WE ARE EXPECTING 2019 to be our best year yet!

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This was our social media announcement on New Year’s Eve!

As many of you dear souls know, N’s and my journey to parenthood thus far has been long and grueling. When the holidays hit last year, I told him I didn’t think I could keep going. I didn’t think I could spend one more Christmas believing it “would be different next year.” I didn’t think I could get my hopes up again, only to endure yet another negative pregnancy test. I didn’t think I could emotionally handle another fertility treatment.

Together, we decided that we would give it one more year. We would call it “Baby or Bust 2018.” We would try every single thing – both legitimate (acupuncture, our two remaining IUI cycles required by our insurance before they’d kick in for IVF, and finally – up to 3 rounds of IVF), and also silly (like every foolish thing that well-meaning people have told me worked for their friend’s cousin’s sister’s aunt). We did it all.

Our last two rounds of IUI failed, bringing the total up to the six failed cycles required by Aetna. I did 3 months of weekly acupuncture. I drank “fertili-Tea,” took herbal supplements, DHEA, read and applied what I learned from books like “The IVF Diet” and “It Starts with the Egg” (including a pretty intense vitamin regimen). We did the Whole 30. I cut out prescription medication I was taking for anxiety and ADHD. I did guided visualization exercises every night while in a fertility treatment. I did prenatal yoga.

Finally, this summer, we were able to begin IVF. For a needle-phobic person such as myself, the process was terrifying. In addition to the 4x daily injections, there was also a minor surgery (which required an IV). But by the second week of injections, I was able to do them myself – and I felt myself getting tougher and stronger (albeit heavier and more emotional). Jaimie and I fought for our relationship and our future during that first cycle – and fought even harder once that cycle failed, when none of our embryos tested PGS normal. I spent the majority of our 10th wedding anniversary trip to California (where we first met 17 years ago), in tears. I felt like we had finally come to the end of the road, and I didn’t think I could take another step.

Our 10th anniversary trip to California this past August ended up being really helpful, though. In addition to an opportunity for us both to grieve, it was a reminder of what makes us “us.” Of what makes us great. Of what has given us the strength to get through career changes, deaths in our families, a deployment, 17 years of life, and 10 of marriage. Oh – and the slow burn that is prolonged infertility. We returned feeling renewed, and closer than we’ve ever been. We had a new plan for our life, and for what we’d start focusing on if we didn’t get to be parents. I was excited and refreshed and optimistic for the first time in years. What an incredible gift to realize that the “worst case scenario” would be to “only” get to share the rest of my days on this earth with my best friend.

With the pressure off, and a new outlook, we decided to undergo another round of IVF. The second time around didn’t feel nearly as awful. We knew what to expect, and we already knew we could handle it – regardless of the outcome. It was our new normal.

Nothing in the world could have prepared me for the phone call I received on November 7, 2018 from my dear nurse at Shady Grove Fertility. I was walking to the Department of Forensic Science with my trial partner to conduct a witness conference for an upcoming trial. My phone rang, and I saw that it was the clinic’s familiar number. Even though I’d already taken several at home tests, all of which were positive, I still didn’t really believe it. I had heard of a chemical pregnancy – it was probably that. Or I had those positive tests, but they were false and it would just be another sad phone call from my poor nurse who has had to make these crappy calls to me this past couple of years. Instead, she just exclaimed, “Do you know you’re going to be a mama?!” (All I could think was – “How did this happen?!”)

I absolutely lost my shit. Sobbing. Cheering. It was all very undignified. My poor trial partner was just like, “… so… good news, I take it?” N and I were so hopeful that the follow up test (2-days later) would also yield happy results, so we decided to call N’s family with the news, and then drive up to Boston to tell my family in person. (Many of the photos in https://spark.adobe.com/video/5CILH2n1qCUOr/embed“>our announcement video, made by my sister Erin, are from that happy trip – all of us in our matching #TeamBabyClark shirts!) I could say so much more about these past couple of months, but this post is already so long!

So we decided to wait until today to post this update. Even though we’ve been as transparent as we were capable of being during our journey, it all felt a bit different once there was an actual baby. We just wanted to be more private during these past couple of months. But today seemed like the perfect day to share this happy news because it feels like a great bookend for the last day of #BabyOrBust2018. Also, I hit 12 weeks last Sunday!

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Baby Clark is doing great so far – we got to hear his or her amazing heartbeat at our midwife appointment 2 weeks ago. It was the most beautiful sound either of us has ever heard. We held each other and sobbed like babies – in complete wonder and disbelief, still, that (with lots and lots and lots of help) we were able to create new life.

This little world-changing warrior is due to come on the scene July 14, 2019. We can’t wait for him or her to meet each of you who has encouraged us, prayed for us, been an ear to listen or a shoulder to cry on these past many years – years when we never thought this day would come. We are proud of the community we are part of, and look forward to our child getting to be a part of it, too. Thank you so much.

Needles, as it turns out, are the easiest part of IVF

This has been a really hard week. This week, we learned that, in spite of all we have done to get here, we will be lucky to have one embryo to transfer.

