This is part two of a blog originally written for If Only They’d Told me, about endometriosis, IVF, and (spoiler alert) motherhood. You can read part one here
I’ll just do IVF
I remember breezily thinking in my twenties, “oh, I could always just do IVF if I don’t get pregnant naturally.” The reality of IVF was a little more intense than I anticipated. The first hurdle was All The Needles. I’m a needle-phobe. I turn into a gigantic child in the face of injections, IVs and blood tests. I’m fine with actual surgery, but not the needles that come with it. You’d think after three surgeries for endometriosis (which involve IVs and drainage tubes) and Amy’s caesarean delivery I would have gotten over myself. Nope. I had to do my first injection about an hour before we were leaving for Jeremy’s 40th birthday dinner, which was probably for the best as there was no time for stuffing around. We’d already decided that for the sake of our marriage it would be best for me to do my own injections. The injection was similar to an epi-pen, really easy to use…and when I summoned my big-girlness (and promised myself two desserts as a reward) and jabbed myself it actually didn’t hurt at all. The nightly injection was to stimulate my ovaries to get as many eggs as possible ready for release. Regular internal ultrasounds monitored how many eggs were on the rise. Herein lay hurdle two: Would enough eggs mature to make the IVF cycle worth continuing?
For a few days it looked like a resounding “no”, but fortunately things got going and we could carry on. Another injection was added to the mix at this point to stop my ovaries from releasing the eggs before they were ready. I was feeling like a pro about my nightly injection, and only wavered slightly when I found out there’d now be two daily injections, and that the new one was the more traditional syringe-style that needed to be drawn down. (Sidenote: the two year old son of our close friends was diagnosed with Type 1 Diabetes several months later, and as I watched him cheerily tolerate his multiple daily injections and his parents coming to grips with the reality of a lifetime of managing his condition, I felt the hugest sense of shame about how I’d thought I was “so brave” dealing with a few weeks of pissy little needles). With my ovaries rearing to go, I was given one final injection (the “trigger shot”) to take home with instructions to use it at precisely midnight so that my eggs could be harvested at an exact time. The eggs are harvested via a probe with an attached needle, which is a painful process, but the drug administered (via IV – I didn’t even flinch!) was so amazing that I was completely wasted and didn’t care one bit. Jeremy has a video of me in recovery, giggling, slurring, and trying to hold up 12 fingers (?!) to demonstrate the egg yield. Six eggs were mature enough to fertilise with the sample that my husband had gallantly provided that morning (FYI, he said the, er, “motivational material” in the little room was a bit crap). Hurdle three – will any eggs actually fertilise? – was cleared, with three of those six eggs fertilising. From our three embryos, only one continued to divide, so back we went to have our embryo inserted. This step isn’t painful at all (the embryo is transferred in via a very thin tube straight into the uterus), but my parents looked after Amy so that Jeremy could come with me – we figured he should at least be in the same room as me when I got pregnant.
Legs in Stirrups Chit Chat
While the nurse performed an external ultrasound and I got my legs sorted in stirrups while nervously chattering away (something about being nude from the waist down without any pre-anaesthetic drugs while in the presence of many medical people makes me want to fill silence with chit chat), the doctor in the vicinity of my nether regions commented “ok, what I’m seeing here looks really good.” Without pausing to engage my brain to think about other things he might mean, I babbled, “Oh thanks! I go to OFF Wax in Newmarket, they’re really good…” Cue mortified silence from my lovely doctor and hysterical laughter from my husband as he staggered around trying not to knock over medical equipment in a fit of mirth. My doctor confirmed that he had, in fact, been referring to the ultrasound view of my uterus. Even though I’d been assured I could just go about my day as normal after the embryo had been inserted, I barely moved for the entire day and went to great lengths not to sneeze. So began hurdle four: The seemingly endless wait to see if the embryo would stick. The lab called the day after our only viable embryo had been inserted to say that one of the other embryos had proved to be a late-starter, and we now had a very healthy look blastocyst on ice. This news was good, but it actually really threw me. I kept wondering what should happen to it if the current embryo took. Although I hadn’t had the myriad of hormonal swings that I’d been prepared for (I was watching TV2’s Private Practice at the time, and I was WAY less of a tool about IVF hormones than Addison Montgomery), worrying about that extra embryo really got to me. So much so that when the nurse called to gently tell me my blood test showed the first embryo hadn’t taken, I took it quite well and decided it must be some sort of sign that the other one would implant.
