Guest Post: 3+1=6?

rutti family

Ashley Rutti and her husband, Jared, have been married just shy of 10 years. They have an energetic 4 ½ year old son and 2 ½ year old identical triplet daughters who are ornery and full of spunk. Yes, they have their dream family, but it took lots of heart ache, struggle, and the powerful word infertility. From Ashley: When I first started this journey, I was so closed off and felt alone.  But through it, I learned to be open and talk about the process.  It helped ease the pain to realize other people are struggling too.  Know that you are not alone.

Our journey started in 2010 when we decided it was time to start a family. After about eight months with no success and lots of frustration, we went to the doctor to see what our options were. (Of course, we had been told, “Just relax.  It will happen when the time is right”—that was easy for people to say who didn’t understand our struggle to get to this point.) We began tracking cycles and ovulation with the at-home kits and timing everything.  Then we moved on to Clomid with no success.

Next, the doctor suggested a hysterosalpingogram (the HSG Scan or the dye test) to see if my Fallopian tubes were open. This is when we found that my right Fallopian tube was blocked as a result of a gallbladder surgery gone terribly wrong in 2009.  At this point we were referred to a fertility clinic in Wichita, three hours from home. There we began all kinds of testing and blood work and were given information about what our best options where.

At this point the doctors suggested we try IUI (Intrauterine Insemination) before moving to IVF (In Vitro Insemination). Yet again we were put on Clomid and had to track ovulation at home.  When I started to ovulate, we had to see the doctor to make sure I was ovulating through the correct Fallopian tube.  Of the six times we tried for an IUI cycle, only three times was the ovulation on the correct side.  Those times, I had to take a trigger shot at an exact time and prepare to travel to Wichita for insemination.

After three failed IUI cycles, many cancelled cycles due to cysts and ovulating on the incorrect side, and lots of tears and struggling with why us, we decided to try IVF.  However, before we could even begin IVF, we had to do more blood work, an exploratory surgery, and save money since the fertility treatments and travel are expensive.

In 2011, we began our IVF journey.  It started with a prep class of how to prepare, what to know through the process, and what all the medications were for, how to use them, and how much to give at each injection time. Giving yourself four to six shots a day in the stomach and backside is overwhelming for anyone, but we did daily and nightly shots for ten days and traveled to Wichita every other day to check levels and adjust dosages and check follicle growth.

Finally after ten days of shots, it was our time for egg retrieval. After the retrieval, we had 13 eggs.  Only 11 embryos made it out of the first stage; then 7 perfect embryos made it out of the final stage. Then it was time for implantation; we transferred one embryo.  Then came the dreaded ten day wait to see if it worked.

Our perfect round of IVF and our perfect egg didn’t take; we had a negative pregnancy test. We were devastated and heartbroken.  Why did this perfect cycle not work?

I had my pity party, picked myself up, and we decided to try it again.  This time, we did the frozen embryo transfer (FET) which is less of a process since we already had the embryos. We transferred frozen embryos multiple times with no success—not even one positive test. Why did we waste all this money for this controlled process not to work?  After we used all our embryos, we decided it was time for a break as all we thought about was this, every minute of every day.  It was mentally and emotionally exhausting.

After a few months’ hiatus, we decided to try again. We did more blood work and another HSG scan and started the IVF process again.  This time we had 13 perfect embryos. We had our first transfer and the dreaded 10 day wait. This time we had a positive pregnancy test.  Are you kidding?  It worked!  We are finally going to have our baby!

So we thought, until my hormone levels started to drop, and we miscarried.  But not just once.  This happened in back-to-back cycles. At this point we were so discouraged and heartbroken, but the doctors assured us they would figure this out.

So we did more in-depth testing including genetic testing.  Everything came back normal except one of my levels was slightly elevated.  Long story short, it was something to do with blood thickness and not letting blood flow to the baby during pregnancy. The fix was a blood thinning shot. We decided to try the FET again, adding the blood thinning shot.  This time, we transferred 2 embryos, and we were pregnant!  The blood hormone levels kept doubling, and it was time for an ultra sound. Is this real?  We saw our tiny little embryo turning in to a baby!

I had a smooth pregnancy and continued the blood thinning shot every day until 36 weeks. In July of 2013 we had our perfect baby boy. However, getting there took a toll on Jared and I both.  We had lots of ups and downs and were always waiting for the other shoe to fall since it took so long to get this point. But through the infertility journey, we have definitely developed a much stronger bond and marriage.