Everything before this week went really well. Our nurse described my IVF cycle as “textbook.” My body responded well to the drugs, and by the end of stims,I was self injecting like a literal freaking pro. Like, standing up in my kitchen, no psych up, super-quick-injecting-because-we-had-to-run-out-the-door-to-get-to-our-early-morning-monitoring-appointment pro. I know, I couldn’t believe it, either. I mean, sure, I still had to roofie myself with a xanax to chill out enough for the IV at egg retrieval, but other than that, smooth sailing on the needle front.

Sadly, we have lost a lot since that initial victory last week. Of the 13 eggs the REs got out of me, 10 were mature (13-3=10). Then, only 5 fertilized. (10-5=5) Our nurse had prepared us for that, estimating 9-10 mature eggs and a 50-60% fertilization rate. We obviously hoped to be a positive outlier, but we weren’t shocked. She even helped us brace for the one embryo we were likely to lose sometime during their 5-day stay in the embryology lab. When we got the call that one little guy stopped dividing at 6 cells, we were sad but not shocked. (5-1=4) We still had 4, and were not expected to have any further attenuation until the PGS testing would knock out around 50%… so we would end up with 2 really solid embryos. Two chances.

Our nurse keeps emphasizing that IVF is also a diagnostic process (especially for “unexplained infertility” couples like us) so we have long been bracing ourselves to deal with the possibility that the first transfer won’t take. But with a baker’s dozen eggs retrieved, I thought we were still in the safe zone. I thought we’d be able to try again without having to go through a whole other exhausting round of stims and retrieval. And waiting. Oh the waiting.

But that’s not how our story went. On day 5, our nurse called and said we had 2 great looking blastocysts. They were biopsied and frozen. But the other 2 were a little behind- one was an early expanded blast with an intercell mass and the other was compacting and almost a blast. Everyone expected that those two little guys would “catch up” over night and would be able to be biopsied and frozen the following morning. We would still have 4. We were uneasy but not really worried.

The next day while we awaited the phone call, we went out and had the best day. For the first time in a long while we felt  like the worst of everything was behind us and we could just “play.” We were silly and funny and very much resembled the “old us.” For the first time in an effing eternity, we were not just a couple in a waiting room at a fertility clinic, or a couple that was timing every intimate encounter that used to be spontaneous and fun, or a couple who gave a crap about follicle size and estrogen levels and Menupur dosages… we were the couple that  everyone must have thought look so happy. Blissful, even. Perhaps annoyingly so.

We were not prepared for the phone call telling us that our two little stragglers seemed to have stopped dividing. It was a sucker punch. Fun day over. We went immediately home. I was too in shock to cry. I just curled up on the couch and fell asleep. When I woke up, I remembered the news, and was devastated again. Eventually I could not stay in our home any longer (on account of the walls closing in) so I put on shoes and left our apartment. I wandered around the city like a zombie for hours. Eventually, N found me at a random jazz bar eating a plate of calamari and drinking a Boston Lager. Yes, I was a tad homesick.

The next morning, I managed to get myself together to go to work to pretend to be a fully functioning adult for the day. Right as I arrived in court, while opposing counsel was trying to talk to me about something or another, my phone rang with that familiar fertility clinic number. I popped into the ante room, where my nurse told me that as we had feared, the 2 embryos we were hoping would pull through…hadn’t. She said words like “stopped dividing” and “disintegrated” and “discarded.” (4-2=2) I sobbed. Every 30 seconds or so, a different opposing counsel would pop their head in with some question and I would waive my hand and point to the phone so they would think I was on an important call and hopefully not notice what a disaster I was. But then, the judge was calling a case, and I had to run in there and actually handle a hearing. (I know, right?) I sniffled through the whole thing because I badly needed to blow my nose but was out of tissue. Mercifully, my co-counsel arrived a few minutes later and I was able to excuse myself to find a bathroom after that hearing was over.

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Photo by Leah Kelley on Pexels.com

I still remember how I felt that first day N and I sat down with an RE and heard about what was coming – like a deer in headlights who had also been shot in the gut. Back then, despite the 3 years we had spent trying to get pregnant, I still thought we didn’t REALLY have a problem, so to hear about all of the (what sounded like) extreme medical interventions we had in store was overwhelming. So severe was my needle-phobia, that I remember feeling like I would never even get through the battery of tests, never mind any actual treatments. When I learned that I’d have to come in for regular, sometimes daily “monitoring appointments” wherein yet more blood would be drawn, I burst into tears.

But we were going to try IUIs first, and aside from those monitoring appointments, it sounded pretty doable. Take a pill for 5 days, come in for monitoring, and then IUI day! Boom. That sounded like an appropriate level of medical intervention for my understanding of the direness of our situation.

After the first round failed, my RE thought we should boost our chances by adding some injectable meds. I remember when that seemed impossible – to endure shots in my stomach. Oh to be that young, innocent girl again!

After the next 2 rounds failed (with the pills and a couple of injections), my RE thought we should try “all injectable” rounds, (since we still had 3 rounds of IUI to go before our insurance would kick in for IVF) which means no pills, just injections, and more frequent blood work. I remember when that seemed impossible, a daily injection and regular blood draws. I also remember feeling so optimistic about it the first time – I felt I was being asked to do SO MUCH, that it just HAD to work. My beta test was scheduled for a couple of days after my 35th birthday – that rubicon in time where everything about a woman’s fertility treatment and pregnancy magically changes overnight.

