Guest Post: I Wish I Could Just Pregnant on my Own

My name is Ashley Aldape I am a wife of almost 10 years, an aunt, a friend, a sister, a daughter, and not a mother.

ashley

Since I went through puberty, I have struggled with insane periods. I get physically sick a few days before, vomiting, light-headed, feverish, etc.  Once that subsides, the flood gates open, and I bleed profusely for weeks, even months. Along with the blood, there is pain, mainly in my right side.

My mother pulled me from doctor to doctor trying to figure out what was wrong with me.  No one could figure it out.  They said it was because I was overweight and had Polycystic Ovary Syndrome (PCOS), a hormonal disorder that causes cysts to develop on the ovaries.  Women with PCOS have difficulty conceiving because the syndrome effects ovulation.

Okay, but why was I in so much pain?  Why would I bleed for months at a time? Why would I go through a box of super plus tampons in a day? One doctor even went so far as to say, “What is heavy bleeding for one person, is not heavy for another person,” basically telling 17 year-old me that it was all in my head.

I was on tons of different medications: birth control, progesterone, metformin, etc.  Yet none of it alleviated the pain and heavy flows. Then the infections started. I had urinary tract infections and yeast infections constantly.  This came on around the time I became sexually active.  I thought maybe I wasn’t cleaning up properly or maybe the guy was giving me a STD or something. I was young, and no one had ever talked about bodily functions with me.  All I knew was it must have been something I was doing wrong.

I was going to a nurse practitioner (I refused to go back to the OB/GYN who had written me off as crazy), and she told me flat out that she didn’t know what was wrong with me and referred me to a specialist a few hours away.

It was the summer before my wedding when I met Dr. Tatpatti. She runs a fertility and women’s health clinic.  She sees people daily who struggle with infertility.  I went in not even thinking that she could help as I wasn’t trying to conceive. I told her my story, and she ordered a sonogram.  I had had hundreds of sonograms at this point, so I was skeptical that she would find something that others missed.  I was right.  She confirmed that I did have PCOS but couldn’t pinpoint the cause of my symptoms.

Then she did something that NO ONE had thought to do.  She ordered an MRI.  As simple as that: an MRI. Why didn’t anyone else think to do that?  I went back a few weeks later and had the MRI.  I hated it.  The little tube smelled funny, and I wasn’t able to move for what seemed like hours.  I just kept telling myself, After this we’ll know what’s wrong with me.

We went to her office to go over the results.  My mom was on one side of me and my soon-to-be husband on the other.  We were all nervous. Dr. Tatpatti dropped a bomb on us all by starting out with, “Did you know you only have one kidney?”  We were all shocked!  No one had ever told us this!  She then told me that I had a bi-coronate uterus. She explained that I had two uteruses and two cervixes and a nub of a second vaginal canal.  The blood was just sloshing back and forth between the uteruses which was causing me to bleed for months and in heavy amounts.

My first thought, and everyone’s first question, was if I was supposed to be a twin or something? That’s not the case.  Dr. Tapatti informed us that I have a rare genetic condition that I was just born with.  (We had no idea that this ran in our family because my dad was adopted, and we don’t know much of his biological history.) It was as if a weight was lifted off of my shoulders.  I believed with all my heart that I would be cured since we figured out what was wrong with me.  We had a plan of action and steps to take to fix me.  She prescribed me progesterone, so we could kick start my period because I needed to be on my period for an exploratory surgery, so she could confer with some peers to figure out what needed to be done.   We would need to do a partial hysterectomy and remove the “extra” uterus and cervix.

A few months after my wedding, I went in for the partial hysterectomy.  Surgery went as expected, and they were able to remove the smaller set of organs.  I’m left with a “working” set but my uterus and cervix are smaller than others.  She told me to expect difficulty getting pregnant, and IF I was able to get pregnant, it would be questionable if I would be able to carry and deliver a baby.   I hadn’t even considered this.  I thought I would be “normal” after the surgery.

