Keeping Calm: the next chapter of our fertility journey

Hi, it’s been a while. This post has been waiting to be posted, and it’s just taken me a little while to consider whether I wanted it all over the blogosphere or not. I decided to go for it. Almost a month ago, I posted this to my Facebook friends:

4cf59c0b5cf1e92a70ecdff876357de6My task today is to clean up my computer files. I’ve just come across a bunch of files relating to the three IVF cycles it took to get Sweet Pea. Notes, numbers, schedules, charts, photos of my little embryos… my heart and hopes in a petri dish, magnified x4000. A mantra I could never quite follow in the form of dozens of .jpg versions of “Keep Calm and Carry On.” Finance spreadsheets that never ended up with a total because by the time we got to “the end” I couldn’t bear to look at anything that showed the monetary value of our failures. Files I still can’t look at, but will never be able to throw away.

Hastily typed-up notes from a phone call with my amazing doctor, May 2012: “recommend another fresh [cycle] ASAP. Frozens there, suspended in time… may not be able to do retrieval in 1-2yrs if wait.” Even now, my heart beats a little fast and I’m slightly nauseated when I read this.”

The last month has had a bit of underlying stress to it as I consider what I want to do, what I hope for, how awesome our family of 3 is as I work on the positives that will hold me together if another baby doesn’t show up.  Tomorrow, Tuesday, exactly one week after my miracle baby turned one, we go see our awesome doctor at the fertility clinic. We owe him a 1-year-old’s birthday picture, anyway. I don’t know what this appointment is going to bring. It is just a discussion of the future. It holds many hopes and lots of questions, but no promises. I have learned to let go of guarantees in my head… but my heart continues to beat just a little fast as I try to meditate away that knot in my stomach.

After much discussion with the Mr., we are sharing this with you, dear readers.  I’m not going to pretend it is an easy decision to share this journey, whatever it brings – on the contrary, it’s rather terrifying. When we started fertility treatment I spent hours reading the blogs of people who were brave enough to write, trying to get some glimpse into what the process might be like. If I can offer that in return, good. If I can offer some perspective to people who have no idea what this is like, good. If I can bring awareness to an issue that I think needs awareness right now, then it will be worth it. And just maybe it’s a little bit selfish too, because I know that support and love can go a long way in carrying people forward.

Ten Things I Wish I’d Known About Fertility Treatment

May 19-26 is Infertility Awareness Week in Canada. I’m going to start a little early, in case I have lots to say on the topic – and also because somebody on Facebook today asked for general tips on surviving fertility treatment. I haven’t talked about this on the blog before, and though I’ve mentioned it on Facebook, I’ve never talked about it this honestly and candidly. If you are squeamish, or think that you don’t want to know certain things about me, then you can stop reading here. I won’t be offended.

I may go back and talk about our story in more detail at a later date, but here’s the nitty gritty: we spent a year trying to conceive before anybody in the medical system would begin to run any tests, even though I was pretty clear that something was “off.” We then spent another year and a half dealing with testing and treatments. It felt like there was diagnosis after diagnosis – both male factor (diabetes complications) and female factor (blocked/damaged tubes and what essentially are lazy ovaries). We delved straight into IVF, and that took a really long time. I’m now 29 weeks pregnant – have been very sick, very nervous, and very excited.

So, in the interest of answering my Facebook friend…

Ten Things I Wish I’d Known About Fertility Treatment:

1) You should talk about the consent forms ahead of time.

This is probably one of the first things you’ll run into at the fertility clinic, so I want to give you the heads up. I knew there were going to be consent forms at our orientation – they had to be signed before I started taking the shots at home. I assumed it would be standard “do you want to go ahead with this optional treatment” stuff, and that was in there. What I didn’t expect was that we were going to have some hard questions like what we wanted done with any frozen sperm or embryos should one or both of us die. And you will have to decide on every variation of this question. For instance, if my husband were to die before the eggs were retrieved and fertilized, could I go ahead with the frozen sperm? Who wants to think about this? Nobody. Who wants 10 minutes to think about this and discuss it with their partner while a nurse hovers outside the door waiting to show you how to plunge a needle into a foam ball? Even fewer people, I’m sure.

If I were to advise you to take action on this, I would get you to have the clinic mail you this form ahead of your first appointment so you can look them over in detail, in private.

2) Treatment might not work.

I know. You’ve read the statistics. You know exactly what the IVF success rate is for your diagnosis, age, and clinic. What you haven’t considered is that those statistics are true, and somebody has to be on the negative end of that. I was, three times. And I was heartbroken every time, because I honestly just thought it would work. Fertility treatment in the media, on movies, in Hollywood – it’s like magic. That’s not so in real life. The truth is, there is a lot of trial and error to getting the IVF process right. I didn’t respond well enough in my first cycle to get to the egg retrieval, and so my doctor tweaked my protocol, and the next one was better. The third was even better in terms of eggs retrieved, but we hadn’t yet identified the support I needed for implantation.

3) Budget for this – and that means TIME.

I’m not going to address the money aspect of pursuing IVF treatment. We all know it’s expensive, and we all know how to go to the bank and get a loan, or call in family for support, or win the lottery (okay, that’s probably not your best bet). But you also have time to budget, and in respect to point #2 above, I was somebody who didn’t do a very good job of this.

My first treatment, I really took time off work to be as stress-free as possible. I had the vacation time available. After all, it was only going to take one round, right? Unfortunately, it meant that figuring out my schedule for subsequent rounds was much more difficult. I’m not going to say I was wrong to take the time off work. We’d been trying to get pregnant for well over a year by that point, and I was emotionally in need of some time to just look after myself. But, it is something I’d consider a little more carefully.

