fate.  All we could do was surrender our lives, our hopes, our dreams and our pride to God.  We acknowledged that as much as we had our future planned out, His plan was already written.  So we chose to put one foot in front of the other, and continued to fight.

Next Post: Our Frozen Embryo Transfer