I was a newlywed, and I was getting questions non-stop about when we were going to have children.  For the first few years, I was able to laugh it off and say, “It’ll happen soon.”

I don’t know when that changed.  I’m no longer able to laugh it off.  It’s awkward and uncomfortable. Most of our friends and family know the story, but strangers (why are strangers even asking me about children?) and new friends are the worst. Once they ask, I feel like I have to explain my condition to them which inevitability leads to more questions and comments. Comments about so and so’s third cousin who went through IVF or your sister’s mother-in-law who adopted a kid and then miraculously got pregnant after they stopped trying.  I know they don’t mean to upset me, but they do.

Commercials for pregnancy tests piss me off. I have taken hundreds of pregnancy tests over the years.  I don’t have a period for months sometimes, and I can’t help but to get my hopes up. They are always negative. The commercials always portray a positive test and a happy family.  It’s unrealistic.  People always reach out to me to go to their doctor, try this weird herbal tea, and try acupuncture because, “It worked for (fill in a name).”  I have to say that I have tried a bunch of weird stuff because it couldn’t hurt right?  Well every time I subconsciously think that it might work, and every time I get my hopes crushed.

I can handle when friends or family tell me they are expecting because I know that they will be good parents and love the crap out of the kid. I mean, it still sucks, and it’s hard to hear, but generally I’m happy for them. But there are others.  A few years ago a friend of my husband’s got his girlfriend of a few months pregnant.  They were both drug users and not in a stable relationship. This was by far the worst one for me to handle.  When the baby was born, we went to the hospital to congratulate the new mom and dad. They were dealing with some family drama (as always) and gave the baby to me to hold.  I just stared down at her little face, turned my back, and cried.  I cried for her–her life was going to be so hard–and I cried because I was mad and sad that my husband and I were not able to have a child.  I quietly wiped my tears, we said our goodbyes, and left.  We walked out of the hospital, and my husband just held me. That was the last time I saw those “friends.” Later, I heard the little girl was taken away from them and put into someone else’s custody.

I have undergone several rounds of progesterone and Clomid. It hasn’t worked.  Dr. Tatpatti told us that if the Clomid fails to work then our next step is IVF.  I’m scared of IVF.  Since my uterus is smaller than others, she recommends that we don’t implant more than one embryo at a time.  This cuts our chances of it taking in half.  And IVF is expensive; I worry that I’ll spend all this money that I don’t have and won’t end up with a baby.

My husband and I have talked about adoption. We are not against it at all, but we would like to have a child with our DNA.

We have been struggling for NINE YEARS. We are going to start ANOTHER round of Clomid this winter. If that doesn’t work, I guess we’ll move onto IVF. I guess I have drug my feet because what if the IVF doesn’t work?

I wish I could just get pregnant on my own.

 

And the Results Are In…

Today, my nurse called with my biopsy results.

Good news and bad news.

The good news is I’m positive for proteins (that help “hold on” to embryos) and everything else looks normal.  There’s nothing to indicate that a transfer will fail.

But that’s also the bad news.  We didn’t find anything wrong, so there’s nothing to do differently.  There’s still no reason why our last transfer failed.

That’s the thing with infertility.  You hope for bad news–that the test results will reveal a problem because that problem could be the cause of your infertility and there might be a treatment for it.  Good news–like positive test results or everything looking good–is actually the bad news because you don’t get any answers.

Irregardless of our unanswered questions, we’re moving forward. This weekend will be spent sorting and ordering medications, printing documents, signing papers, and getting ready.  Monday I start the first of the medications for our frozen embryo transfer (FET) scheduled for early June. Here we go, again.