I was so excited to receive what I knew would be wonderful news, that I decided I’d take an at-home test the morning of my 35th birthday and would have such a happy marker in time. So sure was I that I’d receive wonderful news that I actually ordered from Etsy a little gift to give N to tell him the good news, as well as a little gift for each of the 3 sisters between N and me. I emailed back and forth with the artisian crafting the gift for N to make sure I’d receive it in time for the great news I was sure I’d be receiving.

The night before my 35th birthday, I couldn’t sleep. All of a sudden, my doubts were getting the best of me. Instead of the hope I’d carried for the week and a half prior, I went back to the emotional trauma of the dozens of months where I’d seen only 1 pink line on the stupid stick, and the disappointment and sadness that followed. Why would this time be any different? It wouldn’t, I became sure of it, and down I spiraled into a deep pit of dispair. From that awful place, I wrote a letter to “Future Baby,” a letter that is so raw and pathetic that I won’t share any part of it on here, even in this rather raw and pathetic post. I wrote about the unfairness of it all. My longing to be a mother, to “meet” this baby to whom I kept writing these ridiculous letters. I wrote in desperation. I wrote in fear.

After writing the most cringeworthy 3 pages in the history of writing, as I was spiraling and felt out of control, I sent a late night text to my dear, dear friend W. To say I have depended on this woman for the past 2 years would be such an understatement that it’s actually insulting. This woman has dealt with my bullshit on almost a daily basis. That night, as every other, she said all the right things, and somehow duct taped my heart and brain back together enough that I was able to get some sleep and take the pregnancy test in the morning. I remember when it felt impossible to put on my big-girl clothes and go to work to adult all day after seeing that effing single pink line yet again.

Looking back, I think that 48-hour period surrounding my 35th birthday and the past 48 hours have been the darkest in this journey. Like the shittiest bookends on the shittiest bookshelf in the world.

Once upon a time, I thought that the needles would be the worst part of this crappy road, especially since I am (or I was) so terrified of every single injection. Now, I’d stick however many needles into whatever part of my body I needed to, from now until eternity, if it in any way guaranteed our happy ending, our child. So while it turns out that needles are actually the easiest part of IVF, the hardest is the battle being fought in the midst of this uncertainty for my heart and mind.

Now, I sit here wondering (in a bone chilling fear kind of way more than a contemplative kind of way) not only whether we will have any decent embryos THIS CYCLE, but if we are capable, with our old-ass parts, to cobble together a decent embryo EVER. Like, maybe the reason i haven’t gotten pregnant up until this point isn’t because we hadn’t tried IVF yet, but rather, because it’s actually physically impossible for us. 

And now we wait for fifty-eleven-million years until the PGS results come back…

What to Expect When Your LOVED ONE is STILL Not Expecting

Hi there, this is Elyssa, Erika’s youngest sister here writing a guest post. You may remember me from Erika’s post. Thanks for inviting me, Erika. Erika suggested that I put together a post of what to do if you happen to be a loved one or sort of bystander to this fertility situation. It is hard to navigate the journey initially and there are some helpful and harmful things you could potentially do. I by no means think I am the epitome of all things good here, but I just do my best and it seems like my best is good enough for E&N.

Do become knowledgeable on what the couple is going through

If you had told me years ago that I would be excited that my sister has finished her final IUI treatment before she is eligible with insurance for IVF I would have probably stopped you and asked for definitions of these acronyms. You learn a lot about the process just by being along for the ride. The great thing is that your loved one does not expect you to be an expert about all of these terms or procedures. My lawyer of a sister is very happy to lay it down for me… and her whole demeanor actually changes from “emotional Erika” to “lawyer Erika” when I ask her questions about the procedure. It has always seemed to me that her putting her lawyer hat on helps her to be less afraid of what she is about to go through.

Do support the path they are on

Fertility and reproductive rights have to be one of the most polarizing topics in existence. There are some moral and ethical decisions that are factors in the decision to do some of the procedures that your loved one may be facing. My advice here is to let them tell you what they are nervous or apprehensive about and support their decisions. Early into this process, E&N were not sure if they’d be able to go through with IVF due to some of these roadblocks. I overheard several people telling them to “just do it” and that they shouldn’t care about the un-implanted embryos. It is not our place to pressure, it is our place to love and support!

Don’t ask “why aren’t you just adopting?”

Let me start here by saying that one of my best friends was adopted and her relationship with her parents is one of the absolute best I’ve ever seen between parent and child. The point of avoiding this question is not because I have anything against adoption, but more to the point that it is not helpful to your couple for the journey they are going through. I guarantee they are familiar with the concept of adoption and likely have considered it. They are making the decision at this time to proceed with a biological baby. This is completely within their right to decide to do this, just like it is within other couples’ right to adopt and even others to choose to do neither. Asking this question is sort of subliminal way of saying “I don’t think anything you’re trying is going to work, so just skip it and take a baby someone else made.” On the other hand, if the couple brings this up to you, pop some champagne and toast to their future child!  