4) You might feel insane.

I can almost guarantee this will happen at times. And this is probably because you will also feel sad and worried and stressed and excited and nervous. You might cry a lot over really stupid things (so far, pregnancy hormones have had nothing on IVF hormones). I remember getting to the fertility clinic for a followup and sobbing in the waiting room. My doctor came out to get me for the appointment and quipped that “I don’t usually make people cry before I’ve even talked to them.” And then I laughed like a maniac.

5) Mommy guilt can start well before you’re a mommy.

Why did that cycle fail? Did I not eat well enough? Miss too many acupuncture appointments? I shouldn’t have lifted that box. Maybe the argument I had with my husband made some higher power realize I’m not fit to be a mom. Is it possible I just don’t want it badly enough? How did I forget to tell my doctor that one little thing that may have made the difference in my luteal phase protocol? Maybe I should never have been on birth control in the first place. I’m not pursuing adoption yet, so maybe we don’t actually want this badly enough. Why, oh why, for the love of everything sacred, would it EVER be the case that an embryo could survive days in a petri dish, only to fail in my womb?

I took a break for several months between my 3rd cycle and the subsequent frozen embryo transfer, and I doubt I will ever forget tearfully explaining to my husband that I didn’t want to go ahead because the 4 frozen embryos were just fine as long as they were frozen, but as soon as they were transferred there was the potential for them to fail. I can’t even believe he had the patience to convince me that they weren’t actually fine – they were just suspended in time.

6) All that mommy guilt is bunk.

It is likely that you will not be able to stop making yourself feel guilty. So bookmark this post, and believe me when I tell you this: You are doing the very best job you possibly can at any given moment, and it IS enough. You did not cause your infertility, and you are not causing any particular treatment cycle to fail. You do want it badly enough, I can promise you that, and you are not being punished. Please try to be gentle with yourself – you need it more than ever. And, you are more amazing than you can possibly realize.

7) You will not stop thinking about it.

You are going to have a lot of people tell you to relax, to stop thinking about, to try not to stress about it. I’m going to tell you that unless they’ve been there, they really can’t give advice on this. Fertility treatment can consume your life, for a while – you will need to be aware of every little change your body is going through. Gone are the days of sitting through a movie, because you will probably need to give yourself an injection part way through. People might ask if you’re pregnant because they see that you’re tired and feeling ill and crying over things that don’t make sense to them. You will be driving two hours each way to get to the fertility clinic several times a week, and there’s not much else to think about. You will go through your two week wait analyzing every symptom, simply because you notice every symptom (which never turned out to be symptoms for me after all).

8) But it’s okay to have a life.

And even though you’re thinking about it all the time, and that’s okay, it’s also okay to find a way to resume your life. For me, a key was talking about it. Once I didn’t feel like I needed to hide what we were doing, it was easier to say to people “sure, let’s go play mini golf, but please excuse me to the Tiki Lounge at 9pm so I can do my injection” (true story). I have done those injections in the car, in that Tiki Lounge, at camp, at restaurants, and at parties. I learned what distracted me when I was feeling crummy (The Nanny reruns). And, I took a much-needed break last spring, because I just wanted “regular” life back, without injections, for four solid months.

9) Be compassionate with each other.

This is going to sound hokey, but it’s important. I was worried, for a while, about what fertility treatment could do to our marriage. IVF is physically difficult (mostly on the woman), but also spiritually, emotionally, and financially draining. There was no time for housework, and little energy for spending time with each other. But in all honesty, I will say that our marriage is stronger because of this. I was astounded at how the Mr. supported me through treatment, when I felt at my worst. And it is interesting to hear that the divorce rate is lower among couples who have had failed treatment than the general population, so we’re obviously not alone in this.

I do worry that the future Dad can be forgotten during fertility treatment. I wish I had checked with my husband more, asked how he was doing. But, I think we did okay. And I might just ask him to tell me what he wishes he’d known before IVF, for a future post.

10) How to ask for help.

Telling people that we were infertile and seeking treatment was a slow process for me. That’s okay. It unfolded as it needed to, first with our parents and best friends, then eventually with people who I felt needed to know. Please note – if you don’t want anybody to know, then nobody needs to know. If people knowing will help take certain pressures off of you, then it’s okay to talk about it. Once the information is out there, it’s out there. People will ask you how things are going, and you will sometimes not want to talk about it. It’s okay to tell then you don’t want to talk about it at the moment, even if you’ve talked to them about it before. 

I would share this series of articles with everybody who was part of my life, right off the bat. Some of it doesn’t apply to me, and some of it doesn’t apply to the people I ended up sharing it with, but all of it was valuable in helping people gain understanding. I have shared the link to this series before, and I will share it again, and I will continue to recommend that everybody read it – because whether you know it or not, there is somebody in your life who wants you to know how to support them, and who doesn’t know what to ask for.

I am glad that somebody reached out to her Facebook fans today to ask for help and advice. I wish that more people felt comfortable doing that, but mostly, I want the information to be available to people who are looking for it. That’s why I’m talking about it, and I don’t expect to stop anytime soon. If you need help, advice, resources, or somebody to listen, I will absolutely do that for you. But also be aware that most of your friends will be happy to be that person. I was nervous about starting to talk about infertility, but glad that I eventually did. People, in general, have been completely amazing.