We knew we wanted more kids, so around the time our son was 18 months old, and knowing how long it took us to have him, we decided to try again. Over Thanksgiving break, we made the trip to Wichita to meet with the doctor to discuss another frozen embryo transfer. We felt like pros; at this point, the clinic was our second home.

They gave us the dates of the upcoming transfers, and we were sent home to think about when we wanted to begin the process again. We wanted to start sooner rather than later given our past. So, we kicked off 2015 with a frozen embryo cycle.  We wanted to transfer 2 embryos again, but the doctors said we should only transfer one since our son was still young and they wanted to reduce the chances of multiples and tough pregnancies. After lots of grumbling, I agreed. We did the transfer and were sent home for the dreaded 10 day wait for pregnancy test.

On the day of the test, we typically received a call by 10 a.m. with results.  Jared was out of town, and it was 4 p.m. I just knew it hadn’t worked and prepared myself for the news. I finally called the clinic, and the nurse said, “Oh yeah.  Your levels are through the roof.  You are pregnant!”  No way!  How awesome on the first try! Wahoo!  It was nothing we ever expected.  Follow up test numbers were sky high, and I felt awful morning sickness all day.  I could not keep anything down and lost 12 pounds, nothing I experienced with my first pregnancy.

Finally it was time for the first ultrasound.  Immediately we saw two babies, and the doctor said, “No wonder you have been sick.”  Then he paused and said, “Nurse, can you get the other doctor?”  Our hearts sank in that moment.  Then he said, “I see three.”

I popped up and said, “Are you shitting me?” My husband’s jaw was on the floor along with the two doctors’ and the nurse’s. Everyone was in shock.  We transferred one embryo.  That one embryo split not once, but twice.  Identical triplets was literally a one in a million chance. Our clinic had never seen it happen.

This pregnancy was the polar opposite of my son’s.  We faced so many more emotions: almost losing a baby, talk of selective reduction, intrauterine growth restriction, twin to twin transfusion syndrome, temporary relocation to be close to a high risk doctor and major hospital, pre-term birth, and a lengthy NICU stay (all a different post for a different day).

Today, with our dream family of six, we look back, and it was all worth it.  But no one ever tells you how to prepare. Infertility is a brutal process that can break a person and leave you bruised. And while you should never give up on something that you can’t go a day without thinking about, everyone’s outcome and journey are so different, something we all sometimes forget.

Guilty As Charged

Guilt is a complex emotion in any situation, including infertility.  I hadn’t really addressed it much, but after our failed transfer it could not be ignored.  Rationally, I know no one is to blame for our infertility and failed transfer.  But rationality and emotion are two very different issues.

Guilty.

I’m guilty.

Of so many things.

I’m guilty of being a crappy friend and a worse family member.  I don’t keep in touch with my friends, and when I do see them, I can’t even think to ask about their lives and how their things are going.

And I didn’t do anything for Christmas for any of our family members.  And I don’t just mean buying presents.  I mean nothing.  For anyone.  Not our parents.  Not our siblings.  Not our nieces and nephews.  Not my husband.  I could have cooked something.  I could have made their favorite cookies and treats.  I could have at least been happy when we spent time with them.

But I don’t have any emotional space left to be happy or sad or anything really.  I’m guilty of avoiding social situations because I can’t share in the joy of our friends and family or mourn their losses.  I just can’t do it.

And I’m guilty of bothering everyone else with my problems.  The infertility is my issue, and I’ve drug our friends and family and even strangers along on this nightmare, whining and complaining and venting all along the way.

And I’m guilty of being a worse wife.  I’m hard to live with.  I’m emotional and negative and demanding.  I’m curled on the couch in the fetal position with tears streaming nearly every. other. day.  I’m short-tempered and have no patience.  My husband can’t do anything right.

The other night he made me twice baked potato casserole even though we had a whole pot of potato soup in the fridge just because I asked (and cried).  And he went out into the cold and started my car, so it wouldn’t be freezing when I had to run a quick evening errand.  His reward?  Me following him around the kitchen demanding to know why he was being so nice to me.

You’d think I could at least figure out how to be a decent human being considering it’s my fault we don’t have a kid.  While we both have fertility problems, his is an easy IVF fix.  I, on the other hand, can’t hold up my end of the bargain.  I can’t produce eggs, and the few I do are rotten.

Worse, I even screwed up the donor eggs. Perfectly healthy 19-year-old eggs.  Fertilized beautifully.  Matured beautifully.  Placed beautifully.  Negative pregnancy test.  With all the help of modern medical technology, I can’t give my husband what he wants more than anything else in the world: kids.

I’m guilty.  And there’s no way to put it right.