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Secondary Infertility & IVF

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 )

The upsides of the massive front side

A few friends are pregnant with their first babies at the moment, which has propelled me into a surge of nostalgia – combing through our newborn photos, and getting teary about little socks that I can’t face giving away. My pregnant friends agree that yes, tiny clothes are gorgeous and perusing Moses baskets online is a worthy cause for reaching their data cap, but they all look at me like I’m drunk at 10am when I say, “and isn’t being pregnant just so wonderful?”

Flicking through my pregnancy diary, there are tales of sore hips, exhaustion, uncomfortable nights, and all-day sickness, but I think Mother Nature suppresses those recollections so that the human race continues. Or perhaps the sleep deprivation after Tilly (my youngest) altered my brain function. Either way, the upsides of having a massive front side are dominating my memories.

The clothes

I loved maternity clothes, that wonderful comfortable world of elasticised waist bands and stretchy tops. Seriously, jeans that appear normal, but with little elastic inserts where no one can see? Genius! A couple of friends had babies just before I did and were keen to offload their maternity stuff, so I suddenly had a wardrobe full of extraordinarily comfortable clothes, for FREE. Gone are the sailor dresses and overalls that our mothers wore – preggy gear has taken some serious steps forward in fashion.

Pro tip: hang on to at least one maternity bra. They’re invaluable for stuffing with socks and wearing to costume parties. My husband wore mine just last week when we both had to dress up as Uma Thurman for a quiz night.

The body

Now I realise this one is contentious, because not everyone enjoys the way they morph whilst growing another human, but I thought it was incredible. After years of endometriosis and infertility I’d been feeling a bit let down by my body, but when I was pregnant I felt like it was finally doing something I wanted it to. And when I exceeded the weight gain recommended by the pregnancy books by roughly double (cough), the aforementioned stretchy clothes covered it all up.

Oh, and the boobs…undoubtedly the best bit. When I was six months pregnant, I thought, “Wow, I guess this is how my knockers are going to look from now on, and I’m not at all disappointed”. I realise now I was deluded, but the perky cleavage was fun while it lasted.

Freaking out strangers

A man on a plane displayed his annoyance at having to get out of his seat after I pointed out that me climbing over him with my gigantic bump was a greater inconvenience to both of us than him standing in the aisle for a moment. He then hogged both armrests and rolled his eyes when I asked for the cassava crisps AND the cookie. So just for funsies I spent the flight sporadically wincing and checking the seat for dampness while shooting him worried looks. I’ve never seen anyone bolt so quickly from their seat upon landing.

Terrifying children

When I was pregnant the first time, a curious little boy asked me what was under my shirt. I told him it was a baby, and he asked to hold it. I explained that he couldn’t because it was inside my tummy. He started to back away, looked at me with wide eyes, and whispered: “you mean…you mean you ATE that baby?” Having little experience with the fragile minds of preschoolers at that time, I let out a wicked laugh as he scurried back to his mother and carried on with my day. Now that I have two little girls who cover their eyes during the giant snowman scene in Frozen, I’d like to extend a formal apology to the parents of the little boy who probably still has nightmares about a baby-eating lady.

Food, glorious food

The list of food to avoid when pregnant is lengthy and disappointing. So the logic I employed was to go carte blanche on anything approved for consumption. Eating for two may be a myth, but woe betide anyone who challenges a pregnant woman at a buffet.

The fact I “showed” from eight weeks probably had more to do with the potato scones and lamingtons I inhaled than any actual baby growth. One afternoon I consumed an entire family-sized bag of jellybeans, which I felt justified in doing, as I was, myself, family sized. Then I freaked out about gestational diabetes and was consumed by guilt for days (now there’s a non-fun bit of pregnancy I do remember – the worrying that you’re doing everything wrong bit).

 

Pregnancy is a roller coaster for some, and a walk in the park for others. Then all of a sudden you find yourself moments from holding your baby in your arms and wondering how you’re going to cope with a newborn. But as I remember, all newborns do is sleep, right?

(originally published in the June/July 2016 edition of Little Treasures Magazine)

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¡Feliz cumpleaños

Ushered Tilly to the ‘Dad’ selection of birthday cards, but she insisted her dad would want this one because “he loves Dora and sparkles cos I love Dora and sparkles”.
Two year olds: proving that they’re in charge, even on not-their-birthday.
(I just added an extra 4 on the card and it totally worked for a 44 year old man)

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Because danger needs sparkles

Me: “What would you like to do this afternoon?”
Tilly: “Let’s do…something DANGEROUS. Wait here, I’ll get my sparkly shoes”

Details of a GoFundMe account for Tilly’s legal fees (and footwear) to follow.