Do reach out

I check in with my sister most days (not due to this scenario, but just because that’s the type of relationship we have). When I ask how she’s doing, she generally will update me on all facets of her life including her fertility journey. I think one of the hardest parts of loving someone going through this is wondering how you can broach the topic of their fertility without reminding them of it if God forbid you caught them in a moment that they were not already thinking about it. The fact of the matter is that there is most likely not a moment when they aren’t preoccupied with thoughts of future babies and it is always nice to know that someone is reaching out because they care.

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Photo by rawpixel.com on Pexels.com

Do know what the worst part of the process is for them

…other than the not being pregnant yet part. As you may recall from an earlier blog post, the worst part for Erika tends to be needles and blood work. Based on her details of what all of these procedures consist of, your loved one may have a totally different worst part. Whenever Erika is going to have to have blood work I try to check in a special time that day to make sure she knows I am thinking of her and to see how it went. Some days I think of this journey as a sort of horrific Olympics where she is demonstrating her strength through various obstacles  before she is granted her gold metal, or baby. If you had asked me 5 years ago, I would have thought she was already the strongest person I know.

Do know it’s not about you

There are bound to be good days and bad for your loved one during this journey. Now, add in the possibility of extra hormones (E has been injecting for a while) or just the lack of the pill regulating hormones and you may see additional ups and downs. If this loved one acts out of character, give them grace and just love them harder. (Note: E&N have been nothing but incredible mood-wise when it comes to me – even when I stayed in their home, but I know that this is a factor that COULD come up with loved ones and figured it was worth mentioning!)

Do pray

I am a strong believer of the power of prayer. Most people, even those who are not religious, appreciate the thought of someone praying for them. E&N are both religious so I know they definitely appreciate hearing that people are keeping them in their thoughts and prayers. Many churches even have prayer request forms you could add your loved one to so that a broader group is praying!

Do find the humor in the process

When Erika first described IUI to me we basically decided it was giving the swimmers Red Bull and we have called the procedure “Red Bull” ever since. I think somehow picturing her having a procedure called Red Bull makes it seem a bit less scary than it actually is and finds the humor in it. When Erika turned 35 last year, she informed me that she now would be considered a geriatric pregnancy. After I finished laughing from the outrageousness of that, we made a lot of jokes about how she is as old as dirt. (But seriously now, when the average age of life expectancy has gone up so much can we stop using the word geriatric when referring to someone who is about 50 years away from collecting any Social Security. Bad joke). So many parts of this process are exhausting and emotional that I think it helps to find the humor in things.

Do stay positive and excited

E&N are two of my absolute favorite people and I cannot wait for their future babies. I plan on loving E, N, and their kiddos with the same intensity regardless of if they are conceived naturally, during IUI, during IVF, through adoption, or if they have 4 legs and a tail (don’t get me started on their cute fur-babies). At the end of the day, E&N’s family will be incredible because they are and because they spread that to all who encounter them. Your loved one needs to lean on you a bit now and they definitely will need the extra help changing diapers soon enough!

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Photo by rawpixel.com on Pexels.com

 

 

What to Expect when You’re STILL Not Expecting – Preparing for Your First Appointment with a Reproductive Endocrinologist

So you’ve been trying to get knocked up the old fashioned way for 12 months, and still no nugget in the oven. You’ve had a quiet, nagging feeling for a while now… you’ve been wondering if something is wrong. You think it might be time to see a specialist, and you feel nervous and uneasy. You are who I write to today.

I am writing to you because when you do sit down with a Reproductive Endocrinologist (RE) for the first time, I don’t want you to be as painfully unprepared as I was. I knew literally nothing about infertility.  And back then, I thought we were the only ones struggling. Heck, I didn’t even know there was such a thing as an infertility blog. I didn’t even know WHAT to google. I felt alone and isolated. I don’t want you to get blindsided like I did. It was awful.

I hope that this information is useful to you, and provides you some measure of comfort in this difficult time. Here are some things I suggest considering before your first appointment with your RE.

Picking a good fertility clinic and RE

This is something I didn’t even know to think about before we met with our RE. Here is a list of some things that I suggest considering when choosing your clinic.

  1. The clinic’s success rate

The Center for Disease Control tracks this stuff, so you can check out their website. You can search by state to see the available clinics near you, and their success rates. This might not track all of the information you are looking for. For example, the only stats that the CDC seem to track are those for Assisted Reproductive Technologies (ART), which is basically just in vitro fertilization (IVF) – so other, less invasive fertility treatments (such as intrauterine insemination (IUI)) are not tracked here. Even so, this is worth checking out and should at least get you started.

    2. Picking a good Reproductive Endocrinologist (RE) within the practice

This is another thing that did not occur to me prior to our initial appointment. All I knew was that I wanted a female RE. One thing I wish I had done is to research this particular “service” like I do every other damn thing I buy or do – read the stinking Yelp reviews. Yes, people review not only the practice, but the specific doctors. While this is not a sure fire way to find a good RE, at least it provides a good starting point.