 

 

Integrin Biopsy Day Sucks

Over the last few years, I’ve had a lot of tests and procedures.  I’ve had vaginal ultrasounds and daily blood draws, the “dye” test, and visualization of my uterus.  I’ve had my follicles “aspirated” and embryo-carrying catheters slipped through my cervix.  I’ve learned not to panic, stress, or fear these procedures  They’ve never been as utterly awful as I’ve been lead to believe, and I have a high pain tolerance.

Today, however, I had my integrin biopsy.

It sucked.

I arrived before my 1:15 check-in time. The receptionist warned me that my doctor was in delivery, so I might have to wait. No problem. It’s to be expected.

The waiting room was packed. I was surrounded by pregnant women with their spouses and new moms with their infants. There was even an adorable little boy, about two years old, who was playing and running around all cute.

I sat off to the side, alone, trying to ignore all the happy pregnancy chatter and hormones swirling around the room.  The longer I sat, the worse I felt. I contemplated telling the receptionist I would be waiting out by the elevators instead of in the waiting room.

Finally around 1:45 (the scheduled time of my appointment), my name was called, and I was escorted to the exam room. After a quick medical review, I changed into the open front gown and draped myself with the thin, white sheet. And I waited.

It didn’t take long before the hospital-cold seeped through my lack of clothing, and I started to get chilled.

Around 2:10, the nurse popped her head back in to assure me that they hadn’t forgotten about me.  She said my doctor was next door, so I would be next.   Thank God, I thought.  I was officially freezing.

When I checked the clock again, it was 2:30.  I had been there since 1:15; I had been freezing since 1:45.  I contemplated lying down and trying to nap.

Then a knock at the door came, but it was just the nurse again coming to add insult to injury. She apologized, saying she should have had me give a urine sample for pregnancy test before I came to the room. The doctor wanted to be sure I wasn’t pregnant before she “stuck something up there.”

It took all I had not to make a rude (and honest) comment about the likelihood of my being pregnant considering I was only there because of infertility and a failed donor-egg embryo transfer.

Instead, I got redressed and went back out to the waiting room to give a urine sample while everyone listened. (I declined the specimen cup the nurse offered to bring me in the exam room–which had no bathroom.)

Back in the exam room, unclothed, and freezing again, I resumed waiting (and trying not to think about all the pregnancy bellies and babies outside that door and my impending negative pregnancy test).

Finally, my doctor arrived.  She asked how I was and checked out my biopsy kit. She said it was likely this would be an easy biopsy because given where I was in my cycle, my cervix should be opening slightly to allow sperm to pass.

She was wrong.

She struggled to gain access to my uterus because of the curve of my cervix. Two different tools later, she finally decided my cervix, although open, was tilted toward the back. Multiple adjustments of the speculum, dabbing and wiping of cotton swabs, and finally two or three attempts with the “pinchers” later, she finally had decent access.

She repeatedly apologized as I lay there immobile just trying to breathe through the worsening cramping, sharp pinching pains and repositioning of the tools. Multiple times, she had to wait while the nurse left the room to get another necessary, yet missing, torture device.

Eventually, it was over, and I was left to redress, take my specimen, and find my way to FedEx to overnight it to California.

All the way to FedEx, I fought tears.  All through Wal-Mart, I fought tears (meeting pregnant women and carts devoted to newborns in car seats in every aisle).  All the way home, I fought tears.

As I unloaded groceries, I gave in. The physical pain was bad enough, but it was just the final straw on top of the emotional strain of today.  I had been reminded at every turn how hard it’s been and how unfair it is that we have to work this hard.

And now we wait, yet again, this time for biopsy results. If it shows the necesssary proteins are present, we still have no idea why our last transfer failed or what to do differently next time. If the proteins are missing, we have something else to try but still no guarantee of a successful transfer with our remaining embryo.

Integrin biopsy day sucks.

Guest Post: When Life Brings You IVF and More IVF

jennee pic
Jennee is a psychologist, a wife, and a mother to her rambunctious three-year-old daughter.  She is currently trying to conceive again and is chronicling her IVF experiences as the author of The Not so Fertile Goddess.

