IVF, here we come.

All of a sudden this image represents my reproductive aspirations: a 5-day blastocyst in a petri dish.

Today was the big follow-up appointment with our RE following my recent abnormal HSG.  It was short, only about 10 minutes, and I sort of already knew what she was going to say, but somehow it still felt surreal: she recommended that we go directly to IVF.

It’s felt a little surreal all day.  Is this my life?  How did I get to the point that all of a sudden the safest and most effective way for me to have a baby is to inject myself with a bunch of creepy hormones and then have a scientist extract mature eggs by inserting a giant needle through my vagina and ovaries, which will then be combined with my husband’s sperm in a petri dish?  Really?  For real?  It just doesn’t seem like this could possibly be my life, but it is.

I felt a few things after getting her recommendation.  I felt angry at the midwife who didn’t give me antibiotics despite my concerns about pain and foul-smelling discharge (classic pelvic infection symptoms).  After the disastrous delivery of my daughter at 18 weeks, the placenta had to be manually removed, which is a clear risk factor for infection — and yet she ignored clear signs of the infection that would go on to scar my fallopian tubes.  A simple course of antibiotics would have prevented the loss of my fertility that resulted.  And going further back, I’m still angry at the doctor, who pushed me straight into medically induced labor without even mentioning the possibility of a D&E, even though I specifically asked her if I had any options.  I now know that the complication rate is almost an order of magnitude lower for D&E than for medically induced labor in the second trimester (4% vs. 30%).  I almost certainly wouldn’t have had to deal with retained placenta (which to first order only happens during medically induced labor), and I would have received antibiotics during the procedure, so it’s highly unlikely that my cascade of complications would have happened.

While I’m angry, I think I’ve got the anger under control.  I’m allowing myself to be angry, and considering writing a letter to the practice to let them know what happened (I was so unhappy with so many other things that happened during the loss of my daughter that I immediately switched practices, so they have no idea about everything that’s happened since before I started writing this blog).  At the same time, I really do feel that I’ve accepted that there’s nothing I can do about the past, and it doesn’t make sense to dwell on it.  It’s constructive to write a letter so that they are aware of the extremely serious consequences of their poor care during my pregnancy, and so that hopefully it won’t happen to other women in the future.  But the only thing I can change at this point is my future, so that’s where I’m putting all my mental energy.

And aside from the anger… I really do feel fine.  I can’t explain it — I feel like my worry and despair have been at such extreme levels though the fall, winter, and spring that something finally snapped, and now I’m just sort of OK with everything.  Like I said, I’d done enough reading to basically know what the RE was going to say today, so I don’t feel shell-shocked.  I do feel impatient about getting this process moving and not wanting to waste any more time, but I’ve felt much more depressed and anxious about much less significant setbacks in the past nine months.  I do feel hopeful that IVF is going to be a productive way forward for us, so I’m anxious to get started on it.

I’m worried about the impact IVF will have on our marriage.  I’m worried about the impact it’ll have on my career.  I’m worried that it won’t work — that I’ll be a poor responder, or that my damaged endometrium won’t grow enough to support a pregnancy, or that we’ll need to go through many cycles without success.

But I’m also grateful that we have spectacularly wonderful insurance that covers unlimited IVF cycles, that I’m only 32 with apparently good ovarian reserve, and that we’ve found these problems sooner rather than later.  My medical care has been so thorough (thanks to my own self-advocacy and finding my way to some really good doctors) that I feel like we have answers about what went wrong and a plan for how to avoid the same thing happening in a future pregnancy.  I feel good having a plan.  And I feel good knowing that I have a solid support system.  A second trimester pregnancy loss and nine months of follow-up treatments and procedures for complications and tests have showed me that I have some truly amazing friends and family.  They’re not all the ones I would have expected, but I’ve already gone through the painful process of accepting that there are people whose support I had counted on who just aren’t going to be there for me.  Now I’m in a different place.  Moving on to IVF, I already know who my anchors are, and they’re ready to be there for me.  I’m very lucky.  (And good news!  My very close friends, whose daughter was due the same week as mine, are moving from California to the East Coast this summer!  They’ve been one of my main anchors through this process, and I’m so happy that we’ll have them only a two-hour drive away very soon!)

