I Won The {In}Fertility Jackpot!

So first let me say that I promise not everything I post on this lifestyle section is going to be about our baby journey. It just so happens that it’s a big part of life right now and it’s important to me to talk about it, since so few people do. So if it seems like a big topic at the moment, it won’t always be. At least I sure hope not! 🙂

So a few weeks ago I mentioned that the hubs and I were making appointments and beginning to explore the option of IVF. We’ve been trying to start a family for 4 1/2 years and counting and the next step was a question mark. I was hoping that going into those appointments, I would end up feeling confident in a decision one way or another – to IVF or not to IVF? We’d always been told by my doctor that everything looked good and normal and we had no answers as to why we’d had trouble getting pregnant. In an effort to get more insight and be sure we chose the right place and doctor, I made three appointments that spanned three weeks with different clinics in Atlanta. We ended up canceling the third one because the first two were plenty.

Our first appointment was mid-February. I’ll call our doctor in this appointment DR.#1. Creative, right? But easy to follow.

So Dr.#1 went over the IVF process with us according to the way they do it, which we are pretty familiar with at this point. More on that process later. She then did an ultra sound. Given that doctors had consistently told me my reproductive parts were normal for 3 1/2 years now, I pretty much expected I’d hear that again.

I was wrong.

Upon looking at ovary #1 (on my left), she could see a fair number of cysts. Not entirely surprising to me, since I’ve gotten cysts most of my life. However this was the first time a doctor used the words/acronym “PCOS”. She seemed to indicate to us that it could make this whole IVF process more complicated, which of course was not wonderful to hear.

She then moved to the other ovary. More cysts – plus endometriosis. She seemed even less positive about this ovary being helpful in the IVF process. Apparently both PCOS and endometriosis can make it more difficult to retrieve healthy eggs.

Next was the uterus which (thankfully!) looked great and healthy.

But that healthy uterus wasn’t enough – the tears were a-coming. I hadn’t expected that at all and it felt like she was telling me that my ovaries were nearly useless and our chances at a successful IVF attempt, let alone getting pregnant on our own, were way less than ideal. She also mentioned that PCOS can be an indicator of being at risk for diabetes.

*Um, hi. My name is Lindsay and I have a dessert blog. Don’t put the word diabetes in the same sentence as me. Thanks.*

So she wanted to schedule a blood sugar test to confirm PCOS and check out my diabetes risk. Sounds fun, right?

She also indicated that she thought that we should try IUI before trying IVF. If you aren’t familiar with IUI, I call it the turkey baster. Not entirely accurate, but that’s the general idea.

I should say that the hubs and I had already expressed to her that we’d like to skip IUI altogether. We know of few success stories and given my husband’s super insanely good sperm analysis results, getting those babies into the uterus just seems like it isn’t our issue.

Still, she made a case for it. She also wanted to redo my HSG to see if the endometriosis had caused any blockages that would be an issue for IUI. We were supposed to call at the start of my next cycle to begin scheduling things.

We left that day with me in tears – for about 3 days. It was really difficult to hear that what I’d believed to be true for 4 1/2 years – that I was reproductively healthy – was not true. The choice that I thought we were going to have to make no longer felt like a choice at all. I joked through tears to the hubs that I’d won the infertility jackpot. Both PCOS and endometriosis – what more could a girl ask for?!

It made me wonder about the decisions we’d made previously, but even more so it made me afraid for our options moving forward. If my ovaries are that bad of a waste-land for eggs, would IVF even work for us? Would I go through all of this and still end up in the same place I am now?

That appointment was on Thursday and by Tuesday, I pulled it together. I remembered that the book I’d read on acupuncture while doing acupuncture had chapters on PCOS and endometriosis that I’d initially passed over, believing that I didn’t have those issues. I went back to the book and read those chapters. They were more encouraging as far as treating those issues and women having successful IVF treatments. There were some recommendations as far as eating habits and exercise so I channeled my newfound fear into controlling what I could – my diet and exercise habits. I’d been slowing improving those since the beginning of the year, but lacking my current motivation I hadn’t done as well as I’d liked. Knowing what I know now and that it can have an effect on egg count and quality and my ability carry a successful pregnancy, I’m all over it. I’ve lost about 6 pounds so far and I’m sticking to my healthy eating and working out about 5 days a week. Motivation, baby.

