What IVF Taught Me

 (Photo: personal collection)

I recently completed my first cycle of in vitro fertilization (IVF). It is a long and detailed process, requiring lots of resources, money, time, and patience. The first stage involves, ironically, taking oral contraceptives to reset the hormone milieu and force all eggs into a senescent, follicular stage. The second stage involves injecting repeated doses of hormones to stimulate ovarian growth and maturation of as many eggs as possible. There is quite a bit of monitoring at this stage, including almost daily ultrasounds and blood draws to evaluate the progression of the eggs. The third stage is egg retrieval, in which all fluid-filled cysts within a certain size distribution are aspirated for the contained egg. The eggs are then fertilized with the intended sperm in a lab and are allowed to grow for 3-5 days into multi-celled embryos. The last stage is the embryo transfer in which the best-quality 2-3 embryos are injected back into the uterus for implantation. After that point, it's up to fate (and continued progesterone supplementation)... after the dreaded "2-week wait", it's time for a pregnancy test!

Some of you may not have wanted that much detail, but I figured it would be helpful to understand what is involved. Needless to say, I had to take some time off of work to do this, rearrange travel, etc. It may have been physically challenging, but it was also humbling and eye-opening. Here are some lessons I learned from my experience.

Accept where you are in the process. I never thought I'd be here. First of all, as I've mentioned, we weren't even completely sold on the idea of having kids until recently. Only at that point, I had already been rendered infertile by my brain tumor. Bad timing! We've been married almost 15 years; what if we had started a family years ago? It may have been much easier to have a baby, but who knows how else things would have been different? I probably never would have traveled like I did, gone to medical school, built the strong bond that my husband and I share... "What-if's" are futile, which leads me to the next lesson...

Live in the present moment. I know. This is such a common sentiment these days that it's becoming cliche. In this particular case, I learned to not overplan my life. Whenever I would go to the doctor's office for an ultrasound of my growing eggs, things would be different than I expected. Medication doses changed, the egg harvest day that was originally projected (around which I had built my monthly work schedule) changed three times... And stepping back to a longer term perspective, I honestly had hoped to already be pregnant by the winter! There are times for serious planning and times to live day by day. Things don't always go the way you or others predict; you have to be able to ride the waves.

You have more strength than you think. I'm fully willing and able to perform all sorts of invasive procedures on other people, and I have no problem doing so. But all bets are off when I'm the patient; I've always been a complete baby with shots, IVs, even eye drops! This attachment to a self-imposed identity simply had to explode when I faced four subcutaneous hormone shots a night, frequent ultrasound probes in the nether-regions, and multiple blood draws per week. Then came the progesterone-in-oil, a viscous and irritating liquid injected intramuscularly in the buttocks nightly... for 10 weeks! When I received the progesterone injection supplies from the pharmacist, my eyes widened when I noted that I could see down the barrel of the needles. But you know what? Some ice beforehand, a little heat afterward, and it's really not that bad. (BTW my advice for anyone having to face such frequent injections is to do them yourself; I think it hurts less when you know it's coming.)

Love yourself. My body and my lifestyle changed significantly when I started IVF, and I had no choice but to embrace it. In a month of oral contraceptive use, I easily gained at least five pounds. About 15 pounds separates me now from the fittest, most active time of my postop life, including the last 8 months of hormone injections. Because I "luckily" have lots of eggs for my age, my ovaries grew during the stimulation period to the point where my pelvis felt like it was carrying two water balloons! This feeling persisted and even worsened after my egg retrieval, as the ovaries continued to produce cyst-like fluid for a period of time. My activity level was drastically restricted for the entire IVF process. Thus, I wasn't allowed to lift heavy weights or climb much, or even do much other than lay on the couch at certain times! But if I had fought these changes, held onto some past image of myself, or worried about how my skinny jeans are not fitting, what would be in store for me during pregnancy and parenthood (when bodies and lifestyles change beyond our control!)? The worst thing would be to stress out, ignore recommendations or restrict eating in response... NOT good for fertility!

There is a delicate balance between hope and expectation. Hope and positivity are integral to happiness and stress management. However, an ardent "be the change" approach can easily lead down a slippery slope to rigid expectations. On the flip side, protectively assuming the worst will lead to unhappiness and increased stress. In this brave article, HelloBee discussed what it's like to be pregnant after 3 miscarriages, sadly assuming the worst at every turn which negatively affected her experience and her relationships. Knowing yourself can help to find the fulcrum point between the positive and negative, where you don't go crazy.

After my embryo transfer, I felt blissful and positive. I visualized implantation by meditating on the picture of the implanted embryos given to me by the IVF clinic (above). But part-way through the waiting period, I started experiencing mild cramping that I assumed meant my period was coming. I had yet to experience any classic symptoms that most women describe early in pregnancies; however, one key thing that I had to remember was that if I were like "most women", I wouldn't be needing IVF. So I got positive again... what I did not do was move into a fantasy world shopping for maternity clothes and picking out baby names; statistics are statistics, and just because I saw embryos deposited onto my uterine wall, that did not mean that I was pregnant.

But you know what? Turns out I am! I'm 6 weeks pregnant this week. :)

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