I’ve always had a feeling that I would have a hard time getting pregnant. I don’t have any idea where this notion came from, but I never gave it much thought in my 20’s. I was too busy – busy with college and graduate school, then establishing my career and getting settled in life. It took some time, but I finally found a man who was a good fit for me, and we made a home together. By that point I was in my early 30’s, and we were ready for kids. Without any logical reason why, it came as no surprise to me when a year and half passed with no signs of pregnancy.

I went to my OBGYN, and, without hesitation, she referred me to an infertility specialist. And that’s when I slammed on my brakes. The mere thought of going to a reproductive endocrinologist (RE) was intimidating, not to mention crazy expensive because it wasn’t covered by my insurance. I was caught off guard. I had never known anyone who had gone through infertility treatment. I assumed there had to be something my OBGYN could do – tests, a diagnostic work-up, some treatments – but she basically sent me packing and wanted nothing more to do with me. Looking back I know this doctor clearly wasn’t experienced in working with infertility and could have used a few more lessons in bedside manner. But at the time, I was simply confused and scared.

I spent the following year convincing myself that I didn’t want to have children. I knew several women who chose to not have children, and I envisioned a carefree life with lots of traveling. My husband went along with it, but gradually snuck the topic back into our lives. Apparently he could see what I was refusing to see – that deep down hidden in a place I didn’t want to talk about – I desperately wanted to have a baby. Shortly thereafter, a friend told me about how his wife saw a local OBGYN who prescribed Clomid, and they got pregnant right away. And this doctor was covered by my insurance. It sounded like just what I needed, so I quickly made an appointment and began treatment. I remember that first round of Clomid and how excited I was thinking that this was our magic ticket to parenthood. *sigh*

One year of back-to-back cycles on Clomid or Femara and still there were no double lines in sight. I was given the illusive “unexplained” diagnosis after passing every diagnostic test thrown at me like a boss. Eventually I agreed to an exploratory laparoscopy. I’ll never forget waking up from the surgery and having the nurse tell me that the doctor wanted to talk with me. The nurses wouldn’t give me any other information, and naturally I assumed that my uterus was as barren as the desert.

Fortunately the news wasn’t as bad as that, but it was a little odd. My doctor discovered endometriosis (which occurs when the uterine lining grows outside of the uterus), which he downplayed, saying it wasn’t in any location that should prevent me from getting pregnant; still he removed it. That was unexpected but not the odd part. He told me I didn’t have an appendix – odd because I’d never had it removed – and in its place was a significant amount of scar tissue that had grown onto my right Fallopian tube and was pulling it out of place rendering it nonfunctional. My husband and I made jokes about my apparent alien abduction and stolen appendix. But I prefer to think that I’m so bad ass that I ate my own organ. Because who needs an appendix anyway? The doctor cut away the scar tissue and my tube returned to its correct location. I was so hopeful that this surgery was the answer.

But I continued to not be pregnant, month after month despite the medications. We even tried IUI to no avail. After a year and a half of monthly treatments, I got tired of doing the same thing and expecting different results. So even though my OBGYN thought we should keep trying and was hesitant to refer me to an RE because he thought they “pushed IVF too much,” I simply couldn’t go on like this. I made the call and scheduled a consult with the local infertility specialist – a call I wish I had made all those years ago.

Unlike my OBGYN , the RE said the reason I was not getting pregnant was due to the combination of endometriosis, which negatively impacts egg quality and can cause inflammation, and nonfunctional Fallopian tubes. I asked how that could be since the dye tests showed my tubes were open. He explained that just because they’re open doesn’t mean they work right. All that scar tissue (and of course when you cut away scar tissue you are left with more scars) and inflammation from endometriosis impacted how my tubes work. Oh, and I had diminished ovarian reserve too. Joy. He was confident that IVF was the treatment for me.