So after the first appointment, the hubs and I agreed that our best option moving forward was to try IVF. Where there had been a question in our minds, there was now no more. We also believed we’d go with Dr.#1. We didn’t see why not at that point.

That Wednesday we had appointment number 2 with Dr.#2. She was a recommendation from a friend who works in one of their other offices as a nurse. It was amazing how different the two doctors were! Especially considering that IVF is relatively straight forward and there’s only so much variety. You take eggs and sperm and try to make a baby, you know? But it felt like night and day and immediately after the appointment – before even leaving the office – the hubs and I both knew we’d be going with Dr.#2. I am SO GLAD I made appointments with multiple people.

So what was the difference? Well first of all, the office itself. We live up in the northern ‘burbs of Atlanta, so with both clinics most of our appointments will be at a satellite office. The big stuff we’ll have to go to the main office for, which is 45 minutes to an hour away, but there’s a closer office for the regular appointments. Office #1 was bland and seemed like a shell that was clearly a satellite office. Office #2 felt like a Dr’s Office – home-y, inviting and comfortable. Not the most important thing ever, but it still matters.

The bigger thing was the approach. Her thinking just seemed more in-line with ours. First, she wasn’t convinced that just because I have cysts in my ovaries that I have PCOS. In her opinion, irregular periods are more of an indicator of PCOS, which has never been something I’ve had. I am super regular. Second, she explained that PCOS and endometriosis are such common things to see with infertility, that they almost assume that there’s some level of at least one of those with most couples they see. Hence – my ovaries aren’t a waste-land that will prevent us from being successful. Boy, was that a relief to hear!

And even more importantly, she fully supported our desire to not want to bother with IUI. Given our history and likely endometriosis (she hadn’t done an ultrasound yet), it seemed unlikely to her that IUI would be helpful. It was a relief to feel like we wouldn’t have to fight to not have to do IUI.

So instead of testing for blood sugar issues, she wanted to schedule an ultrasound at the beginning of my next cycle and then schedule a hysteroscopy to take a look inside my uterus and check out the lining to see if there are any issues that would prevent an embryo from implanting and becoming a healthy baby. Also, a third and final sperm analysis for the hubs, since the last one was a year and a half ago.

Her plan made so much more sense to us. No HSG since we want to bypass the tubes altogether with IVF and a hysteroscopy to make sure a baby would be able to implant and grow successfully with IVF.

My cycle started again shortly after that appointment. Since we liked her so much, we went ahead and cancelled the third appointment and moved forward with her testing. I’ve since had the ultrasound. She was able to see what Dr.#1 saw, but didn’t seemed concerned. She could also see a healthy-looking uterus (is it not weird to talk about a uterus like that?) and the little dark spots in my ovaries that could develop into follicles/eggs this month. She seemed very positive. The way she has put it is that we will get embryos – we just need to make sure the uterus is good to go for allowing a baby to implant and grow.

So the hysteroscopy is on for Thursday. Lucky me – I get three shots to the cervix to numb it and then I get to see my uterus on a monitor and take a little sneaky-peak at the lining. I’m not gonna lie – the whole thing is kind of fascinating to me.

After that, we’ll schedule a meeting with her to go over all test results and hear her plan and then have the big, bad financial meeting where they tell us how they’re going to take all our money. 😉 Then we make decisions and plans. It’s kind of nutty and could start very soon. Like in a few weeks.

So what does the IVF process actually look like?

Not all doctors do it the same way, but here’s how our doctor will do it.