Oh my smug, childless self

I shall title this photo: “Working From Home With Kids Will Be Easy” and file it under: “Shit I Said Before I Was A Mother And Now Want To Punch Myself In The Face For” (it’s a really large collection).

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Giveaway time!

I’m running a little competition over on the McPikelets Facebook page. If you’d like to win a copy of ‘Music Box 2016’ (a collection of songs from this year’s Children’s Music Awards) then get yourself over to Facebook.com/mcpikelets or click hereMusicBox-2016_Cover-Art.jpg

The wedding is OFF

Amy told me in the car this morning that she never wants to get married. I launched into a lengthy monologue about how we’re fortunate to live in a country where marriage is a choice, so she absolutely never has to get married unless she really wants to. Equality was discussed. Freedom to parent outside the realms of traditional marriage was also covered, as was the freedom to decide never to be a parent. There was a long pause while she took it all in. I took a moment during that pause to marvel at this little girl who so clearly knows her own mind, and to be grateful for the society we live in. I wondered what political or economic topics we should cover on the drive home. I may have teared up a little.

Then: “Yeah, I don’t want to get married because I never want to get my ears pierced. Oh wait, is it earrings you do when you get married, or is it rings on your finger? If it’s rings on your finger then I might. Are we nearly at school? I need to go to the toilet”.

Endometriosis and Motherhood

I always knew I wanted to be a mother.

Right from when I was tiny, I fed, bathed and bedded my dollies and teddies, and wouldn’t let anyone do up the top buttons on their tiny clothes in case it choked them (this could have been an early indicator of OCD, in hindsight). I gravitated toward anyone with a baby in their arms, and when my parents finally delivered on a sibling for me when I was 11, my poor little brother essentially had three parents all over him, all the time. I even attended antenatal classes with my parents, and remember thinking “this will all come in handy for me one day.” There were many things I wanted to do in my life, and having babies was always part of my grand plan.

Despite practicing for “becoming a woman” long before my time (generally by trying on Mum’s bras and stealing from her boxes of Tampax so I could watch them puff up in water), I was completely blindsided by puberty. Health class showed us pictures of girls swimming, running, wearing white pants while hanging out with their friends, laughingly passing each other itty-bitty tampons from colourful cases in their bags, whereas each month I was a miserable mess, huddled over a hot water bottle, sleeping with a towel under me and wondering how I could get out of PE. Our wonderful family GP understood my plight and put me on a high-dose pill, which meant that I could skip periods and just deal with them every few months. The downside was that the hormone overload sprouted me hips and took me from a B cup to a D cup almost overnight; a process that left angry pink stretch marks in its wake. Teamed with pimples, no real understanding of fashion (I still lack in this area), and accidentally getting The Worst Short Haircut Ever, my early-to-mid teens were a particularly awkward and unattractive time.

The pain I experienced each month got worse as I got older…

to the point that the simple act of going to the loo could cause me to pass out or throw up. My GP sent me off to a female gynaecologist when I was nineteen, thinking I’d be more comfortable seeing a female specialist. She was a cold woman who said I might have something called endometriosis, but to just take painkillers and put up with it until I was ready to start a family, and go back to see her then. Helpful.

A year later I was nannying for the gorgeous little boy of a family friend during University holidays when the mother clocked the hot water bottle stashed in my bag, asked me a few questions, then told me of her experience with endometriosis. She urged me to see her specialist. The next month, after being scooped up off the bathroom floor by my Dad one particularly bad day, I set off to see Dr Mark Insull. He was A-mazing. He made me feel so at ease and understood, and slotted me in for a laparoscopy as soon as possible. As it turned out, his expedient approach saved my ovaries…the laparoscopy showed that my insides looked as if someone had gone crazy with a hot glue gun and soldering iron. When you have endometriosis, rogue cells that should be in your uterus bleed and create scar tissue each time you have a period. The cells can be anywhere, but tend to be in the pelvic area. The scar tissue that had been growing with each cycle inside me had stuck things together that definitely shouldn’t be stuck together and had grown over my ovaries. I was somewhat horrified to be told that the sensations I’d described as feeling like something was splitting and tearing inside me were, in fact, attributed to scar tissue splitting and tearing inside me. That surgery altered my life for the better.

Eighteen months later I had a tune-up surgery after a few niggly pains resurfaced, and elected to try out the Mirena IUD. Following that, I became one of the all-swimming, all-laughing, white-pant-wearing girls who had just itty-bitty tampons in her handbag (it was the early 2000’s, so I can be forgiven for the white pants).

