Keeping It Real: IVF

Where have I been, dear readers? All these months I've been coping with the reality of infertility and focusing on getting through two cycles of IVF. 

As I sit here, in bed, recovering from my oocyte retrieval this morning I feel like I'm finally ready to write about what IVF has been like for me. 

Most people I've talked to typically have no idea (or a very vague idea) of what In Vitro Fertilization is and the cost it takes emotionally and financially on a couple. Like everything else to do with women's bodies and health, we just don't talk about it. That shit is private yo. 

But you know what? How is that fair? So eff that. If you're dealing with infertility, or know someone who is, this post is for you. Because you are NOT alone.

As I've written before, the absolute shock that my body isn't doing something that a) I have fought long and hard to PREVENT for all those years and b) everyone else seems to be able to do simply by sneezing is a constant grieving process that I relive every time I hear a colleague or friend is pregnant, every time I see a happy little family with their child, every single step of the IVF process. For most people conceiving is a very intimate and magical process filled with fun times and orgasms. 

Not us. 

It took months to accept that our 1% chance of conceiving each month meant that our options were... IVF. 

In Nova Scotia IVF is not covered by medicare. No matter that our infertility is a medical condition. Or that the Nova Scotia government bemoans the decreasing birth rate and losing it's young families. Or that other, more "cosmetic" surgeries are covered. Nope, in order for us to conceive we had to fork out 6550$ to BEGIN the IVF process. 

Thankfully, MAGICALLY, my insurance provides coverage for most of the injectable medication... otherwise the final tally would have been closer to 14-16k. For ONE cycle. In a country where healthcare is "free", I find it deplorable that conceiving a baby is like purchasing a car. Only with more needles. 

In all, this cycle we will have spent close to 8,000$ just to TRY to conceive. 

So. What exactly happens in an IVF cycle? I mean, you know it's a "test tube" type sitch, but the deets!

Step by step breakdown:

1. Have period. Call the clinic to tell them the date of your "day one". Pay the clinic 6550$. Cut out caffeine (sob) and alcohol, ingest a ridiculous amount of supplements, like 25 pills a day. Do yoga 6x a week. 

2. Day 21: start Suprafact Nasal Spray 5x a day. This will cause your body to go into a sort of "menopause". Yep- don't want your body doing anything it naturally does on it's own. Set 5 alarms on your phone. For two weeks you can be found awkwardly snorting up hormones since you HAVE to take the nasal spray at the exact times during the day. Awkwardly excuse yourself from your clinic sessions with clients stating you "have to take medication now". Take while driving and hope you don't cause an accident. Break the vial on the hospital floor outside of a conference and breakdown sobbing in front of colleagues. Repeat.

3. Down Regulation Check: Go in for blood work to check whether your body thinks it's in menopause. Since you have a phobia of needles, this is the beginning of a lovely relationship with the blood work nurse. They have foamy sperm shaped stress "balls" (hah) that you can squeeze. It's hilarious. 

4. You get a phone call from the clinic that yes, you are good to start injections. Pick up said needles at the pharmacy. Now starts the GOOD STUFF.

5. That night you start injections. These hormones are meant to make your ovaries make a RIDICULOUS amount of eggs. Like your ovaries may swell up to the size of oranges. The first time around I only had 1 needle a night. Since I have a phobia of needles I thought this was the worse.thing.ever. The second time around I had 2 needles for four days followed by 3 needles for 8 days. In total that is 33 needles in twelve days (including the final "Trigger" shot). This is where the cost can skyrocket depending on how much medication you need. What we learned from the first failed cycle is that my ovaries just really don't like the hormones and are like "eff you guys". Which meant I ended up on the max meds (hence the 3 needles per night). One medication, saizen (human growth hormone, which is terrifying- I know) wasn't covered and cost us 1600$ for a week. I feel so thankful that the rest were, otherwise we likely would have been out 700-800$ a day for 12 days. 

(My nightly trophies. Two of the needles involved mixing the medication with a saline or bacteria-free water solution. The "pen" was pre-mixed. In all this took approximately 30min per night). 

I am also so thankful that my husband is such a phenomenal person. He did such a great job. I had minimal bruising (which is a miracle), I got hugs and kisses after each injection and he was my steady calming force when I cried at the injustice of needles vs orgasms each night. 

