Tuesday, April 25, 2017

Infertility: Our Journey



In honor of national infertility awareness week I thought I would finally do a post talking about my infertility journey. Because it felt so personal, its a post that I've had trouble publishing. While logically I knew going through this process that infertility wasn't something that I needed to feel ashamed about, not being able to do what most women biologically can do so easily was very  difficult for me and I really struggled with my self worth and confidence during the process. The emotional impact of struggling for 4+ years cannot really be put into words. That being said, writing something like this can also be difficult because I know how sensitive a topic this is for women struggling with infertility and how different things about the experience affects women in different ways. What was hard for me might seem small for someone else, and vice versa. As a preface, I know I am very lucky that I only had to go through one round of IVF and that I was able to save enough money to pay for it. If you are currently struggling, please know that my heart hurts for you, that my thoughts are constantly on you, and that in at least some way I know what you are going through and believe your pain cannot be overstated.

Skyler and I knew we wanted to wait a few years after we were married to have a baby while I started law school and he graduated from undergrad. We got married when I was 22 so I felt like we had plenty of time and didn't really think about having children. My mother had no problems having children, and I hadn't really followed any people on social media who struggled with infertility so the thought of it happening to me didn't occur to me at all. During my second year of law school I had an emergency appendectomy. During the appendectomy they found out that I had endometriosis. After talking to my gynecologist the options presented to me were either to go on a birth control that would totally stop my period and stop the growth of the endometriosis, or to start trying to have a baby. I am very sensitive to hormones so birth control is really hard for me to handle, and we were feeling ready to start a family, so we decided to start trying to have a baby. I remember excitedly texting my best friends that we were going to start trying. Because we didn't know yet how bad my endometriosis was we still were picky about things like not trying to conceive on months that would make the baby born in December, or when I would be starting classes and work, etc. You technically aren't considered to have infertility issues until you have been trying to conceive for a year so we still didn't worry about it that much as the months passed and I still wasn't pregnant. 

After about a year of trying my period stopped and I thought for sure I was pregnant (I had always had a very scheduled period so this was way abnormal for me). I kept taking pregnancy tests and they weren't positive so finally I went to my gynecologist after missing two cycles to see what was the matter. During my examination they found a huge ovarian cyst that was totally crushing my left ovary. Surgery was immediately scheduled as certain kinds of cysts can be very dangerous if they burst inside you, and the doctors weren't able to tell from the ultrasound what kind of cyst it was. During the surgery my gynecologist told me that he would burn off my endometriosis and flush my fallopian tubes with dyes to help with my fertility issues. After I got out of surgery the doctor told me that I had stage 4 endometriosis (which is the worst kind), but that after burning off as much as he could and flushing my fallopian tubes, my chances for conception would be significantly higher for the 9 months or so after the surgery. 

A year after the surgery I still hadn't gotten pregnant so we decided to visit a fertility specialist and start treatments. We used Dr. Conway at the Utah Fertility Center and had a really good experience with her. I was very lucky to know that I had endometriosis going into my fertility treatments because it allowed the doctor to really focus my treatment on the source of the problem instead of wasting my time and money trying to find out what was wrong. Endometriosis is almost impossible to diagnose without a surgery, and the surgery can increase your scar tissue and make your issues worse, so a lot of people don't find out they have endometriosis until they have done several rounds of IVF. Because of my endometriosis we moved immediately to doing IUIs because just taking Clomid or Fermara wasn't likely to have very  much success for me. I took Fermara at the same time as the IUI and was really excited and hopeful to start. After the first one failed, I was upset but still felt hopeful. When the second one failed I began to get pretty depressed. Our insurance didn't cover fertility procedures so it felt like we were basically throwing a thousand dollars away a month. How IUI's work is after the monitored procedure, you wait two weeks to have a blood test to confirm if you are pregnant. In the first two IUIs my period had started before I even had the blood test so my expectations had been low going into them. During the third IUI my period hadn't started yet so I was pretty positive I was pregnant. I went to get my hair done with Danica the Saturday before the blood test and was so excited that I thought I was pregnant. She started crying and told me she was 7 weeks pregnant and had been holding off on saying anything because of my fertility issues. We were so excited about the possibility of both being pregnant at the same time.  The Monday of my blood test I went to the doctor's so excited and nervous. On the way downstairs after the blood test (they call you with the results in the afternoon so I didn't know the results yet), I stopped in the restroom. In the restroom I found out that my period had started. I remember sinking down on the bathroom stall and sobbing harder than I think I had ever cried before in my life. After that experience we decided to take a break and start saving for IVF.

