The Vulnerability of Hope: IVF Round One

In Vitro Fertilization (IVF) is a gauntlet. A challenge to your mind and body that leaves you physically bruised and emotionally exhausted. I struggled a little bit with how to respond when people congratulated us on starting IVF because those of you who have been there know, it’s no celebration. In my experience, it is more like a consolation prize after trying for far too long to start a family, but failing. It’s the one of the last stops along a journey full of ovulation strips, supplements, doctor consultations and a battery of tests. IVF is a means to a possible end, and an expensive one at that. Between the injections, the time off work for bloodwork and ultrasounds every few days, and the waiting and wondering after every appointment, I wouldn’t choose this route if I didn’t have to. And because no part of this process is without paradox, I am also grateful that modern medicine allows for this option and that genetic testing is able to help select the most promising embryo. We are all hoping this process will be one and done, but for many, it takes multiple rounds to be successful.

Physically, IVF is more bark than bite, if you can handle needles. You follow strict, time-sensitive instructions, mixing vials and preparing the injection site while trying to remember where you stuck yourself last night. You rearrange your calendar to be at appointments for ultrasounds and bloodwork while trying to interpret if the furrowed brow of your ultrasound tech is a bad sign or if that’s just her face. Your stomach bruises and spots with blood that you cover with cute pineapple (the official mascot of IVF) bandages from your college roommate, and you write down your dosages in a matching pineapple IVF planner from your childhood friend. You bloat and your breasts feel as hard as rock from the estrogen coursing through your body, but the show must go on. You show up to work, the gym, another board meeting, and whatever else is on your calendar, because you don’t know what else to do. You call friends who have been there to see if these symptoms sound normal and if you should really re-order medication for the second time. You do it, because it’s either this or risk having to let go of a dream.

Emotionally, though, IVF hits harder. The hormones don’t get you on day one, but gradually the build up starts to take a toll. I felt a general sense of mild depression, moody and irritable, but then felt guilty that I’d stormed out of the room in response to nothing in particular. Everyone tells you to ‘stay positive’ and ‘remain hopeful,’ but I just never felt like I could keep it up for long. It’s safer to beat the disappointment to the proverbial punch. After every appointment with sub-par results, I tried to keep that little flame of hope alive, but would inevitably give in to tears at the prospect of a canceled or failed cycle.

I’ve mentioned in a previous blog post that I have low ovarian reserve and am therefore not a great candidate for IVF because ultimately it’s a numbers game. We went ahead at our doctor’s recommendation because genetically testing our embryos gives us the best chance of not having another miscarriage. On day 1 of this cycle the ultrasound showed 15 follicles (the fluid filled sacs within the ovary that contain eggs), which is a lot for me given my diagnosis of low ovarian reserve. I was elated — what a positive sign! However, at subsequent ultrasounds we found out that my right ovary decided it would not be forced to grow it’s follicles, and we lost a few in the left ovary as well. After increasing my medication dosages to the point that we had to order more medication, we still only had three follicles that were within the range of size appropriate for retrieval. I was prepared at that point for the doctor to cancel the cycle, but in the end he decided to proceed. The doctor retrieved three eggs, but we found out twenty four hours later that only one egg fertilized. We were disappointed, but trying to remain hopeful and doing our best to put the thought out of our minds all week as we went about our lives. On day six we got the unfortunate news that our single embryo did not make it to the blastocyst phase where genetic testing and freezing would have taken place.

We are back to square one.

Ecclesiastes chapter three talks about a season for everything, and right now is a time to weep. Hope is such a vulnerable thing. We fought hard to give ourselves the best chance: strict diet, low impact exercise, lots of sleep, water, and supplements. No alcohol, gluten, dairy, sugar or caffeine. You name it, I tried it: massage, acupuncture, chiropractic, yoga, prayer & meditation. What more can I do? To have faith that the outcome you wish for will turn out as you imagine it, and yet to have so little real control, is fragile place to be. My hope nearly shattered when I got the news. Another heartbreak, another failed attempt at starting our family, another season of waiting until we can try again. I recognize that I chose to walk this journey out in the open, and yet I fight the urge to disappear into the background. But, as I promised myself, I will tell this story so that other people don’t feel as alone as I did. Tomorrow, we pick up the pieces and figure out how to move forward, but today, we mourn all we have lost.

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