So finally after four years, with a one year break in the middle, I began IVF. Well, after one more surgery to remove a polyp – there’s always one more thing, isn’t there? For my first IVF I had seven mature eggs retrieved, all fertilized naturally, and on day 5 I had three early blastocysts. Since they were a bit slow growing (I was 36 years old so quality was just starting to decline) and I had that polyp removed (which basically left a spot in my uterus where nothing could implant), my RE suggested transferring all three embryos at my day-5 fresh transfer. And so we did. I was in absolute shock when I got the positive beta results. I now have a rambunctious, very opinionated 3-year-old daughter.

I truly though I’d never do IVF again after that hellish journey. But as time passed, the desire to grow our family became strong. It took a long time for my cycle to return. When it did I hoped to be one of those magical unicorns who get pregnant naturally after IVF. I wasn’t, and I wish I had gotten into my RE sooner than I did.

Just a couple of months before my 40th birthday, I had another egg retrieval. Technology had changed the way my clinic operated since my last IVF, and they now encourage Preimplantation Genetic Screening (PGS testing) and frozen embryo transfers. I ended up with one PGS normal girl that round. We were so excited and completely assumed it would work. It was such a difference from our first round when I was convinced it hadn’t worked.

When she failed to implant, the floor dropped out from under me. The next two rounds of IVF ended in zero blasts – nothing to test. Following that we got two embryos, and both were PGS abnormal. That’s three rounds of IVF with nothing to transfer. That means zero chance of pregnancy. I might as well have forgone the torture of all the treatments and procedures and just had sex.

Now I’m in the middle of my sixth round of IVF and will be doing a fresh 3-day transfer next week. We decided, after careful consideration, lots of research, and many discussions with my RE, that PGS isn’t for us. (That’s a whole other discussion which I’ve written about on my blog.) I know conception is still a long shot, but at least it gives us some chance, and I like the idea of getting my embryos back in their natural environment as soon as possible.

My heart breaks every time my daughter asks for a baby sibling. I hope I can make her a big sister and give my husband, who is an amazing dad, another child. I will be forever grateful for my daughter and that I get be a mom – that is something that is very different about infertility the second time around. But still I have space in my heart for another child to make our family complete. Sometimes I feel guilty that I want more when so many women end up without even one. But then I look around and see all the families, and I realize just how normal my longing is. And so with my fingers crossed (and my legs uncrossed) I’m going for it.

Today I Made THE Infertility Mistake

mistakeEvery woman who has ever struggled with infertility knows that panicky, hyper-vigilant obsession with her calendar. Everything is regimented and timed and scheduled.  (Literally everything: every medication, every test, and sometimes, even every sexual encounter.)  The importance of the medications and the precision of the calendar are oppressive.  Some medications must be taken on an exact schedule; varying by even five minutes can dramatically affect the consistency of one’s hormone levels and the outcome of a procedure.

Like my sisters in infertility, I, too, obsessively and manically check my calendar.  I have multiple copies: one in the living room, one taped inside the bathroom cabinet, one in my purse.  I check it in the morning when I first awake, organizing my day around my medication schedule.  I check it throughout the day whenever a wave of panic sweeps over me because I haven’t checked the clock in the last fifteen minutes and might be late for a dose.  I check it every night, planning my medications for the evening, night, and next morning.  I currently have five alarms set on my phone and six reminders on my medication app.

And yet, today, I experienced what so many other woman have: I messed up my medications.  Rather, I realized today that I made a mistake days ago.

Shortly before 6:30 a.m., I started gathering materials for my third medication of the day.  I grabbed my patches, calendar, and permanent marker (I write the day on one patch, so I always know when I put them on).  As I glanced over my calendar, something was off.  Today is the 9th.  But my calendar didn’t show patches for today.  Shit!  I double checked the date on my phone and cross-checked against the calendar.  Today had to be the day.  I put new patches on Saturday (the top left patch on the right side of my stomach confirmed, “Sat”), and patches are every other day.