Anyway, I know I’ll write more soon, but I wanted to get my feelings down on paper this afternoon, and to get the news out there.  I also want to thank the women who write the blogs I read who have chronicled their own IVF journeys.  It makes it seem less scary and mysterious now that I’ve already read about other women who have been through it and come out the other side. This sucks, but we’ll get through it.  One way or another, whether through IVF or adoption, we will be parents to a living child one day.

15 thoughts on “IVF, here we come.

  1. My Perfect Breakdown

    I’m glad you have a plan, and you are at peace with your IVF plan! Heck, I’m glad you even have a back up plan, when you say in your last line “One way or another, whether through IVF or adoption, we will be parents to a living child one day.” Honestly, I think this is awesome as you are open minded to multiple different options! Try one first, and move on to the next when/if you need to.
    Also, I still harbor anger towards my first RE who didn’t do simple tests and didn’t listen to us when we asked/begged for further testing. Honestly, in many ways i blame him for our 4th and 5th losses. It’s something I try not to dwell on because nothing good will come from these emotions. Like you I’m choosing to focus my effort and energy where it is needed, and that’s on our future family not our past losses.
    Sending you love and wishing you the absolute best!

    1. lyra211 Post author

      Thank you. You’re insightful as always. 🙂 The thought of adoption, and knowing that both my husband and I are open to building our family that way, has been an immense comfort through this process. In the last couple of weeks, there have even been a few times when I’ve thought that maybe IVF is just too much, and that we should go straight to adoption — but I do think IVF is the best way forward for us right now, and I’m not going to let fear stop me from doing what’s best for our family.

      Another thought that went through my mind as I wrote that last sentence is that it’s an amazingly limited set of options, compared to where we started. We started off normal, and now all of a sudden our options are either the most invasive and high-risk approach to getting pregnant, or adoption. It’s a little scary to see our options narrow so much… but you’re right that I should keep being grateful for the fact that we do have options, and that both of them at least right now appear to have a high probability of success. I have not lost sight of that fact.

      1. My Perfect Breakdown

        Every time I hear your story, and I hear how you ended up in this position I find myself getting a angry for you. I’m just so sorry you’ve had to go through it, and that you are facing these options because of someone’s negligence!
        That said, if your gut and heart are saying to do IVF first, then I think it is wise to listen! Adoption will always be there as an option, so you don’t have to rush to it. I think you should try whatever you want, try it as many times as you want, just know that you are doing what is best for you. 🙂

  2. theskyandback

    I would be angry too. You’ve been through so much in the last year, and then to tack on incompetent medical professionals on top of that?! Inexcusable. I think writing a letter is a great idea and will hopefully help others. All that said, I’m glad you have a plan and feel hopeful. And I swear IVF really isn’t that bad! The scariest part is the anticipation leading up to it.

    1. lyra211 Post author

      Thanks — it really does help to read about your story and the stories of other women on here to see that IVF isn’t something to be terrified of. It feels like a Big Scary Thing right now, but it’s also just a well-established set of procedures that thousands of women have been through before, and if you all can do it, I can do it too (I hope). I really appreciate your support through all of this!

  3. Wifey

    I’m glad that you will be going into IVF feeling good about your plan. Even though you have the normal fears and worries, I know it helps to feel like you are taking positive steps in the right direction. I know it’s not the path you would choose to take, but I hope it turns out to be the path that works for you. And, I can tell you from experience, the actual process of IVF is not that scary and you most certainly can handle the shots and the procedures. Like most things, it’s the waiting and the not knowing that’s the hard part. I think that’s what I was least prepared for when we started all of this. And, I’m thrilled to hear about your excellent insurance coverage. Not having the added financial burden will be huge. I will be anxious to hear how things are going every step of the way!