3. Insurance coverage

This aspect of the decision making process might end up being dispositive. If you are fortunate enough to have health insurance that will cover any or all of your testing/treatment, your insurance company might only work with one clinic in your area. If that’s the case for you (as it was for us), that might make the decision for you. Just do your best to pick a good RE within the covered practice – and be grateful that your insurance is helping at all. So many insurance companies/workplaces do not.

Cost

Fertility treatment is expensive, and many insurance companies don’t cover it. You need to brace yourself for this. The cost will depend greatly upon your and your partner’s diagnosis. In our case, there are three separate “phases,” each with a different associated cost:

  1. Testing – I’ll get more into the specifics of what the “testing” phase entails below, but in my observation, even insurance companies that do NOT cover any kind of treatment might cover the testing. Every little bit helps.
  2. IUI – this is a less invasive fertility treatment. Depending upon your diagnosis, your RE might think it’s worth trying IUI before moving into the more expensive and more invasive IVF. Some insurance companies that do not cover IVF do seem to cover IUI, likely because it’s way less expensive and also way less controversial. (It runs about $1800 per cycle at our clinic, plus medication.)
  3. IVF – this is the crown jewel of fertility treatment. It is also the most invasive, expensive, and controversial treatment. The average cost of one cycle of IVF is $12,000 nationally, plus between $3000-$5000 for medication. There are other potentially expensive procedures/tests that your RE might advise such as ICSI or PGD.

Timing

One of the most surprising things about our first appointment with our RE was the timing of the process. By the time we finally went to the RE, we’d been off of birth control for almost 3 years because it took me a long time to acknowledge that there might be a real problem. Then, of course, it takes forever to get an appointment with the RE. My point is, that by the time you get in to see the RE, you’re freaking ready to get started. You’ve been waiting a long time, and you’re over it and just want to get a baby in your belly! 🙂

Maybe I’m the only one, but I thought it would be a pretty quick process. I thought that we’d have our initial appointment, I’d pretty much start IVF on my next cycle, and we’d be parents within 1 year.

Look, maybe that happens for some people, but that was not my experience or anyone I know.

The main holdups you’ll likely have to deal with after your initial RE appointment are (1) getting clearance from your insurance provider, and (2) getting through all of the testing. (More on the latter below.) Look, I know it’s frustrating because you just want to get started, but I would humbly suggest trying to view the testing process as just a means by which you will obtain useful information. Your doctors want to get you knocked up ASAP, and they are requiring these tests (or at least they SHOULD be) because they want to figure out what’s going on and which treatments have the best likelihood of making you a mother or father. I know when you read that last sentence you might be thinking, “Duh!” but I’m writing it anyway in case there comes a time for you, as there did for me, when you are just sick of waiting and want to try something, anything. Try your best to hang in there, just a little while longer. Everyone wants to see you succeed!

Female Testing

Before you get started with any kind of treatment, your RE will (hopefully) set you up for some tests. Like all medical testing, this will help the doc figure out what is wrong, and how to help. There are 3 kinds of basic tests (though I assume that if the doc finds something unusual, s/he might order some more specialized tests). My understanding is that these baseline tests screen for the most common causes of infertility.

If you’re pretty motivated to get this all done, you could finish all of your testing in a couple of weeks. (It took me months, but that had nothing to do with the clinic. I’ll explain more in the next section.)  If your clinic is anything like mine, you’ll have to go in two different days, for three total tests.

Here are the diagnostic tests that I think most REs require before developing a treatment plan:

DAY 3 TESTING (Day 3 of your cycle)

  • Ultrasound – Also on Day 3, your clinic will likely want to conduct a trans-vaginal ultrasound to check out your ovaries and your uterus for structural abnormalities. This is awkward, but not painful. (And by the time you’re in treatment and do it fifty-eleven-million times, it gets much less awkward.)
  • Blood testing
    1. hormonal testing – I don’t understand all of the science behind this, but even with an very basic understanding of biology, I know that hormones play a hugely important role in conceiving a baby. Your RE will order labs to see if you have any hormonal imbalances that might be affecting your fertility.
    2. ovarian reserve testing – By testing for certain specific hormones, your RE will be able to determine what’s up with your egg supply. (Cool, right?!)

ADDITIONAL BLOOD TESTING

  1. Health panel/STIs – some clinics (like mine) also require a full general health/STI panel for both partners. They might or night not do it in house (my clinic usually makes you go over to LabCorps, but since I’m so terrified of needles, they helped me out by doing it at the same time, in house.) This test doesn’t need to be done at a certain time, but if your clinic will do it in house for you with the day 3 blood work, that’s great!
  2. Genetic Screening – You and your partner might also elect to do genetic screening. This can give you a heads up for any potential genetic issues. This can be helpful in deciding whether IUI or IVF would be the best place to start for you because, if you have a high liklihood of passing on certain genetic issues, your RE might advise that you go straight to IVF (when you otherwise could have started with IUI) so that the embryos could be tested for that particular issue. Like the health panel/STI panel, this test does not need to be done at a certain time.