I will readily admit that Danica's pregnancy was very hard on me. Seeing someone so close to me get pregnant and have an experience that I had been trying for for several years was so difficult. I struggled with guilt for feeling upset about it, and worthlessness that I couldn't give Skyler what other girls easily could. I definitely wasn't there for her the first couple of months of her pregnancy because it was just too hard for me to be around. I avoided going to my inlaws for dinner and having to hear about the pregnancy, and I avoided all pregnant people in general. If you have a friend that is struggling with infertility and they act weird around you pregnant, please be patient with them. I promise they are super happy for you, but are really hurting at the same time. It will get better for them eventually (at least it did for me). 

Because of how severe my endometriosis was I had to take the maximum dose of fertility drugs that my doctor allowed at her clinic. I also had to take medicine in the months proceeding IVF that put my body into menopause in an effort to compress the endometrial cells. As my insurance didn't cover IVF either, this cost us around $30,000 out of pocket (quite the chunk of change). It was so nerve wracking because there are obviously no guarantees and saving up that much money takes time and a lot of sacrifices and I didn't know what we would do if it didn't work. When we finally saved up the money we met with our IVF coordinator at the clinic and started the medicine. As I mentioned earlier, I am very sensitive to hormones. On birth control I gained weight really quickly and became super irritable and emotional, so you can imagine that hormones of the magnitude that my IVF protocol required wreaked havoc on my body. I happened to be in the middle of trial during alot of my IVF cycle. To give you a little perspective on how hard the drugs were on my body, I had bought a suit for a trial a month before IVF started. The suit fit perfectly at that trial. During my trial the next month I had to squeeze myself into the suit. I gained over 20 pounds during my IVF month despite trying to eat low carb and healthy and being off all caffeine. I definitely looked pregnant before I even got pregnant. I had frequent hot flashes and in general felt awful. I had to give myself shots morning and night and my stomach became super bruised, bloated, and tender. Towards the end of my shot cycle I broke down in my office crying because I felt so sick, tired, and emotional. 

During my egg retrieval the doctor was able to harvest 16 eggs. We chose to do a process called  intracytoplasmic sperm injection (ICSI) as part of our treatment. In ICSI they inject the sperm directly into the egg rather than just mixing it together in the petri dish. This helps prevent issues that might exist with the sperm not wanting to mix with the egg. After this injection, its a nerve wracking time as the doctor calls you every day, or every other day to tell you how many of the eggs have survived and started growing. After 5-7 days we had 4 blastocysts that were ready for insertion. They graded our blastocysts and we had two that were grade A. Grade A is the highest quality kind (which we were excited about because endometriosis often destroys egg quality). Because of their quality my doctor convinced us to only put one in and we froze the other three. Even though you aren't supposed to, I did pregnancy tests before I actually had my blood test. As the tests turned out positive I got more and more excited. I was in the nail salon when the doctor called me confirming that my blood test showed I was pregnant. I burst into tears in the salon and told all the strangers there that I was pregnant lol. It was definitely a moment I will never forget. Harper Rae Johnston was born on February 17, 2017. You can read about her birth story here. We feel so overjoyed to have her in our life. Words won't ever be enough to explain what it felt like the first time I saw her and the joy I feel everyday at the chance to be her mom.

I have very few pictures of our IVF cycle, and the ones I have are definitely not edited, but I included a few of them below that I took with my phone along the way.

My needle container

                    
During the procedure to put the embryo inside you, they have a screen showing it entering your uterus. Here, Skyler is pointing to Harper!
One of my early tests trying to do the "ring test" to reflect light on the strip to see the line better.
The test I took on the day of the blood test!
Our announcement

Please let me know if you have any questions about the IVF process and I will do my best to answer them.  Love you all!

3 comments:

  1. Question--do they tell you the gender of each embryo? Do they only implant grade A embryos? Thanks!

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    1. Sara they will implant A and B and sometimes C but they don't like to do the C ones because they don't have a very high rate of success and can be damaged. They can tell you the gender of the embryo with a test. We didn't choose to do the test because we would have been happy with either gender. Let me know if you have any more questions!

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  2. So brave of you to share. We also had to do fertility to get pregnant with Bennett. It is such a lonely process even though so many people go through it. So glad you finally got to meet your little angel, Harper Rae!

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