Every night you are reminded that THIS is what you have to go through just to conceive. 

6. Every other day during injections you go in for blood work and vaginal ultrasounds. to check on how well you are responding to the meds. For me this was so stressful, since each step we were informed just how I wasn't responding. When the nurse informed me I would actually be moving forward to retrieval I actually sobbed on the ultrasound table.

(my ultra sound from Tuesday. This is the left side, only showing half of the follicles. The follicles are the large black holes. In reality they were between 17-20 millimetres (1.7-2.0 cm). Neato eh?)

The neat part of this is you get to see the follicles growing in your ovaries on the ultrasound. This time around I had one monstrous follicle on the right (we named him Arnold) and 10 on the left. 

7. Once the follicles have reached a good size (and you are bloated and feel nauseous and uncomfortable) they deem you ready for "retrieval". You get a "trigger" shot that you are to take EXACTLY 36hrs pre-retrieval. Not five minutes more or less. EXACTLY 36hrs. 

8. You get one entire day of NO MEDICATIONS. It was bliss. 

9. Retrieval. This is what happened today. I went in to the clinic at 8:30am for acupressure (see- needle phobia). Then we went into surgery prep. I was terrified. All of it is overwhelming and scary- from the hair nets, hospital gowns, slippers. The nurses were lovely and super kind in the face of my holding back tears of fear and hiding the iv from my sight. The wheel you in an operating room where the Doctor (Dr Ripley.... hah!) uses a ultrasound probe with a long thin needle attached to go through the vaginal walls straight to the ovaries and suck out all the follicles and fluid. Thankfully drugs are involved. 

(this little gal is one of six oocytes sucked out of the follicles today. Andrew grabbed a pic with my phone. Andrew thinks she could kick some serious ass. I agree.)

While this is happening the embryologist shouts out the number of eggs she finds. Some follicles may not have any eggs (or oocytes). My count: six. As soon as that first egg was found I started to cry. I think it looks like either a weird mould spore or a gorgeous sun of life. 

10. Your partner does his "thing" and they fertilize the eggs. (or they use a donor if your partner is a "she" :) ).  

11. You get daily calls on the status of how the eggs are doing, which ones were successfully fertilized and how they look. They actually RATE THEM on a scale of 1-20. I hear this is stressful, since it is likely quite a few won't make the cut. Since every single step of this process has been a battle for us, I just hope 1 or 2 make it to the end. 

12. Since your body has no idea what the hell just happened, you have to take progesterone vaginal suppositories (3x a day) AND estrogen (estrace) pills (2x day) to keep up that uterine lining. GO UTERUS. This would continue until 11th week of pregnancy if you manage to be successful. 

13. Transfer day: This happens at day 3 or 5 post retrieval. They pick the best 1 or 2 embryos and put 'em back in the uterus. This will likely be a much less of a big deal compared to retrieval. Yin yoga will be my jam at this point. 

14. Wait 16 days for a blood test to reveal whether or not it worked. 

Start all over again if this fails. 

There you have it. I know one day I will look on this whole horrible "adventure" and think (hopefully): it was worth every single gods damned needle. Andrew and I have only grown closer because of it. I couldn't have done it without him. 

I also have a completely new perspective on just how lucky people are to have children. No sleep? Complete change in lifestyle? Responsibilities up the wazoo coupled with no more private time? BRING IT. 

Infertility and Me: I am coming out of the closet.

Last week Andrew and I came out on Facebook as Infertile.

It was terrifying yet completely exhilarating.

Not that I think my uterus and our sex life is anybody's effing business, but the effort and feelings of shame in keeping it a secret while simultaneously fielding the awful (inappropriate) questions from virtually everyone about when we were going to have a baby (of if we "wanted" to have kids, or just how BIG our house was for just the two of us... yeah) was emotionally exhausting and like continuously getting punched in the heart every time.

That and I realized that people at home in my rural nosy village already knew. And I'd rather they not talk about it as the shameful secret they weren't supposed to know. Because eff that noise.

What I've realized in both living and sharing about our experience is that infertility is VERY common among couples. And usually the only time someone "comes out" is when they actually manage to get pregnant. Which is so unfair.

