A Punch in the Gut

      Normal, everyday life is comprised of a series of little surprises. Some good, some bad, and most are average. These mini events lead to happiness, joy, anxiety, excitement,  and anger. You name it, and you feel it over the course of a given day. In the Land of Infertility, nothing stings more than an unexpected pregnancy announcement. In fact, I wouldn't even say it stings. It's more like a punch to the gut.

Over the past few weeks I've been trying to heal from a chemical pregnancy and the overwhelming journey that 2015 has brought me on. Between therapy, my mind/body group, acupuncture and mediation, I've really worked hard at keeping my calm during this storm. I've finally stopped feeling like a kicked dog every time I see a pregnant woman, and I've stopped rolling my eyes at them. Now, I mostly study them walking throughout the stores, conducting their pregnant business as if they are curious creatures who, by virtue of getting pregnant, have performed a magic trick for which I will never know the secret.

I have begun to accept infertility, and have learned to expect that everyone I know will end up pregnant, and will likely give birth before I do. I have a tally in my head of friends who are pregnant, those who are trying, and those who will likely try soon. It's a not a sick obsession (although I'm sure my husband would beg to differ), rather, it's a protective mechanism. If I can stay on the defensive and on top of this fertility roster in my mind, then I won't ever fall victim to the unexpected pregnancy announcement, for I know when to expect them all.

Yesterday I found myself on the losing end of that game, with a one-two punch to the gut. In a 30-second time span, I received news that my father was in the hospital and may be having a heart attack, and that a college friend of mine and his wife are expecting. The pregnancy notice came complete with a group text (to ensure that you constantly have to re-live this information with every response from the group) as well as an ultrasound photo. The worst.

The group text messages began pouring in, with everyone exchanging excitement and due dates. I was still disoriented about the news of my father and simply responded to the text with "Congrats. Please remove me from this group text." I then tried to re-focus my energy on my dad, who, while still hospitalized, did NOT have a heart attack, but is awaiting further cardiac function tests over the next day or two.

I knew my friend and his wife were going to begin trying last winter. I knew she would likely get pregnant soon. I'm guessing it took them about 9 months to get pregnant, which is better than hearing it happened immediately, but still. A group text complete with an ultrasound photo is as bad as it gets. I would love to say that I'm someone who "is happy for other people but sad for myself" but that simply isn't true. I'm not happy for them. I'm not excited for them. I don't wish them harm. I don't wish them trouble conceiving. I just am blah about the whole thing.

In an abstract way, I feel that each person who gets pregnant moves me further away from pregnancy myself. I know that is not true, and I know that another person's pregnancy has nothing to do with me, but each announcement is another reminder that everyone else is able to do something that I can't. And that sucks. Badly.

I did go on to apologize to my friend and explain the news of my father and through gritted teeth, I extended another congratulatory message. For now, I walk away from another gut punch, bruised, but okay.

MTHFR

I find it super fitting that my latest diagnosis is for a mutation in the MTHFR gene, because my first thought when I see that abbreviation is "motherfucker." Which pretty much sums up my gut reaction to every single piece of reproductive news we have heard this year.

Essentially, having a MTHFR mutation affects folic acid use and metabolism by the body. I have a heterozygous mutation, which means that of the two copies of the genes that exist in my body (one from my mom, one from my dad), one copy is normal, and the other copy is mutated. From what I have read, this means that the body functions influenced by this mutation operate at 60-70% capacity. If you have a homozygous mutation, or a mutation in both copies of the MTHFR gene, your functioning is significantly lower. From my reading, it is important that your homocysteine levels are checked in conjunction with your MTHFR genes, as MTHFR transfers homocyteine into another compound in the body (I can't remember the details), but its common for your homocysteine levels to be elevated, which can lead to cardiovascular problems and body inflammation.

This sounds pretty scary but the treatment is actually pretty easy. For me, all of my other values were normal, so I just have to supplement with a prescription called Folgard. Its a high dose of folic acid, with some B vitamins thrown in. For individuals with a more severe mutation or abnormal values, methylfolate and B vitamins are prescribed, however, your lab values should be carefully monitored to make sure that you don't go from under-treating to over-treating as these vitamins come with significant side effects when on inappropriate doses.

So, another diagnosis to add to the list and I haven't had even a fraction of the tests that Mr. New RE wants to prescribe. If I had a dollar for each infertility diagnosis...I could pay for an entire IVF cycle! 

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The Calm After the Storm

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      IVF is a giant, fucked up roller coaster ride of emotions. At first, you are super excited to try something new. Then reality sets in that several weeks of your life will ultimately culminate in one stupid test and you start to freak out. The other part of  the equation is that unless you are one of the 30-40% who get pregnant the first cycle you do IVF, have 434333 frozen embryos and generally swim through IVF, you wind up going up shits creek without a paddle each and every cycle. As I am thoroughly up shits creek enduring a shitstorm, I'm going to focus on the unlucky group of us who struggle through IVF.