1. Egg retrieval – starting on Day 1 of the cycle we decide to do the retrieval, I will take birth control for 10-14 days. This apparently regulates things, etc. Afterwards, I begin the hormones and other medications. We don’t know yet what the doctor will prescribe for me, but it’ll likely be some mix of shots and oral medications that I take for 2-ish weeks.

Around Day 6 I start going for daily or every-other-day appointments, depending on what they decide. They do ultrasounds at the appointments to make sure I have follicles growing (follicles are basically the eggs – the eggs are inside the follicles). They can adjust medications as needed, depending on what they see. Those appointments continue until they are happy with what we’ve got and then I get the trigger shot, which triggers ovulation.

A couple days after the trigger shot, they retrieve my eggs. I am sedated for the procedure and they put a needle up into my ovaries and take my eggs. Of course this is a somewhat simplified explanation of everything, but you get the picture. I’ll be a bloated blimp full of eggs and then they take them. 🙂

After they have the eggs, they join them with the sperm to see how many fertilize. They can let them all party together and see who decides to join forces or they can grab a specific sperm and put it straight into the egg. If it seems like the sperm could have trouble penetrating the eggs, the later would be recommended.

Once they’ve got fertilized eggs, they let them grow for about 5 days to see how many continue to grow into blastocysts/embryos that have around 100 cells total. The ones that have grown get a biopsy and then they are frozen. The biopsy is sent out for testing and they will tell you which embryos are the healthiest.

It’s also important to note that there’s a general rate of loss with each stage once they retrieve the eggs. From retrieval to fertilization, normally only 70-80% make it. Then from fertilization to blastocysts/embryos, the same rate of loss can occur. Then when you get the test results back, not all of them are usually healthy. So the whole process with the eggs is emotional and involved. It’ll be several weeks after egg retrieval before you really know how many truly healthy embryos you have to work with. And if you don’t get pregnant with the first transfer of an embryo, you’ll definitely need more than one or two.

2. Transfer – After the retrieval, we will then wait a full cycle. The egg retrieval happens one cycle, we wait one cycle and then the third cycle will be when an embryo is transferred and you hope for the best. There’s more that happens before the transfer, but we haven’t gotten to that conversation yet. My understanding is that there’s more shots and medicine to prepare your body for the transfer and then if you get pregnant, there are other medications and shots to help the pregnancy be successful. LOTS of shots.

I’m also very aware that not everyone gets pregnant right away. It can take several transfers. And even when you get pregnant, miscarriage is a very real reality, particularly since we’ve had a miscarriage before. Pregnancy isn’t guaranteed and getting there is a very emotional and long journey. Some people do several rounds of egg retrieval, some do several rounds of transfers. I am already preparing myself for all of the possibilities.

While there have been many emotions over the last few weeks – and it certainly began with lots of tears – I am feeling very positive and hopeful. The hubs and I are taking things a day at a time. I am so thankful to have found our doctor. I’m a big fan and I feel very comfortable with her.

While this is definitely not the path I wanted and I struggled for a few days to accept it, I feel ready to take it on. I am so thankful that I’m surrounded by such a supportive husband, family and great friends. I have a very close friend who is in the middle of IVF right now (with a different clinic in Atlanta) and we are sharing every little detail with each other. As much as I hate to see anyone go through this, it’s nice to have another couple for us to share things with.

I have no idea what God has in store for us – I’d be lying if I said I knew. I know God uses all kinds of experiences and hardships (and heartaches) for His good. I also know that however this all works out, it will be according to His plan and even though it may be hard at times, I trust Him fully.

I remain grateful for every single little good thing we continue to experience every day. Though I can’t say I’m excited to do IVF because it’s not a super fun process, I’m ready to begin and see where God will lead us. I am so thankful that we have the opportunity and option to try IVF. I am also incredibly grateful for my husband, who is so wonderfully supportive and ready to do this with me. We are all in and going through the last few years of this journey with him, I love him more and more every day. I hope and pray that at the end of this, I’ll be looking into a tiny little face that reminds me of the man I get to have by my side through all of it.