Our journey reads like almost every other blog post out there.

Up until about three years ago I had no idea, no concept that making a baby would be that difficult. I mean, I had just spent ALL of my adult life actively avoiding that very thing. It was never even a QUESTION whether or not I'd be able to make a baby. The ability to conceive was always a choice I had.

At least. That's what I thought.

If you're not experiencing a similar journey, you have absolutely no idea what it feels like to be so betrayed by your own body. And no matter what anyone says, in today's society infertility still implies shame and blame on the would-be mother.

For us it started with testing prior to actively trying to conceive due to my years of disordered cycles. All those awful, invasive tests followed by loads of blood work just to determine that well- everything physically appeared just fine.

Then, two years ago we decided to try to conceive. We figured it would take a couple months, at the max five or six.

Hah.

Months of daily temperature checks, cutting caffeine in half, eating almond butter from a spoon every morning and following a ridiculous meal regime recommended by the naturopath, tracking my cycle-symptoms and sex life with a ridiculous App on my phone... And every three weeks the crushing, heart wrenching realization that we had failed. Again.

All this in secret.

At the year mark it became obvious that we weren't going to just "make a baby". A referral to the fertility gynaecologist was made.

Followed by more blood work and more invasive test after invasive test. All the while every three weeks we faced another cycle gone by. Another missed opportunity, another failure where we must have done something wrong. Each month I can't help telling myself- "NEXT month we'll do things right. We'll eat better, meditate more and catch it exactly at the right part of the cycle. Next month we will succeed."

At around month 16 "living as if I were pregnant" was starting to wear on me. All it did was to remind me several times over the course of the day what we'd failed and what we struggle against.  My first waking thought was shutting off the alarm and sleepily taking my morning temperature. Followed by a disgusting breakfast that hurt my stomach, lunch vitamins, a special fertility three part cycle specific smoothie at supper and the evening Folic Acid.

I decided it was too much. We stopped going to the Naturopath- I couldn't take the daily reminders of our failure with the intense fertility regime AND go through all the painful and personal medical testing that had to be done.

Last fall the gynaecologist sat us down and shared our options: either we keep trying (which for the past 18 months had not been working), I go through exploratory surgery to see whether I had endometriosis (for which I have ZERO symptoms other than infertility) or we go to the fertility clinic and begin the process for fertility treatments.

January 9th we returned to the Naturopath and the fertility "boosts" have returned.

On January 12th we met the fertility specialist at the fertility clinic and paid 175$ for 30 minutes of her time (NOT covered by Canadian Health Care system nor my work health insurance). As we sat there, I still had a tiny glimmer of hope that she would have some good news.

Holding hands nervously, we listened as she outlined the truth: at this stage of trying to conceive Andrew and I have a 3% chance each month. The longer we aren't successful, the lower that percentage gets.

It felt like being slapped in the face. It still feels surreal. My body FEELS fine. I am healthy, I am active, I eat well, I have taken care of my body. I did all the right things and I have all the right parts. I AM SUPPOSED TO BE ABLE TO DO THIS.

Our only real option with any hope for results over 20% success rate is IVF: In Vitro Fertilization. She kindly went through a diagram of the entire process. I could barely process a word she said. I remember acronyms, weeks of drug injections, more blood tests and then some scary procedures.

There's an info session. We haven't gone to it yet.

The week before this appointment, on January 5th, Andrew lost his job. IVF costs over 10,000$ per procedure. None of that is covered in our health care system nor in my insurance.

So. Here we are. Last week I tried acupuncture. It was awful. The acupuncturist judged me and gave unhelpful and hurtful advice. She told me to "just act as if you're pregnant all the time". I wanted to slap her. Who can live that way for years on end?

This is not like "choosing" to wait until later to have a baby, or "choosing" to not have a baby at all. This is not my choice.
This has been the most difficult part of my adult life so far.

So, EcoYogi peeps. I am sharing this here because it's such a huge part of my life now.

Because...

Because I think it's unfair that we keep something that happens to SO many couples a shameful secret. Because I want at least one person reading this to reconsider the next time they ask someone "when are you going to have a baby" or "do you even WANT kids?".

And because I haven't given up.