But I was wrong.  While I did put on four patches on Saturday, April 7 as scheduled, my calendar also indicated four patches on Sunday.  Saturday and Sunday called for back-to-back patches, violating the every-other-day pattern present through the rest of the calendar (and all my previous calendars).

I was sick, almost literally.

I went ahead and put on four patches today, so I wasn’t on three-day-old patches and sent a message to my nurse at 6:45 a.m. (5:45 a.m. Mountain time, where she is).  I confessed my error, my temporary “solution,” and held my breath for a reply that all would be okay.

While I waited for a reply, all the what-ifs surfaced.  What if this meant we had to cancel our calendar and start over next month?  That would mean losing all the money for the medications and losing another month.  What if we could keep going, but it would effect the outcome of the biopsy?  We’d have to cancel; I couldn’t live with getting a compromised biopsy result.  This biopsy might explain why our transfer failed and what we can do to fix it.

Intellectually, I knew this kind of thing happens all the time.  Surely my patches wouldn’t be that big of a problem; I’ve heard of women missing injections completely.  I was still getting the hormones; I was still wearing the patches after all, just on day two instead day one.

Regardless, the guilt of screwing up the medications, the one thing I can actually do to try to get pregnant, gnawed at me until I got the nurse’s reply a few hours later:  “No worries just get back on track with your patches.” There was an immediate sigh of relief because I didn’t ruin everything.

But it’s not a very deep sigh.  Because when struggling with infertility, we don’t get to relax.  We always half-hold our breaths, waiting for the next thing to go wrong.   The stress and anxiety hang around in the background, always there just like our shadows.  And they’re accompanied by guilt.  Because if our next transfer fails, we wonder what we did wrong.  Did that one medication error do it?  Were we too stressed?  Should we have exercised more?  Or less?  Did that one mini chocolate bar we broke down and ate on a day when the whole world sucked ruin it all?  We know how crazy these questions are just as we know it’s not our faults we’re infertile, and we shouldn’t blame ourselves.  But infertility is uncontrollable, so we obsess over the things we can control, and we do feel guilty, even when we follow our calendars perfectly.

Guest Post: 12 Months of TTC

heather rey

 

Heather Rey is has gone through two failed IUI’s and is currently at a standstill while she waits to have surgery. She has a chocolate cyst on her right ovary also called an endometrioma. (An endometrioma occurs when endrometrial tissue grows inside an ovary.)  Her doctor also suspects that she has severe endometriosis (which is when the uterine lining grows outside of the uterus). She is desperately hoping that it all gets taken care of in two weeks, and this is finally her answer.

 

I never thought I would be writing this, that is, writing a post about infertility, because I didn’t think it would happen to me. When most people think of infertility they think that those people will never have kids. That isn’t the actual definition though; it is “a couple who has been actively trying for a year without success.” That’s where I am at the moment. Well it’s over a year now.  I’m on month eighteen and going to see a fertility specialist this month.

As much as I know people hate it when someone says, “You can’t understand what it’s like unless you go through it” that is exactly what this is. Sure you can imagine it’s horrible, but you won’t ever understand exactly what it’s like. But I’m hoping to help you have a bit better of an understanding of the first twelve months.

Think back ladies to when you first starting ttc (trying to conceive). You were excited, maybe a little nervous, but mostly excited. You probably went a little crazy that first month. You looked up when your due date would be. Figured out exactly when you would be telling everyone that you’re having a baby! Planned how you would tell everyone, from your husband to both sets of parents. If you were planing to post on FB, you were sitting there planing that announcement out too. If you were lucky, this is how it all played out. But, for most, it just doesn’t happen like that. Your period comes, and you feel crushed. You’ve done your research though, and you know that it doesn’t happen for most people that first month. So you try to not let it get you too down.