PRO TIP FOR NEEDLE-PHOBES: If you, like me, are extremely needle phobic, first of all, let me tell you that YOU CAN DO THIS. Also, I’ve figured out a couple of things that make this process easier for me.

First, at your meeting with your RE, ask if there is a particular phlebotomist that is really good with needle phobic people. You are not the first and won’t be the last that they have dealt with, so they will likely have some suggestions, or will be able to find out and get back to you.

Second, and you probably already knew this, you can ask to lay down during the “scary part” (blood draw). At my clinic, they put me in the same room that I’ll have my ultrasound in, and one of the wonderful flabotomists comes in and deals with me there. I never see anything, and it makes the process suck way less.

Third, ask for a hot pack. They probably have them, and if you put it on your arm a couple of minutes before they do their thing, it makes the process a lot easier. (I appreciate my amazing friend W for this advice!)

Fourth, this is a new thing that I recently realized, and it is really helpful for me. Ask to speak to the phlebotomist for a minute or two before she does her thing. For me, this has made a world of difference, to just spend a moment to connect at a human level before turning over my arm for this terrifying thing to happen. I have ended up getting quite attached to my phlebotomist over the past two years – Kelly, Nicci, Jennifer, and Sara. They are all so dear to N and me, and without their compassion and humanness, I’m not sure I could have gotten as far as I have. These ladies work the crappiest hours, around hormonal, frustrated women all day – in what appears to be a pretty thankless job. Meanwhile, without these four women, I would have had no chance of ever becoming a biological mother. Find your own Kelly, Nicci, Jennifer, or Sara. Believe me, it’ll make an enormous difference. 

HYSTEROSOLPINGOGRAM (HSG) – this is a radiology test done during the first half of your cycle that looks for blockages in your fallopian tubes. To you, it’ll feel pretty close to a pap that you happen to be getting x-rayed during. Lasts less than 10 minutes, start to finish.

PRO TIP: If at all possible, try to do this one in house. (This is actually a good thing for you to ask about at your initial RE appointment – whether they have the equipment to do your HSG in house.) The reason I suggest this is because, if this is done in house, you’ve got a person who specializes in this sort of thing. (As my Nurse practitioner said – she’s “in vaginas all day.”) This is great because then you basically have a gyno-type-person who’s gonna have a helper in the room to take x-rays while she quickly and masterfully does what she needs to do to your lady bits. (Versus a non-gyno-type-person radiology expert handling this process.) 

Also, if your clinic is like mine, they’ll have a special x-ray machine that they can move around. This is great because the alternative is that YOU will have to move around… while you’re getting this pap-like thing done. Not the worst thing in the world, I’m sure, but throughout this whole process, it’s nice when you can find a way to lessen your discomfort.

Male Testing – Yeah… so your partner just needs bang out a quick sample for a semen analysis – In most cases, this is all the testing that the male partner needs to do. If any issues are detected, he will likely be referred to a Reproductive Urologist.

Doubts

Throughout this process, and definitely at the beginning, I had a lot of doubts. I thought that maybe we didn’t really need to go through all of the hollaballou of fertility testing and treatment. I figured the problem must have been that we had just been timing things incorrectly, or that we were just too stressed out in law school or during bar prep. I figured that since we had finished law school and passed the bar, I’d just get pregnant without medical intervention. I did not know anyone personally who had been through this (or, probably more accurately, I did not know anyone who had TOLD me). However, from what I understood about IVF (the only fertility treatment I had heard of) it’s a really, really big deal, and I just couldn’t imagine that we would need such a thing. We were young and healthy, for goodness sake! Everyone around us was having millions of babies every day, or at least that’s what my Facebook feed indicated.

Because I kept thinking “it would happen,” (and because of my paralyzing fear of needles) it took me MONTHS after our initial appointment with the RE to even go for the initial Day 3 testing. After having that hurdle cleared, I felt like some of the pressure was off, and thought we should at least wait until after we went on vacation, since, you know, we kept receiving the wise counsel that if we would “just relax” it would happen. (Don’t get me started.) We had planned a really special vacation that year we were going with N’s family to Greece to visit the island from which N’s great grandfather came. Also, it was our 8th anniversary. (since, you know, we thought we’d better do it THEN since we’d be unable to travel for the next few years on account of being new parents). I was supposed to get my period towards the beginning of the trip, but it didn’t come. I brought a grip of pregnancy tests, just in case, and they all read negative. You can set a watch (or a calendar I guess) on how accurate my cycles are, so I thought for sure I was pregnant. Then, about 5 hours into our 10 hour flight home, after getting the back of my chair kicked for about 4 of those hours by a giant greek man sitting behind me who was VERY UPSET that my husband “allowed me” to recline my chair, I got my period. When I exited the bathroom, I signaled to N to come over so I could tell him. And I just started sobbing, and he just held me, and we just stood there like idiots.

Even still, when we returned, it took me another 4 months to finally go get the 10-minute HSG done. I thought that maybe all of the benefits that “relaxing” was supposed to have on our fertility might take a few months to really manifest. Mostly, I was in denial. Denial, I am told, is the first stage of grief. And believe me when I tell you, you will grieve.