Two months later I had daily blood tests to pinpoint the perfect time for embryo #2 to be inserted. I was also having acupuncture (look at me, actually paying someone to stick me with needles and finding it really relaxing!) and planned to go straight to Ponsonby Acupuncture following embryo transfer to increase my chances. On the morning of our scheduled transfer, the lab called to say defrosting was a success and they’d see us in a couple of hours. I was so excited, and kept looking at the photo they’d emailed me of our little bunch of cells, imagining the little person those cells would turn into. A short time later I jumped out of the shower to answer my phone…it was the lab calling to say that they were really sorry, but the cells were dying off one by one and the embryo was no longer viable. I was devastated, and sat sobbing, dripping tears, water and shampoo all over the carpet. Jeremy was amazing about it, and took me out for a massive bowl of creamy pasta and several buckets of wine while my parents looked after Amy. We decided to take a breather before trying another round of IVF. I continued with acupuncture to get myself in top shape. I always thought acupuncture was fringe lunacy, but have since been convinced of the benefits. I also took a trip back to see Dr Insull as I could point to an exact painful spot on my abdomen where I could sense endometriosis trouble. A laparoscopy revealed scarring had stuck over one of my fallopian tubes (exactly where I could feel the pain), but there was no new endometriosis in evidence – great news from a fertility perspective! I started wondering if maybe falling pregnant naturally wasn’t completely off the cards. Herein began a little bit of actual fringe lunacy: A very good friend and I read about fertility by the moon, where you were supposed to stand, barefoot on the grass, staring at the moon every night. The theory being you’d get your cycle to match the lunar cycle, ovulating on a full moon. I tried it (and, oddly enough, I did start to sync up with the moon). My friend also sent me Lily of the Valley soap. Something about the scent of a lily attracting sperm. Probably a load of bollocks, but I smelled really pretty. It was nice having a buddy in baby-making who I could commiserate with over negative tests every month.
Secondary Infertility and well-meaning advice
Secondary infertility is a tricky old beast. Especially when people weigh in with their opinions. My family and close friends knew what we were going through and how much we wanted a second baby. My parents, in particular, were a huge support as they’d gone through their own struggles on the “when are you giving your daughter a sibling” front (the eleven-year age gap between my brother and me was not by design). Other people who vaguely knew of our struggles would offer well-meaning nuggets of sympathy along the lines of “oh well, you’ve already got one baby, some people can’t have any at all”, which is true, and we love Amy more than anything in the world, but that wasn’t really the point. We didn’t feel our family was complete. The other gem was “you’ll get pregnant when you least expect it”. Really? I least expected to get pregnant when I was on the pill. Not when I’m doing ovulation tests, going through IVF, having acupuncture and standing on the lawn staring at the fecking moon night after night. On the flipside, there’s the “when are you having number two?” question, often from complete strangers. Usually this question could be politely brushed off with a “one day!” or “we’re hoping soon!” response, but the harmless question in itself could make me feel like bursting into tears, especially if it came the day of yet another negative test. When I was recovering from my last endometriosis surgery, a lady and I were chatting in a park as I watched Amy play. I’d never met this woman in my life, but she said she hoped I was thinking about giving my daughter a sibling, as it was “very selfish” to have an only child. I thought to myself “she has no idea how badly I want to give Amy a sibling and what I’m going through”, but then was even more furious about her judging anyone’s personal choice about how many children to have.
When do you draw a line in the sand?
Many months and negative pregnancy tests later, Jeremy and I went for a long walk together while staying in Taupo over Easter. He was in the middle of a health kick after discovering he had ridiculously high blood pressure and cholesterol, and I’d just returned from attending the funeral for the mother of one of my closest friends. The high blood pressure and saying farewell to someone well before their time had made us take stock of what was really important in life, and I was worried that I was on the cusp of becoming obsessed about having another baby. I didn’t want to wish away time waiting to see if we’d been successful each month – Amy was growing so fast, and I just wanted to enjoy her. We talked about how far we’d go, and finally decided that we’d calmly do two more rounds of IVF, and if that didn’t work then we’d draw a line in the sand. We agreed we had a wonderful little family of three, and should think about a second baby as a bonus. We decided to start the next round of IVF that month, so I got myself all geared up to pick up my drugs from Fertility Associates when Day One would inevitably roll around two weeks later. A week after our Taupo trip, an hour before I was about to host a baby shower for a good friend, my baby-making buddy called me on FaceTime, holding up a positive pregnancy test. I was so excited for her I couldn’t stop screaming. She said she was sure I was pregnant too. I said it was very unlikely, but that I was nervously excited about starting IVF the following week.
The next weekend, with IVF due to get underway that coming week, I decided to do a test…one for the road. When two lines started appearing, I really thought my eyes were playing tricks. With shaky hands I showed the test to Jeremy, and we sat there, grinning like a pair of idiots, before calling our family and close friends. Again, despite all-day sickness, I was so grateful and happy to be pregnant. I still miss my pregnant belly and look wistfully at pregnant women in a way that makes Jeremy lay my pill packet next to a glass of water every morning in a very deliberate manner. I was more nervous about pregnancy the second time around, and more aware of what could go wrong. Nine months later, we welcomed Tilly into the world. There is so much love for this new little person, and I tell both my girls how wanted and loved they are every day. Watching Amy hold her baby sister in the hospital will endure as one of my favourite moments of all time, and Tilly constantly looks at her big sister with such adoration that it melts my heart. I will try to remember these moments when they’re teenagers threatening to kill each other and accusing me of ruining their lives.
( this post originally appeared on If Only They’d Told Me )