IVF has taught me to never be too optimistic, no matter how great things are going, because inevitably, your infertility will find a way to fuck you up at some point. Case-in-point, my first cycle, I left my monitoring appointments balling my eyes out over how few follicles I had, yet the cycle ended on an upswing when we retrieved 7 eggs and had 4 fertilize. We had a downswing again when I ended up needing a 3 day transfer, but up-swinged when it was a really excellent embryo. That cycle resulted in the biggest kick to the balls yet when I got my motherfucking period two days before beta. That sucked so bad, and while I thought I dealt with it well, I didn't. It really demolished me.

IVF #2 was sure to bring great things as we were moving on to an estrogen priming protocol (EPP) for poor responders. The stimming process went awesome. I got my period unexpectedly early (which was very exciting since IVF is so much of a hurry-up-and-wait process) and I started stims as we went on a weekend away in the mountains. My estrogen levels and follicle counts were a bit higher this cycle and I set my sights on retrieving 10 eggs. The downswing was when we retrieved 7 eggs again (WTF?!?!?) and only 3 fertilized. When I heard that, I lost my shit. Having learned a thing or two from the previous cycle (and after threatening to not attend transfer), we transferred two embryos on day 3 - an excellent 8-cell and an average 10-cell. Unfortunately, that resulted in a chemical pregnancy, which was actually super exciting to me as I never thought I would get pregnant ever and I did. 

I can't really adequately explain the depression I fell into at some point in this process. After 6 months of testing alone, followed by two IVF cycles and no baby in sight, my body and mind finally had enough and we succumbed to infertility. I finally realized that I had been fighting this path that I'm on, and it resulted in so much anger and resentment - mostly focused on those who were fertile, and then on those for which IVF worked immediately. Accepting infertility really helped to change things up for me. A therapist, mind/body group and acupuncture also do their fair share in keeping me (somewhat) sane as I exist in this infertility limbo until next cycle. 

What has helped you endure this battle?

 

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This is my life right now. After 2 IVF cycles, it's pretty hard to overwhelm me. But here I am, minus the glorious glass of oversized wine.

 

 

I'll recap my journey some other time because it's a doozy. For now, pass the wine.

 

 

You need to know that I'm batshit crazy. I'm a nurse, I'm anal retentive, and I have access to medical journals through my grad program. This is a recipe for IVF research disaster. When you add in some badass online infertility forums, my knowledge about all things IVF is pretty amazing, and I'm hip to the latest and greatest treatments in the infertility world. As such, I knew that I would only be giving my RE two IVF cycles before I peaced the fuck out.

 

 

After seeing his name plastered e.v.e.r.y.w.h.e.r.e. I searched for "DOR," it was clear to me that I was going to jump ship to Dr. Wang at SIRM-CT, The Sher Institutes newest location. I had been told that Dr. Wang would blow my mind, and so far, he has. He wants you to e-mail him. Like, actual doctor-to-patient communication! He does his own monitoring! He thinks outside the box! He fully educates you on everything! And, the most mind-blowing of all, him and his entire office staff answer e-mails after hours. WTF. Mind blown.

 

 

IVF #2 resulted in a chemical pregnancy, and I've heard that this is actually really great news for my fertility, or, as good as having an early miscarriage can be. Dr. W decided that I needed more testing before the January cycle:

 

-Thrombophilia panel

-STD panel

-EFT biopsy (9-11dpo)

-3D saline sono because my ute is titled (sometime pre-O)

-CD2/3 bloodwork...again...because it's been a year since we first visited the RE (?!?!?!)

-DNA fragmentation test for husband

-Basic immune testing

 

The timing of a couple of these tests is so specific that we really had to think of ways to manipulate my body, all while suppressing me, so we would be ready to stim on 1/4, and trying to fit it all in has been super stressful. All my body needs to do is ovulate....its CD19 and ovulation is nowhere to be seen! I'm kickin' it old school with temping, charting, OPKs, and aside from a darkened but not-quite-positive OPK on Monday night, nada. I literally have to ovulate by tomorrow to make the January cycle, which doesn't seem like its going to happen.

 

So much for the January cycle. The idea of my body cooperating with me was laughable anyways.

 

Looks like now I won't be so rushed to get all of the testing done, and I can ease into the next cycle normally. Plus, alcohol. Glorious alcohol. So, there's that.

An Intro

I always find intro posts on blogs to be awkward. How does one sum up everything that led them to this? What finally made you crack and realize you must share your life, of a portion of it with the blogosphere?


For me, it's the fact that everyone but me....is pregnant.


Literally everyone. Friends, acquaintances, and almost every member of the world around me.


So, pull up a seat and stay a while...this is the newest infertility blog to hit the stands.