Around that time, I ended up making an amazing friend who used the wisdom she gained through her own struggles in this area to help me get my sh*t together. (She asked to remain anonymous, so in this and future posts, so I will call her W for Wisdom.) Prior to her learning about my struggle, we were more like acquaintances, but as soon as she found out what I was going through we were like:

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I hope you will make similar friendships! She has mentored and supported me through this process, and I can’t believe how lucky I am that our paths crossed. So just in case you are deep in denial like I was, and you have not yet met your own W, I’d like to share with you some of W’s wisdom.

She said that I am not one of those gals who can glance sideways at my partner and get pregnant without trying/on the first try/etc. I’m not a part of that group, and that’s okay. And I need to accept that I’m not part of that group because sitting over there in denial, with those people and insisting that I don’t have a problem, or that it will “just happen” is NOT going to make me a mother. But if I could instead get to a place of acceptance that I belong in this other group – a group where we need a little extra help to become bio parents – THAT is my best chance of getting to be a mom. While it’s true that no amount of wishing or hoping or denial made me fit in with the other group, I DO fit in here. I belong here, and the sooner I embrace that, the sooner I can get the help I need to achieve my dream of motherhood.

I hope you find your own W. If you’re stuck in denial, it’ll make your journey to acceptance a lot faster and easier. And even if you’re not stuck in denial (or after you accept your new situation), having your own W in your life will make this process feel manageable and much more hopeful.

All Because Two People Fell In Love

Let me tell you about my middle sister.

She never wants anyone to feel excluded or “less than.” Attempts to do so really piss her off, and she advocates fiercely for marginalized people and groups.

She is one of the most creative people I have ever met. I’ve often said that the one thing that would have improved most people’s childhoods would be have had “an Erin” of their own. We are only 15 months apart and, while as opposite as two little girls could have been, I think we were good for each other–or at least she was good for me. As the adventurous one, she would get me to “play outside” (something I hated) and would somehow make it fun. Even playing indoors was more fun with Erin – for example, the way she saw it, our mother’s house plants were actually a jungle, and we were wild cats running around (and through) the “trees.” Or it wasn’t just an ordinary plastic grocery bag. No. It was a parachute, perfect for putting our arms through the handles and jumping from the top of our bunkbeds onto the pile of pillows and stuffed animals below. Almost every single one of my happiest childhood memories involve Erin. In fact, every memory that feels quintessentially like childhood absolutely involved Erin and one of her wild ideas.

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Also, Erin’s hilarious. Like, really, really funny. So sometime in the past few years, it has become an inside joke between us, this … frustrating… saying that is printed on onsies or calligraphed on nursery walls in homes that I can only assume have not known the despair of 60 consecutive months of negative pregnancy tests. “All because two people fell in love.”

I wasn’t even aware that this saying existed until one day, when Erin was consoling me about yet another BFN (That’s “Big Fat Negative” in infertility parlance.), she went off about how insensitive and unrealistic this saying is. She said something about how in her view, it almost never goes that way. Almost never does it “just happen,” regardless of the love the partners share.

She said the saying should go something like, “All because two people did three rounds of IVF” or something like that. More accurate, but less catchy.

She continued her rant, (she was really on a roll) listing off the numerous crappy things that people who struggle with infertility have to do to attempt to create new life out of science and sheer freaking will. Hearing all of these things, listed out in rapid succession – all to get pregnant, which is apparently something that’s supposed to magically happen “just because two people love each other,” was actually… hilarious. We dissolved into laughter.

That’s how Erin is. She’ll take the worst day of your life, and after showing a very respectable amount of compassion, she’ll transition into vicarious anger, and then, somehow, she’ll make you laugh like only she can do.

Anyway, she said once I finally do get pregnant, it would be funny to get the whole litany of crap N and I had done memorialized in some uber traditional medium since the juxtaposition would highlight the ridiculousness of this unfair freaking situation all the more. She suggested cross stitching. On a pillow. Oh yes.

If we were to do that, this is what my pillow would say thus far:

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  • Tried for 5 years the “old fashioned way,” (4 of which with ovulation predictor kits and timed intercourse. Side note: I remember when we started doing this, I used to think that was as unromantic as things could get. Looking back, I’m like, “Oh sweet, innocent, naive Erika. Bless your little heart! You had no idea about how truly “unromantic” this process would become!)
  •  4   5 failed IUIs (As of this week)
  • 3 months of acupuncture
  • Whole 30
  • Fertility Yoga
  • Dozens of cups of Fertili Tea
  • Months of 2 different kinds of fertility herbs
  • 3 rounds of Clomid
  • Dozens of hormone injections (At first, in conjunction with the Clomid, then my doctor decided we should try “all injectable” rounds of IUI – so no pills, just nightly stomach injections. Did I mention my crippling needle-phobia?)
  • Dozens of early morning blood draws
  • Dozens of early morning ultrasounds
  • And also… these two people fell in love

I told Erin that I would actually love to have a cross stitched pillow like that. I would display it proudly to get myself through, what I’m told, are hard times when you are sleep-deprived and exhausted with a young nugget at home. (#aspirationalproblems)

As I reflect upon nearly three and a half decades with Erin, and especially the past 5 years, I realize that one very special thing that would improve most people’s fertility journey, as with most people’s childhoods, would be to have “an Erin” of their very own.