I’d been gently warned not to leave having children until I was in my 30’s…

But I was wildly optimistic at 29 when my husband and I started trying. Quite frankly, I was a bit put out when the first pregnancy test I did came up with one line instead of two. I’d planned how I was going to tell Jeremy and how we’d announce it to my parents and everything! So began the first of many, many disappointing moments after weeing on white sticks in the bathroom. I wish I’d bought shares in Clear Blue and Crystal Clear tests. Each month I’d nonchalantly buy a test, telling myself I’d wait until day 28 before using it. Day 24 would see me impatiently ripping into the box after re-reading the bit about how the test is so effective you can test up to four days early. Days 25 to 28 would see me racing back to the chemist to buy more.

Trying for a baby was a funny thing…

At first it was all wistfully looking at baby shops, plugging dates into due date calculators to work out when the possible baby would be born, happily laughing about All The Sex, and thinking about the sort of parent I would be (I’d make all their food from scratch! There’d be no TV watching! I’d never yell at my children! I’d get back in shape really quickly and never stuff chocolate in my mouth while hiding from the kids in the pantry! Now, quite often, I want to smack the pre-baby me really hard in the face). Then after months of disappointment I was still wistfully looking at baby shops, but I was also frustrated, wishing time away – particularly the second half of each cycle so I could hurry up and find out if we’d been successful, spending too much money on ovulation and pregnancy test kits, and saying incredibly loving and sexy things such as “I don’t CARE if you’re tired, it’s DAY FOURTEEN, get your pants OFF!”

Without the aid of an IUD or the pill, I noticed that endometriosis pain was creeping back. I tried to ignore it because I didn’t want to be out of circulation and miss any baby-making opportunities, until one evening I found myself clutching the walls in a restaurant loo to stop myself yelling with pain, and decided it really was time I went back to see Dr Insull. He whisked me in for surgery and found that endometriosis was running rampant once again. If I had miraculously fallen pregnant, it would have been very painful when all my organs started moving around to accommodate a bump. I was sent home to recover, with a plan in place to go to Fertility Associates in a few months’ time to get the fertility show on the road.

With no baby in immediate sight, we decided to crack into renovating our house, had a trip overseas with our best friends, and I took on a few extra projects at work.

One morning, the month we were due to go to Fertility Associates, I picked my way over the plywood and tarps that were standing in for floors in our demo-zone house, did a test out of pure day-28 habit, and watched in ecstatic disbelief as a plus sign appeared. I ran back to our room yelling for Jeremy, and we sat on our bed staring at the stick, until he went all pale and whispered “what have we done?”
1458586_10151770046626078_1539389153_n.jpgOur friends and family were thrilled for us, and despite revolting all-day sickness until nearly five months, I absolutely loved being pregnant, and constantly felt a combination of grateful, excited, and nervous that something would go wrong (thanks to an unnecessary scare at the 12 week scan, but that’s a blog for another day). I loved the baby from the second I saw that plus sign, and the moment that our beautiful Amy arrived (crossly protesting) Jeremy fell head over heels for her, too. We fall more in love with her every day. Well, most days.

We adored our obstetrician (Paul Robinson at Origins) as he was completely fantastic, understood Jeremy and I as a couple, and was well versed in endometriosis himself. I felt very safe in his care, and actually really missed him after the 6-week post-natal check. My mother in law said we should invite him to dinner, but I said there’s probably some sort of rule about that, and, anyway, I generally like to limit the number of people who’ve seen me with my knickers off to one in any given dinner party setting.

Given the time involved in Amy coming to be, we decided to charge into trying for a second baby when she was about five months old. Feeling a little more pragmatic and a little less naively optimistic this time around, I sought the advice of our GP after several unsuccessful months. Subsequent blood tests indicated low fertility levels, so off we went to Fertility Associates. An AMH test (which indicates how many eggs are remaining) revealed that I had a drastically depleted egg reserve, probably due to the scarring over my ovaries from years of endometriosis. We were advised that IVF presented our best option for conceiving another baby, and, armed with the knowledge that time was not in our favour, we decided to give it a try.

Our team at Fertility Associates was made up of seriously great people. Dr McChesney and his nurses Juanita and Miranda were pillars of both knowledge and support. I think it would have been a different experience without them.

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.

**To be Continued**

(blog originally appeared on ifonlytheytoldme.com)

Baby Shower (no actual showering involved)

The two year old was devastated I wasn’t taking her with me to a baby shower (because, seriously, unleashing Tornado Tilly in the home of an uninitiated mother-of-twins-to-be just seemed cruel). Luckily the five year old set her straight on how mundane the event would be:
“Tilly, you don’t want to go to a baby shower. It’s just a whole lot of women together, and they help the pregnant lady to have a shower, then they all take turns giving each other showers all afternoon. Bor-ring.”
Great. So then my husband was suddenly interested in coming along, too.

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