Onto months two and three: you’ve told yourself you need to chill the F out. No more calculating the due date, deciding what date you will be telling everyone. Of course, though, you don’t listen to yourself, and you do everything you said you wouldn’t. You can’t help it; you’re just so excited to bring this new little life into your family.  Family members are asking when you plan on having a baby.  You say, “Don’t know/not quite yet/ etc.” because you want to surprise them with the good news soon. But then it still doesn’t happen.

Months four and five: you’ve finally calmed down about the dates of when you’d tell the whole world. You know what you are still doing though? Symptom spotting. Twinge here? Pinch there? You MUST be pregnant; there is no question about it. Of course, though, both of those months end the same. You give yourself time to cry, but put on a happy face around other people. They don’t know you’ve been trying, and you aren’t ready to tell, so you only cry when you’re alone.

Month six comes along: SURELY it will happen this month. Most couples who are actively trying are pregnant by month six. You have been doing everything right, timing, taking your prenatals, you’ve probably even have started doing other crazy things you’ve read about online that other people have said helped them get pregnant. But then month six ends the same way all the other months did. You, again, give yourself time to cry.

Months seven and eight: by now you’ve probably have seen at least one person you know get pregnant. You are wondering why it hasn’t been your turn yet. However, you are still hopeful. Know what though? Month seven and eight both don’t end in a pregnancy. You’re starting to wonder if you should go ahead and tell people. At least so they will stop asking you when you are giving them a “grandbaby/niece/nephew/baby to play with.” You’ve heard horror stories, though, about people telling, and then those people they were hoping to get support from just starting saying things like, “You just need to relax; once you stop stressing, it will happen” or “When it’s meant to happen, it will happen.” So you just hold it in.

Month nine: Month nine is HARD. Know what you would be doing right now if you were lucky back at month one? Getting ready to meet your little one. But you weren’t lucky. You’re still trying. Hopefully you have someone to confide in because it’s not happening this month either. You cry and wonder why this is so hard, especially when you know so many people that have accidentally gotten pregnant.

Months ten and eleven: somehow you haven’t lost all your hope yet; you still are symptom spotting.  At the same time, though, you keep telling yourself you aren’t pregnant just so you’re prepared when it turns out that you aren’t. Guess what though? It doesn’t matter that you’ve been “preparing yourself,” it still hurts. You still cry.

Month twelve: I know, at least for me, this is the month I would start crying even before I knew that it was a no go. This is the month you really start to wonder, “Will this ever happen for us? Am I going to have to give up my dream of becoming a mother?” Your family is still asking when you’re going to have a baby. You still tell them, “I don’t know,” but now you are saying it cause you honestly have no clue when you will have a baby.

By month twelve if you haven’t already, you call a fertility specialist. Of course it takes a least a month to get into see them. And you just hope that when you get in, it’s something that can be fixed easily.

Here We Go Again . . . April Fool’s

Last week, I messaged our nurse to confirm the general timeline for our next frozen embryo transfer (FET).  We were looking ahead, trying to plan the next few months and trying another transfer.  I was expecting the same general experience as in December, without the extra days for fertilization.  While she did confirm my understanding of the procedures, our nurse also insisted I call her regarding a biopsy.  This was news to me.  When we talked with the doctor following our failed transfer, he reviewed several options we could try but didn’t make any of them sound like they were necessary or even strongly recommended.

Our nurse, however, insisted that we do the integrin biopsy, explaining the doctor told her and wrote in my chart that it was “highly recommended.”  She explained that the uterus should contain proteins that help “hold on” to an embryo, and if these proteins are missing, it is unlikely that any pregnancy will ever occur regardless of the number or quality of embryos transferred.  If the biopsy was normal, we could proceed with the FET.  If the biopsy indicated a lack of proteins, I would need several shots over the course of a couple of months to correct the deficiency before trying again.