I’m certainly grateful that I do.

 

 

To the mother of my future child

To the mother of my future child,

Mother’s Day is here. For many, this means another year has passed and they are celebrating the family they have started. For us, it’s another year of tests and procedures. As much as it is ever is, I know that for you it is another year of pokes and prods; needles and ultrasounds.

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For me, it’s another year of watching the person I love the most go through the thing they fear the most for a baby we don’t even know yet. In short, it’s been quite a year. It’s been a year of you facing your phobia several times a week. A year of watching you stare down that cold gripping fear, and subdue it.

It makes me think – if I had to cling to the side of a skyscraper several times a week for us to have a baby… well, I’d like to think that I would be brave enough to do that. I’d like to think that, but I can’t guarantee it.

What I can guarantee is that our child is going to be incredibly lucky because they will be born to the bravest mom in the world. The kind of mom who does not just talk about going through hell for her kid, but the kind of mom who has gone through hell for her kid. The kind of mom who is willing to push through her greatest fear for the opportunity at her greatest hope.

So thank you. Thank you for doing everything in your power to make our dream possible. Thank you for facing your fears several times a week to give us the opportunity at a family. Thank you for being the kind of woman that I look forward to celebrating on the next Mother’s Day.

Love,

“N”

I HAVE NOT ALWAYS WANTED TO BE A MOTHER. (PART 4)

Last week I wrote this post about the long road my husband and I took to be at peace with my decision not to have children. This is the final post in this series about how that all went to poop.

Strike 3 – Realizing that my husband would be the best father ever

There have been many moments over the years when I have realized that N would make an amazing father. Those are usually moments when he is being a wonderful husband because, as far as I understand it, many of the skills are transferable.

While I am a chronic worrier, N is a perpetual optimist. Where I see hopelessness, he sees opportunity. He focuses on solutions, not shame.

For example, when I come home after an especially crappy day at work, maybe after I royally screwed something up and am feeling like the sky is falling, his default posture is one of support and reassurance. When I’m ready to talk about it and ask for help, he stages a strategy session wherein we together form a plan about how to proceed/do better in the future/damage control. When I try to direct the conversation back to what a FUBAR I made of the situation, he is quick to point out that focusing on shame and guilt won’t help anything, and besides, what I did really wasn’t so bad anyway, and he thinks I’m pretty great. In moments like that, I’m grateful not only that this man is my husband, but also that any children we have will get to have him as their father. Lucky little buggers.

From time to time, I get to see N in action being amazing to children. One such day was several years ago at my best friend Layla’s wedding. The whole group of us went up to Lake Michigan for the weekend. Layla had rented a beach house for the bridal party and her family. The entire weekend was from a story book: amazing couple, beautiful bride, perfect weather, great people in attendance. The bride’s parents are missionaries, and her father officiated the ceremony. There was not a dry eye anywhere.

The day after the wedding, we were all enjoying our last couple of hours together and reliving the mental highlight reel of the beautiful weekend. At some point, Layla’s 2-year-old niece managed to climb up onto a bar stool at the kitchen island. No one really noticed her getting up there, but she had our full and undivided attention a few moments later.

The first crash we heard was of the chair hitting the ground. We then the thud of a tiny 2-year-old body doing the same. Then came the screams – first from the child, then from all of us adults. We all ran to the injured girl. Her mother picked her up and tried to comfort her, as did the girl’s grandmother and two aunts. For whatever reason, she was having none of that.

Then, she caught an eyeful of N.

She instantly stopped crying and reached out her pudgy little two-year-old arms towards him. All of the girl’s female relatives stopped what they were doing, and looked to see for whom the child was reaching. Everyone was shocked to see that it was the non-female, non-father, heck – non-family-member N.

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The child’s mother handed the enamored girl to N. At first, N was just as shocked as everyone else. He’s your typical alpha-male military type; what did he know about kids? But instantly and instinctively, he began reassuring the hurting girl that everything would be okay.

N knew that this child and her family live in a part of the world where three different langues are spoken, and as luck would have it, he happens to speak all three, so he asked the girl’s mother which language the child prefers. Her mother said they are trying to teach the girl all three, but she’s not especially fluent in any since she’s only 2-years-old.

Without missing a beat, N started singing what sounded to me like lullabys in one language, then another, then English which I totally understood. The child was absolutely delighted by this, and she grabbed two fists full of N’s beard and squealed happily along with his songs.

The rest of us silently watched the two of them. Even I, who had been married to the man for a couple of years by that point was like – who IS this guy!?

Eventually, when N had run through his entire repertoire, and the child seemed to have forgotten all about her injury, N handed her back to her mother.

While this is but one of dozens of heart-melting moments of N with the children in our lives over the past decade, I chose to memorialize this one because it is my favorite. It’s my favorite because it was my first glimpse into the kind of dad N would be.

He’ll meet you where you are, and he’ll leave you better than he found you. That’s one of the reasons why N is an incredible husband, and also one of the top reasons I know would be the best father ever.