    1. lyra211 Post author

      I know you’re a veteran IVFer at this point, so it’s really helpful to hear that it’s not that scary! The flip side of reading about so many people’s IVF experiences, though, is that you learn that it’s not magic, and it doesn’t work for everyone — I think that’s what scares me most right now. I’m willing to go through all the injections and procedures, but then not to have a baby at the end of a few cycles would just be devastating all over again (as you know all too well). Oh, well… no sense borrowing trouble. We’ll cross that bridge when/if we come to it! I don’t know our timeline yet, but it sounds like we might be starting IVF around the time you start your next FET (or maybe a couple months later — I have to do one more test to check whether my “partial hydrosalpinx” needs to be surgically removed before we start IVF). I can’t wait to hear how things go for you next time around!

  4. andthewindscreamsmary

    I think your feelings of anger are to be expected. I would feel the same, and I like to think I would have your restraint but I don’t know if I would be able to stop at a letter! But like you said, it’s the past and you can’t change it now. At least you have some answers and have a plan now, and you have a solid emotional support system and financial support from your insurance. Will certainly be wishing you all the best and cheering you on in your next steps.

    1. lyra211 Post author

      Ha, yeah, my mom did say to me, “You know, if you were a different type of person, you’d have a great lawsuit on your hands” — and she’s a women’s health NP, so she knows what she’s talking about. Maybe if we didn’t have insurance coverage for IVF we’d try to get them to cover those costs, but… I just don’t think it’s worth the emotional stress for us.

      Thanks so much for your good wishes — it means a lot. Isn’t it crazy how even if we’ve never met, our online relationships can be such important sources of support? I’m really appreciative that you’re here. Not that people with second trimester losses are the only ones who can comprehend what we’re going through, but it does make such a difference to find women who’ve been there — there aren’t enough of us that I know any in real life.

  5. TryTryAgain

    This is lovely news! I know what you mean about being wary of IVF, but it’s great that you have a plan now and don’t have the stress of only having 1/2 cycles paid for. Hopefully this will allow you to relax into it (as much as you can!) and get a great result.

    I’m sorry about all of the anger which you have about the care that you received too. You’re so vulnerable at that time and put all your trust in the doctors, it’s horrible to think that other options/ treatments were available and you weren’t given them. I agree about writing a letter to them though, so others don’t have to go through it in future, but definitely best to focus on yourself and your treatment going forward.

    Really looking forward to hearing how it all goes xxx

    1. lyra211 Post author

      Thank you — it’s very sweet of you to be so positive and encouraging at a time when you must be feeling so much pain. I’m not sure if I’m at the point yet where I can really call this “lovely news,” though I do appreciate your optimism. 🙂 I’m still mourning the loss of my fertility (not that it was awesome to begin with!), and wrapping my head around the fact that my husband and I will never again be able to just have sex and get pregnant (in fact, we need to actively avoid that outcome because of the risk of ectopic pregnancy) — it’s a loss of privacy, it’s a loss of part of my body, it’s a loss of function, and I worry about the stress that IVF is going to place on our relationship, my job, and my physical and mental well being, especially if it doesn’t work. But you’re absolutely right that I’m incredibly lucky to have one promising way forward towards a biological child — I realize that I’m very fortunate in that way, and I need to keep that in perspective. Anyway, thanks so much for all your support through this process — it means a lot. I’m hoping for the best for you going forward, and looking forward to hearing all about how you spend time during your break and what you decide your next steps will be.

      1. TryTryAgain

        Yes, I think maybe I was a bit over-optimistic there! Sorry, I didn’t mean to sound insensitive….

        I guess I haven’t got my head around IVF as a whole yet, but you’re right, there are a lot of things which you lose in the process, id never really thought about it all in that way xx

      2. lyra211 Post author

        Oh, please don’t worry at all about it! Believe me, I know that if you had an option that was as likely to work as IVF is for me, you’d be jumping up and down, and it’s helpful to be reminded that there are ways in which this is a really good thing. And I’m pretty sure that I wrote a whiny blog post a while ago in which I revealed my own pseudo-envy at people moving on to IVF (something along the lines of “everyone on the internet is either pregnant or moving on to IVF and I’m just sitting here doing nothing”). It’s complicated. I get it. 🙂 I still think you’re amazingly sweet and sensitive to have been commenting so optimistically on my news so soon after receiving such terribly sad news of your own, and I always, always appreciate your support.

  6. Pingback: Plot Twist! | The Pregnant Physicist

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