The biopsy, like all things infertility, needs to be done on a specific day.  I had two options: one unmedicated and one medicated.  The unmedicated relied on my confidence in ovulation testing.  While I, like every other woman who has ever struggled to conceive, have done ovulation testing, I was not confident that I could catch the exact day of ovulation when a $790 test (plus office call) was at stake.

So, I opted for the medicated cycle.  This required starting estrogen patches on Cycle Day 3 (CD3), staying on those patches (while increasing the dose from 1 patch every other day to 4 patches every other day) for 12 days, then adding vaginal progesterone for 10 days, and ending with an endometrial biopsy.

Unfortunately, the day I called the nurse was also Cycle Day 1, so in order to do the biopsy this month (and not waste even more time), I needed to start medications two days later on a Saturday.  This also meant I had to contact my local obgyn and make sure she would do the biopsy.  The frantic planning began immediately.  On my way home, I stopped by my pharmacy, and my pharmacist assured me she could get the patches by Monday and that we could work out an appropriate dose from the patches currently in stock in the meantime.  She gave me her cell number, so I could text a picture of my patches (I knew I had some left over at home).  Miracle #1

When I got home, I dug out my medication box and rifled through my patches, counting 20 total.  I also downloaded the orders for the biopsy from our fertility clinic’s patient portal and submitted them through my local doctor’s portal, hoping that my awesome local nurse would get the message and could work another miracle for me.  I also messaged my donor nurse to let her know my local pharmacy could get my meds by Monday (I wanted to avoid the specialty pharmacy and shipping the medications from Arizona if I could) and that I could get by on leftovers until then.  I also asked her to confirm the day of my biopsy (according to my math it would be a Sunday which would pose a not-insignificant problem).

The next day was Friday and around a dental appointment and four meetings, I made phone calls and sent messages.  My donor nurse confirmed the timeline for the biopsy, identifying Monday, April 16 as the day.  When I hadn’t heard from my local nurse by almost noon, I called in only to discover that she wasn’t working.  I explained the situation to the receptionist who patched me through to another nurse.  I left her a message.  Of course, as soon as I went to the bathroom, she called me back.  Luckily, I caught her and explained the situation. She checked with my doctor and scheduled my biopsy appointment.  Miracle #2.

I messaged the donor nurse that the medications and biopsy were worked out, and she sent me my calendar.  Shortly, I got a text from my pharmacist confirming two prescriptions that would be available on Monday.  We were good to go.

Today, however, things went awry.  I, of course, had triple checked my meds calendar, making sure I was taking the right medications in the right doses on the right days.  However, something just felt odd about the calendar, but every time I checked, it was fine.  This morning I drug my sleepy self out of bed for thyroid medication at 5:30 a.m. and again at 6:30 a.m. to change patches.

At 9:30, though, that funny feeling was back, so I checked the calendar again.  I had put on one patch which was scheduled for March 30.  But today isn’t March 30; it’s April 1.  I last changed patches on Friday, so I should skip Saturday, and put on a new patch on Sunday.  Today is Sunday.  But today is not March 30.  It’s April 1.  I checked again: the calendar says 1 patch on March 30 and 2 patches on April 2.  It skips April 1.  Shit.

Since today is Sunday, April 1, I know my nurse isn’t checking her messages, but someone should be in the clinic even though it’s Easter Sunday (and ironically, April Fool’s Day).  So I called, hoping any nurse would answer.

The nurse who answered the donor line pulled up my calendar and confirmed that there was indeed an error.  She told me go to two patches today and that my nurse will call me tomorrow with a corrected calendar.  However, if everything on the calendar moves down one day (like it should), the biopsy needs to be on Sunday, April 15–just like I thought when we were trying to plan this whole mess.

So now I’m sick, waiting on a phone call that won’t come until tomorrow (an all-too familiar experience with infertility), so I can spend Tuesday (because nothing will be open on Monday) making more frantic phone calls trying to find somewhere to get a biopsy done on a Sunday.

Welcome to infertility where everything and nothing goes as planned.

april fools