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.